RESUMO
BACKGROUND: Orthopedic rapid maxillary expansion (RME) is a common treatment of choice for managing transverse deficiency of the maxilla. This approach may have desired and undesired skeletal, dental and periodontal effects that may be assessed clinically or through imaging techniques. This study aims to investigate the dental, skeletal and periodontal effects of orthopedic RME using the soft-tissue cone-beam computed tomography (CBCT) technique. MATERIAL AND METHODS: The sample consisted of 10 patients (5males and 5 females) aged between 10 and 14 years (mean age: 12.5 years) treated with Hyrax orthopedic device. CBCT scans set for the registration of soft tissue (ST-CBCT) were taken from each patient before (T1) and 120 days after (T2) RME. Skeletal (n=10), dental (n=1) and periodontal (n=4) parameters measured in ST-CBCT were compared between T1 and T2 using t-test within a significance level of 5%. RESULTS: The skeletal parameters with statistically significant increase (p<0.05) in T2 were the width of the buccal alveolar bone crest, the external width of the dental arch at the level of buccal cusps, and the width of the dental arch at the level of most prominent dental surface contour. Representing the dental parameter, the inclination of the anchor teeth was statistically significant for premolars (p<0.05). The only statistically significant outcome in periodontal parameters was the decrease in buccal bone plate thickness of first molars (p<0.05). CONCLUSIONS: Dentists must be aware of the ST-CBCT technique for the analysis of hard and soft tissue after orthodontic and orthopedic treatments. This technique revealed that the RME reached optimal skeletal and dental effects with minimal periodontal side effects. Key words:Cone-beam computed tomography, imaging, orthodontics, orthopedics.
RESUMO
PURPOSE: In order to assist in the selection of artificial teeth for complete dentures, this study aimed to assess the relationship between horizontal and vertical measurements of the face and the morphology of the maxillary central incisor. MATERIALS AND METHODS: This was a study of 50 plaster casts and 100 teleradiographs - 50 in lateral norm and 50 in frontal norm, belonging to 50 individuals, Caucasian, with a naturally optimal occlusion, matching at least four of the six keys of Andrews. Images of the upper central incisors were obtained by scanning the plaster casts (three-dimensional) and subjectively classified by three examiners as oval, triangular or quadrangular. Facial measures (vertical and horizontal) were defined by means of teleradiographs. In order to check inter-examiner agreement on the classification of central incisor, the Kappa test was used. To verify whether data had normal distribution, the Kolmogorov-Smirnov test was used (P > 0.2) was used. One-way analysis of variance was employed to assess the association between variables (P > 0.05). RESULTS: When vertical measurements were compared with the three incisor shapes, there was no statistically significant difference (P > 0.05): Triangular (0.54), oval (0.63) and quadrangular (0.51). Similarly, no difference (P > 0.05) was found for facial width (139.08, 143.37, 141.65), maxillary width (76.68, 78.99, 76.91) and mandibular width (103.47, 105.50, 103.11). CONCLUSIONS: The majority of cases showed that horizontal and vertical measurements of the face cannot be used as a reference for determining the morphology of the maxillary central incisor crown. It is relevant to analyze and compare other morphological structures to improve the oral health-related quality of life for the conventional denture wearer.
Assuntos
Face/anatomia & histologia , Incisivo/anatomia & histologia , Maxila/anatomia & histologia , Brasil , Feminino , Humanos , MasculinoRESUMO
A busca por uma face bela e harmônica é objetivo de grande parcela da população. Por esta razão, é fundamental que os profissionais da Odontologia, especialmente os ortodontistas, sejam capazes de diagnosticar alterações faciais e, assim, propor tratamentos adequados aos anseios de seus pacientes. Para que isto seja possível, odontólogos e leigos necessitam possuir conceitos de beleza semelhantes. O objetivo deste trabalho foi determinar se as medidas faciais de Arnett e Bergman são coerentes às percepções estéticas de cirurgiões-dentistas (ortodontistas e clínicos gerais) e leigos. Para isto, utilizou-se uma amostra composta por 50 indivíduos, sendo 26 mulheres e 24 homens. Um especialista em ortodontia mensurou cinco medidas dentre as utilizadas por Arnett e Bergman em radiografias cefalométricas de perfil. De acordo com estas medidas, cada indivíduo foi classificado em consonância com número de medidas dentro da norma: perfil muito agradável, agradável, aceitável, desagradável e muito desagradável. Em uma segunda etapa, foram formados três grupos (leigos, clínicos gerais e ortodontistas), de 20 avaliadores cada que, por meio de um álbum de fotografias de perfil facial, classificaram o grau de agradabilidade facial segundo a escala (VAS) adaptada. A análise das proporções observadas nos graus da escala de avaliação para os diferentes avaliadores foi conduzida utilizando-se o Teste chiquadrado de Pearson (p>0,05). Entre as proporções dos avaliadores e os valores padrões de Arnett e Bergman foi utilizado o teste exato de Fisher (p>0,05). Os resultados demonstraram que, pela classificação segundo às medidas de Arnett e Bergman, pacientes com perfil muito agradável foram classificados da mesma maneira em 0%, 1,66% e 5% pelos leigos, clínicos gerais e ortodontistas, respectivamente; com perfil agradável em 3,75%, 16,88% e 18,75% pelos leigos, clínicos gerais e ortodontistas, respectivamente; com perfil aceitável em 35%, 34,73% e 36,67% pelos leigos, clínicos gerais e ortodontistas, respectivamente; com perfil desagradável em 32,5%, 40%, 30,5% pelos leigos, clínicos gerais e ortodontistas, respectivamente; e por fim, com perfil muito desagradável em 15,45%, 15,45% e 10,45%, pelos leigos, clínicos gerais e ortodontistas, respectivamente. Foi possível concluir que não há similaridade entre a percepção estética dos diferentes grupos de avaliadores com as medidas propostas por Arnett e Bergman.
The search for a beautiful and harmonic face is a goal of a large portion of the population. With this purpose, it is essential for dental professionals, especially orthodontists, to be able to diagnose facial changes and, thus suggest appropriate treatments to the demands of their patients. To make this possible, dentists and lay people need to have similar concepts of beauty. The aim of this study was to determine whether Arnett and Bergman facial measures are consistent with aesthetic perceptions of dentists (orthodontists and general practitioners) and lay people. It was used a sample of 50 subjects, including 26 women and 24 men. A specialist in orthodontics measured five measures among those used by Arnett and Bergman on lateral cephalometric radiographs. According to these measures, each individual was classified based on the number of measures within the norm: very pleasant, pleasant, acceptable, very unpleasant and unpleasant profile. In a second phase, three groups were created (laypeople, general practitioners and orthodontists), with 20 examiners each. By means of an album of photographs of facial profile, they rated the degree of facial pleasantness according to an adapted scale (VAS).The analysis of the proportions observed according to the different degrees of the scale for the different examiners was performed using Pearson chi-square test (p> 0.05).In order to evaluate the proportions by the examiners and the default values by Arnett and Bergman, Fisher's exact test was used (p>0.05).The results showed that based on the classification by Arnett and Bergman, lay people, general practitioners and orthodontists categorized in the same manner: patients with a very pleasant profile in 0%, 1.66% and 5%, respectively; patients with pleasant profile in 3.75%, 16.88% and 18.75% respectively; patients with acceptable profile in 35%, 34.73% and 36.67% respectively; patients with unpleasant profile in 32.5%, 40%, 30.5%, respectively; and finally, patients with a very unpleasant profile in 15.45%, 15.45% and 10.45%, respectively. It was concluded that there is no similarity between the aesthetic perception of the different groups of examiners with the measures proposed by Arnett and Bergman.
Assuntos
Cefalometria , Estética , Face , OrtodontistasRESUMO
BACKGROUND: Given the benefits of radiographic cephalometric studies in determining patterns of dental-skeletal-facial normality in orthodontics, the aim of this study was to investigate the association between mandibular dental arch shape and cross-sectional and vertical facial measurements. MATERIALS AND METHODS: It was analyzed plaster casts and teleradiographs in frontal and lateral norm belonging to 50 individuals, aged between 15 and 19 years, with no previous history of orthodontic treatment and falling into four of the six Andrews's occlusion keys. The plaster models were scanned (3D) and the images of the dental arches were classified subjectively as oval, triangular and quadrangular by three calibrated examiners, with moderate inter-examiner agreement (Kappa = 0.50). After evaluation of the method error by paired t test (p > 0.05), it was carried out the analysis of cross-sectional and vertical facial measurements to be compared to the shape of the dental arch. Data were subjected to one-way analysis of variance with a significance level of 5%. RESULTS: When the VERT index was compared with the three arch shapes, no measurement showed statistically significant differences (p > 0.05): triangular (0.54); oval (0.43); and quadrangular (0.73); as well as there were no differences (p > 0.05) in the widths of the face (141.20; 141.26; 143.27); maxilla (77.27; 77.57; 78.59) and mandible (105.13; 103.96; 104.28). CONCLUSION: It can be concluded that there was no correlation between different shapes of the mandibular dental arch and the cross-sectional and vertical facial measurements investigated.