Avaliação das alterações em três dimensões e por planos de referência dos tecidos moles faciais de pacientes classe III esquelética submetidos à cirurgia ortognática bimaxilar

• Ano de defesa: 2016
• Autor(a) principal: Becker, Otávio Emmel
• Orientador(a): Oliveira, Rogerio Belle de
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul
• Programa de Pós-Graduação: Programa de Pós-Graduação em Odontologia
• Departamento: Faculdade de Odontologia
• País: Brasil
• Palavras-chave em Português: TECIDO MOLE (ODONTOLOGIA); CEFALOMETRIA; CIRURGIA ORTOGNÁTICA; TOMOGRAFIA COMPUTADORIZADA; ODONTOLOGIA
• Área do conhecimento CNPq: CIENCIAS DA SAUDE::ODONTOLOGIA
• Link de acesso: http://tede2.pucrs.br/tede2/handle/tede/6733

PURPOSE: Present and evaluate a 3D cephalometric analysis of hard and soft tissues to describe, compare, correlate and predict changes in measures assessed in soft tissues in relation to bone changes resulting from double-jaw orthognathic surgery in Class III patients. Also to correlate changes observed only in soft tissues. The hypothesis is that skeletal changes may affect and are correlated to changes in facial soft tissues in different forms in several regions of the face and also differently in relation to each individual reference plane and in 3D. MATERIALS AND METHODS: Calibration of the measures was carried out using the intraclass correlation coefficient (ICC) and the absolute difference between intra and inter evaluators assessments. Cone beam tomography pre and postoperative of 23 (9 male, 14 female, average age of 28 years and 7 months) were evaluated in Dolphing Imaging 3D software. The t-Student test for paired samples was applied in order to compare the pre and postoperative values for all the analyzed measures and changes in soft tissue in relation to bone alterations. The analysis of the effect size was also applied by the Cohen’s "d" coefficient. Pearson correlation coefficient was used in order to correlate the bone movement with soft tissue changes and the latter only among themselves. The stepwise multiple regression analysis was applied to try to identify the degree of influence of each Independent Variables individually on each of the Dependent Variables. All analyzes were applied in relation to three reference planes individually and in 3D. The level of significance was set at 95%. RESULTS: The degree of correlation in intra and inter evaluators assessmens was high, with the average of Absolute Differences for the total set of each type of measurement ranging below the limits of clinical relevance of 2mm and 4 °. Higher changes and higher correlations were identified more in the mandible than in the maxilla and more in the central region than in the peripheral face. The movements of the soft tissue correlated significantly with the movements of the underlying skeletal bone (midle third of the face in relation to the maxilla and inferior third of the face in relation to the mandible) and in relation to the same reference plane, although there were exceptions. Fully satisfactory values of prediction for the results of soft tissues after this type of surgery were not identified, especially in 3D. CONCLUSIONS: The results allow validation of the measures, except for Nasolabial and Labiomentual angles. The null hypothesis could be rejected, since the skeletal changes affected and were correlated to changes in facial soft tissues in different forms in several regions of the face and also differently in relation to each individual reference plane and in 3D.