Avaliação tomográfica da ATM e sua inter-relação entre os padrões esqueléticos e de crescimento craniofacial [Digital]
Dissertação
Português
616.716.4-008.6
Fortaleza, 2023.
152f.
A tecnologia tem auxiliado muito na confecção da documentação clínica e no diagnóstico do paciente estando, atualmente, cada vez mais presente nos consultórios odontológicos. Estruturas antes não vistas com precisão como a articulação temporomandibular, agora podem ser visualizadas e estudadas com...
Ver mais
A tecnologia tem auxiliado muito na confecção da documentação clínica e no diagnóstico do paciente estando, atualmente, cada vez mais presente nos consultórios odontológicos. Estruturas antes não vistas com precisão como a articulação temporomandibular, agora podem ser visualizadas e estudadas com detalhes e precisão por meio da Tomografia Computadorizada de Feixe Cônico. O côndilo mandibular atua como um local de crescimento adaptativo sob carga funcional suportada por sua cartilagem, tendo interação entre forma e função, justificando suas diferenças entre os diversos pacientes. Porém, os estudos sobre a influência da oclusão na morfologia condilar não são completamente conclusivos, havendo a necessidade de análises mais precisas. O presente estudo teve como objetivo analisar a relação côndilo-fossa quanto à sua forma, posicionamento e sua associação com os diversos tipos de más oclusões esqueléticas de acordo com a análise de Steiner, buscando correlacionar esses fatores com os diferentes tipos de padrões faciais de crescimento, assim como verificar se há diferenças entre os lados direito e esquerdo do mesmo paciente. De uma amostra de quinhentas tomografias cedidas por um centro de diagnóstico tomográfico, situado em Brasília, Distrito Federal, Brasil, foram selecionadas de acordo com os critérios de inclusão e exclusão, cento e cinquenta tomografias, correspondentes a trezentas articulações temporomandibulares. Estas foram analisadas utilizando o software Blue sky Plan 3®. Por meio do Modo Cephalometric, com função de classificar o ANB, as tomografias dos pacientes foram classificadas em mesofaciais, dolicofacias ou braquifaciais. Também se categorizou de acordo com o padrão esquelético utilizando o ângulo ANB (Classe I esquelética, Classe II esquelética, Classe III esquelética). No modo Surgical Guide Advanced utilizou-se os cortes Sagital e Axial para mensurar as medidas lineares e angulares. No plano Sagital foram mensurados a Delimitação da Fossa Articular (FA), o Espaço Articular Anterior (EAA), o Espaço Articular Superior (EAS), o Espaço Articular Posterior (EAP) e a Altura da Fossa Articular (AFA). No plano Axial as medidas de maior distância mediolateral dos processos condilares da mandíbula, a distância anteroposterior dos processos condilares da mandíbula, a distância dos centros geométricos dos côndilos direito e esquerdo e o ângulo entre o plano mediolateral dos processos condilares da mandíbula e plano mediano foram aferidos e submetidos a análise anova para verificação dos achados. Diante dos resultados, concluiu-se que
a morfologia e o posicionamento condilar sofrem influência em função dos diferentes tipos de padrões esqueléticos e de crescimento craniofacial, assim como a altura da fossa articular foi afetada pelas interações dos padrões esqueléticos verticais. Foram encontradas diferenças estatisticamente significantes entre os lados.
Palavras-chave: articulação temporomandibular; tomografia computadorizada de feixe cônico; morfologia condilar; remodelação. Ver menos
a morfologia e o posicionamento condilar sofrem influência em função dos diferentes tipos de padrões esqueléticos e de crescimento craniofacial, assim como a altura da fossa articular foi afetada pelas interações dos padrões esqueléticos verticais. Foram encontradas diferenças estatisticamente significantes entre os lados.
Palavras-chave: articulação temporomandibular; tomografia computadorizada de feixe cônico; morfologia condilar; remodelação. Ver menos
Technology has helped a lot in the preparation of clinical documentation and in
the diagnosis of the patient being, currently, increasingly present in dental offices.
Structures previously not seen with precision such as the temporomandibular joint, can
now be visualized and studied in detail and... Ver mais Technology has helped a lot in the preparation of clinical documentation and in
the diagnosis of the patient being, currently, increasingly present in dental offices.
Structures previously not seen with precision such as the temporomandibular joint, can
now be visualized and studied in detail and precision by means of Conical Beam
Computed Tomography. The condyle mandibular acts as a site of adaptive growth
under functional load supported by its cartilage, having interaction between form and
function, justifying its differences between the various patients. However, studies on
the influence of occlusion on condylar morphology are not completely conclusive, and
there is a need for more precise analyses. The present study aimed to analyze the
condyle-fossa relationship regarding its shape, positioning and its association with the
various types of skeletal malocclusions according to Steiner's analysis, seeking to
correlate these factors with the different types of facial growth patterns, as well as to
verify if there are differences between the right and left sides of the same patient.From
a sample of five hundred CT scans provided by a tomographic diagnostic center,
located in Brasília, Distrito Federal, Brazil, one hundred and fifty CT scans
corresponding to three hundred temporomandibular joints were selected according to
the inclusion and exclusion criteria. These were analyzed using the Blue sky Plan 3
software®. By means of the Cephalometric Mode, with the function of classifying the
ANB, the CT scans of the patients were classified as mesosoccia, dolicofacial or
brachyfacial. It was also categorized according to the skeletal pattern using the ANB
angle (Class I skeletal, Class II skeletal, Class III skeletal). In the Surgical Guide
Advanced mode, the Sagittal and Axial sections were used to measure the linear and
angular measurements. In the Sagittal plane, the Delimitation of the Joint Fossa (AF),
the Anterior Joint Space (AAS), the Superior Joint Space (SAS), the Posterior Joint
Space (EAP) and the Height of the Joint Fossa (AFA) were measured. In the Axial
plane the measurements of greater mediolateral distance of the condylar processes of
the mandible, the anteroposterior distance of the condylar processes of the mandible,
the distance from the geometric centers of the right and left condyles and the angle
between the mediolateral plane of the condylar processes of the mandible and median
plane were measured and submitted to anova analysis to verify the findings. In view of
the results, it was concluded that the morphology and condylar positioning are
influenced due to the different types of skeletal patterns and craniofacial growth, as
well as the height of the joint fossa was affected by the interactions of vertical skeletal
patterns. Statistically significant differences were found between the sides. The
measurement and evaluation of the joint spaces should be done independently, on the
right and left sides.
Keywords: temporomandibular joint; conical beam computed tomography; condylar
morphology; remodeling. Ver menos
the diagnosis of the patient being, currently, increasingly present in dental offices.
Structures previously not seen with precision such as the temporomandibular joint, can
now be visualized and studied in detail and... Ver mais Technology has helped a lot in the preparation of clinical documentation and in
the diagnosis of the patient being, currently, increasingly present in dental offices.
Structures previously not seen with precision such as the temporomandibular joint, can
now be visualized and studied in detail and precision by means of Conical Beam
Computed Tomography. The condyle mandibular acts as a site of adaptive growth
under functional load supported by its cartilage, having interaction between form and
function, justifying its differences between the various patients. However, studies on
the influence of occlusion on condylar morphology are not completely conclusive, and
there is a need for more precise analyses. The present study aimed to analyze the
condyle-fossa relationship regarding its shape, positioning and its association with the
various types of skeletal malocclusions according to Steiner's analysis, seeking to
correlate these factors with the different types of facial growth patterns, as well as to
verify if there are differences between the right and left sides of the same patient.From
a sample of five hundred CT scans provided by a tomographic diagnostic center,
located in Brasília, Distrito Federal, Brazil, one hundred and fifty CT scans
corresponding to three hundred temporomandibular joints were selected according to
the inclusion and exclusion criteria. These were analyzed using the Blue sky Plan 3
software®. By means of the Cephalometric Mode, with the function of classifying the
ANB, the CT scans of the patients were classified as mesosoccia, dolicofacial or
brachyfacial. It was also categorized according to the skeletal pattern using the ANB
angle (Class I skeletal, Class II skeletal, Class III skeletal). In the Surgical Guide
Advanced mode, the Sagittal and Axial sections were used to measure the linear and
angular measurements. In the Sagittal plane, the Delimitation of the Joint Fossa (AF),
the Anterior Joint Space (AAS), the Superior Joint Space (SAS), the Posterior Joint
Space (EAP) and the Height of the Joint Fossa (AFA) were measured. In the Axial
plane the measurements of greater mediolateral distance of the condylar processes of
the mandible, the anteroposterior distance of the condylar processes of the mandible,
the distance from the geometric centers of the right and left condyles and the angle
between the mediolateral plane of the condylar processes of the mandible and median
plane were measured and submitted to anova analysis to verify the findings. In view of
the results, it was concluded that the morphology and condylar positioning are
influenced due to the different types of skeletal patterns and craniofacial growth, as
well as the height of the joint fossa was affected by the interactions of vertical skeletal
patterns. Statistically significant differences were found between the sides. The
measurement and evaluation of the joint spaces should be done independently, on the
right and left sides.
Keywords: temporomandibular joint; conical beam computed tomography; condylar
morphology; remodeling. Ver menos
Goes, Denise Rocha
Orientador
Meloti, Aparecida Fernanda
Banca examinadora
Sampaio, Luana Paz
Banca examinadora
Universidade de Fortaleza. Mestrado Profissional em Odontologia
Dissertação (mestrado)