Influência dos diferentes padrões faciais nas dimensões do espaço aéreo faríngeo avaliados em tomografia computadorizada de feixe cônico
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2018-04-16
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Universidade Federal de Goiás
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The pharyngeal airway space (PAS) determines vital functional processes such as
swallowing and phonation. It includes nasopharynx and oropharynx and actively
contributes to the development of facial morphology as a whole and the ideal
occlusion. Pathological alterations that lead to PAS narrowing may cause alterations
in craniofacial development due to variations in the respiratory pattern and swallowing.
The relationship between PAS, severity of malocclusion, and variations in the skeletal
pattern is well established. This study aimed to assess whether there is a relationship
between the dimensions of PAS and the different skeletal facial patterns. A total of 207
cone beam computed tomographies (CBCTs) of patients between 20 and 40 years of
age referred to orthodontic treatment were selected. These tomographic images were
analyzed and divided into groups regarding anteroposterior skeletal facial pattern
(APP) or maxillomandibular anteroposterior relationship (Classes I, II, and III) and
vertical skeletal facial patterns (VP) dolichofacial, mesofacial, and brachyfacial. All the
measures were performed by only one rater, using the software Dolphin. Statistical
tests of rater calibration and of the measures obtained were conducted using the
software Statistical Package for the Social Sciences (SPSS) for Windows version 24.0
at the 5% level of significance. For interrater reliability analysis, the intraclass
correlation coefficient (ICC) was used. The Kruskal-Wallis test and Mann-Whitney
post-test, the one-way analysis of variance (one-way ANOVA) and Tukey post-test, as
well as Pearson correlation and the multivariate analysis of variance (MANOVA) of all
measures of APP and VP were used. Excellent ICC results, above 0.9, were found for
intrarater reliability. Statistically significant differences were found in the comparison of
Class I regarding pharyngeal (p = 0.033) and oropharyngeal minimum area (p = 0.036)
and pharyngeal (p = 0.024), nasopharingeal (p = 0.008), and oropharingeal
anteroposterior width (p = 0.008) among mesofacial and dolichofacial patients.
Mesofacial patients had significant differences in pharyngeal volume (p = 0.039),
pharyngeal minimum area (p = 0.013), nasopharyngeal length (p = 0.017), and
oropharyngeal length (p = 0.001) among Classes I, II, and III. For Class III, significant
differences were found in nasopharyngeal (p = 0.046) and oropharyngeal length (p =
0.039) among mesofacial and dolichofacial patients. Dolichofacial patients had
significant differences in nasopharingeal (p = 0.019) and oropharyngeal
anteroposterior width (p = 0.012) among Classes I, II, and III. A negative correlation
was found between VP and the location of minimum area of nasopharynx (p = 0.001)
and oropharynx (p = 0.002), as well as between APP and nasopharingeal (p = 0.002)
and oropharingeal anteroposterior width (p = 0.003). Interactions were found between
APP, VP, and APP x VP. Therefore, significant differences were observed in the
comparisons, correlations, and interactions between APPs and VPs and PAS
dimensions.
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ALVES, C. B. C. Influência dos diferentes padrões faciais nas dimensões do espaço aéreo faríngeo avaliados em tomografia computadorizada de feixe cônico. 2018. 109 f. Tese (Doutorado em Odontologia) - Universidade Federal de Goiás, Goiânia, 2018.