Avaliação clínica da sensibilidade cutânea, na região mentual e lábio inferior, em pacientes tratados por meio de duas diferentes técnicas de osteotomia sagital do ramo da mandíbula
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Data
2022-09-02
Autores
Ferreira, Gabriely
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Universidade Estadual Paulista (Unesp)
Resumo
A osteotomia sagital bilateral da mandíbula é um dos procedimentos mais utilizados em cirurgia ortognática para correções de deformidades dento esqueléticas. Este estudo clínico foi planejado para avaliar clinicamente a sensibilidade cutânea em oito áreas na região do mento e lábio inferior, lado direito e esquerdo, em pacientes submetidos à cirurgia ortognática, em que tenha sido realizada osteotomia sagital do ramo mandibular por meio da técnica convencional e por meio da osteotomia sagital curta. A amostra foi composta de pacientes provenientes da disciplina de Cirurgia e Traumatologia Buco-Maxilo-Facial da Faculdade de Odontologia de Araraquara – Unesp. Esses pacientes foram alocados aleatoriamente em dois grupos. Em um grupo foi realizado a osteotomia sagital convencional (grupo I) e no outro realizado a osteotomia sagital curta (grupo II). Os pacientes foram avaliados de forma duplo cega no período pré-operatório, para controle, e nos períodos pós-operatórios de uma semana, um mês, dois meses e seis meses. A avaliação da sensibilidade foi realizada nas regiões do mento e lábio inferior, previamente demarcadas, com o auxílio de monofilamentos de nylon de Semmes-Weinstein (SORRI – Bauru®). Foram avaliados 58 pacientes no total (n=31/grupo I e n=27/grupo II). Observou-se que grupo I, todos os pacientes relataram alterações na avaliação pós-operatória de uma semana, em uma ou mais região avaliada. No grupo II, 25 pacientes (92,6%) relataram alterações na avaliação pós-operatória de uma semana, em uma ou mais região avaliada. Durante a avaliação final, no grupo I, 21 pacientes (67,74%) apresentaram, recuperação total da sensibilidade em todas as oito áreas, enquanto no grupo II, 25 pacientes (92,6%) tiveram recuperação total da sensibilidade em todas as áreas avaliadas. Os resultados mostraram que existe diferença estatística entre o grupo I e o grupo II na perda e retorno da sensibilidade cutânea na região de lábio inferior e mento, em função do tempo, concluindo que a osteotomia sagital do ramo mandibular curta permite um retorno mais rápido da sensibilidade, além de ser menos traumática.
Bilateral sagittal osteotomy of the mandible is one of the most used procedures in orthognathic surgery for correcting skeletal deformities. This clinical study was designed to clinically assess skin sensitivity in eight areas in the chin and lower lip, right and left sides, in patients undergoing orthognathic surgery, in which sagittal split ramus osteotomy has been performed using the conventional technique and through short sagittal osteotomy. The sample consisted of patients from Oral and Maxillofacial Surgery Division of the Araraquara Dental School - Unesp. These patients were randomly assigned to two groups. In one group, conventional sagittal split ramus osteotomy (group I) was performed and in the other, short sagittal osteotomy (group II). The patients were evaluated in a double blind manner in the preoperative period, for control, and in the postoperative periods of one week, one month, two months and six months. Sensitivity assessment was performed in the regions of the chin and lower lip, previously demarcated, with the help of Semmes-Weinstein nylon monofilaments (SORRI - Bauru®). A total of 58 patients were evaluated (n=31/group I and n=27/group II). It was observed that in group I, all patients reported changes in the one-week postoperative evaluation, in one or more evaluated regions. In group II, 25 patients (92.6%) reported changes in the one-week postoperative evaluation, in one or more evaluated regions. During the final evaluation, in group I, 21 patients (67.74%) had full recovery of sensitivity in all eight areas, while in group II, 25 patients (92.6%) had full recovery of sensitivity in all areas. evaluated areas. The results showed that there is a statistical difference between group I and group II in the loss and return of skin sensitivity in the lower lip and chin region, as a function of time, concluding that the short sagittal ramus osteotomy allows a faster return of sensitivity, in addition to being less traumatic.
Bilateral sagittal osteotomy of the mandible is one of the most used procedures in orthognathic surgery for correcting skeletal deformities. This clinical study was designed to clinically assess skin sensitivity in eight areas in the chin and lower lip, right and left sides, in patients undergoing orthognathic surgery, in which sagittal split ramus osteotomy has been performed using the conventional technique and through short sagittal osteotomy. The sample consisted of patients from Oral and Maxillofacial Surgery Division of the Araraquara Dental School - Unesp. These patients were randomly assigned to two groups. In one group, conventional sagittal split ramus osteotomy (group I) was performed and in the other, short sagittal osteotomy (group II). The patients were evaluated in a double blind manner in the preoperative period, for control, and in the postoperative periods of one week, one month, two months and six months. Sensitivity assessment was performed in the regions of the chin and lower lip, previously demarcated, with the help of Semmes-Weinstein nylon monofilaments (SORRI - Bauru®). A total of 58 patients were evaluated (n=31/group I and n=27/group II). It was observed that in group I, all patients reported changes in the one-week postoperative evaluation, in one or more evaluated regions. In group II, 25 patients (92.6%) reported changes in the one-week postoperative evaluation, in one or more evaluated regions. During the final evaluation, in group I, 21 patients (67.74%) had full recovery of sensitivity in all eight areas, while in group II, 25 patients (92.6%) had full recovery of sensitivity in all areas. evaluated areas. The results showed that there is a statistical difference between group I and group II in the loss and return of skin sensitivity in the lower lip and chin region, as a function of time, concluding that the short sagittal ramus osteotomy allows a faster return of sensitivity, in addition to being less traumatic.
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Palavras-chave
Cirurgia Ortognática, Osteotomia Sagital do Ramo Mandibular, Parestesia, Orthognathic Surgery, Osteotomy, Sagittal Split Ramus, Paresthesia