Avaliação tomográfica das alterações dentárias induzidas pelo aparelho Herbst
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Data
2018-09-14
Autores
Schwartz, João Paulo
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Este estudo avaliou quantitativamente as alterações dentárias induzidas pelo aparelho Herbst imediatamente após o tratamento. Amostra composta por 23 indivíduos brasileiros (12 do gênero masculino e 11 do gênero feminino), média de idade 15,76 ± 1,75, Padrão II com deficiência mandibular, apresentando má oclusão Classe II, divisão 1. Alterações na inclinação dos incisivos inferiores, no trespasse horizontal, no trespasse vertical, na inclinação dos caninos inferiores, na distância intercanino inferior, no perímetro, no comprimento e na largura das arcadas dentárias superior e inferior foram avaliadas por meio de tomografias computadorizadas de feixe cônico realizadas antes e após o tratamento com aparelho Herbst. O erro do método foi determinado pelo Coeficiente de Correlação Intraclasse e o Teste Shapiro-Wilk avaliou a distribuição normal. O Teste t de Student e o Teste T de Wilcoxon compararam as amostras dependentes nos casos paramétricos e não paramétricos, respectivamente. O Teste t de Student para amostras independentes foi utilizado para a comparação entre os gêneros e os coeficientes de correlação de Pearson e de Spearman foram calculados para avaliar associações entre as alterações dentárias. Os resultados foram considerados para um nível de significância de 5%. Houve diferença significativa com aumento da inclinação dos incisivos inferiores e diminuição do trespasse horizontal e do trespasse vertical. Os caninos inferiores não apresentaram diferença significativa para inclinação e para a distância intercanina na cúspide e no ápice. O comprimento da arcada aumentou e diminuiu significativamente na maxila e na mandíbula, respectivamente. Houve diferença significativa com aumento do perímetro para arcada superior e para arcada inferior feminina. A largura da arcada superior aumentou significativamente para o primeiro pré-molar, segundo pré-molar e primeiro molar masculino. A avaliação tridimensional das alterações dentárias demonstrou que o aparelho Herbst, imediatamente após o tratamento, aumenta a inclinação dos incisivos inferiores, diminui o trespasse horizontal, o trespasse vertical, não altera a inclinação dos caninos inferiores, a distância intercanina inferior e, na arcada dentária superior, aumenta o comprimento, o perímetro, a largura para primeiro pré-molar, segundo pré-molar, primeiro molar masculino e, na arcada dentária inferior, diminui o comprimento e aumenta o perímetro feminino.
This study evaluated quantitatively the dental changes induced by Herbst appliance immediately after the treatment. Sample consisted of 23 patients (12 men, 11 women), mean ages of 15.76 ± 1.75 years, presenting Class II, division 1 and mandibular deficiency. Changes in the mandibular incisor inclination, overjet, overbite, mandibular canine inclination, mandibular intercanine distance, perimeter, length and width of maxillary and mandibular dental arches were evaluated by means of cone-beam computed tomography images obtained before and after Herbst treatment. Intraclass Correlation Coefficient evaluated the error of method. Student’s t-Test and Wilcoxon t-Test were used to compare dependent samples in parametric and non-parametric cases, respectively, after the data had been tested for normality with the Shapiro-Wilk Test. Student’s independent t-Tests was used for gender comparison and Pearson’s and Spearman’s rank correlation analyses were performed to determine the relationship between the dental changes. Results were considered at a significance level of 5%. There was significantly increase in the mandibular incisor inclination and decrease in the overjet and overbite. The mandibular canine showed no statistical significance in the inclination and intercanine distance at the cusp and apex levels. The length increased and decreased significantly in the maxillary and mandibular dental arches, respectively. There was significantly increase in the maxillary and female mandibular dental arches perimeter. The maxillary dental arch width increased significantly in the first premolar, second premolar and male first molar. The three-dimensional evaluation of dental changes showed that Herbst appliance, immediately after the treatment, increase mandibular incisor inclination, decrease overjet, overbite, do not change the mandibular canine inclination, mandibular intercanine distance and, in the maxillary arch, increase length, perimeter, width in the first premolar, second premolar and male first molar and, in the mandibular arch, decrease length and increase female perimeter.
This study evaluated quantitatively the dental changes induced by Herbst appliance immediately after the treatment. Sample consisted of 23 patients (12 men, 11 women), mean ages of 15.76 ± 1.75 years, presenting Class II, division 1 and mandibular deficiency. Changes in the mandibular incisor inclination, overjet, overbite, mandibular canine inclination, mandibular intercanine distance, perimeter, length and width of maxillary and mandibular dental arches were evaluated by means of cone-beam computed tomography images obtained before and after Herbst treatment. Intraclass Correlation Coefficient evaluated the error of method. Student’s t-Test and Wilcoxon t-Test were used to compare dependent samples in parametric and non-parametric cases, respectively, after the data had been tested for normality with the Shapiro-Wilk Test. Student’s independent t-Tests was used for gender comparison and Pearson’s and Spearman’s rank correlation analyses were performed to determine the relationship between the dental changes. Results were considered at a significance level of 5%. There was significantly increase in the mandibular incisor inclination and decrease in the overjet and overbite. The mandibular canine showed no statistical significance in the inclination and intercanine distance at the cusp and apex levels. The length increased and decreased significantly in the maxillary and mandibular dental arches, respectively. There was significantly increase in the maxillary and female mandibular dental arches perimeter. The maxillary dental arch width increased significantly in the first premolar, second premolar and male first molar. The three-dimensional evaluation of dental changes showed that Herbst appliance, immediately after the treatment, increase mandibular incisor inclination, decrease overjet, overbite, do not change the mandibular canine inclination, mandibular intercanine distance and, in the maxillary arch, increase length, perimeter, width in the first premolar, second premolar and male first molar and, in the mandibular arch, decrease length and increase female perimeter.
Descrição
Palavras-chave
Tomografia computadorizada de feixe cônico, Avanço mandibular, Técnicas de movimentação dentária, Cone-beam computed tomography, Mandibular advancement, Tooth movement techniques