Navegando por Palavras-chave "Palatal expansion technique"
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- ItemAcesso aberto (Open Access)Avaliação tomográfica das alterações dimensionais do espaço orofaríngeo pré e pós expansão rápida da maxila(Universidade Federal de São Paulo (UNIFESP), 2017-06-29) Yuki, Aparecida Keiko Akutsu [UNIFESP]; Pignatari, Shirley Shizue Nagata [UNIFESP]; Cappellette Júnior, Mário [UNIFESP]; http://lattes.cnpq.br/3772804052798387; http://lattes.cnpq.br/4416616059943202; http://lattes.cnpq.br/0364119997044968; Universidade Federal de São Paulo (UNIFESP)Este estudo tem por objetivo avaliar, em curto prazo, as possíveis alterações dimensionais do espaço orofaríngeo pré e pós-expansão rápida da maxila (ERM) por meio de tomografia computadorizada (TC) em pacientes respiradores orais. Material e método: Neste estudo retrospectivo selecionados 35 pacientes respiradores orais com atresia maxilar sendo 20 do gênero masculino e 15 do gênero feminino, com média de idade 9,6 anos, desvio padrão de 1,8 anos variando de 5 a 12 anos. Os exames de tomografia computadorizada (TC) foram realizados em dois momentos: pré-ERM (T1) e 6 meses após a finalização da fase ativa da ERM (T2). Após a seleção dos pacientes do banco de dados, as imagens tomográficas foram obtidas por meio do programa de manipulação de imagens e as comparações entre as TC iniciais (T1) e finais (T2) foram executadas com o auxilio do programa Dolphin Imaging Version 11.7 Preminun, de acordo com as estruturas e avaliações a serem realizadas. Os dados foram submetidos a análises do erro intra e inter-observador e testes estatísticos para comprovar a significância dos resultados obtidos. Resultados: Houve aumento significativo nas mensurações de área e volume da orofaringe. A área aumentou em 12,6% e o volume em 16,3% pós ERM. Em relação as medidas lineares de deslocamento da maxila houve aumento da distância ENACli em 1,45mm e da distância ENA-Ba em 1,31mm. Conclusões: Os resultados obtidos neste trabalho permitem concluir que a ERM promove, em curto prazo, deslocamento anterior da maxila com aumentos significativos da área e volume da orofaringe.
- ItemAcesso aberto (Open Access)Efeitos sagitais e verticais a longo prazo nos tecidos esqueléticos, dentais e moles após a expansão rápida da maxila assistida cirurgicamente : estudo longitudinal(Universidade Federal de São Paulo (UNIFESP), 2017-06-01) Farfel, Vivian [UNIFESP]; Pereira, Max Domingues [UNIFESP]; Morea, Gladys Cristina Dominguez; http://lattes.cnpq.br/7521436623167474; http://lattes.cnpq.br/9679136417299816; http://lattes.cnpq.br/2590392546914029; Universidade Federal de São Paulo (UNIFESP)Introdução: Não há consenso na literatura quanto a avaliação das alterações sagitais e verticais nos tecidos esqueléticos, dentais e nos tecidos moles da maxila após a ERMAC. Objetivo: Avaliar os efeitos sagitais e verticais nos tecidos esqueléticos, dentais e nos tecidos moles da maxila após a ERMAC. Métodos: 112 radiografias cefalométricas da cabeça em norma lateral de 28 pacientes adultos com DTM ≥ 7mm, submetidos a ERMAC, foram medidas em quatro tempos distintos: na fase pré-operatória, em média uma semana antes da operação (T1); na fase pós-operatória, logo após o final da ativação do aparelho expansor (T2), após quatro meses do término da ativação (T3) e após dez meses do término da ativação (T4). Foram obtidas medidas cefalométricas esqueléticas e dentais da maxila em todas as telerradiografias de T1 a T4 e medidas cefalométricas dos tecidos moles em T1 e T4 de todos os pacientes. Resultados: As medidas esqueléticas e de tecidos moles não apresentaram diferenças estatisticamente significantes. As medidas dentais apresentaram uma inclinação em direção anterior dos incisivos de T1 para T2 porém não estatisticamente significante, seguida de uma inclinação para posterior, estatisticamente significante, de T2 para T3 e T4. Aos dez meses (T4) os dentes mantiveram uma inclinação em direção posterior em relação ao pré-operatório T1, porém não estatisticamente significante. Conclusão: Não há alterações sagitais e verticais nos tecidos esqueléticos e moles da maxila após a ERMAC. Os incisivos superiores inclinam-se em direção posterior.
- ItemAcesso aberto (Open Access)Efetividade da expansão rápida da maxila assistida cirurgicamente utilizando técnica de osteotomias em dois e três segmentos: ensaio clinico randomizado(Universidade Federal de São Paulo (UNIFESP), 2017-06-01) Prado, Gabriela Pereira Ribeiro [UNIFESP]; Pereira, Max Domingues [UNIFESP]; Furtado, Fabianne Magalhães Girardin Pimentel [UNIFESP]; http://lattes.cnpq.br/5809529650066993; http://lattes.cnpq.br/9679136417299816; http://lattes.cnpq.br/9612434112678451; Universidade Federal de São Paulo (UNIFESP)Introduction: The treatment of choice for adult transversal maxillary deficiency (TMD) ≥ 5mm is surgically assisted rapid maxillary expansion (SARME). There is no consensus in the literature on the best operatory technique, type and location of the osteotomies. Objective: Comparing 2- and 3-segment SARME effectiveness concerning quality of life (QL), maxillary expansion symmetry, stability of changes in palate area and volume, changes in nose width and topology of the paranasal area. Methods: 32 adult patients with TMD ≥ 5mm were randomly assigned to groups 2S (n=16) and 3S (n=16). Physical and psychological assessments were carried out before SARME (PREVIOUS) and in one of the following points in time: expansion accomplishment (EA), and four, six and ten months after EA (4M, 6M and 10M, respectively). QL was assessed according to Oral Health Impact Profile (OHIP-49) and Brazilian Orthognatic Quality of Life Questionaire (B-OQLQ). Symmetry of maxillary expansion was determined by superposing PRE and FE tomographs; stability of palate volume changes was assessed on 3D digital images produced from scanning PRE, 4M and 10M plaster casts; changes in nose width was established by superimposing PRE and 6M digital images obtained from scanning of patients faces; and clinical complications. Results: Results: There was statistical differences in the domains of Deficiency and Social Inability of OHIP-49 between 2S and 3S techniques. None of the tools assessing QL showed any statistically significant difference in total scoring when comparing groups 2S and 3S. There was an asymmetry of the expansion between the two techniques, however no differences were detected between the groups. The 2S and 3S techniques showed a significant increase in the area and volume of the A b s t r a c t | 161 palate at 4M, and at 10M the area measurement was stable while the volume showed a significant increase. The mean increase in nose width was greater (p=0.17) in group 2S (2.73mm) as compared with group 3S (1.92mm). There were no differences between the techniques regarding total, anteroposterior (Z axis) and vertical (Y axis) displacements, excepting for changes along X-axis (transversal) which were greater for 3S technique (p=0.014). The clinical postoperative complications were low and did not differ statistically between groups. Conclusion: Both SARME techniques produced the same positive quality-of-life impact on groups 2S and 3S as assessed 6 months after intervention; in the parameters used, the maxillary expansion asymmetry is similar in the 2S and 3S techniques; stable increase in palate area and volume as assessed in 10-month followup; similar forward changes in the topology of paranasal areas and 2S technique produced a larger nose width as compared with 3S intervention; postoperative complications were similar in 2S and 3S techniques .
- ItemAcesso aberto (Open Access)Expansão rápida da maxila: análise da densidade radiográfica da sutura palatina mediana e sua correlação nos estágios de neoformação óssea, por meio de imagem digitalizada(Dental Press Editora, 2009-10-01) Martins, Milleni Campos Fernandes [UNIFESP]; Costa, Claudio; Abrão, Jorge; Borri, Maria Lucia [UNIFESP]; Universidade Camilo Castelo Branco; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)AIM: To evaluate the new bone formation of the midpalatal suture in different phases of the rapid maxillary expansion procedure by means of the scanned image and to compare the radiographic density of the different selected areas along this suture in predetermined periods. METHODS: The sample consisted of 23 individuals, aged from 9 to 12 years who underwent rapid maxillary expansion in accordance with a protocol which consisted initially of a full turn on the screw, followed by ¼ turn by morning and ¼ turn at night for two weeks. Were obtained 69 occlusal radiographs at different phases of the procedure, which passed through the scanning process via scanner and then were subjected to the software Digora for Windows 5.6, to perform the readings of radiographic density. RESULTS: In all phases of the procedure, the values of gray levels were, on average, different from each other, showing partial bone healing of the midpalatal suture. CONCLUSIONS: The results revealed that are necessary more than three months for complete sutural recovery after the rapid maxillary expansion and that the method used to read the densities proved to be trustworthy, because of its ability to display details. Therefore, it can be concluded that the expander should be removed only after full sutural bone recovery in order to avoid relapses.
- ItemSomente MetadadadosPrediction of Transverse Maxillary Dimension Using Orthodontic Models(Lippincott Williams & Wilkins, 2008-11-01) Oliveira, Melchiades Alves de [UNIFESP]; Pereira, Max Domingues [UNIFESP]; Hino, Claudia Toyama [UNIFESP]; Campaner, Anelisa Bittencourt [UNIFESP]; Scanavini, Marco Antonio [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The main objective of this study was to quantify the transverse maxillary dimensions using orthodontic cast models of individuals with natural normal occlusion. Sixty-eight pairs of orthodontic models were evaluated with the respective posteroanterior radiographies of white adults (38 women and 30 men; mean age, 1.7 years and 5 months). the models were placed in Class I molar occlusion, and on each pair, 4 points were marked on the alveolar buccal ridge (2 on the premolar region and 2 on the molar), determining the upper and lower transverse interpremolar and intermolar dimensions. the variables analyzed in the 3 measurements, obtained from the cephalometric radiographies and the cast models, showed no statistical differences. the upper intermolar distance was 57.20 +/- 2.60 mm; the lower intermolar, 55.16 +/- 2.40 mm; the upper interpremolar, 42.17 +/- 2.19 mm, and the lower interpremolar; 39.67 +/- 1.77 mm. On the posteroanterior cephalograms, the maxillary width was 65.97 +/- 3.42 mm and the mandibular width was 87.92 +/- 4.60 mm. There was intraresearcher and interresearcher correlation. There was no sexual dimorphism. the method proposed in this study can predict the transverse maxillary dimension, applying the formula (y) over cap (m) = 8.62 + 0.88x(m) ((y) over cap (m) = expected upper intermolar distance, x(m) = lower intermolar distance) for the molar region, and (y) over cap (m) = 4.87 + 0.94x(pm) ((y) over cap (pm) = expected upper interpremolar distance, x(pm) = lower interpremolar distance) for the premolar region.
- ItemAcesso aberto (Open Access)Rapid maxillary expansion in mouth breathers: a short-term skeletal and soft-tissue effect on the nose(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2018) Badreddine, Fauze Ramez [UNIFESP]; Fujita, Reginaldo Raimundo [UNIFESP]; Alves, Fabio Eduardo Maiello Monteiro [UNIFESP]; Cappellette Junior, Mario [UNIFESP]Introduction: Rapid maxillary expansion can change the form and function of the nose. The skeletal and soft tissue changes can influence the esthetics and the stability of the results obtained by the procedure. Objective: The aim of this retrospective study was to evaluate the short-term effects of rapid maxillary expansion on the skeletal and soft tissue structures of the nose, in mouth-breathing patients, using a reliable and reproducible, but simple methodology, with the aid of computed tomography. Methods: A total of 55 mouth-breathing patients with maxillary hypoplasia were assessed and were divided into an experimental group treated with rapid maxillary expansion (39 patients, 23 of which were male and 16 female, with an average age of 9.7 years and a standard deviation of 2.28, ranging from 6.5 to 14.7 years) and a control group (16 patients, 9 of which were male and 7 female, with an average age of 8.8 years, standard deviation of 2.17, ranging from 5.11 to 13.7 years). The patients of the experimental group were submitted to multistice computed tomography examinations at two different points in time: (Ti) pre-rapid maxillary expansion and (T2) three months after the procedure. The control group underwent to the same exams at the same intervals of time. Four skeletal and soft tissue variables were assessed, comparing the results of T1 and T2. Results: There was in the experimental group a significant increases in all the skeletal and soft tissue variables (p < 0.05) but no significant alteration was found in the control group. When comparing the experimental group and the control group, the most important change occurred in the width of the pyriform aperture (p < 0.001). Conclusion: Rapid maxillary expansion is capable of altering the shape and function of the nose, promoting alterations in skeletal and soft tissue structures. This kind of study may, in the future, permit the proper planning of esthetic procedures at the tip and base of the nose and also the performance of objective measurements in early or late surgical outcomes. (C) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.