Avaliação das arcadas dentárias por escâner intraoral em pacientes com distúrbio respiratório obstrutivo do sono
Data
2023-06-13
Autores
Brassanini, Guilherme William 
Orientadores
Haddad, Fernanda Louise Martinho
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O escaneamento intraoral emergiu como uma técnica inovadora adotada na odontologia, de fácil realização e ausência de radiação. Por décadas, a cefalometria tem sido empregada na avaliação das estruturas ósseas em pacientes com distúrbios respiratórios obstrutivos do sono (DROS). No entanto, o escaneamento intraoral ainda não é rotineiramente utilizado para essa finalidade, e não existem estudos comparativos entre esses dois métodos nessa população específica. Objetivos: Avaliar se existe correlação entre medidas dos arcos dentários da maxila e da mandíbula obtidas através de modelos digitais por escâner intraoral com medidas cefalométricas em pacientes com DROS, e correlacionar as medidas dos arcos dentários da maxila e da mandíbula obtidas por escaneamento intraoral com parâmetros respiratórios polissonográficos. Métodos: Foram revisados 147 prontuários de pacientes em uma clínica odontológica atendidos entre 2018 e 2023, com DROS e indicação de tratamento com aparelho intraoral de avanço mandibular. Destes, foram incluídos no estudo 117 pacientes que apresentaram dados completos da cefalometria e do escâner intraoral (iTero). Dos pacientes incluídos, 99 apresentavam dados da polissonografia tipo I ou II. Resultados: Houve correlação entre medidas das arcadas dentárias superiores e inferiores e as medidas obtidas por cefalometria (SNB: Correlação positiva com área (p=0,006), distância interpremolar (p=0,007) e intermolar (p=0,031)). As correlações encontradas entre as medidas cefalométricas e as medidas das arcadas dentárias inferiores (mandíbula) foram: SNA: correlação positiva com área (p=0,007), distância interpremolar (p=0,04) e comprimento da arcada (p=0,022). SNB: Correlação positiva com área (p=0,005) e distância interpremolar (p<0,001). Correlação negativa com a razão comprimento/medida interpremolar (p=0,045). ANB: Correlação positiva com o comprimento da mandíbula (p=0,009) e a razão comprimento/ medida interpremolar (p<0,001) e razão comprimento/ medida intermolar (p=0,007). Correlação negativa com a medida interpremolar (p=0,049). Houve correlação positiva entre maiores valores do índice de apneia e hipopneia (IAH) com menores medidas das arcadas dentárias superiores (maxila) e aumento da razão comprimento/medida interpremolar da maxila (p=0,05). Conclusão: Houve correlação entre medidas das arcadas dentárias superiores e inferiores com as medidas obtidas por cefalometria, sugerindo que o escaneamento intraoral possa ser, também, um método de avaliação anatômica da região maxilomandibular de fácil realização em pacientes com DROS. Além disso, houve correlação entre maiores valores do IAH com menores medidas das arcadas dentárias superiores (maxila).
Introduction: Intraoral scanning has emerged as an innovative and easily performed technique in dentistry, with the advantage of being radiationfree. For decades, cephalometry has been employed to assess bony structures in patients with obstructive sleepdisordered breathing (SDB). However, intraoral scanning is not yet routinely used for this purpose, and there are no comparative studies between these two methods in this specific population. Objectives: To assess whether there is a correlation between measurements of the maxillary and mandibular dental arches obtained through digital models via intraoral scanning and cephalometric measurements in patients with SDB, and to correlate these dental arch measurements obtained through intraoral scanning with polysomnographic respiratory parameters. Methods: We reviewed 147 patient records from a dental clinic between 2018 and 2023, involving individuals with SDB and an indication for mandibular advancement device treatment. Of these, 117 patients with complete cephalometric and intraoral scanning (iTero) data were included in the study, and 99 of them had type 1 or 2 polysomnography data. Results: There was a correlation between measurements of the upper and lower dental arches and those obtained by Cephalometry. SNB: Positive correlation with area (p=0.006), interpremolar distance (p=0.007), and intermolar distance (p=0.031). The correlations found between cephalometric measurements and measurements of the lower dental arches (mandible) were: SNA: Positive correlation with area (p=0.007), interpremolar distance (p=0.04), and arch length (p=0.022). SNB: Positive correlation with area (p=0.005) and interpremolar distance (p<0.001). Negative correlation with the length/interpremolar measurement ratio (p=0.045). ANB: Positive correlation with mandibular length (p=0.009) and the length/interpremolar measurement ratio (p<0.001) and the length/intermolar measurement ratio (p=0.007). Negative correlation with the interpremolar measurement (p=0.049). There was a positive correlation between higher AHI values and smaller measurements of the upper dental arches (maxilla) an increase in the length/interpremolar measurement ratio of the maxilla (p=0.05). Conclusion: Correlations were observed between measurements of the upper and lower dental arches and cephalometric measurements, indicating that intraoral scanning can be a feasible method for anatomical evaluation of the maxillomandibular region in patients with SDB. Additionally, higher AHI values were correlated with smaller measurements of the upper dental arch (maxilla).
Introduction: Intraoral scanning has emerged as an innovative and easily performed technique in dentistry, with the advantage of being radiationfree. For decades, cephalometry has been employed to assess bony structures in patients with obstructive sleepdisordered breathing (SDB). However, intraoral scanning is not yet routinely used for this purpose, and there are no comparative studies between these two methods in this specific population. Objectives: To assess whether there is a correlation between measurements of the maxillary and mandibular dental arches obtained through digital models via intraoral scanning and cephalometric measurements in patients with SDB, and to correlate these dental arch measurements obtained through intraoral scanning with polysomnographic respiratory parameters. Methods: We reviewed 147 patient records from a dental clinic between 2018 and 2023, involving individuals with SDB and an indication for mandibular advancement device treatment. Of these, 117 patients with complete cephalometric and intraoral scanning (iTero) data were included in the study, and 99 of them had type 1 or 2 polysomnography data. Results: There was a correlation between measurements of the upper and lower dental arches and those obtained by Cephalometry. SNB: Positive correlation with area (p=0.006), interpremolar distance (p=0.007), and intermolar distance (p=0.031). The correlations found between cephalometric measurements and measurements of the lower dental arches (mandible) were: SNA: Positive correlation with area (p=0.007), interpremolar distance (p=0.04), and arch length (p=0.022). SNB: Positive correlation with area (p=0.005) and interpremolar distance (p<0.001). Negative correlation with the length/interpremolar measurement ratio (p=0.045). ANB: Positive correlation with mandibular length (p=0.009) and the length/interpremolar measurement ratio (p<0.001) and the length/intermolar measurement ratio (p=0.007). Negative correlation with the interpremolar measurement (p=0.049). There was a positive correlation between higher AHI values and smaller measurements of the upper dental arches (maxilla) an increase in the length/interpremolar measurement ratio of the maxilla (p=0.05). Conclusion: Correlations were observed between measurements of the upper and lower dental arches and cephalometric measurements, indicating that intraoral scanning can be a feasible method for anatomical evaluation of the maxillomandibular region in patients with SDB. Additionally, higher AHI values were correlated with smaller measurements of the upper dental arch (maxilla).
Descrição
Citação
BRASSANINI, Guilherme William. Avaliação das arcadas dentárias por escâner intraoral em pacientes com distúrbio respiratório obstrutivo do sono. 2023. 94 f. Dissertação (Mestrado em Otorrinolaringologia) - Escola Paulista de Medidicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2023.