Thiesen Guilherme, Freitas Maria Perpétua Mota, Gribel Bruno Frazão, Kim Ki Beom
Universidade do Sul de Santa Catarina, Departamento de Ortodontia (Florianópolis/SC, Brazil).
Universidade Luterana do Brasil, Departamento de Ortodontia (Canoas/RS, Brazil).
Dental Press J Orthod. 2019 Sep 5;24(4):54-62. doi: 10.1590/2177-6709.24.4.054-062.oar.
The present study aims at using cone beam computed tomography (CBCT) to analyze the maxillomandibular characteristics present in adults with mandibular asymmetries and different sagittal jaw relationships.
360 patients were selected and divided into three groups (Class I, Class II, and Class III), with 120 individuals per group. The groups were then subdivided according to the intensity of lateral deviation of the gnathion point, into: 1) relative symmetry, 2) moderate asymmetry, and 3) severe asymmetry. Three planes of reference were established in the CBCT images and several measurements were taken to compare the bilateral skeletal differences between the intensities of asymmetry for the different sagittal jaw relationships.
When the groups were compared by the intensity of asymmetry, significant differences among patients with relative symmetry and moderate to severe asymmetry were found. This was especially noticed for severe asymmetry, suggesting that the deviation of the chin did not constitute the only morphological alteration for these patients, especially because a series of measurements showed significant bilateral differences. When comparing sagittal jaw relationships, the only significant finding was the vertical positioning of the gonion between Class II and III patients with severe asymmetry.
When comparing the three sagittal jaw relationships with the same intensity of asymmetry, most maxillofacial aspects were quite similar. The only difference was found for patients with severe asymmetry, as the individuals with Class II showed greater bilateral difference in the vertical positioning of the gonion, when compared to patients with Class III.
本研究旨在使用锥形束计算机断层扫描(CBCT)分析下颌不对称且矢状颌关系不同的成年人的上下颌特征。
选取360例患者,分为三组(I类、II类和III类),每组120人。然后根据颏点的侧向偏斜强度将这些组再细分,分为:1)相对对称,2)中度不对称,3)重度不对称。在CBCT图像中建立三个参考平面,并进行多项测量,以比较不同矢状颌关系的不对称强度之间的双侧骨骼差异。
按不对称强度对各组进行比较时,发现相对对称患者与中度至重度不对称患者之间存在显著差异。重度不对称患者尤其明显,这表明下巴的偏斜并非这些患者唯一的形态改变,特别是因为一系列测量显示出显著的双侧差异。比较矢状颌关系时,唯一显著的发现是II类和III类重度不对称患者之间下颌角的垂直位置。
在比较三种具有相同不对称强度的矢状颌关系时,大多数颌面特征非常相似。唯一的差异出现在重度不对称患者中,与III类患者相比,II类患者下颌角的垂直位置双侧差异更大。