[Planning options of reconstructive and orthognathic operation by means of three-dimensional imaging]. / Arcrekonstrukciós és orthognath mutétek tervezési lehetoségei háromdimenziós képalkotói módszerekkel.

We summarize up-to-date planning technics of orthognathic and reconstructive surgery operation which appeared with three-dimensional imaging, using literature data and some clinical examples. In many cases, orthognathic and reconstructive operations mean the only treatment of facial deformity caused by tumour, traumatic injury or congenital anomaly. In this field, radiology plays an important role not only in the diagnosis but also in the planning of the treatment. With the appearance of cone-beam computed tomography (CBCT), the previously used two-dimensional cephalometric analysis on lateral cephalogram was changed for three-dimensional cephalometric measurements. The first step of the adaptation was the lateral and frontal x-ray images generated from the CBCT database and later the volume rendered surface and segmentation technics provided the moving of the facial bones in three dimensions which meant virtual surgical planning. With the development of CAD/CAM technic and the three-dimensional printing, many opportunities became available, such as preoperative bending splints and plates and printed surgical model for the tangible planning. The progress of imaging facilitated the individual, accurate, and reliable planning which significantly determines the success of the treatment. Orv Hetil. 2018; 159(39): 1584-1592.

Upper airway assessment in obstructive sleep apnea patients: can computed tomography with lateral cephalometry replace drug-induced sleep endoscopy (DISE)?

OBJECTIVE: To evaluate the association between results from drug-induced sleep endoscopy (DISE) and computed tomography with lateral cephalometry (CTLC) of the pharynx in obstructive sleep apnea (OSA) patients, regarding the same anatomic level, in order to understand if CTLC could replace DISE in selected patients. STUDY DESIGN: Cross-sectional. SETTING: Tertiary hospital. METHODS: A total of 71 patients who attended the Sleep Medicine Consultation in the Otorhinolaryngology Department of Hospital CUF Tejo between 1.6.2019 and 30.9.2021, performed a polysomnographic sleep study and were elected to undergo DISE and CTLC of the pharynx for diagnostic purposes were selected. Obstructions at the same anatomic levels - tongue base, epiglottis and velum - were compared in both exams. RESULTS: Patients with reduction of epiglottis-pharynx space on CTLC had also a complete obstruction at epiglottis level on the VOTE classification of DISE (p = 0,027). Reduction of velum-pharynx space or tongue base-pharynx space were not related to complete obstruction of the velum (P = 0,623) or the tongue base (p = 0,594) found in DISE. Those with two or more space reductions had a tendency to multilevel obstruction observed in DISE (p = 0.089). CONCLUSION: When evaluating the obstruction level(s) of an OSA patient, efforts should be made to perform DISE, since CTLC measures, though regarding at the same structures, don´t correlate completely with obstructions observed in DISE.

Using craniofacial characteristics to predict optimum airway pressure in obstructive sleep apnea treatment.

INTRODUCTION: Manual titration is the gold standard to determinate optimal continuous positive airway pressure, and the prediction of the optimal pressure is important to avoid delays in prescribing a continuous positive airway pressure treatment. OBJECTIVE: To verify whether anthropometric, polysomnographic, cephalometric, and upper airway clinical assessments can predict the optimal continuous positive airway pressure setting for obstructive sleep apnea patients. METHODS: Fifty men between 25 and 65 years, with body mass indexes of less than or equal to 35kg/m2 were selected. All patients had baseline polysomnography followed by cephalometric and otolaryngological clinical assessments. On a second night, titration polysomnography was carried out to establish the optimal pressure. RESULTS: The average age of the patients was 43±12.3 years, with a mean body mass index of 27.1±3.4kg/m2 and an apnea-hypopnea index of 17.8±10.5 events per hour. Smaller mandibular length (p=0.03), smaller atlas-jaw distance (p=0.03), and the presence of a Mallampati III and IV (p=0.02) were predictors for higher continuous positive airway pressure. The formula for the optimal continuous positive airway pressure was: 17.244-(0.133×jaw length)+(0.969×Mallampati III and IV classification)-(0.926×atlas-jaw distance). CONCLUSION: In a sample of male patients with mild-to-moderate obstructive sleep apnea, the optimal continuous positive airway pressure was predicted using the mandibular length, atlas-jaw distance and Mallampati classification.

Comparative cephalometric study of the airways between different ethnic groups with normal occlusion

ABSTRACT Objective: This study aimed to compare the nasopharynx and oropharynx airway dimensions of Caucasians, Blacks, Japanese, Japanese Brazilians, and Black Caucasians. Methods: A sample of 216 lateral radiographs of untreated young Brazilian subjects (mean age of 12.94 years; SD 0.88) were divided into five groups: Black Caucasian, Black, Caucasian, Japanese, and Japanese Brazilian. Lateral radiographs were used to measure the oropharynx (from the midpoint on the soft palate to the closest point on the anterior pharyngeal wall) and the nasopharynx (from the intersection of the posterior border of the tongue and the inferior border of the mandible to the closest point on the posterior pharyngeal wall). Analyses of variance (ANOVA) and Tukey's test were performed (p< 0.05). Results: The linear dimension of the oropharynx was similar among the different ethnic groups. Caucasian individuals presented a significantly greater linear dimension of the nasopharynx than Black Caucasian and Black individuals. Conclusions: All the groups had similar buccopharyngeal values. However, Caucasian individuals had significantly higher values when compared to Black Caucasians and Black individuals.

RESUMO Objetivo: Este estudo teve como objetivo comparar as dimensões das vias aéreas da nasofaringe e da bucofaringe de leucodermas, melanodermas, xantodermas, feodermas e nipo-brasileiros. Material e métodos: Uma amostra de 216 telerradiografias laterais de jovens brasileiros não tratados (idade média de 12,94 anos; DP 0,88) foi dividida em cinco grupos: melanodermas, leucodermas, xantodermas, feodermas e nipo-brasileiros. As telerradiografias foram utilizadas para medir a bucofaringe (do ponto médio do palato mole até o ponto mais próximo da parede anterior da faringe) e a nasofaringe (da intersecção da borda posterior da língua e da borda inferior da mandíbula até o ponto mais próximo). Foram realizadas análises de variância (ANOVA) e teste de Tukey (p < 0,05). Resultados: A dimensão linear da bucofaringe foi semelhante entre os diferentes grupos étnicos. Indivíduos leucodermas apresentaram dimensão linear da nasofaringe significativamente maior do que indivíduos feodermas e melanodermas. Conclusões: Todos os grupos apresentaram valores da bucofaringe semelhantes. No entanto, os indivíduos leucodermas apresentaram valores significantemente maiores, quando comparados aos feodermas e melanodermas.

The efficiency of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization

ABSTRACT Objective: To assess the effectiveness of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization. Methods: Seventeen patients aged between 12.5 and 24 years underwent distalization with a customized distalizer. Lateral cephalogram and cast analysis were performed before and after distalization. Linear and angular parameters of the upper first molar, first premolar, and central incisor were assessed. Results: Distalization with the force passing near the center of resistance (CRes) of the upper first molars resulted in distal movement, with minimal distal tipping (2.8±0.45°, p<0.05). However, distalization passing occlusal to the CRes led to greater distal tipping (13.6±1.63°, p<0.05). Statistically significant spontaneous distal tipping and distal movement of the upper first premolars occurred, with a mean of 6.2±1.24° (p<0.05) and 0.68±0.34 mm (p<0.05), respectively. The positional change of the upper central incisors presented a mean of -0.23±0.1 mm (p>0.05) and 2.65±1.1° (p<0.05). Upper first molar intrusion was statistically significant, with a mean of 0.88±0.2 mm (p<0.05). Upper right and left first molars rotation towards palatal midline presented mean of 4.1±0.19° (p<0.05) and 3.4 ±0.1° (p<0.05), respectively. Additionally, the distance between upper right and left first molars increased significantly, with a mean of 2.54±0.01 mm (p<0.05). Conclusion: The study successfully demonstrated the efficiency of molar distalization without anchorage loss using a customized distalizer anchored on palatal miniscrews.

RESUMO Objetivo: Avaliar a eficácia de um distalizador personalizado com parafusos Variety SP® ancorado em mini-implantes palatinos para distalização de molares superiores. Métodos: Dezessete pacientes com idade entre 12,5 e 24 anos foram submetidos à distalização com o distalizador customizado. Análises das radiografias cefalométricas laterais e dos modelos de gesso foram realizadas antes e depois da distalização. Foram avaliados parâmetros lineares e angulares dos primeiros molares, primeiros pré-molares e incisivos centrais superiores. Resultados: A distalização com a força passando perto do centro de resistência (CRes) dos primeiros molares superiores resultou em distalização com inclinação mínima (2,8 ± 0,45°, p<0,05). Entretanto, a distalização passando oclusal ao CRes levou a uma maior inclinação para distal (13,6 ± 1,63°, p<0,05). Ocorreu inclinação distal espontânea e movimento distal estatisticamente significativo dos primeiros pré-molares superiores, com média de 6,2 ± 1,24° (p<0,05) e 0,68 ± 0,34 mm (p<0,05), respectivamente. A mudança de posicionamento dos incisivos centrais superiores apresentou média de -0,23 ± 0,1 mm (p>0,05) e 2,65 ± 1,1° (p<0,05). A intrusão dos primeiros molares superiores foi estatisticamente significativa, com média de 0,88 ± 0,2 mm (p<0,05). A rotação dos primeiros molares superiores direito e esquerdo em direção à linha média palatina apresentou média de 4,1 ± 0,19° (p<0,05) e 3,4 ± 0,1° (p<0,05), respectivamente. Além disso, a distância entre os primeiros molares superiores direito e esquerdo aumentou significativamente, com média de 2,54 ± 0,01 mm (p<0,05). Conclusão: O estudo demonstrou com sucesso a eficiência da distalização de molares sem perda de ancoragem utilizando um distalizador customizado ancorado em mini-implantes palatinos.

Variabilidad en la medición del ángulo ANB de Steiner entre estudiantes de odontología y ortodoncia. Medición del Angulo ANB de Steiner

Introducción: El ángulo ANB de Steiner entrega la relación entre el maxilar y la mandíbula en sentido anteroposterior y es una de las medidas cefalométricas más aplicadas en ortodoncia. Su identificación precisa podría presentar dificultades, influyendo directamente en el posterior estudio cefalométrico, diagnóstico y plan de tratamiento. El objetivo de esta investigación fue comparar la medición del ángulo ANB de Steiner entre estudiantes de pregrado de odontología y postítulo de ortodoncia de la Facultad de Odontología de la Universidad de Chile 2020. Materiales y Métodos: Por medio del programa Adobe Photoshop CS6 (Adobe System ®), se solicitó a los estudiantes la identificación de los puntos Nasion, A y B en 5 telerradiografías laterales de cráneo. Al aplicar los criterios de inclusión y exclusión se reclutaron 15 estudiantes de cada grupo. Luego se unieron los puntos mediante trazados, se midió el ángulo ANB de Steiner y se utilizó el coeficiente de correlación intraclase (ICC) para determinar el grado de acuerdo. Resultados: Se encontró un coeficiente de correlación intraclase ICC promedio de 0.97 entre ambos grupos de estudiantes. Conclusión: No hay diferencia estadística en la determinación del ángulo ANB de Steiner entre estudiantes de pregrado de odontología y postítulo de ortodoncia.

Background: The Steiner ANB angle measures the relationship between the maxilla and mandible in the anteroposterior direction and is one of the most applied cephalometric measurements in orthodontics. Its precise identification could pose difficulties, directly influencing the subsequent cephalometric study, diagnosis and treatment plan. The aim of this research was to compare the measurement of the Steiner ANB angle between dental student and postgraduate students in orthodontics from the Faculty of Dentistry of the University of Chile 2020. Materials and Methods: Using the Adobe Photoshop CS6 program (Adobe System ®), the students were asked to identify the Nasion, A and B points in 5 lateral cephalogram of the skull. By applying the inclusion and exclusion criteria, 15 students were recruited from each group. The points were then joined by tracing, the Steiner ANB angle was measured, and the intraclass correlation coefficient (ICC) was used to determine the degree of agreement. Results: An average ICC intraclass correlation coefficient of 0.97 was found between both groups of students. Conclusion: T here is no statistical difference in the determination of the Steiner ANB angle between undergraduate students of dentistry and postgraduate students of orthodontics.

Study of the cephalometric standards of individuals with normal occlusion and prevalence of the malocclusion in the city of Rio de Janeiro, Rio de Janeiro, Brazil / Estudo dos padrões cefalométricos de indivíduos com oclusão normal e prevalência das maloclusões no município do Rio de Janeiro

ABSTRACT Objective: The accomplishment of this cephalometric objective to evaluate the face characteristics of this cefalometric work individuals had to the city of this cephalometric prevalence, as well as measure the objective of malocclusion. Methods: For this study, 531 sort of individuals of the masculine organizations of Rio de Janeiro had been submitted to the clinical chait of the course of Master in Orthodontics of the Center Research Leopold Mandic, of which if it got prevalence of malocclusion. Results: Of this sample, it was observed that 22 individuals with normal occlusion and that if they had never submitted the orthodontic treatment. In these patients they had been made taken from normal head in lateral cephalometric radiographs and evaluated the cephalometrics largeness: SNA, SNB, ANB, Axle "Y", NS.Go-Me, FMA, FMIA, IMPA, 1.NA, 1- NA, 1.NB, 1-NB, 1.1, 1.SN, 1.Go-Gn, SN.PLO, AO-BO, Line H, Z angle, P-NB, AFA, AFP and IAF. The gotten date had been submitted to the analysis with a level of significance of 5% (p< 0.05) and used descriptive statistics and the error of Dalbergh. The results showed that of the total of the evaluated sample, the malocclusion of 44.3% of Classroom I; 29.5% of Classroom II; 17.2% of Classroom III and 9.2% of normal occlusion. Conclusion: The individuals with normal occlusion of the city of Rio De Janeiro had presented equal cephalometric characteristics with many standard measures described in literature, except for the superior incisor that were presented vestibulate and the well inclined inferior incisor for vestibular contest.

RESUMO Objetivos: A realização deste trabalho teve como objetivo avaliar cefalometricamente as características faciais de indivíduos pertencentes ao município do Rio de Janeiro-RJ, bem como mensurar a prevalência de maloclusão. Métodos: Para este estudo, 531 indivíduos do gênero masculino pertencentes às organizações militares do Rio de Janeiro foram submetidos à ficha clínica do curso de Mestrado em Ortodontia da Faculdade São Leopoldo Mandic, dos quais se obteve a prevalência de maloclusão. Resultados: Dessa amostra, observou-se que 22 indivíduos possuíam oclusão normal e que nunca haviam se submetido a tratamento ortodôntico. Nesses pacientes foram feitas tomadas de telerradiografias de cabeça em norma lateral e avaliadas as grandezas cefalométricas: SNA, SNB, ANB, Eixo "Y", NS.Go-Me, FMA, FMIA, IMPA, 1.NA, 1-NA, 1.NB,1-NB, 1.1, 1.SN, 1.Go-Gn, SN.PLO, AO-BO, Linha H, ângulo Z, P-NB, AFA, AFP e IAF. Os dados obtidos foram submetidos à análise com nível de significância de 5% (p< 0,05) e utilizadas estatísticas descritivas e o erro de Dalbergh. Os resultados mostraram que do total da amostra avaliada, a maloclusão foi de 44,3% de Classe I; 29,5% de Classe II; 17,2% de Classe III e 9,2% de oclusão normal. Conclusão: Os indivíduos com oclusão normal do município do Rio de Janeiro apresentaram características cefalométricas condizentes com muitas medidas padrões descritas na literatura, exceto para o incisivo superior que apresentou-se vestibularizado e o incisivo inferior bem inclinado para vestibular.

Reproducibility of linear and angular cephalometric measurements obtained by an artificial-intelligence assisted software (WebCeph) in comparison with digital software (AutoCEPH) and manual tracing method

ABSTRACT Introduction: It has been suggested that human errors during manual tracing of linear/angular cephalometric parameters can be eliminated by using computer-aided analysis. The landmarks, however, are located manually and the computer system completes the analysis. With the advent of Artificial Intelligence in the field of Dentistry, automatic location of the landmarks has become a promising tool in digital Orthodontics. Methods: Fifty pretreatment lateral cephalograms obtained from the Orthodontic department of SRM dental college (India) were used. Analysis were done by the same investigator using the following methods: WebCeph™, AutoCEPH© for Windows or manual tracing. Landmark identification was carried out automatically by Artificial Intelligence in WebCeph™ and with a mouse driven cursor in AutoCEPH©, and manually using acetate sheet and 0.3-mm pencil, ruler and a protractor. The mean differences of the cephalometric parameters obtained between the three methods were calculated using ANOVA with statistical significance set at p<0.05. Intraclass correlation coefficient (ICC) was used to determine both reproducibility and agreement between linear and angular measurements obtained from the three methods and intrarater reliability of repeated measurements. ICC value of >0.75 indicated good agreement. Results: Intraclass correlation coefficient between the three groups was >0.830, showing good level of agreement, and the value within each group was >0.950, indicating high intrarater reliability. Conclusion: Artificial Intelligence assisted software showed good agreement with AutoCEPH© and manual tracing for all the cephalometric measurements.

RESUMO Introdução: Tem sido sugerido que os erros humanos durante o traçado manual das medidas cefalométricas lineares/angulares podem ser eliminados usando a análise guiada por computador. Os pontos de referência, no entanto, são localizados manualmente e o sistema computadorizado completa a análise. Com o advento da Inteligência Artificial na Odontologia, a localização automática dos pontos de referência tornou-se uma ferramenta promissora na Ortodontia digital. Métodos: Cinquenta cefalogramas laterais pré-tratamento obtidos do departamento de Ortodontia da Faculdade de Odontologia SRM (Índia) foram usados. Todas as análises foram feitas pelo mesmo investigador, usando os seguintes métodos: WebCeph™, AutoCEPH© para Windows ou traçado manual. A identificação dos pontos foi realizada automaticamente por Inteligência Artificial no WebCeph™; com o cursor do mouse, no AutoCEPH©; e manualmente, utilizando folha de acetato e lápis 0,3 mm, régua e transferidor. As diferenças médias dos parâmetros cefalométricos entre os três métodos foram calculadas por ANOVA com significância estatística fixada em p<0,05. O coeficiente de correlação intraclasse (ICC) foi usado para determinar a reprodutibilidade e a concordância entre as medidas lineares e angulares obtidas pelos três métodos e a confiabilidade intraexaminador para medidas repetidas. O valor de ICC > 0,75 indicou boa concordância. Resultados: O ICC entre os três grupos foi >0,830, mostrando bom nível de concordância, e o valor dentro de cada grupo foi >0,950, indicando alta confiabilidade intra-avaliador. Conclusão: O software assistido por Inteligência Artificial mostrou boa concordância com o AutoCEPH© e o traçado manual para todas as medidas cefalométricas.

Cephalometric Characteristics in Chilean Latino Population with Normal Occlusion and Harmonic Profiles in Permanent Dentition. A Retrospective Study / Características Cefalométricas en Población Latina Chilena con Oclusión Normal y Perfiles Armónicos en Dentición Permanente. Un Estudio Retrospectivo

SUMMARY: Malocclusion is usually treated based on clinical decisions complemented with a cephalometric analysis, allowing the comparison of an individual with standard reference norms. Cephalometric standards have mostly been obtained from Caucasian population, but may not be appropriate for other ethnic groups, becoming a clinically relevant problem in multicultural and multiracial societies. The present study aimed to establish cephalometric norms for Chilean-Latino population, using a representative sample of class I individuals in permanent dentition. A sample of 72 cephalometric x-rays of class I growing individuals (47 women and 25 men) between 10 and 20 years of age with class I occlusion and harmonic profile was obtained from the records of the Universidad de los Andes taken between 2012 and 2019, including 1164 individuals. The radiographs were classified according to their cervical vertebral maturation status, and cephalometrically analyzed, obtaining vertical and sagittal parameters in soft and hard tissues, which were compared with Caucasian cephalometric norms. The statistical analysis was performed using descriptive and inferential statistics (T-test, ANOVA and Bonferroni tests). Cephalometric norms were obtained for hard and soft tissues. Upon comparison with Caucasian norms, the subjects included in the sample present a tendency towards a convex profile, significant incisal proclination, dental protrusion, labial biprotrusion and an acute nasolabial angle. There are cephalometric differences between the Caucasian cephalometric norms and those observed Chilean Latino population, displaying differences at a hard and soft tissue level that should be taken into account for clinical decision making in Orthodontics.

La maloclusión generalmente se trata con base en decisiones clínicas complementadas con un análisis cefalométrico, lo que permite la comparación de un individuo con normas de referencia estándar. Los estándares cefalométricos se han obtenido en su mayoría de población caucásica, pero pueden no ser apropiados para otros grupos étnicos, convirtiéndose en un problema clínicamente relevante en sociedades multiculturales y multirraciales. El presente estudio tuvo como objetivo establecer normas cefalométricas para población chileno-latina, utilizando una muestra representativa de individuos clase I en dentición permanente. Se obtuvo una muestra de 72 radiografías cefalométricas de individuos en crecimiento clase I (47 mujeres y 25 hombres) entre 10 y 20 años de edad con oclusión clase I y perfil armónico de los registros de la Universidad de los Andes tomados entre 2012 y 2019, incluidas 1164 personas. Las radiografías se clasificaron según su estado de maduración vertebral cervical, y se analizaron cefalométricamente, obteniendo parámetros verticales y sagitales en tejidos blandos y duros, que se compararon con normas cefalométricas caucásicas. El análisis estadístico se realizó mediante estadística descriptiva e inferencial (T-test, ANOVA y pruebas de Bonferroni). Se obtuvieron normas cefalométricas para tejidos duros y blandos. En comparación con las normas caucásicas, los sujetos incluidos en la muestra presentan una tendencia hacia un perfil convexo, proinclinación incisal significativa, protrusión dental, biprotrusión labial y un ángulo nasolabial agudo. Existen diferencias entre las normas cefalométricas caucásicas y las observadas en población latina chilena, mostrando diferencias a nivel de tejidos duros y blandos que se deben considerar para la toma de decisiones clínicas en Ortodoncia.

Volumetric Evaluation of the Upper Airways in Relation to the Gonial Angle / Avaliação Volumétrica das Vias Aéreas Superiores com Relação ao Ângulo Goníaco

The upper airspace is essential to understand the physiology and pathogenesis of its obstruction, complementary exams based on images have been used to evaluate the upper airspace. The objective of this study was to evaluate, by means of computed tomography, the upper airways (UAS), in relation to anatomical variables, emphasizing the gonial angle and comparing it with volume in mm³, sex and age. A total of 124 computed tomography scans were analyzed using DICOM files (digital image communication in medicine) made available by a radiology clinic using the ITK-snap program (version 3.6.0), upper airway volumes, sex, age and gonial angle values on both the right and left sides were tabulated in a table in the Excel 2010 program of the Microsoft Office 2010 package, and subsequently analyzed in the SPSS software with statistical analysis using the Levene Test and also the ANOVA test, to obtain of the results. The values found for the gonial angle did not indicate a significant difference. However, the present work confirms that within each of these groups there is a homogeneity of variances, corroborating the results reported in the literature. However, regarding the volume of the upper airways, we found that in men and in individuals aged over 34 years, the volume is greater.(AU)

O espaço aéreo superior é essencial para compreender a fisiologia e a patogênese de sua obstrução, exames complementares baseados em imagens têm sido empregados para avaliar o espaço aéreo superior. O objetivo desse estudo foi avaliar por meio de tomografia computadorizada, as vias aéreas superiores (VAS), com relação a variáveis anatômicas, dando ênfase ao ângulo goníaco e comparando com volume em mm³, sexo e idade. Foram analisados 124 exames de tomográfica computadorizada, por meio dos arquivos DICOM (comunicação de imagens digitais em medicina) disponibilizados por uma clínica radiológica, através do programa ITK-snap (versão 3.6.0), os volumes das vias aéreas superiores, o sexo, a idade e os valores do ângulo goníaco tanto do lado direito como do lado esquerdo foram tabulados em tabela no programa Excel 2010 do pacote Microsoft Office 2010, e analisados posteriormente no software SPSS com análise estatística pelo Teste de Levene e também teste ANOVA, para obtenção dos resultados. Os valores encontrados para o ângulo goníaco não indicaram diferença significativa. Contudo, o presente trabalho confirma que dentro de cada um desses grupos há uma homogeneidade das variâncias e corroborando com os resultados relatados na literatura. No entanto com relação ao volume das vias aéreas superiores encontramos que em homens e em indivíduos com idade superior a 34 anos o volume é superior.(AU)

Craniofacial abnormalities and malocclusion findings in sickle cell disease related to ethnic-racial populations: a critical review of the literature

Introduction: sickle Cell Disease (SCD) is an inherited, hematological, chronic disease that mostly affects racial/ethnic groups. The dental literature discusses SCD's oral symptoms, such as malocclusion and craniofacial abnormalities, without considering the significance of a racial/ethnic perspective. Objective: this article critically reviewed the findings of the studies based on a racial/ethnic standpoint and SCD landmarks. Sources of data: primary and secondary searches selected 146 studies from four scientific literature databases. Two reviewers independently extracted data from eleven included studies. Synthesis of data: most studies used lateral cephalometry and reported craniofacial abnormalities and malocclusions, such as maxillary protrusion, class II skeletal patterns, vertical facial growth patterns, convex facial profile, mandibular retrusion, and the posterior rotation of the jaw. However, there is no mention of racial or ethnic cephalometric patterns to support these findings in the studied populations. In addition, a misunderstanding occurs when overlooking the different periods of growth or ages within and between the studied groups. Furthermore, there is no mention of previous orthodontic treatment. By contrast, there is a lack of information about the medically compromised health status of people with SCD, such as the life period of SCD's diagnosis; the number and timing of blood transfusions; the medical history of hospitalizations, vaso-occlusive crises, or hydroxyurea use. Conclusion: racial and ethnic concerns for the diagnosis of malocclusions and craniofacial anomalies, as well as SCD landmarks, are underappreciated in the examined dental literature. Discarding them also demonstrates institutional racism.

Introdução: a doença falciforme é uma doença hematológica, hereditária, crônica, que afeta principalmente, a população negra, em escala global. Na literatura odontológica, os achados craniofaciais e oclusais relacionados à doença falciforme são discordantes, mas, em comum, desconsideram a perspectiva racial. Objetivo: este artigo revisou criticamente a literatura odontológica e discutiu os achados encontrados na perspectiva racial/étnica. Fonte dos dados: estudos primários e secundários selecionaram 146 ocorrências de quatro bases de dados da literatura científica. Dois revisores extraíram independentemente os dados dos onze estudos incluídos. Síntese dos dados: com base na cefalometria lateral, a maioria dos estudos concluiu que as anormalidades craniofaciais e maloclusões, como protrusão maxilar, padrão esquelético de classe II, padrão de crescimento facial vertical, perfil facial convexo, retrusão mandibular e rotação posterior da mandíbula foram os mais comuns achados para pessoas com doença falciforme. No entanto, ao considerar a perspectiva étnico-racial, não há menção na maioria dos estudos de ajustes dos padrões cefalométricos específicos para as populações racializadas, nem tampouco são consideradas características do grupo populacional e da doença falciforme em si, como sua severidade, o momento de vida em que o diagnóstico ocorreu, número e período de hemotransfusões, internações, crises vaso-oclusivas ou uso de hidroxiureia. Além disso, a ampla faixa etária em diferentes períodos de crescimento ósseo e a ausência de informação sobre tratamento ortodôntico prévio foram observadas. Conclusão: há omissão sobre considerações étnico-raciais para relatar anormalidades craniofaciais e maloclusões sobre doença falciforme na literatura odontológica revisada. Isto pode ser uma expressão do racismo.

Does Postpartum Hypopituitarism Influence the Craniofacial Pattern? A Case-Control Study with Sheehan's Syndrome Patients

This study aimed to assess the craniofacial morphologic aspects of Sheehan's syndrome (SHS) patients.An observational study was performed with 19 women diagnosed with SHS and 19 controls matched by age and sex. Lateral cephalometric radiographs were obtained, and 30 linear and angular measurements were analyzed using the Radiocef Studio 2 software. The mean age of patients was 65.47 ± 10.19 years. The main findings were propositioned maxilla (52.63 %) and mandible (52.63 %) relative to the cranial base, mandibular prognathism in 73.68 %, deep growth pattern in 42.1 %, increased mandibular plane in 36.84 %, and reduction in anterior facial height. The SHS group showed statistically significant differences in SNB (p=0.026), N-Me (p=0.006), soft palate length (p=0.011), and Ena-Me (p<0.001) in comparison with controls. The standard deviation score analysis revealed altered values in relation to total maxillary and mandibular lengths. SHS showed altered craniofacial morphology, characterized by maxillo- mandibular prognathism, brachyfacial type, increased mandibular plane, and reduction in soft palate length. This study reports novel findings in SHS.

Este estudio tuvo como objetivo evaluar los aspectos morfológicos craneofaciales de los pacientes con síndrome de Sheehan (SHS). Se realizó un estudio observacional con 19 mujeres diagnosticadas con SHS y 19 controles asociados por edad y sexo. Se obtuvieron radiografías cefalométricas laterales y se analizaron 30 medidas lineales y angulares mediante el software Radiocef Studio 2. La edad media de los pacientes fue de 65,47 ± 10,19 años. Los principales hallazgos fueron proposición maxilar (52,63 %) y mandíbula (52,63 %) con respecto a la base del cráneo, prognatismo mandibular en 73,68 %, patrón de crecimiento profundo en 42,1 %, aumento del plano mandibular en 36,84 % y reducción de la altura facial anterior. El grupo SHS mostró diferencias estadísticamente significativas en SNB (p=0,026), N-Me (p=0,006), longitud del paladar blando (p=0,011) y Ena-Me (p<0,001) en comparación con los controles. El análisis de la puntuación de la desviación estándar reveló valores alterados en relación con las longitudes maxilares y mandibulares totales. El SHS mostró una morfología craneofacial alterada, caracterizada por prognatismo maxilomandibular, tipo braquifacial, aumento del plano mandibular y reducción de la longitud del velo del paladar. Este estudio informa hallazgos novedosos en SHS.

Cephalometric Evaluation of Maxillary Incisors Torque and Vertical Changes Utilizing Standard Edgewise Mechanics

In 1995 Gebeck & Merrifield studied a successful and unsuccessful treated Class I and Class II's samples; they found a -1.33 mm intrusion in the former and a 0.80 mm extrusion in the latter. The purpose of this article was to perform a cephalometric evaluation of maxillary incisors torque and vertical changes. We studied a sample of 129 patients, 30 males and 99 females, taken from The Charles H. Tweed Foundation Long Term Study, at pretreatment mean age 12.93 years, posttreatment mean age 16.19 years and follow up post retention mean age 29.83 years, a 13.88 years interval. The records were collected from private practitioners across the North American continent who used Standard Edgewise Mechanics and were members of the Charles H. Tweed Foundation. All patients were Class I and II American whites treated with the extraction of 4 premolars. We found an Upper anterior incisal edge to PP vertical linear measurement 28.7 and 29.2 mm, +0.53 mm (p<0.019) from pretreatment to posttreatment. The average Upper 1 to SN angle was 103.2 ° at pretreatment and 100.1° at posttreatment, -3.2° (p<0.000), Upper 1 to PP 111.0° and 108.9°, -2.2° (p<0.000), the three of them statistically significant. Conversely, Upper 1 to commissure was not. The four measurements were also statistically significant posttreatment to follow up, upper anteriors kept losing torque after posttreatment, and less upper anteriors surface was below the commissure. Some torque loss and vertical extrusion can be expected while treating patients with extractions of four premolars, therefore, upper incisor inclination increase and vertical change by itself cannot determine the success of treatment.

En 1995, Gebeck y Merrifield estudiaron muestras de Clase I y Clase II tratadas con éxito y sin éxito; encontraron una intrusión de -1,33 mm en el primero y una extrusión de 0,80 mm en el segundo. El propósito de este artículo fue realizar una evaluación cefalométrica del torque y los cambios verticales de los incisivos maxilares. Estudiamos una muestra de 129 pacientes, 30 hombres y 99 mujeres, tomados del estudio a largo plazo de la Fundación Charles H. Tweed, con una edad media previa al tratamiento de 12,93 años, una edad media posterior al tratamiento de 16,19 años y una edad media de seguimiento posterior a la retención de 29,83 años, con un intervalo de de 13,88 años. Los registros se recopilaron de médicos privados en todo el continente norteamericano que utilizaron Standard Edgewise Mechanics y eran miembros de la Fundación Charles H. Tweed. Todos los pacientes eran blancos americanos Clase I y II tratados con extracción de 4 premolares. Encontramos una medida lineal vertical del borde incisal anterior superior a PP de 28,7 y 29,2 mm, +0,53 mm (p<0,019) desde el pretratamiento hasta el postratamiento. El promedio del ángulo Superior 1 a SN fue de 103,2° en el pretratamiento y 100,1° en el postratamiento, -3,2° (p<0,000), Superior 1 a PP 111,0° y 108,9°, -2,2° (p<0,000), los tres estadísticamente significante. Por el contrario, Superior 1 a la comisura no lo era. Las cuatro mediciones también fueron estadísticamente significativas para el seguimiento después del tratamiento, los dientes anteriores superiores siguieron perdiendo torsión después del tratamiento y se observó menor superficie de los dientes anteriores superiores debajo de la comisura. Se puede esperar cierta pérdida de torque y extrusión vertical al tratar a pacientes con extracciones de cuatro premolares, por lo tanto, el aumento de la inclinación del incisivo superior y el cambio vertical por sí mismos no pueden determinar el éxito del tratamiento.

Germenectomía de los terceros molares con cefalometría predictiva de brote / Germenectomy of third molars with predictive cephalometry of abnormal eruption

Introducción: Las complicaciones, asociadas al brote anormal de los terceros molares, es posible evitarlas con la germenectomía de estos dientes. Objetivo: Caracterizar la evolución de la germenectomía de terceros molares en pacientes con diagnóstico cefalométrico de brote anormal. Métodos: Se realizó un estudio observacional, descriptivo y transversal en el Servicio de Cirugía Maxilofacial del Hospital Provincial "Saturnino Lora Torres", desde febrero de 2019 hasta marzo de 2021. Se estudiaron 32 pacientes de 13 a 15 años de edad, interviniéndose quirúrgicamente 78 terceros molares. Las variables fueron edad, sexo, color de la piel, localización y posición del tercer molar; así como las complicaciones trans y posoperatorias y la evolución. Resultados: Entre los 32 pacientes incluidos en el estudio predominó el sexo femenino (62,5 por ciento) y la edad de 14 años (40,6 por ciento). Las complicaciones ocurridas durante la germenectomía fueron más frecuentes en la arcada inferior. Aunque no fueron detectadas diferencias estadísticamente significativas según localización (valor de p>0,05); con 30 transoperatorias para un 38,4 por ciento y 75 posoperatorias para un 96,2 por ciento. Conclusiones: Se evidencia una evolución marcadamente favorable posterior a la germenectomía de terceros molares en la población de pacientes con diagnóstico cefalométrico de brote anormal. En ellos el sangrado transoperatorio y el dolor posoperatorio constituyen las complicaciones a considerar en este tipo de procedimiento quirúrgico(AU)

Introduction: Complications associated with the abnormal eruption of third molars can be avoided with germenectomy of these teeth. Objective: To characterize the evolution of third molar germenectomy in patients with a cephalometric diagnosis of abnormal bud. Methods: An observational, descriptive and cross-sectional study was carried out in the Maxillofacial Surgery Service at Saturnino Lora Torres Provincial Hospital, from February 2019 to March 2021. Thirty two patients aged 13 to 15 years were studied, with 78 third molars undergoing surgery. The variables were age, sex, skin color, location and position of the third molar; as well as trans and postoperative complications and evolution. Results: Among the 32 patients included in the study, the female sex (62.5 percent) and the age of 14 years (40.6 percent) predominated. Complications that occurred during germenectomy were more frequent in the lower arch. Although no statistically significant differences were perceived according to location (p value > 0.05); with 30 intraoperative for 38.4 percent and 75 postoperative for 96.2 percent. Conclusions: There is evidence of a markedly favorable evolution after germenectomy of third molars in the population of patients with cephalometric diagnosis of abnormal bud. In them, transoperative bleeding and postoperative pain are the complications to consider in this type of surgical procedure(AU)

Caracterización epidemiológica, clínica y cefalométrica del brote anormal de los terceros molares / Epidemiological, clinical and cephalometric characterization of the abnormal eruption of third molars

Introducción: El brote de los terceros molares es un proceso que no está del todo explicado, pero durante su erupción puede provocar diferentes accidentes o complicaciones. Objetivo: Caracterizar el brote anormal de los terceros molares según variables epidemiológicas, clínicas y cefalométricas. Método: Se realizó un estudio observacional, descriptivo y transversal en la Clínica Estomatológica Provincial Docente «Mártires del Moncada», de Santiago de Cuba, desde noviembre de 2019 a febrero de 2020. La población estuvo conformada por jóvenes de 18 a 25 años de edad; la muestra fue seleccionada por muestreo aleatorio simple. Se tuvieron en cuenta las siguientes variables: sexo, color de la piel, brote anormal y otras variables cefalométricas. Resultados: De los 84 dientes incluidos en el estudio, se detectaron 66 terceros molares con brote anormal (78,6 %). El promedio asociado al brote de estos molares de espacio óseo superior insuficiente fue igual para los superiores con medias de 25,9 mm; el de angulación inadecuada resultó obtuso en el superior izquierdo con 128,3º y agudo en los inferiores derechos con 58,8º; asimismo el mayor diámetro mesiodistal inadecuado fue el de los inferiores derechos con 15,7 mm. Conclusiones: El brote anormal de los terceros molares se caracteriza por afectar, de forma importante, a féminas y a individuos mestizos. Su observación se singulariza, fundamentalmente, en molares inferiores con espacios óseos posteriores reducidos, mesioangulaciones y diámetros mesiodistales considerables.

Introduction: eruption of the third molars is a process that is not fully explained in the literature; however it is known that their eruption can cause different complications. Objective: to characterize the abnormal eruption of third molars according to epidemiological, clinical and cephalometric variables. Methods: an observational, descriptive and cross-sectional study was carried out at "Mártires del Moncada" Provincial Teaching Dental Clinic, in Santiago de Cuba, from November 2019 to February 2020. The population consisted of young people aged 18-25 years; the sample was selected by simple random sampling. Gender, skin color, abnormal eruption and other cephalometric variables were taken into account. Results: sixty-six third molars with abnormal eruption were detected from the 84 teeth included in the study (78.6%). The average associated with the eruption of these molars with insufficient upper bone space was the same for the upper ones with means of 25.9 mm; the average with inadequate angulation was obtuse in the upper left third molar with 128.3º and the acute one in the lower right third molars with 58.8º; the lower right third molars likewise had the largest inadequate mesiodistal diameter with 15.7 mm. Conclusions: the abnormal eruption of third molars is characterized by significantly affecting females and mixed-race individuals. Its observation is singled out, fundamentally, in lower molars with reduced posterior bone spaces, mesioangulations and considerable mesiodistal diameters.

Relationship between the occlusal plane and three different levels of ala-tragus line in a sample of sudanese adults / Relación entre el plano oclusal y tres niveles diferentes de la línea ala-trago en una muestra de adultos sudaneses

Aim: Correct orientation of the occlusal plane plays a vital role in achieving the perfect occlusal balance and function of complete dentures. This study aimed to evaluate the most reliable posterior reference point of the ala-tragus line (ATL) concerning occlusal plane (OP) in a sample of the dentate Sudanese population. Materials and Methods: A total of 150 subjects with healthy and well-aligned permanent teeth were randomly selected. Right lateral profile photographs were taken with subjects having a fox plane placed intra-orally, contacting the occlusal plane. Reference points corresponding to inferior, middle, and superior borders of the tragus and inferior border of the ala of the nose were marked on photographs. The angles between the lines were measured using the Auto-CAD software program, and the most parallel relationship was determined. Descriptive statistics in terms of means and standard deviations were presented. Independent t-test and one-way ANOVA tests were used to compare as appropriate. A p-value < 0.05 was considered significant. Results: The mean angle formed by the OP and ATL was 8.5±3.69º for the superior level, 4.68±3.13º for the middle line, and 2.89±2.57º for the inferior line. A significant difference was found between the means of the three angles (p< 0.001), while no significant difference (p> 0.05) was found between both genders regarding the measured angles. Conclusions: The line joining the inferior border of the ala of the nose with the inferior border of the tragus of the ear was the most reliable line in terms of parallelism to determine the occlusal plane orientation.

Antecedentes: La orientación correcta del plano oclusal juega un papel vital para lograr el equilibrio oclusal perfecto y la función de las prótesis completas. Este estudio tuvo como objetivo evaluar el punto de referencia posterior más confiable de la línea ala-trago (ATL) con respecto al plano oclusal (OP) en una muestra de la población dentada de Sudán. Materiales y Métodos: Se seleccionaron aleatoriamente un total de 150 sujetos con dientes permanentes sanos y bien alineados. Se tomaron fotografías de perfil lateral derecho de sujetos a los que se les colocó un plano de zorro intraoralmente, en contacto con el plano oclusal. En las fotografías se marcaron los puntos de referencia correspondientes a los bordes inferior, medio y superior del trago y al borde inferior del ala de la nariz. Los ángulos entre las líneas se midieron utilizando el programa de software Auto-CAD y se determinó la relación más paralela. Se presentaron estadísticas descriptivas en términos de medias y desviaciones estándar. Se utilizaron prueba-t independiente y prueba ANOVA unidireccional para las comparaciones, según correspondiera. Se consideró significativo un valor de p<0,05. Resultados: El ángulo medio formado por OP y ATL fue de 8,5±3,69º para el nivel superior, 4,68±3,13º para la línea media y 2,89±2,57º para la línea inferior. Se encontró una diferencia significativa entre las medias de los tres ángulos (p< 0,001), mientras que no se encontró diferencia significativa (p>0,05) entre ambos sexos con respecto a los ángulos medidos. Conclusión: La línea que une el borde inferior del ala de la nariz con el borde inferior del trago de la oreja fue la línea más confiable en términos de paralelismo para determinar la orientación del plano oclusal.

Concordance of the vestibular bone thickness at the level of point a between teleradiography and cone beam computed tomography / Concordancia del espesor óseo vestibular a nivel del punto a entre telerradiografía y tomografía computarizada de haz cónico

Objective: The aim of this study was to determine the concordance of the vestibular bone thickness measured at the level of point A between Teleradiography and Cone Beam Computed Tomography (CBCT). Materials and Methods: This study consisted of a cross-sectional analytical design of concordance that evaluated the teleradiographies and CBCTs of 32 patients. The measurements were performed by three evaluators, specialists in orthodontics. Two of them measured the CBCTs and one evaluated the teleradiographs. The concordance of both tests was determined using the Concordance Correlation Coefficient. Results: When evaluating the value of the vestibular bone thickness at the level of point A between the CBCT and the teleradiography, it was observed that the mean value of the absolute difference between the two was 0.95±0.74, 95%CI [0.68­1.22], being statistically significant (p=0.0027). When the concordance between both tests was analyzed, it was observed that it was poor (CCC=0.204 95%CI [0.014­0.394]), although statistically significant (p<0.00001). Conclusions: It was possible to conclude that there is no concordance in the measurement of the vestibular bone thickness at the level of Point A between the Teleradiography and the CBCT.

Objetivo: El objetivo de este estudio fue determinar la concordancia del espesor óseo vestibular medido a nivel del punto A entre la Telerradiografía y la Tomografía computarizada de haz cónico (CBCT). Materiales y Métodos: Esta investigación presentó un diseño analítico transversal de concordancia en el que se evaluaron las telerradiografías y CBCT de 32 pacientes. Las mediciones fueron realizadas por tres evaluadores especialistas en ortodoncia, dos de ellos midieron los CBCT y uno las telerradiografías. La concordancia de ambos exámenes fue medida mediante Coeficiente de Correlación de Concordancia. Resultados: Al evaluar el valor del grosor óseo vestibular a nivel del punto A entre el CBCT y la telerradiografía, se observó que el valor promedio de diferencia absoluta entre ambos fue de 0,95±0,74 IC95% [0,68­1,22], siendo estadísticamente significativas (p=0,0027). Cuando se analizó la concordancia entre ambos exámenes se observó que esta fue pobre (CCC=0,204 IC95 % [0,014­0,394]), aunque estadísticamente significativa (p<0,00001). Conclusión: Se pudo concluir que no existe concordancia en la medición del espesor óseo vestibular medido a nivel del Punto A entre la Telerradiografía y el CBCT.

Evaluation of the cephalometric centroid point in individuals before and after the pubertal growth peak / Avaliação do comportamento do ponto cefalométrico centróide em pacientes antes e após o pico de crescimento da puberdade

ABSTRACT Objective: The purpose of this study was to evaluate the behavior of the Centroid point, known as the geometric center of the face, before and after the growth peak using lateral cephalometric x-ray. Methods: Sample consisted of 40 patients before and after pubertal peak of growth selected from the archive of the São Leopoldo Mandic Institute and Research Center, Campinas, Brazil. Anatomical structures, reference points, lines and planes were traced, and posteriorly a superimposition was performed using the palatal plane and a line perpendicular to this passage through the most posterior point of the pterygomaxillary fossa as reference. Later, the distance between the two centroid points (before and after the peak of puberty) was measured using the digital caliper, both horizontally and vertically. The palatal plane (x-axis) and a line perpendicular to this passage through the most posterior point of the pterygomaxilary fossa (y-axis) were chosen because they undergo minimal changes during growth. Results: No significant difference on the location of Centroid points on both X and Y axis (p >0.05) were observed between before and after the growth peak cephalometric tracings, showing an average change in positioning of 0.36mm on the X axis and 0.37mm on the Y axis. Conclusions: For this reason, this point can be indicated to be used clinically as a stable reference to evaluate craniofacial growth while performing superimposition methods.

RESUMO Objetivo: O objetivo deste estudo foi utilizar telerradiografias lateriais de pacientes antes e depois do pico de crescimento, e realizar sobreposições de desenhos cefalométricos para avaliar o comportamento do ponto Centróide, o centro geométrico da face. Métodos: Foram selecionadas telerradiografias de norma lateral de 40 pacientes tomadas antes e depois de seu pico de puberdade do acervo de Ortodontia do Centro de Pesquisas Odontológicas São Leopoldo Mandic, na cidade de Campinas. As estruturas e traçados cefalométricos devidamente desenhados, foram sobrepostos tendo como referência estável o plano palatal e a linha perpendicular a esta que passe pelo ponto mais posterior da fossa pterigomaxilar. Em seguida foi medida a distância entre os dois pontos centroides (antes e após o pico de puberdade) por meio de paquímetro digital tanto no sentido horizontal quanto no vertical. O plano palatal (eixo x) e a linha perpendicular a esta que passe pelo ponto mais posterior da fossa pterigomaxilar (eixo y) foram escolhidos por sofrerem mínimas alterações nas suas direções durante o crescimento. Resultados: Não foi observada diferença estatisticamente significante na localização dos pontos Centróides em ambos os eixos X e Y (p>0,05) quando comparou-se os traçados antes e depois do pico de crescimento, mostrando uma alteração, em média, no posicionamento de 0,36mm no Eixo X e 0,37mm no Eixo Y. Conclusão: Assim, este ponto pode ser utilizado como referência estável para avaliação do crescimento craniofacial nas sobreposições.

Estudio dimensional de los puntos craneométricos mediosagitales en cráneos de población chilena / Dimensional study of midsagital craneometric points in skulls of Chilean population

RESUMEN: La utilidad de los puntos craneométricos en neurocirugía radica en la estudiada relación que poseen con las estructuras encefálicas y vasculares que subyacen, siendo relevantes al momento de planificar y realizar diversos abordajes y disminuir la morbilidad asociada. A pesar de esto, hasta el momento no se disponen de datos publicados de las distancias de estos puntos craneométricos en población chilena. Se utilizaron 45 cráneos secos de cadáveres adultos. Se realizaron mediciones de las distancias superficiales entre diversos puntos craneométricos mediosagitales. La distancia superficial promedio entre nasion y bregma fue de 12,71 cm; entre bregma y lambda, 12,34 cm; entre lambda e inion, 6,64 cm; entre inion y opistocranio, 5,16 cm; entre lambda y opistocráneo, 3,88 cm y entre inion y opistion, 5,16 cm. Se encontraron diferencias estadísticamente significativas (p<0,05) entre el grupo estudiado con datos obtenidos de la literatura en las distancias nasion-bregma, bregma-lambda, lambda-opistocranio. Las distancias entre los distintos puntos craneométricos en cráneos de población chilena fueron caracterizadas en el presente estudio existiendo algunas diferencias con los datos de la literatura que deben ser considerados en el contexto de la práctica quirúrgica relacionada.

Longitud del maxilar superior en relación con el biotipo facial en individuos de Cuenca, Ecuador

RESUMEN Introducción: El crecimiento y desarrollo craneofacial pueden ser evaluados mediante las radiografías cefálicas laterales, con el fin de brindar un buen diagnóstico y un plan de tratamiento efectivo. Objetivo: Identificar la relación entre la longitud del maxilar superior y el biotipo facial en individuos de 18 a 45 años de la ciudad de Cuenca, Ecuador, durante el año 2019. Método: Se realizó un estudio cuantitativo, descriptivo y relacional, la muestra fue de 160 radiografías cefálicas laterales obtenidas en un centro radiológico dental maxilofacial de la ciudad de Cuenca. Se utilizó el software AutoCAD para el trazado cefalométrico. Para el análisis estadístico se usó la prueba de Kruskal-Wallis y la prueba post hoc de Tukey con un nivel de confiabilidad del 95 % (p<0,05). Se utilizó el coeficiente de correlación Rho de Spearman para determinar la relación entre la longitud maxilar (mm) y la medición esqueletal. Resultados: Se encontró que la longitud del maxilar superior de acuerdo al biotipo facial es menor en el alto y aumenta en el bajo; el biotipo facial alto presentó la menor longitud maxilar (52,18 ±4,20 mm) y el promedio más alto fue el medio-bajo (54,37 ±4,15 mm). En el sexo masculino el promedio más alto se observó en el biotipo bajo (55,38 ±4,55 mm) y el menor valor fue en el biotipo medio alto (53,10 ±3,23 mm), en el sexo femenino el promedio más alto se encontró en el biotipo facial medio bajo (53,84 ±4,01 mm) y el promedio más bajo fue en el biotipo alto (51,64 ±3,68 mm). Conclusiones: En la medida que el biotipo facial aumenta la longitud del maxilar disminuye. No existe una relación significativa entre la longitud maxilar y edad y entre la longitud y sexo.

ABSTRACT Introduction: Craniofacial growth and development can be evaluated through lateral head radiographs, in order to provide a good diagnosis and an effective treatment plan. Objective: To identify the relationship between the length of the upper jaw and the facial biotype in individuals aged 18 to 45 years in the city of Cuenca, Ecuador, during the year 2019. Method: A quantitative, descriptive and relational study was carried out; the sample was of 160 lateral head radiographs obtained in a maxillofacial dental radiology center in the city of Cuenca. AutoCAD software was used for the cephalometric tracing. For statistical analysis, the Kruskal-Wallis test and Tukey's post hoc test were used with a reliability level of 95% (p<0.05). Spearman's Rho correlation coefficient was used to determine the relationship between maxillary length (mm) and skeletal measurement. Results: It was found that the length of the upper jaw according to facial biotype is shorter in the upper jaw and increases in the lower; the tall facial biotype presented the shortest maxillary length (52.18±4.20 mm) and the highest average was the medium-low (54.37±4.15 mm). In males, the highest average was observed in the low biotype (55.38±4.55 mm) and the lowest value was in the medium high biotype (53.10±3.23 mm); in females, the highest average was found in the medium-low facial biotype (53.84±4.01 mm) and the lowest average was in the high biotype (51.64±3.68 mm). Conclusions: As the facial biotype increases, the length of the maxillary decreases. There is no significant relationship between maxillary length and age, or between length and sex.

RESUMO Introdução: O crescimento e desenvolvimento craniofacial podem ser avaliados por meio de radiografias laterais da cabeça, a fim de fornecer um bom diagnóstico e um plano de tratamento eficaz. Objetivo: Identificar a relação entre o comprimento do maxilar superior e o biótipo facial em indivíduos de 18 a 45 anos na cidade de Cuenca, Equador, durante o ano de 2019. Método: Foi realizado um estudo quantitativo, descritivo e relacional, a amostra foi de 160 radiografias cefálicas laterais obtidas em um centro de radiologia. O software AutoCAD foi utilizado para o traçado cefalométrico. Para análise estatística, foram utilizados o teste de Kruskal-Wallis e o teste post hoc de Tukey com nível de confiabilidade de 95% (p<0,05). O coeficiente de correlação de Rho Spearman foi utilizado para determinar a relação entre o comprimento maxilar (mm) e a medida esquelética. Resultados: Verificou-se que o comprimento do maxilar superior de acordo com o biótipo facial é menor nos altos e aumenta nos baixos ; o biótipo facial alto apresentou o menor comprimento maxilar (52,18 ± 4,20 mm) e a maior média foi o médio-baixo (54,37 ± 4,15 mm). No sexo masculino, a maior média foi observada no biótipo baixo (55,38 ± 4,55 mm) e o menor valor foi no biótipo médio alto (53,10 ± 3,23 mm), no sexo feminino a maior média foi encontrada no biótipo médio. - biótipo facial baixo (53,84 ± 4,01 mm) e a menor média foi no biótipo alto (51,64 ± 3,68 mm). Conclusões: À medida que o biótipo facial aumenta, o comprimento da maxila diminui. Não há relação significativa entre comprimento maxilar e idade e entre comprimento e sexo.