Tratamiento integral de la clase III esquelética severa, mordida abierta y asimetría facial / Comprehensive treatment of severe skeletal class III, open bite and facial asymmetry

Introducción: La cirugía ortognática está especialmente indicada en casos complejos, donde los procedimientos conservadores fracasan o son insuficientes. El diagnóstico, planificación y tratamiento deben estar a cargo de un equipo multidisciplinario que trabaje en estrecha relación. Objetivo: Reportar el trabajo multidisciplinario en el tratamiento ortodóncico quirúrgico de una desarmonía dentomaxilofacial compleja. Presentación de caso: Paciente masculino, 19 años de edad, mestizo, clase III esquelética grave, hiperdivergente con mordida abierta y asimetría del tercio inferior, que recibió tratamiento prequirúrgico descompensador de ortodoncia. Se realizó cirugía ortognática bimaxilar con genioplastia de ascenso. Conclusiones: El tratamiento de las desarmonías dentomaxilofaciales es complejo y necesita la concurrencia de varias especialidades. Para la resolución del presente caso fue necesario el trabajo coordinado y simultáneo de especialistas de ortodoncia, prótesis dental, cirugía maxilofacial, periodoncia, psicología y otorrinolaringología. Se alcanzaron resultados estéticos y funcionales acorde a los objetivos del tratamiento propuestos y hubo estabilidad un año después de la cirugía(AU)

Introduction: Orthognathic surgery is especially indicated in complex cases, where conservative procedures fail or are insufficient. Diagnosis, planning and treatment should be carried out by a multidisciplinary team that works closely together. Objective: Report the multidisciplinary work in the surgical orthodontic treatment of a complex dentomaxillofacial disharmony. Case presentation: Male patient, 19 years old, mestizo, severe skeletal class III, hyperdivergent with open bite and asymmetry of the lower third, who received presurgical treatment decompensating orthodontics. Bimaxillary orthognathic surgery was performed with ascent genioplasty. Conclusions: The treatment of dentomaxillofacial disharmonies is complex and requires the concurrence of several specialties. For the resolution of this case, the coordinated and simultaneous work of specialists in orthodontics, dental prostheses, maxillofacial surgery, periodontics, psychology and otolaryngology was necessary. Aesthetic and functional results were achieved according to the proposed treatment objectives and there was stability one year after surgery(AU)

Thresholds of Identification and Aesthetic Perception of Simulated Alar Base Widening Among Oral and Maxillofacial Surgeons: an Online Questionnaire-Based International Study / Limiares de Identificação e Percepção Estética do Alargamento Simulado da Base Alar Entre Cirurgiões Buco-Maxilo-Faciais: um Levantamento Internacional

This study aimed to compare the thresholds of identification and aesthetic perception of simulated alar base widening among oral and maxillofacial (OMF) surgeons from Brazil and other countries through an online data collection form. Photographs of one male and one female model were digitally manipulated to obtain aesthetically acceptable, symmetrical faces and to gradually widen the alar base to produce six different images from each original photograph. The online questionnaire was sent to OMF surgeons of different nationalities. The results mshowed that the majority of Brazilian (88%) and international (89%) evaluators considered the female faces with 0 to 2 mm of alar base widening as being more pleasant. In turn, Brazilian (93%) and international (94%) respondents agreed that faces with the greatest widening (8 and 10 mm) were less pleasant. As for the male model, Brazilian (93%) and international (85%) OMF surgeons agreed that faces with none or small widening (0 and 2 mm) were more pleasant. The male face with the greatest widening (10 mm) was considered the least attractive by the respondents (93% in both groups). The findings of this study suggest that alar base widening up to the limit of 2 mm did not alter the perception of facial attractiveness. Thus, faces without alar base widening were considered the most attractive, while those with significant alterations were considered less attractive. Most importantly, despite the limitations of this study design, it seems that different cultural and professional contexts have minor influence on aesthetics analysis performed by OMF surgeons. (AU)

Este estudo teve como objetivo comparar os limiares de identificação e percepção estética do alargamento simulado da base alar entre cirurgiões bucomaxilofaciais (BMF) do Brasil e de outros países por meio de um formulário de coleta de dados online. Fotografias de um modelo masculino e de uma modelo feminina foram manipuladas digitalmente para obter faces esteticamente aceitáveis e simétricas e para ampliar gradualmente a base alar produzindo seis imagens diferentes de cada fotografia original. O questionário online foi enviado aos cirurgiões BMF de diferentes nacionalidades. Os resultados mostraram que a maioria dos avaliadores brasileiros (88%) e internacionais (89%) consideraram as faces femininas com 0 a 2 mm de alargamento da base alar como mais agradáveis. Por sua vez, os entrevistados brasileiros (93%) e internacionais (94%) concordaram que os rostos com maior alargamento (8 e 10 mm) foram os menos agradáveis. Quanto ao modelo masculino, os cirurgiões brasileiros (93%) e internacionais (85%) da OMF concordaram que faces com nenhum ou pequeno alargamento (0 e 2 mm) eram mais agradáveis. A face masculina com maior alargamento (10 mm) foi considerada a menos atraente pelos entrevistados (93% em ambos os grupos). Nossos achados sugerem que o alargamento da base alar até o limite de 2 mm não alterou a percepção da atratividade facial. Assim, rostos sem alargamento da base alar foram considerados os mais atraentes, enquanto aqueles com alterações significativas foram considerados menos atraentes. Mais importante ainda, apesar das limitações, parece que diferentes contextos culturais e profissionais têm pouca influência na análise estética realizada pelos cirurgiões da OMF. (AU)

Orthognathic surgery with anterior segmental osteotomy as alternative of treatment in patients with dento-skeletal deformity class III AP maxillary deficiency with dental compensation: case report / Cirugía ortognática con osteotomía segmentaria anterior como alternativa de tratamiento en pacientes con deformidades dento esqueletales (DDE) clases III por deficiencia AP maxilar compensados dentalmente: caso clínico

Introduction: Orthognathic surgery is a routine procedure carried out by maxillofacial surgeons in patients with dento-skeletal deformations (DSD) with the objective of achieving functional and esthetical satisfactory results. However, some in cases, due to the decision of the patient or the orthodontic team, the occlusion is tried to be compensated with the intention of avoiding surgery, without optimal results. As a consequence, some extra procedures are required in the surgery to correct and obtain better results. Objective: The aim of this case is to propose the anterior segmental osteotomy (ASO) as alternative of treatment in patients with dento-skeletal deformity class III with maxillary and para-nasal deficiency which have been orthodontically compensated. Material and methods: A 18 years old female with DED Class III due anterior-posterior (AP) maxillary and paranasal deficiency and AP mandibular excess. The surgery was carried out through Le Fort I osteotomy in combination with a segmentary osteotomy at the expense of first premolars and bilateral setback sagittal split osteotomy (BSSO). Clinical and imageology post operatory controls were made during the first 6 months and at two years. Results: Through the realization of the anterior segmental osteotomy the correction of occlusal and transversal alterations of the patient maxilla were performed and additionally favorable facial changes were obtained. Conclusion: The initial orthodontic management of patients with DSD will influence the surgical procedures and the achievement of a balance between esthetics and function. This illustrates why the treatment of these patients must be multidisciplinary; the treatment that was chosen in this case was innovative and could be an alternative for the treatments of patients with DED Class III.

Introducción: La cirugía ortognática es un procedimiento de rutina que realizan los cirujanos bucomaxilofaciales en pacientes con deformidades dento esqueletales (DDE) con la finalidad de lograr un resultado funcional y estético satisfactorio. Sin embargo, hay casos en los cuales, ya sea por decisión del paciente o por el ortodoncista, se intenta compensar la oclusión con el fin de evitar la fase quirúrgica no obteniendo los resultados más óptimos; y como consecuencia, se requiere de procedimientos adicionales a los convencionales en la cirugía para corregir y lograr el mejor resultado. Objetivo: El propósito de este caso es proponer la osteotomía segmentaria anterior (OSA) como alternativa de tratamiento en pacientes con Deformidad Dento Esqueletal clase III con deficiencia maxilar y paranasal los cuales han sido compensados ortodonticamente. Material y Métodos: Paciente femenina de 18 años de edad con Deformidad Dento Esqueletal Clase III por deficiencia AP maxilar y paranasal y exceso AP mandibular. Se realiza cirugía mediante osteotomía Le Fort I en combinación con osteotomía segmentaria a expensas de primeros premolares, osteotomía sagital de rama bilateral de retroposición. Se realizan controles post-operatorios clínico e imagenológicos durante los primeros 6 meses. Resultados: Por medio de la realización de la osteotomía segmentaria anterior se pudo realizar la corrección de las alteraciones oclusales y transversales del maxilar de la paciente, además de producir cambios faciales favorables. Conclusión: El manejo inicial de los pacientes con deformidades dento-esqueletales por parte del ortodoncista va influir en los procedimientos quirúrgicos y en lograr un balance entre lo estético y lo funcional, por lo que el tratamiento en estos pacientes es multidisciplinario; el tratamiento realizado en este caso en una solución innovadora y puede llegar a tomarse como alternativa en los tratamientos de las clases III.

Stability of joint orthognathic and orthodontic treatment for dental-facial deformity in patients with cleft lip and palate / 中华医学美学美容杂志

Objective To evaluate the skeletal stability of joint orthognathic and orthodontic treatment for cleft patients compared with non-cleft patients.Methods Fifteen cleft patient diagnosed with dental facial deformities underwent joint orthognathic and orthodontic treatment.Cephalometric analysis was carried out at T0 (before treatment),T1 (2 weeks after surgery),T2 (6 months after surgery) and T3 (24 months after surgery).The comparison of maxillary anterior-posterior and superiorinferior movement was performed with non-cleft orthognathic group (n =15) at the same follow-up time point.Results The maxilla was move forward for (3.8 ± 1.5) mm and downward for (2.4± 0.8) mm of cleft group.The relapse distance was (1.2±-0.7) mm (T1-T2:31.6％) in AP direction and (0.9±0.6) mm (T1-T2:37.5％) in vertical direction.At the time of 24 months after operation,the relapse distance was (1.0±0.5) mm (T1-T3:26.0％) in AP direction and (0.8±0.8) mm (T1-T3:33.3％) vertically.In non-cleft group,the maxilla was move (4.3±1.2) mm anteriorly and (2.2± 1.9) mm vertically.The relapse distance was (0.9±1.2) mm (T1-T2:20.9％) anteriorly and (0.8± 0.9) mm (T1-T2:36.6％) vertically at 6 months post-operatively.At 24 months after surgery the relapse distance was (1.1±0.6) mm (T1-T3:25.6％) anteriorly and (0.9±0.5) mm (T1-T3:40.9％) vertically.There were no statistical significant in both 6 months and 24 months follow-up between cleft and non-cleft group (P＞0.05).Conclusions There is no statistic difference of post-surgical relapse rate between cleft and non-cleft orthognathic and orthodontic treatments,although the relapse distances are greater than that in cleft group.

Successful application of high-flow nasal cannula in a patient with postoperative respiratory disturbance after bilateral sagittal split ramus osteotomy surgery: A case report

Bilateral sagittal split ramus osteotomy (BSSRO) is generally indicated for mandibular setback, to improve occlusion, masticatory function, and aesthetics by altering the mandibular position. However, BSSRO narrows the pharyngeal airway and increases airway resistance, resulting in postoperative respiratory disturbances during emergence from anesthesia. Oxygen delivery system via high-flow nasal cannula (HFNC) has been known to improve airway patency and oxygenation via low-level positive pressure as well as reduce the respiratory load. We report a case of postoperative respiratory disturbance, following a large mandibular setback, despite nasotracheal extubation in the fully awake patient. Respiratory disturbance was successfully controlled after oxygen delivery via HFNC until self-respiration was completely restored. Therefore, the use of HFNC may facilitate the control of postoperative respiratory disturbances induced by anatomical changes in upper airway after BSSRO surgery.

Correção da má oclusão Esquelética de Classe III de Angle com corticotomia e tração reversa de maxila com máscara facial ancorada em miniplacas: relato de caso / Treatment of skeletal Class III malocclusion with corticotomy and reverse traction of maxilla with facial mask anchored to miniplates: a case report

A má oclusão de Classe III, de acordo com o sistema de classificação preconizado por Angle, muito embora seja uma das menos prevalentes, é considerada a de maior complexidade quanto ao tratamento. A abordagem terapêutica pode ser instituída durante o crescimento facial, por meio de aparelhos ortopédicos, preferencialmente entre o final da dentição decídua e o início da dentição mista. Entretanto, antes e após esta fase, os movimentos ortopédicos dos ossos são acompanhados pelos movimentos dentários, considerando o apoio dentário superior. A ancoragem esquelética, por meio de miniplacas, tem sido sugerida como dispositivos que potencializam a força ortopédica nos casos com retração de maxila. A corticotomia tem sido utilizada como meio de favorecer o movimento dentário, com pouca indicação para o movimento esquelético, sobretudo, na protração da maxila com máscara facial. O objetivo desse trabalho é apresentar um caso clínico de uma menina tratada na dentição permanente com má oclusão de Classe III, com mordida cruzada anterior e retração de maxila por meio de máscara facial conectada a miniplacas instaladas na região lateral à cavidade nasal. A corticotomia bilateral horizontal foi realizada previamente à tração. Após seis meses de tratamento, houve a correção da má oclusão com avanço de maxila e melhora do perfil facial. A abordagem ortopédica de tração reversa associada à ancoragem esquelética e corticotomia mostrou-se efetiva e rápida.

Angle’s Class III malocclusion, although it is considered the malocclusion with the lowest prevalence, it is the most complex regarding treatment. Therapeutic approach may be instituted during facial growth through orthopedic appliances, preferably between the end of primary teeth and early mixed dentition. However, before and after this phase, the orthopedic bone movements are accompanied by tooth movements, considering the upper dental support. Skeletal anchorage using miniplates, has been suggested as a device that may enhance orthopedic force in cases with jaw retraction. Corticotomy has been used as a method to perform tooth movement, with little indication for skeletal movement, especially in maxillary protraction with facial mask. The aim of this paper is to present a clinical case of a girl treated in the permanent dentition with Class III malocclusion with anterior cross bite and jaw retraction through a face mask connected to mini-plates installed in the lateral nasal cavity. The horizontal bilateral corticotomy was performed before traction. After six months of treatment, the correction of malocclusion with maxillary advancement and improvement of facial profile was achieved. The approach of orthopedic protraction associated with skeletal anchorage and corticotomy has proven to be effective and fast.

Outcome Analysis of Extended, Long, Curved Ostectomy with Outer Cortex Grinding for Prominent Mandibular Angle and Broad Chin to Achieve V-line Contouring

BACKGROUND: In Asian countries, patients with a square-shaped lower face want a narrow chin as well as improvements in the mandibular angle contour, which is called a "V-line shape." Currently, various surgical techniques have been developed for mandibuloplasty. METHODS: We have developed an extended, long, curved ostectomy, which starts from the inferior mandibular margin below the lateral incisor to the angle, using reciprocating and oscillating saws. We also used a small round bur to grind the outer cortex of the chin and ramus. A total of 243 patients were included in this study from 2012 to 2014. RESULTS: To analyze aesthetic outcomes, we compared mandibular angles and gonial-gonial (G-G) distances on preoperative three-dimensional computed tomography scans with postoperative images. Mandibular measurements demonstrated significant increments in angle degrees on the right (115.2degrees+/-11.1 vs 129.3degrees+/-11.5, P<0.05) and left sides (112.2degrees+/-10.2 vs 130.4degrees+/-11.3, P<0.05). The G-G distance was reduced postoperatively from 123.7 mm+/-7.9 to 110.0 mm+/-3.5 (P<0.05). CONCLUSIONS: In this study, we demonstrate the effectiveness of our technique and assume that we can improve frontal shape and lateral contour with its use.

Avaliação do estado nutricional pré e pós-operatório em pacientes submetidos à cirurgia ortognática: estudo piloto / Evaluation the nutritional status of subjects before and after orthognathic surgery: pilot study

Objetivo: Avaliar a importância do acompanhamento nutricional em pacientes submetidos à cirurgia ortognática através de análise comparativa entre os resultados antropométricos e laboratoriais mensurados nos período pré e pós-operatório. Metodologia: Dez pacientes estudados com valor mediano de idade 26,5 anos, seis do sexo feminino (60%) e quatro do sexo masculino (40%) e diferentes raças (dois brancos, cinco negros e três mestiços). Todos os pacientes foram orientados pelo nutricionista a ingerir dieta líquida e/ou pastosa hipercalórica e suplementação adicional (2500 Kcal/dia) durante o período pós-operatório. As avaliações do estado nutricional, medidas antropométricas (peso, altura e índice de massa corpórea) foram realizados no pré e pós-operatórios, enquanto os exames laboratoriais (proteínas totais, albumina e globulina), foram realizados em três períodos distintos; pré-operatório, 15º Dia Pós Operatório (DPO) e 45ºDPO. Resultados: Ao se comparar os índices antropométricos e os exames laboratoriais entre o período pré e pós-operatório, observou-se que houve pouca perda de massa corporal, recuperada durante o decorrer do estudo, e manutenção dos indicadores laboratoriais nutricionais. Conclusão: A terapia nutricional no período pós-operatório de pacientes submetidos à cirurgia ortognática, dieta hipercalórica e suplementação, ajudaram a manter os índices do estado nutricional em níveis semelhantes aos obtidos no pré-operatório... (AU)

Objective: evaluate the importance of nutritional monitoring in patients submitted to orthognathic surgery through anthropometrics and laboratory analysis in the pre and post-operative period. Methods: 10 patients were studied with the average age 26.5 years, 06 female sex (60%) and 04 male sex (40%) of the different races (02 white, 05 black, and 03 mixed races). In the post-operative period all the patients were submitted to the oral liquid diet with hypercaloric nutritional supplementation for 45 days. The evaluations of the nutritional status, anthropometrics measurements (indices of body mass) and laboratory studies (total proteins, albumin and globulin) were carried out in three distinct periods; preoperative, 15th postoperative day, 45th postoperative day. Results: to compare anthropometrics measurements and laboratory studies between the period pre and post-operative, it was observed that there was little loss of body mass and stabilization of the laboratory indicators. Conclusion: the nutritional therapy and hypercaloric supplementation keep the good nutritional status during the post-operative period of patients submitted the orthognathic surgery... (AU)

Avaliação de déficit neurossensorial em pacientes com síndromes craniofaciais submetidos a avanço horizontal do mento / Evaluation of neurosensory disturbance in patients with craniofacial syndrome subjected to horizontal chin advancement

INTRODUÇÃO: Embora os distúrbios neurossensoriais após genioplastias tenham sido avaliados em diferentes estudos, não existe uma padronização de como testar e classificar tais alterações. Por essa razão, a incidência de distúrbios neurossensoriais varia de 0 a 100%, dependendo da definição da lesão dos nervos, da sensibilidade do método diagnóstico e do período de seguimento. Portanto, o propósito deste estudo foi avaliar objetivamente o déficit neurossensorial permanente em pacientes submetidos a avanço horizontal do mento. MÉTODO: Foi realizado estudo retrospectivo de todos os pacientes submetidos a avanço horizontal do mento no Hospital SOBRAPAR, no período de 2009 a 2010. A avaliação neurossensorial objetiva do lábio inferior e do mento foi realizada com dois testes neurológicos (teste dos limiares de pressão de Semmes-Weinstein e teste de sensibilidade térmica). O déficit neurossensorial permanente foi definido como testes clínicos anormais com no mínimo 12 meses de pós-operatório. RESULTADOS: Foram avaliados 13 pacientes, sendo 8 deles portadores de síndromes craniofaciais. Houve predomínio de pacientes com os testes de sensibilidade tátil à pressão e térmica (quente e frio) normal (P < 0,05). A análise dos pacientes sindrômicos revelou que a maioria teve o teste de sensibilidade tátil à pressão normal (P < 0,003), não existindo diferenças no teste de sensibilidade térmica (P = 0,317). Não foram identificadas diferenças entre as regiões anatômicas com testes de sensibilidade anormais (P > 0,05). CONCLUSÕES: A maioria dos pacientes apresenta sensibilidade tátil (pressão e temperatura) do lábio inferior e mento preservada 12 meses após terem sido submetidos a avanço horizontal do mento.

BACKGROUND: Although neurosensory disturbances after genioplasty have been evaluated in different studies, standardization for testing and grading of neurosensory injuries is lacking. For this reason, the incidence of neurosensory disturbance varies from 0% to 100%, depending on the definition of nerve damage, the sensitivity of the diagnostic test method, and the follow-up period. Therefore, the aim of this study was to perform an objective evaluation of the permanent neurosensory disturbances in patients who underwent horizontal chin advancement. METHODS:A retrospective study of all patients who underwent horizontal chin advancement at the Hospital SOBRAPAR between 2009 and 2010 was conducted. The objective neurosensory assessment of the lower lip and chin was performed using 2 neurological tests, namely the Semmes-Weinstein pressure and thermal sensitivity tests. Permanent neurosensory disturbance was defined as abnormal clinical test results obtained at least 12 months after surgery. RESULTS: Thirteen patients (8 with craniofacial syndrome) were evaluated. The prevalence of the patients who showed normal results for sensitivity to pressure/touch and thermal sensitivity (warm and cold; P < 0.05) was significantly high. The analysis of the data of the patients with craniofacial syndrome revealed that most of the patients had normal pressure sensitivity test results (P < 0.003). Results from the thermal sensitivity tests showed no significant difference between these patients (P = 0.317). No significant differences were observed between the anatomical regions with abnormal sensitivity test results (P > 0.05). CONCLUSIONS: Tactile sensitivities of the lower lip and chin to pressure and temperature were preserved in most of the patients 12 months after horizontal chin advancement.

Comparison between manual and software surgical planning predictions in orthognathic surgery / Comparação entre os prognósticos do planejamento cirúrgico manual ou porSoftware em cirurgia ortognótica

Objetivo: Avaliar comparativamente o prognostico do planejamento cirurgico por software com o metodo manual. Metodo: Radiografias laterais cefalometricas e modelos de estudo pre e pos-cirurgia de vinte pacientes Classe III (12 mulheres e 8 homens, media de idade: 22,5 ñ 2,3) que tinham se submetidos a cirurgia no Departamento de Ortodontia. Para o planejamento manual, com combinacao de oclusogramas pre e pos-cirurgia com radiografias cefalometricas laterais de cada paciente, foram feitas analises tridimensionais. Prognosticos da movimentacao esqueletica foram elaborados. Em seguida, mensurou-se tridimensionalmente a movimentacao esqueletica. Quinze variaveis angulares e lineares foram avaliadas e os resultados analisados estatisticamente. Para cada paciente, o prognostico manual e por software antes e apos a cirurgia foram comparados entre si. O teste t pareado foi usado para verificar possiveis diferencas (p<0,05). Resultados: Nao foram observadas diferencas entre os metodos. Conclusao: O Software Dolphin Imaging (versao 10) tem boa acuracia para a predicao do resultado pre e pos-cirurgico de cirurgias ortognaticas.

Objective: To evaluate the proximity of computer imaging soft ware surgical planning prediction methods, with standard manual methods. Method: Lateral cephalometry radiographs and study cast records of pre and post surgery of twenty longface Cl III patients (12 Females and 8 Males, mean age: 22.5 ñ 2.3), that had been undergone surgery in Department of Orthodontics. For manual prediction, with combination of pre and post surgical occlusograms with lateral cephalometric radiograph tracings of each samples, three dimensional analysis was done. Predictions of skeletal movement with tacing overlay method, has prepared. Finally, measured the rate of skeletal movements at in three dimensional of spaces. Fifteen angular and linear variables were measured, and the results, analyzed using the statistical soft ware statistics. For each patient, the manual and computer soft ware prediction before and after surgery were compared with each other. The paired t-test was used to evaluate possible differences between manual and computer soft ware prediction (p<0.05). Results: The difference of the variables of the soft ware prediction in the pre and postsurgical stages in comparison with standard manual prediction method was insignificant. Conclusion: Dolphin Imaging software (version 10.0) has a good accuracy for prediction of pre and postsurgical outcome of orthognathic samples.

Comparação Entre os Prognósticos do Planejamento Cirúrgico Manual ou porSoftware em Cirurgia Ortognática / Comparison between manual and software surgical planning predictions in orthognathic surgery

Objetivo: Avaliar comparativamente o prognostico do planejamento cirurgico por software com o metodo manual. Metodo: Radiografias laterais cefalometricas e modelos de estudo pre e pos-cirurgia de vinte pacientes Classe III (12 mulheres e 8 homens, media de idade: 22,5 ± 2,3) que tinham se submetidos a cirurgia no Departamento de Ortodontia. Para o planejamento manual, com combinacao de oclusogramas pre e pos-cirurgia com radiografias cefalometricas laterais de cada paciente, foram feitas analises tridimensionais. Prognosticos da movimentacao esqueletica foram elaborados. Em seguida, mensurou-se tridimensionalmente a movimentacao esqueletica. Quinze variaveis angulares e lineares foram avaliadas e os resultados analisados estatisticamente. Para cada paciente, o prognostico manual e por software antes e apos a cirurgia foram comparados entre si. O teste t pareado foi usado para verificar possiveis diferencas (p<0,05). Resultados: Nao foram observadas diferencas entre os metodos. Conclusao: O Software Dolphin Imaging (versao 10) tem boa acuracia para a predicao do resultado pre e pos-cirurgico de cirurgias ortognaticas.

Objective: To evaluate the proximity of computer imaging soft ware surgical planning prediction methods, with standard manual methods. Method: Lateral cephalometry radiographs and study cast records of pre and post surgery of twenty longface Cl III patients (12 Females and 8 Males, mean age: 22.5 ± 2.3), that had been undergone surgery in Department of Orthodontics. For manual prediction, with combination of pre and post surgical occlusograms with lateral cephalometric radiograph tracings of each samples, three dimensional analysis was done. Predictions of skeletal movement with tacing overlay method, has prepared. Finally, measured the rate of skeletal movements at in three dimensional of spaces. Fifteen angular and linear variables were measured, and the results, analyzed using the statistical soft ware statistics. For each patient, the manual and computer soft ware prediction before and after surgery were compared with each other. The paired t-test was used to evaluate possible differences between manual and computer soft ware prediction (p<0.05). Results: The difference of the variables of the soft ware prediction in the pre and postsurgical stages in comparison with standard manual prediction method was insignificant. Conclusion: Dolphin Imaging software (version 10.0) has a good accuracy for prediction of pre and postsurgical outcome of orthognathic samples.