GAND classification and volumetric assessment of unilateral cleft lip and palate malformations using cone beam computed tomography.

The aim of this study was to propose a classification for unilateral cleft lip and palate (UCLP) malformations based on cone beam computed tomography (CBCT) images, as well as to estimate the amount of bone necessary for grafting, and to evaluate the relationship of this volume with scores obtained using the classification. CBCT images of 33 subjects with UCLP were evaluated according to gap, arch, nasal, and dental parameters (GAND classification). Additionally, these defects were segmented and the amount of graft needed for alveolar bone grafting was estimated. The reproducibility of GAND classification was analyzed by weighted kappa test. The association of volume assessment with the classification (gap and nasal parameters) was verified using analysis of variance, while the intra-observer agreement was analyzed using the intra-class correlation coefficient. The intra-observer reproducibility of the classification ranged from 0.29 to 0.92 and the inter-observer agreement ranged from 0.29 to 0.91. There were no statistically significant values when evaluating the association of the volume with the classification (P>0.05). The GAND classification is a novel system that allows the quick estimation of the extent and complexity of the cleft. It is not possible to estimate the amount of bone needed for alveolar bone grafting based on the classification; individualized surgical planning should be done for each patient specifically.

Estudio de las alteraciones maxilares en pacientes adultos con maloclusión de clase II, división 1ª, tratados con extracciones de primeros premolares superiores / No disponible

Se realizó un estudio cefalométrico, evaluando el comportamiento de las medidas SNA y A-NPerp con el propósito de verificar las alteraciones en la posición Anteroposterior del maxilar. La muestra utilizada estaba formada por 60 telerradiagrafias de 30 adultos con Clase II, división 1ª tomadas antes y después del tratamiento correctivo. En todos los casos fueron realizadas extracciones de los primeros premolares superiores. Observando el análisis descriptivo de los datos, se verificó que la medida SNA inicial disminuyó en media 1,66 grados cuando fue comparada con la magnitud SNA final. Por otro lado el valor A-Nperp presentó una disminución media de 2.6 mm. Se concluye que ambas medidas SNA y ANPerp representan el mismo comportamiento en los pacientes de la muestra, sugiriendo que cualquiera de las dos magnitudes analizadas expresan de forma similar la posición anteroposterior maxilar. El resultado del trabajo, demostró que en pacientes sin crecimiento, el tratamiento ortodóncico con extracciones de los primeros premolares superiores, induce una retrusión maxilar, con disminución del ángulo SNA y la magnitud A-NPerp (AU)

It was done a cefalometric study, analyzing the behavior of the SNA and ANperp measurements with the aim of verifying the alterations on the anteroposterior position of maxilla. The sample was 60 teleradiography on lateral pattern, at the beginning and end of treatment, from 30 adults, Class 11,1st division, who were submitted to corrective orthodontic treatment with extraction of both upper first premolars. After analyzing the results, we could observe that the SNA value reduced a mean rate of 1,7 degrees when compared to the final SNA value. TheA-Nperp showed a mean rate of 2,4 degrees of reduction. lt was concluded that the angular measurement SNA as well as the linear measurement ANperp had the same behavior and a strong correlation (r=O.698) in this sample, suggesting that any of these two magnitudes analyzed expressed similarly the antero-posterior position of the maxilla. The results of this paper showed that the orthodontic treatment on adults with extraction of the first premolars had a retraction of the antero-posterior position of the maxilla, with reduction of the SNA and A-Nperp values (AU)