RESUMO
OBJECTIVE: The aim of this study was to compare the cephalometric pattern of children with and without adenoid obstruction. METHODS: The sample comprised 100 children aged between four and 14 years old, both males and females, subjected to cephalometric examination for sagittal and vertical skeletal analysis. The sample also underwent nasofiberendoscopic examination intended to objectively assess the degree of adenoid obstruction. RESULTS: The individuals presented tendencies towards vertical craniofacial growth, convex profile and mandibular retrusion. However, there were no differences between obstructive and non-obstructive patients concerning all cephalometric variables. Correlations between skeletal parameters and the percentage of adenoid obstruction were either low or not significant. CONCLUSIONS: Results suggest that specific craniofacial patterns, such as Class II and hyperdivergency, might not be associated with adenoid hypertrophy.
Assuntos
Tonsila Faríngea/patologia , Obstrução das Vias Respiratórias/classificação , Cefalometria/métodos , Ossos Faciais/anatomia & histologia , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Endoscopia/métodos , Ossos Faciais/crescimento & desenvolvimento , Feminino , Humanos , Hipertrofia , Masculino , Má Oclusão/classificação , Mandíbula/anatomia & histologia , Maxila/anatomia & histologia , Desenvolvimento Maxilofacial/fisiologia , Respiração Bucal/classificação , Nasofaringe/patologia , Retrognatismo/classificação , Dimensão VerticalRESUMO
INTRODUCTION: Lateral cephalometric radiographs are traditionally required for orthodontic treatment, yet rarely used to assess asymmetries. OBJECTIVE: The objective of the present study was to use lateral cephalometric radiographs to identify existing skeletal and dentoalveolar morphological alterations in Class II subdivision and to compare them with the existing morphology in Class I and II relationship. MATERIAL AND METHODS: Ninety initial lateral cephalometric radiographs of male and female Brazilian children aged between 12 to 15 years old were randomly and proportionally divided into three groups: Group 1 (Class I), Group 2 (Class II) and Group 3 (Class II subdivision). Analysis of lateral cephalometric radiographs included angular measurements, horizontal linear measurements and two indexes of asymmetry that were prepared for this study. RESULTS: In accordance with an Index of Dental Asymmetry (IDA), greater mandibular dental asymmetry was identified in Group 3. An Index of Mandibular Asymmetry (IMA) revealed less skeletal and dental mandibular asymmetry in Group 2, greater skeletal mandibular asymmetry in Group 1, and greater mandibular dental asymmetry in Group 3. CONCLUSION: Both IDA and IMA revealed greater mandibular dental asymmetry for Group 3 in comparison to Groups 1 and 2. These results are in accordance with those found by other diagnostic methods, showing that lateral cephalometric radiography is an acceptable method to identify existing skeletal and dentoalveolar morphological alterations in malocclusions.
Assuntos
Cefalometria/métodos , Assimetria Facial/diagnóstico por imagem , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe I de Angle/diagnóstico por imagem , Adolescente , Processo Alveolar/diagnóstico por imagem , Criança , Queixo/diagnóstico por imagem , Arco Dental/diagnóstico por imagem , Assimetria Facial/classificação , Ossos Faciais/diagnóstico por imagem , Feminino , Humanos , Incisivo/diagnóstico por imagem , Masculino , Má Oclusão Classe II de Angle/classificação , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Osso Nasal/diagnóstico por imagem , Palato/diagnóstico por imagem , Radiografia , Retrognatismo/classificação , Retrognatismo/diagnóstico por imagem , Sela Túrcica/diagnóstico por imagemRESUMO
INTRODUCTION: Lateral cephalometric radiographs are traditionally required for orthodontic treatment, yet rarely used to assess asymmetries. OBJECTIVE: The objective of the present study was to use lateral cephalometric radiographs to identify existing skeletal and dentoalveolar morphological alterations in Class II subdivision and to compare them with the existing morphology in Class I and II relationship. MATERIAL AND METHODS: Ninety initial lateral cephalometric radiographs of male and female Brazilian children aged between 12 to 15 years old were randomly and proportionally divided into three groups: Group 1 (Class I), Group 2 (Class II) and Group 3 (Class II subdivision). Analysis of lateral cephalometric radiographs included angular measurements, horizontal linear measurements and two indexes of asymmetry that were prepared for this study. RESULTS: In accordance with an Index of Dental Asymmetry (IDA), greater mandibular dental asymmetry was identified in Group 3. An Index of Mandibular Asymmetry (IMA) revealed less skeletal and dental mandibular asymmetry in Group 2, greater skeletal mandibular asymmetry in Group 1, and greater mandibular dental asymmetry in Group 3. CONCLUSION: Both IDA and IMA revealed greater mandibular dental asymmetry for Group 3 in comparison to Groups 1 and 2. These results are in accordance with those found by other diagnostic methods, showing that lateral cephalometric radiography is an acceptable method to identify existing skeletal and dentoalveolar morphological alterations in malocclusions. .
INTRODUÇÃO: as telerradiografias laterais são tradicionalmente solicitadas para planejamento ortodôntico, mas raramente utilizadas para avaliar assimetrias. OBJETIVO: o objetivo do presente estudo foi utilizar as telerradiografias laterais para identificar as alterações morfológicas esqueléticas e dentoalveolares existentes na má oclusão de Classe II subdivisão e compará-las com a morfologia existente nas más oclusões de Classe I e II. MÉTODOS: noventa telerradiografias laterais iniciais de adolescentes brasileiros de ambos os sexos, com idade cronológica entre 12 e 15 anos, foram divididas em três grupos randomizados e proporcionais: Grupo 1 (Classe I), Grupo 2 (Classe II) e Grupo 3 (Classe II subdivisão). A análise das telerradiografias laterais envolveu mensurações angulares, mensurações lineares horizontais e dois índices de assimetria, estipulados para o presente estudo. RESULTADOS: foi identificada, de acordo com o Índice de assimetria dentária (IAD), uma maior assimetria dentária inferior no Grupo 3. O Índice de assimetria mandibular (IAM) revelou menor assimetria esquelética e dentária no Grupo 2, maior assimetria esquelética no Grupo 1 e maior assimetria dentária inferior no Grupo 3. CONCLUSÃO: o IAD e o IAM mostraram maior assimetria dentária inferior no Grupo 3 do que nos Grupos 1 e 2. Esses resultados estão de acordo com os encontrados em outros métodos de diagnóstico, indicando que a telerradiografia lateral é um método aceitável para avaliar alterações morfológicas esqueléticas e dentoalveolares nas más oclusões. .
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Cefalometria/métodos , Assimetria Facial , Má Oclusão Classe I de Angle , Má Oclusão Classe II de Angle , Processo Alveolar , Queixo , Arco Dental , Assimetria Facial/classificação , Ossos Faciais , Incisivo , Má Oclusão Classe II de Angle/classificação , Mandíbula , Maxila , Dente Molar , Osso Nasal , Palato , Retrognatismo/classificação , Retrognatismo , Sela TúrcicaRESUMO
OBJECTIVES/HYPOTHESIS: To identify upper airway and craniofacial abnormalities is the principal goal of clinical examination in patients with obstructive sleep apnea-hypopnea syndrome. The aim was to identify anatomical abnormalities that could be seen during a simple physical examination and determine their correlation with apnea-hypopnea index (AHI). STUDY DESIGN: Consecutive patients with obstructive sleep apnea-hypopnea syndrome who were evaluated in a public otorhinolaryngology center were studied. METHODS: Adult patients evaluated previously with polysomnography met the inclusion criteria. All subjects underwent clinical history and otolaryngological examination and filled out a sleepiness scale. Physical examination included evaluation of pharyngeal soft tissue, facial skeletal development, and anterior rhinoscopy. RESULTS: Two hundred twenty-three patients (142 men and 81 women) were included (mean age, 48 +/- 12 y; body mass index, 29 +/- 5 kg/m2; AHI, 23.8 +/- 24.8 events per hour). Patients were distributed into two groups according to the AHI: snorers (18.4%) and patients with sleep apnea (81.7%). Sleepiness and nasal obstruction were reported by approximately half of patients, but the most common complaint was snoring. There was a statistically significant correlation between AHI and body mass index (P <.000), modified Mallampati classification (P =.002), and ogivale-palate (P <.001). The retrognathia was not correlated to AHI, but the presence of this anatomical alteration was much more frequent in patients with severe apnea when compared with the snorers (P =.05). Other correlations with AHI were performed considering multiple factors divided into two groups of anatomical abnormalities: pharyngeal (three or more) and craniofacial (two or more) abnormalities. There was a statistically significant correlation between pharyngeal landmarks and AHI (correlation coefficient [r] = 0.147, P =.027), but not between craniofacial landmarks and AHI. The combination of pharyngeal anatomical abnormalities, modified Mallampati classification, and body mass index were also predictive of apnea severity. CONCLUSIONS: Systematic physical examination that was used in the present study indicated that, in combination, body mass index, modified Mallampati classification, and pharyngeal anatomical abnormalities are related to both presence and severity of obstructive sleep apnea-hypopnea syndrome. Hypertrophied tonsils were observed in only a small portion of the patients. The frequency of symptoms of nasal obstruction was high in sleep apnea patients. Further studies are needed to find the best combination of anatomical and other clinical landmarks that are related to obstructive sleep apnea.