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Avaliação tridimensional da localização do canal mandibular : estudo retrospetivo
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Resumo(s)
Objetivos: Com a realização deste estudo pretendeu-se avaliar qual a localização da Mandibular Buccal Shelf (MBS) mais segura para inserção de micro-implantes (MI) e qual a angulação máxima e comprimento dos MI possíveis, sem interferir com o canal mandibular (CM).
Materiais e métodos: Amostra constituída por CBCT de 96 pacientes (58 mulheres e 38 homens) com idade média de 25,54±10,20. Foram realizadas medições bilaterais em quatro zonas da MBS: tangente a cada uma das superfícies distais do 2º molar inferior (7D); da cúspide disto-vestibular dos 2º molares inferiores (7CD), do sulco vestibular dos 2º molares inferiores (7S) e da cúspide mesio-vestibular dos 2º molares inferiores (7M). Inicialmente mediu-se a largura transversal da MBS superficialmente para determinar o seu ponto médio. Foi medida a angulação máxima desse ponto até ao CM, relativamente ao plano vertical verdadeiro. Mediu-se com essa angulação a distância do ponto médio da MBS ao CM. Além da estatística descritiva, foram realizados testes t pareados e não pareados, com um nível de significância p < 0,05.
Resultados: Diferenças significativas entre idade e sexo, além de assimetria bilateral, foram observadas em relação a várias variáveis (p < 0,05). A largura transversal da MBS e a distância do ponto médio da MBS ao ponto mais próximo do CM aumentaram progressivamente em direção posterior, contrariamente à medição angular, que diminuiu progressivamente em direção posterior, indicando que quanto mais posteriormente mais vertical é a relação do CM com o ponto médio da MBS.
Conclusão: Com base na amostra estudada, a localização ideal para a inserção de MI na MBS, na ausência de terceiros molares inclusos, é a região tangente à superfície distal do segundo molar. No entanto, devido à variabilidade nos resultados obtidos, recomenda-se o uso do CBCT para a sua inserção, diminuindo o risco de provocar lesões no NAI.
Objectives: This study aimed to evaluate the safest location on the Mandibular Buccal Shelf (MBS) for the insertion of mini-implants (MI) and to determine the maximum possible angulation and length of the MI without interfering with the mandibular canal (MC). Materials and methods: The sample consisted of CBCT images of 96 patients (58 females and 38 males) with an average age of 25.54±10.20 years. Measurements were taken in four zones of the MBS bilaterally: tangent to each of the distal surface of the second lower molars (7D), distobuccal cusp tip of the second lower molars (7CD), buccal groove of the second lower molars (7S) and mesiobuccal cusp tip of the second lower molars (7CM). Initially, the superficial transverse width of the MBS was measured to determine its midpoint. The maximum angulation from this midpoint to the MC was measured relative to the true vertical plane. The distance from the MBS midpoint to the MC was then measured at this angulation. Descriptive statistics in addition to paired and unpaired t-tests were undertaken at p ˂ 0.05. Results: Significant differences in age and sex, as well as bilateral asymmetry, were observed in relation to several variables (p ˂ 0.05). The transverse width of the MBS and the distance from the MBS midpoint to the nearest point on the MC progressively decreased in the posterior direction. This indicates that the further posterior the location, the more vertical the relationship between the MC and the MBS midpoint. Conclusions: Based on the sample studies, the optimal location for MI insertion in the MBS, in the absence of impacted third molars, is adjacent to the distal surface of the second molar. However, due to the variability in the results obtained, the use of CBCT is recommended for insertion to minimize the risk of injury to the IAN.
Objectives: This study aimed to evaluate the safest location on the Mandibular Buccal Shelf (MBS) for the insertion of mini-implants (MI) and to determine the maximum possible angulation and length of the MI without interfering with the mandibular canal (MC). Materials and methods: The sample consisted of CBCT images of 96 patients (58 females and 38 males) with an average age of 25.54±10.20 years. Measurements were taken in four zones of the MBS bilaterally: tangent to each of the distal surface of the second lower molars (7D), distobuccal cusp tip of the second lower molars (7CD), buccal groove of the second lower molars (7S) and mesiobuccal cusp tip of the second lower molars (7CM). Initially, the superficial transverse width of the MBS was measured to determine its midpoint. The maximum angulation from this midpoint to the MC was measured relative to the true vertical plane. The distance from the MBS midpoint to the MC was then measured at this angulation. Descriptive statistics in addition to paired and unpaired t-tests were undertaken at p ˂ 0.05. Results: Significant differences in age and sex, as well as bilateral asymmetry, were observed in relation to several variables (p ˂ 0.05). The transverse width of the MBS and the distance from the MBS midpoint to the nearest point on the MC progressively decreased in the posterior direction. This indicates that the further posterior the location, the more vertical the relationship between the MC and the MBS midpoint. Conclusions: Based on the sample studies, the optimal location for MI insertion in the MBS, in the absence of impacted third molars, is adjacent to the distal surface of the second molar. However, due to the variability in the results obtained, the use of CBCT is recommended for insertion to minimize the risk of injury to the IAN.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Micro-implantes Canal mandibular Buccal shelf mandibular CBCT