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Avaliação tridimensional da localização posterior ideal para colocação de microimplantes na expansão palatina com ancoragem esquelética
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Advisor(s)
Abstract(s)
Objetivo: O presente estudo teve como objetivo avaliar tridimensionalmente a espessura óssea (EO) máxima disponível e o ângulo de inserção (AI) de microimplantes (MI) no local de inserção supra-alveolar palatino posterior (PPSAIS), assegurando que as estruturas anatómicas adjacentes, nomeadamente a cavidade nasal e os seios maxilares, não fossem comprometidas.
Materiais e Métodos: A amostra foi constituída por 120 pacientes (60 mulheres e 60 homens), com idade média de 28,8 ± 11,3 anos. Analisaram-se bilateralmente três regiões do palato: entre o segundo pré-molar e o primeiro molar (P2-M1), ao nível do sulco vestibular do primeiro molar (M1S) e entre o primeiro e o segundo molar (M1-M2). Em cada localização mediram-se a EO e o AI, totalizando 1440 medições. Avaliaram-se ainda possíveis variações em função do lado, do sexo e da idade. A análise estatística recorreu à ANOVA, ao Teste t de Student e ao coeficiente de correlação de Spearman, considerando-se um nível de significância de 5%.
Resultados: Os valores médios da EO e do AI foram significativamente superiores em P2-M1 (p<0,05), diminuindo progressivamente em direção posterior. Observou-se simetria da EO entre lados (p>0,05), enquanto o AI foi consistentemente superior à direita em todas as localizações (p<0,001 em P2-M1 e M1-M2; p=0,003 em M1S). Não se verificaram diferenças entre sexos para a EO ou o AI (p>0,05). As correlações com a idade, quando significativas, foram sempre muito fracas para ambas as variáveis.
Conclusão: A EO palatina posterior não é uniforme e tende a diminuir no sentido posterior. A região P2-M1 apresenta maior EO e constitui a zona mais favorável para a inserção de MIs na PPSAIS. Contudo, dada a variabilidade individual observada, recomenda-se a avaliação prévia por tomografia computorizada de feixe cónico (CBCT), de modo a determinar a EO e o AI mais adequados para uma inserção segura e previsível.
Objectives: This study aimed to perform a three-dimensional assessment of the maximum available palatal bone thickness (EO) and the insertion angle (AI) of microimplants (MI) at the palatal posterior supra-alveolar insertion site (PPSAIS), while ensuring that adjacent anatomical structures, namely the nasal cavity and maxillary sinuses, were not compromised. Materials and Methods: The sample comprised 120 patients (60 females and 60 males) with a mean age of 28.8 ± 11.3 years. Three palatal regions were analysed bilaterally: between the second premolar and the first molar (P2–M1), at the level of the first molar vestibular groove (M1S), and between the first and second molars (M1–M2). In each region, EO and AI were measured, totalling 1440 measurements. Possible variations according to side, sex, and age were also evaluated. Statistical analysis included ANOVA, Student’s t-test, and Spearman’s correlation coefficient, with the level of significance set at 5%. Results: Mean EO and AI values were significantly higher at P2-M1 (p < 0.05), decreasing progressively toward the posterior region. EO was symmetrical between sides (p > 0.05), whereas AI was consistently greater on the right side across all locations (p <0.001 at P2-M1 and M1-M2; p = 0.003 at M1S). No significant sex-related differences were found for either EO or AI (p > 0.05). Correlations with age, when significant, were consistently very weak for both variables. Conclusion: Posterior palatal bone thickness is not uniform and tends to decrease posteriorly. The P2-M1 region exhibits the greatest EO and represents the most favourable site for MIs placement within the PPSAIS. Nevertheless, given the interindividual variability observed, a preoperative cone beam computed tomography (CBCT) assessment is recommended to determine the most appropriate EO and AI for safe and predictable MIs placement.
Objectives: This study aimed to perform a three-dimensional assessment of the maximum available palatal bone thickness (EO) and the insertion angle (AI) of microimplants (MI) at the palatal posterior supra-alveolar insertion site (PPSAIS), while ensuring that adjacent anatomical structures, namely the nasal cavity and maxillary sinuses, were not compromised. Materials and Methods: The sample comprised 120 patients (60 females and 60 males) with a mean age of 28.8 ± 11.3 years. Three palatal regions were analysed bilaterally: between the second premolar and the first molar (P2–M1), at the level of the first molar vestibular groove (M1S), and between the first and second molars (M1–M2). In each region, EO and AI were measured, totalling 1440 measurements. Possible variations according to side, sex, and age were also evaluated. Statistical analysis included ANOVA, Student’s t-test, and Spearman’s correlation coefficient, with the level of significance set at 5%. Results: Mean EO and AI values were significantly higher at P2-M1 (p < 0.05), decreasing progressively toward the posterior region. EO was symmetrical between sides (p > 0.05), whereas AI was consistently greater on the right side across all locations (p <0.001 at P2-M1 and M1-M2; p = 0.003 at M1S). No significant sex-related differences were found for either EO or AI (p > 0.05). Correlations with age, when significant, were consistently very weak for both variables. Conclusion: Posterior palatal bone thickness is not uniform and tends to decrease posteriorly. The P2-M1 region exhibits the greatest EO and represents the most favourable site for MIs placement within the PPSAIS. Nevertheless, given the interindividual variability observed, a preoperative cone beam computed tomography (CBCT) assessment is recommended to determine the most appropriate EO and AI for safe and predictable MIs placement.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
MARPE CBCT Ancoragem esquelética temporária Palato