Objective
To identify optimal areas for the insertion of extra-alveolar miniscrews into the infrazygomatic crest (IZC) and mandibular buccal shelf (MBS), using cone beam computed tomography (CBCT) imaging in patients with different craniofacial patterns.
Methods
CBCT reconstructions of untreated individuals were used to evaluate the IZC and MBS areas. The participants were divided into three groups, based on the craniofacial pattern, namely, brachyfacial (n = 15; mean age, 23.3 years), mesofacial (n = 15; mean age, 19.24 years), and dolichofacial (n = 15; mean age, 17.79 years). In the IZC, the evaluated areas were at 11, 13, and 15 mm above the buccal cusp tips of the right and left first molars. In the MBS, the evaluated areas were at the projections of the first molars’ distal roots and second molars’ mesial and distal roots, at a 4- and 8-mm distance from the cementoenamel junction. Intergroup comparisons were performed with analysis of variance and the Tukey test.
Results
There was no statistically significant difference in the IZC bone thickness among the groups. For MBS bone availability, some comparisons revealed no difference; meanwhile, other comparisons revealed increased MBS bone thickness in the brachyfacial (first molars distal roots) and dolichofacial (second molars mesial and distal roots) patterns.
Conclusions
There was no significant difference in the IZC bone thickness among the groups. The facial skeletal pattern may affect the availability of ideal bone thickness for the insertion of extra-alveolar miniscrews in the MBS region; however, this variability is unlikely to be clinically meaningful.
INTRODUÇÃO: a espessura das tábuas ósseas que recobrem os dentes por vestibular e lingual constitui um dos fatores limitantes da movimentação dentária. O avanço tecnológico em Imaginologia permitiu avaliar detalhadamente essas regiões anatômicas por meio da utilização da tomografia computadorizada de feixe cônico (TCFC). OBJETIVO: descrever e padronizar, pormenorizadamente, um método para mensuração das tábuas ósseas vestibular e lingual dos maxilares nas imagens de tomografia computadorizada de feixe cônico. METODOLOGIA: a padronização digital da posição da imagem da face deve constituir o primeiro passo antes da seleção dos cortes de TCFC. Dois cortes axiais de cada maxilar foram empregados para a mensuração da espessura do osso alveolar vestibular e lingual. Utilizou-se como referência a junção cemento-esmalte dos primeiros molares permanentes, tanto na arcada superior quanto na inferior. RESULTADOS: cortes axiais paralelos ao plano palatino foram indicados para avaliação quantitativa do osso alveolar na maxila. Na arcada inferior, os cortes axiais devem ser paralelos ao plano oclusal funcional. CONCLUSÃO: o método descrito apresenta reprodutibilidade para utilização em pesquisas, assim como para a avaliação clínica das repercussões periodontais da movimentação dentária, ao permitir a comparação de imagens pré e pós-tratamento.
Objective The purpose of this study was to evaluate and compare the axial inclination of the mandibular first molars and their respective bone morphology among individuals with different facial patterns.
Materials and Methods The sample comprised the cone beam computed tomographies (CBCTs) of 58 subjects divided into three groups according to the facial patterns: 18 brachyfacial (Group 1), with a mean age of 21.58 years; 23 mesofacial (Group 2), with a mean age of 19.14 years; and 17 dolichofacial subjects (Group 3), with a mean age of 19.09 years. Eight variables were evaluated on CBCT scans of each subject: buccal and lingual mandibular height, cervical and middle mandibular width, inclination of mandibular body, inclination of the mandibular molar buccal surface, molar width, molar angulation and tooth/bone angle. Intergroup comparisons were performed with one-way analysis of variance followed by Tukey tests.
Results Buccal mandibular height presented statistically significant difference in the three facial patterns. Lingual mandibular height and mandibular inclination showed to be statistically and significantly smaller in brachyfacial subjects than in the other two groups. Mandibular width presented a statistically significant difference between brachyfacial and mesofacial groups. Negative correlations could be observed between the facial pattern and the buccal and lingual mandibular heights and inclination of the mandibular body.
Conclusion Buccal mandibular height was significantly and progressively larger in brachyfacial, mesofacial, and dolichofacial subjects. Lingual mandibular height was significantly smaller in brachyfacial than in mesofacial and dolichofacial subjects. Mandibular width was significantly thicker in brachyfacial than in mesofacial subjects. Brachyfacial subjects had smaller mandibular inclination than mesofacial and dolichofacial subjects.
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