Previsibilidade da cefalometria no diagnóstico e na interpretação de alterações dento-esqueléticas em relação ao tratamento cirúrgico de indivíduos padrão face longa

Abstract

In considering the wide use of the cephalometric analysis in the diagnosis of individuals with dentofacial deformities, the objective of this retrospective study was to evaluate the correlation between the surgical treatment suggested by the cephalometry and the actual orthognathic surgery performed in long face pattern individuals, and additionally to comparing the alterations among the averages of the cephalometric measurements obtained in the pre and postsurgical period. The sample was composed by 32 lateral pre and postsurgical x-rays of 16 individuals of both genders with average age of 29 years and 11 months. From the tracings in the x-rays it was evaluated: sagittal maxilo-mandibular relation, maxilo-mandibular relation, effective length of the maxilla, mandible, and facial heights, vertical relation, and also the dental relations to their apical bases. The averages of each pre and postsurgical variables were also compared using tests t of Student and Wilcoxon. The results had shown that it did not have a relation between the cephalometric diagnosis and the actual surgery performed. Since the long face pattern individuals present a great imbalance between the facial vertical components, in 93,75% of the cases they underwent a superior replacement of the maxilla associated or not to a mandible advancement and genioplasty. Regarding to the averages of the cephalometric values between the before and after-surgical measurements it had statistically significant difference (p<0,05) for: SNA, SNB, ANB, A' Pp - B' Pp, Nperp- A, Nperp-Pog, Co-A, Co-Gn, ENA-Me, SN.Gn, SN.GoMe, SN.Pp, Pp.Po and Pp.GoMe. After the data exam it was concluded that the cephalometric analysis, although integrant part of the diagnosis resources, separately, is not capable to predict the surgical treatment and must, always, be associated to the facial analysis.