Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.04920
Revista de Odontologia da UNESP
Original Article

Immediate and late follow-up effects of class III early correction in cleft lip and palate patients treated with maxillary protraction

Efeitos imediatos e a longo prazo da correção precoce da classe III em pacientes com fissura lábio palatal tratados com protração maxilar

Carolina Mazon MIRANDA; Rodrigo Matos de SOUZA; Giovana Cherubini VENEZIAN; Cristina FRANZINI; William CUSTODIO

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Abstract

Abstract: Introduction: There is no consensus about the immediate and latte follow-up effects of maxillary protraction in cleft lip and palate patients.

Objective: To evaluate the stability of Class III early treatment in cleft lip and palate patients through maxillary expansion and protraction.

Material and method: The sample consists in three lateral cephalometric radiographs of 28 patients (mean pre-treatment age of 6.7±1.8 years) who presented cleft lip and palate and were treated with maxillary expansion and Petit facial mask. The angular (SNA, SNB, ANB, SN.GoGn, FMA, Z Angle) and linear (overjet, Co-A, Co-Gn, Nperp-A, Nperp-Pg, AO-BO) cephalometric measures were evaluated through the Dolphin® software, in three moments: T0 (initial), T1 (after treatment), and T2 (follow-up). Data were submitted to the analysis of variance (ANOVA) and Tukey-Kramer test. The correlation between cephalometric measures and patient’s age was determined by Pearson’s chi-squared test.

Result: The SNA, ANB, and AO-BO measures increased considerably (p<0.05), and they did not present any differences compared to the initial ones after the follow-up time. The overjet measure increased (p<0.05) after treatment and, even with its decrease at the follow-up time, it was still higher than at the beginning (p<0.05). The Z angle showed improvement with treatment and remained stable at the follow-up time.

Conclusion: After treatment (maxillary expansion associated with protraction), there was a skeletal pattern improvement. During the follow-up period, those alterations decreased to a measure close to the beginning. There was an improvement in the dental pattern and facial profile that continued in the follow-up period.

Keywords

Cleft lip and palate, long-term follow-up, maxillary protraction

Resumo

Resumo: Introdução: Não há consenso sobre os efeitos imediatos e tardios da protração maxilar em pacientes com fissura lábio palatal.

Objetivo: avaliar a estabilidade do tratamento precoce da Classe III em pacientes com fissura labiopalatina por meio da expansão e protração maxilar.

Material e método: A amostra consistiu de 28 pacientes com fissura lábio palatal com (média de idade pré tratamento de 6.7±1.8) com fissura lábio palatal transforame unilateral, tratados com disjuntor maxilar e com máscara facial de Petit. Por meio de análise em telerradiografias laterais as grandezas angulares (SNA, SNB, ANB, SN.GoGn, FMA, Ângulo Z) e lineares (overjet, Co-A, Co-Gn, Nperp-A, Nperp-Pg, AO-BO) foram avaliadas, com o software Dolphin®, nos tempos: inicial (T0), após o tratamento (T1) e acompanhamento de 2 a 6 anos (T2). Os dados foram submetidos à ANOVA e teste Tukey-Kramer. A correlação entre as grandezas cefalométricas e a idade do paciente foi determinada pelo teste de Pearson. Todas as análises foram realizadas com nível de significância de 5%.

Resultado: SNA, ANB e AO-BO aumentaram significativamente (p<0,05) e após o período de acompanhamento voltaram a ser semelhantes às iniciais (p>0,05). O overjet aumentou significativamente após o tratamento e mesmo tendo diminuído com o tempo, ainda se apresentava maior quando comparado ao momento inicial (p<0,05). O ângulo Z apresentou melhora com o tratamento e se manteve estável no período de acompanhamento (p<0,05).

Conclusão: após o tratamento (disjunção associada à protração maxilar) houve melhora do padrão esquelético. No período de acompanhamento, verificou-se que essas melhoras voltaram a medidas próximas das iniciais. Houve melhora no padrão dentário e no perfil facial que se manteve no período de controle.
 

Palavras-chave

Fissura lábio palatal, acompanhamento a longo prazo, protração maxilar

References

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Submitted date:
07/04/2020

Accepted date:
11/18/2020

5ff358150e8825de52770dea rou Articles
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