Cambios en perfil del pacientes retrognático maxilar logrado con terapia de expansión y protracción desarrollado con la norma ecuatoriana, 2013
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2013
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Universidad de Guayaquil. Unidad de Postgrado. Investigación y Desarrollo
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Estudio con diseño no experimental, descriptivo - longitudinal, cuyo objetivo fue evaluar efectividad del tratamiento de protracción maxilar con máscara facial previa expansión palatina con disyuntor, en pacientes fisurados o no fisurados, Clase III esquelética por retrusión maxilar superior, en relación con norma ecuatoriana. De universo de 81 Historias Clínicas FUNARMAF, se realizó muestreo de oportunidad seleccionándose mediante análisis cefalométrico, 21 historias clínicas de pacientes fisurados (26%), (15m, 6f ), promedio de edad 12ª 11ms, y 7 historias clínicas de pacientes no fisurados (9%), (3m,4f) promedio de edad 11ª, que constituyen 35% del universo, los que presentaban al inicio de tratamiento dentición temporaria, mixta y permanente joven. Luego de protracción fueron comparados con grupo de pacientes norma promedio ecuatoriana (9m, 21f), Clase I esqueletal y dental, edad promedio 16ª2ms; tiempo promedio de tratamiento 16ms en fisurados; 20ms en no fisurados; 19 medidas angulares y 12 medidas lineales fueron comparadas pre – postratamiento, postratamiento - norma promedio ecuatoriana. Utilizando análisis estadístico t Test de pares se evaluó su efecto en perfil facial, observándose con significancia estadística una tendencia de crecimiento horario, tipo facial dólico severo, severa rotación horaria mandibular, aumento de altura maxilar y altura facial inferior superando significativamente norma promedio más acentuado en fisurados que en no fisurados. Adelantamiento significativo del maxilar superior y relación normal intermaxilar, sin llegar a la norma en fisurados, y diferencia poco significativa con la norma en no fisurados; debiendo observarse disminución de ángulo SNB en movimiento mandíbular antero posterior poco significativo en ambos grupos y la rotación horaria mandibular en mejoramiento de relación intermaxilar.. En grupo fisurados mejoró significativamente la protrusión e inclinación incisiva superior e inferior, sobresaliencia y sobre mordida aunque sin llegar a norma; mientras que en grupo no fisurados, se presenta diferencia poco significativa con la norma, a excepción de evidente retroclinación incisiva inferior propia de tratamiento ortodóncico. Además, labio inferior, sobrepasa norma significativamente en grupo fisurados afectando perfil facial; no así en los no fisurados.
A non-experimental descriptive and longitudinal study - with the objetive of evaluating effectivity of protracting treatment of maxilla bone with use of facial mask previous expansion of palatal bone with a palatal expansion screw on fissured and non fissured patients, class III skeletal jaw relationship by retrusion of maxilla in relation to Ecuadorian norm. With statistical universe of 81 clinical records from FUNARMAF, selection was made based on cephalometric analysis , where 21 of the patient's clinical records who were fissured patients,Class III skeletal jaw relationship by retrognatism of maxilla (26%)(15m 6f), age average:12y.o. 11mths. and 7 clinical records of non-fissured patients (9%)(3m,4f) with age average of 11 years of age which constitutes a 35% of statistical universe. These patients presented temporary mixed and young permanent dentition at start of treatment. Upon protraction were compared with a group patients with average ecuadorian norm. (9m,21f), Class I skeletal jaw relationship and Dental Class I with an age average of 16years2mths. The average of treatment was 16mths with fissured patients; 20 mths non-fissured patients with 19 angular measures and 12 linear measures. They were compared pre and post treatment, post treatment to Average Ecuadorian norm including test error. Its effect was evaluated, using a statistic analysis t Test of pairs with significant statistics and tendency to scheduled growth , severe dolic facial type, severe hourly rotation of mandible, an increase in inferior facial height significantly greater than average norm more in fissured patients than non-fissured patients. A notable increase in maxillary height greater than norm in fissured patients. Significant advance maxilla and normal positive intermaxillary relationship without reaching the norm of the fissured group and a difference slightly significant of norm in non-fissured group. Notable decrease in SNB angle of antero-posterior mandibular movement with little significance in both groups and hourly mandibular rotation with a better intermaxillary relationship. With fissured group there was a significant change resulting in protrusion and inclining of the upper and lower incisors, overjet and overbite without reaching average norm; while in non-fissured group, presented a difference with small significance compared to norm with exception of evident retroinclining of lower incisors in comparison with norm of active ortodonthic treatment, the lower lip exceeds norm significantly with fissured group affecting facial profile while non-fissured group does not present this. KEY
A non-experimental descriptive and longitudinal study - with the objetive of evaluating effectivity of protracting treatment of maxilla bone with use of facial mask previous expansion of palatal bone with a palatal expansion screw on fissured and non fissured patients, class III skeletal jaw relationship by retrusion of maxilla in relation to Ecuadorian norm. With statistical universe of 81 clinical records from FUNARMAF, selection was made based on cephalometric analysis , where 21 of the patient's clinical records who were fissured patients,Class III skeletal jaw relationship by retrognatism of maxilla (26%)(15m 6f), age average:12y.o. 11mths. and 7 clinical records of non-fissured patients (9%)(3m,4f) with age average of 11 years of age which constitutes a 35% of statistical universe. These patients presented temporary mixed and young permanent dentition at start of treatment. Upon protraction were compared with a group patients with average ecuadorian norm. (9m,21f), Class I skeletal jaw relationship and Dental Class I with an age average of 16years2mths. The average of treatment was 16mths with fissured patients; 20 mths non-fissured patients with 19 angular measures and 12 linear measures. They were compared pre and post treatment, post treatment to Average Ecuadorian norm including test error. Its effect was evaluated, using a statistic analysis t Test of pairs with significant statistics and tendency to scheduled growth , severe dolic facial type, severe hourly rotation of mandible, an increase in inferior facial height significantly greater than average norm more in fissured patients than non-fissured patients. A notable increase in maxillary height greater than norm in fissured patients. Significant advance maxilla and normal positive intermaxillary relationship without reaching the norm of the fissured group and a difference slightly significant of norm in non-fissured group. Notable decrease in SNB angle of antero-posterior mandibular movement with little significance in both groups and hourly mandibular rotation with a better intermaxillary relationship. With fissured group there was a significant change resulting in protrusion and inclining of the upper and lower incisors, overjet and overbite without reaching average norm; while in non-fissured group, presented a difference with small significance compared to norm with exception of evident retroinclining of lower incisors in comparison with norm of active ortodonthic treatment, the lower lip exceeds norm significantly with fissured group affecting facial profile while non-fissured group does not present this. KEY
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Técnica de expansión palatina, Protracción maxilar, Epidemiología descriptiva, Fundación Nacional de Rehabilitación Maxilo Facial (FUNARMAF), Cantón Guayaquil, Ecuador, Retrognatismo, Labio leporino