Avaliação da deformidade do terço médio da face em portadores de fissura labiopalatina unilateral por meio de tomografia computadorizada por feixe cônico (TCFC) utilizando o software OsiriX

Abstract

Lopez MT. Evaluation of deformity midface in patients with unilateral cleft lip and palate through Cone Beam Computed Tomography (CBCT) and software OsiriX [thesis]. São Paulo, Faculdade de Odontologia; 2012. Versão original. The facial morphology of children born with complete unilateral cleft lip and palate (CLP) have injuries of soft and hard tissues of nasomaxillary complex. The purpose of this research was to evaluate the bony structures of the midface of patients with complete unilateral CLP by cone beam computed tomography (CBCT) using the OsiriX software. The sample consisted of CBCT in 28 children with complete unilateral cleft lip and palate in which 19 on the left side and 9 on the right side, with a mean age of 9 years and 6 months. All CBCT were obtained immediately before the secondary alveolar bone graft after maxillary expansion. The structures analysis of the midface was performed using the OsiriX TM DICOM Viewer software, run on a personal computer MacBook Pro, with the operation system MAC OS X Version 10.6.8 Apple Inc. The hemifacial measurements were performed through the demarcation of seven pairs of bilateral points (Zf, Zy, Nm, Cn, J, Or and Po) and by the definition of the median sagittal and coronal planes. The facial asymmetry was verified becoming th side without cleft like the control side and the side cleft like the study side. The distance between each point was calculated in the referred plans for the sagittal and transverse dimensions, which the vertical was estimated by each point in the axial section. The data were tabulated and submitted to statistical analysis by test the Wilcoxon signed-stations, with a significance level p0.050. The results showed a tendency of the cleft side be smaller than the noncleft for transverse evaluations. About the laterality of the cleft it was verified that the clefts on the left show higher degree of asymmetry transverse to the variables "Zf", "Nm", "Or" and "Zy". In the sagittal assessment, only "Cn" variable shows a statistically significant difference between the cleft side and noncleft, regardless of laterality of the cleft. Using estimated measurements with axial slices, due to the limitation of the software OsiriX TM , "Cn" also was the only variable to show statistical significance in the vertical assessment, independent of laterality of the cleft. It can be concluded that the software OsiriX TM has limitations in the assessments vertical. Patients with complete unilateral CLP had transverse asymmetries related to laterality of the cleft, mainly on the left side. The sagittal and vertical asymmetries were focused in the nasal region, independent of laterality of the cleft.