ABSTRACT
Abstract Objective To verify changes in facial soft tissue using the RadiANT-DICOM-viewer and Dolphin Imaging software, through linear measurements of tomographic points in a 3D reconstruction of the face and volumetric evaluation with three-dimensional measurements of the upper airways of patients with transverse maxillary discrepancy undergoing Surgically Assisted Rapid Maxillary Expansion (SARME). Methods Retrospective, transverse, and descriptive study, through the analysis of computed tomography scans of the face of patients with transverse maxillary discrepancy, treated from July 2019 to December 2022. The sample consisted of 15 patients of both sexes, aged 21-42 years old, who underwent surgically assisted rapid maxillary expansion using the transpalatal distractor. Analysis was performed through linear, angular, and three-dimensional measurements in millimeters, in the preoperative and late four-month postoperative period, in frontal 3D tomographic images of the face, in the region of the width of the nose and alar base and also angular measurement in the lateral tomography for the angle nasolabial and upper airways of rhinopharynx, oropharynx and hypopharynx. Results There was an increase in nasal width with an average of 1.3467 mm and an increase in the alar base with an average of 1.7333 mm. A significant difference was found in the pre- and postoperative assessments of the measurements of nasal width, alar base and nasolabial angle, as well as the upper airways in all their extension. The results favour a better understanding of the professional and the patient regarding the diagnosis and management of patients with transverse maxillary width discrepancies. Conclusion Although our study shows an increase in soft tissues after SARME, no aesthetic changes are observed clinically, and all patients report significant respiratory improvement. SARME may therefore contribute to the improvement of professionals working in the field of oral and maxillofacial surgery and orthodontics. Level of evidence: Level 4.
ABSTRACT
Descrever a eficiência da cirurgia ortognática em pacientes com síndrome da apnéia obstrutiva do sono. Método: pesquisa da literatura sobre o tema, em base de dados PUBMED/MEDLINE. Discussão e considerações finais: Sindrome da Apneia Obstrutiva do Sono é uma doença preocupante causada pelo colapso das vias aéreas superiores durante o sono. Resultada influência dos ossos da face e estruturas relacionadas a eles no desenvolvimento desta síndrome, o cirurgião buco-maxilo-facial desempenha um importante papel na identificação do paciente que necessita ser acompanhado por especialistas em doenças do sono e no tratamento destes pacientes em determinados casos. Tratamentos não cirúrgicos convencionais podem ser inaceitáveis ou intoleráveis por alguns pacientes. Nestas situações, o avanço maxilomandibularque é eficaz no tratamento de pacientes com apnéia obstrutiva do sono moderada ou grave, pode ser uma opção viável.
The study aim was to describe the effectiveness of the orthognatic surgery in patients suffering from obstructive sleep apnea syndrome. Method: bibliography search on PUBMED/MEDLINE. Discussion and final considerations: Obstructive sleep apnea syndrome (OSAS)is a lifethreatening disease that is caused by the collapse of the upper airway during sleep. Because the jaws and related structures influence the development of this syndrome, oral and maxillofacial surgeons play an important role in both identifying patients who should be assessed by sleepspecialists and instituting treatment in selected cases. Conventional nonsurgical treatment options may be unacceptable or intolerable to some patients. In these situations, Maxillomandibular advancement is very effective in treating patients with moderate or severe obstructive sleep apnea and may be a viable option.