Métodos de evaluación de la Dimensión Vertical Oclusal / Methods of evaluation of the Occlusal Vertical Dimension

RESUMEN: Antecedentes: La evaluación de la Dimensión Vertical Oclusal, es una fase importante en el diagnóstico y planificación del tratamiento que determina las relaciones estéticas y funcionales entre los maxilares. Objetivo: Conocer los métodos que ayuden a determinarla, ventajas y desventajas de cada uno, y los parámetros para reestablecerla. Materiales y Métodos: Se recopiló información científica desde las bases electrónicas Medline/Pubmed, EBSCO y Schoolar Google desde Enero del 2010, hasta Marzo del 2016 tanto en Inglés y Español, utilizando las palabras Dimensión Vertical Oclusal, Altura Facial Inferior y Espacio de Inoclusión Fisiológica, se leyeron los títulos y resúmenes para descartar los artículos no relacionados, eliminando los repetidos. Resultados y Discusión: La relación proporcional entre los segmentos de la cara varían de acuerdo a los estudios, de estos, las mediciones antropométricas presentan el mayor número de discrepancias, y sus resultados no pueden ser aplicados a todos los individuos. Conclusiones: no hay un método único que determine con exactitud la Dimensión Vertical Oclusal, ni evidencia científica que respalde la asociación de Trastornos Témporo Mandibulares con variaciones en la misma, incrementos de 5mm son predecibles y aunque pueden manifestar incomodidades iniciales a los pacientes, son auto limitante y remiten en pocos días.

ABSTRACT Background: The evaluation of the Occlusal Vertical Dimension is an important phase in the diagnosis and treatment planning that determines the aesthetic and functional relationships between the jaws. Objective: To know the methods that help to determine it, the advantages and disadvantages of each one, and the parameters to reestablish it. Materials and Methods: Scientific information was collected from the electronic databases Medline / Pubmed, EBSCO and Schoolar Google from January 2010 to March 2016 in both English and Spanish, using the words Occlusal Vertical Density, Lower Facial Height and Physiological Inoculation Space, Titles and abstracts were read to discard unrelated articles, eliminating repeated ones. Results and Discussion: The proportional relationship between the segments of the face varies according tothe studies; out of these, the anthropometric measurements present the greatest number of discrepancies, and their results can not be applied to all individuals. Conclusions: There is no single method that accurately determines the occlusal vertical dimension, nor scientific evidence supporting the association of temporomandibular disorders with variations in it; increments of 5mm are predictable and although they may cause initial discomforts to patients, they are self-limiting and diminish in a few days.

Avaliação da proporção facial vertical: relação entre as alturas tegumentar e esquelética / Evaluation of facial proportions in the vertical plane to investigate the relationship between skeletal and soft tissue dimensions

OBJETIVO: determinar a relação entre as alturas faciais obtidas na avaliação do tegumento e do esqueleto subjacente, na análise da proporção facial vertical, na região anterior. MÉTODOS: foram utilizadas 24 radiografias cefalométricas de perfil e 48 fotografias da face, sendo 24 de perfil e 24 frontais, pertencentes a 24 indivíduos brasileiros, 7 do sexo masculino e 17 do feminino, na faixa etária de 19 a 38 anos. Foram realizados traçados cefalométricos e, sobre esses, obtidas medidas lineares, segundo as análises preconizadas por Schudy, Wylie e Johnson e Thompson e Brodie. Sobre as fotografias faciais, foram demarcados os pontos glabela, subnasal e mento, o que permitiu a medição das distâncias lineares entre os mesmos. Os dados obtidos foram, então, tratados estatisticamente. RESULTADOS E CONCLUSÕES: encontrou-se correlação positiva entre as avaliações do tegumento e do esqueleto subjacente, com base nas análises de Schudy (r=0,619, p<0,001), Wylie e Johnson (r=0,595, p<0,002) e Thompson e Brodie (r=0,630, p<0,001), embora, individualmente, algumas discordâncias tenham sido identificadas, devido à variabilidade em espessura nos tecidos moles.

OBJECTIVE: To determine the relationship between facial heights by evaluating the soft tissues and underlying skeleton and by analyzing vertical facial proportions in the anterior region. METHODS: The study used 24 lateral cephalometric x-rays and 48 photographs of the face, 24 in profile view and 24 in front view, belonging to 24 Brazilian individuals, 7 men and 17 women whose ages ranged from 19 to 38 years. Cephalometric tracings were performed and linear measurements obtained according to the analyses suggested by Schudy, Wylie & Johnson, and Thompson & Brodie. The anatomical landmarks glabella, subnasal and menton were identified on the photographs, which allowed the measurement of linear distances between these points. The data were then statistically analyzed. RESULTS AND CONCLUSIONS: A positive correlation was found between evaluations of the soft tissues and underlying skeleton based on the analyses advanced by Schudy (r=0.619, p<0.001), Wylie & Johnson (r=0.595, p<0.002) and Thompson & Brodie (r=0.630, p<0.001), although, individually, some discrepancies were identified due to variability in soft tissue thickness.

Estudio estadístico de la altura facial inferior y su correcta clasificación. (1a. parte) / Statistical study of the lower facial height and correct classification (Part. 1)

Es fundamental a la hora de establecer un diagnostico, contar con las herramientas adecuadas y a su vez utilizar estas en forma eficiente. Es conocido que la cuantificación objetiva que nos dan en las medidas cefalométricas nos acercan a establecer patrones y biotipos, pero lejos de ser esta la única vara con la que debemos medir nuestros pacientes es común obtener resultados que se contradicen con una detallada observación clínica del mismo

It is essential when establishing a diagnosis, having the right tools and in turn use these efficiently. It is known that the objective quantification that give us the cephalometric measurements bring us to establish patterns and biotypes, but far from the only yardstick by which we measure our patients is common to get results that conflict with a detailed clinical observation of it