Características esqueletales para la determinación cualitativa del biotipo facial en telerradiografía lateral: Estudio Piloto / Skeletal characteristics for subjective determination of facial type in cephalometric x-ray: a pilot study

RESUMEN: Objetivo: Determinar parámetros visuales sencillos para la evaluación de características esqueletales relacionadas con el biotipo facial en una telerradiografía lateral. Material y método: Estudio transversal descriptivo. Se confeccionó una guía visual impresa acerca de ocho características morfológicas del esqueleto facial visibles en la telerradiografía de perfil. Ésta fue entregada a un grupo de 69 estudiantes de Odontología de 5º año sin estudios previos en cefalometría, quienes la analizaron durante 10 minutos. Inmediatamente se les mostraron una serie de telerradiografías, y se les pidió que evaluaran las 8 características a través de una serie de opciones presentadas en una escala visual que se correspondía con la guía estudiada. Las respuestas fueron registradas utilizando un sistema digital de cliqueras. Los datos fueron analizados con el método Rasch para determinar la dificultad de los ítems, estableciéndose el grado de dificultad a través del Logit. Resultados: Los estudiantes lograron identificar y graduar sin dificultad 5 de las 8 características presentadas. Éstas fueron: Proyección del mentón (-2,49), Divergencia facial (-2,85), Ancho de la rama mandibular (-1,97), Escotadura sigmoidea (-0,96) y Relación de la rama con el cuerpo mandibular (-0,06). Conclusión: Se determinó que hay 5 características de la morfología ósea facial relacionadas con el biotipo que se pueden identificar y graduar sin dificultad por estudiantes de pregrado de odontología. Ésta información podría ser utilizada para construir una escala sencilla de identificación del biotipo facial.

ABSTRACT: Aim: Determine simple visual parameters to evaluate skeletal characteristics related to facial types in lateral teleradiographs. Materials and Methods: Descriptive cross-sectional study. A printed visual guideline about the eight visible morphological characteristics of the facial skeleton in cephalometric x-rays was created. The guideline was given to 69 undergraduate dental students (fifth year) without previous studies in cephalometric to analyze it for 10 minutes. Immediately after, they were shown a series of teleradiographs and were asked to evaluate 8 characteristics through a series of options presented in a visual scale according to the guideline. The answers were recorded through a digital audience response system (clickers). The data obtained were analyzed with the Rasch method to assess each item level of difficulty, establishing the Logit number for each one. Results: The students identified and graded without difficulty 5 of the 8 characteristics. These were: Chin projection (-2.49), Facial divergence (-2.85), Mandibular ramus width (-1.97), Sigmoid notch (-0.96) and Mandibular body with ramus relationship (-0.06). Conclusions: Five facial osseous morphological characteristics related to the facial types can be identified and graded without difficulty by undergraduate dental students. This information may be used to create a facial type identification scale.

Investigation of the relationship between "sella turcica bridge" and "ponticulus posticus": a lateral cephalometric study / Investigación sobre la relación entre "puente silla turca" y "ponticulus posticus": un estudio cefalométrico lateral

The ponticulus posticus (PP) is a bridge of bone sometimes found on the atlas vertebra surrounding the vertebral artery and the first cervical nerve root. Sella turcica bridging (STB) is the fusion of anterior and posterior clinoid processes. The objective of this study was to find out the association between STB and PP. For the study, 752 digital lateral cephalograms were retrieved from the archived records of Necmettin Erbakan University, Faculty of Dentistry, Konya, Turkey. There was a significant relationship between the presence of STB and PP (p=0.000, p<0.001). This study indicates that there is a significant correlation between the presence of STB and PP.

El Ponticulus Posticus (PP) es un puente de hueso que se encuentra, a veces, en el atlas y rodea la arteria vertebral y la primera raíz del nervio cervical. El puente de la silla turca (PST) es la fusión de los procesos clinoides anteriores y posteriores. El objetivo de este estudio fue conocer la asociación entre PST y PP. Para el estudio, fueron utilizados 752 cefalogramas digitales laterales, obtenidos de los registros archivados de la Facultad de Odontología de la Universidad Necmettin Erbakan, Konya, Turquía. Hubo una relación significativa entre la presencia de PST y PP (p = 0,000, p <0,001). Este estudio indica que existe una correlación significativa entre la presencia de PST y PP.

Estudo do crescimento da maxila em três planos cefalométricos, no crescimento puberal / Maxilary growth study in the three cephalometric dimensions during the puberal development

O presente estudo tem por finalidade contribuir com os estudos do crescimento maxilar nos planos vertical, sagital e transversal, interrelacionando-os, dando assim uma visão tridimensional ao crescimento da maxila. Foram estudados 27 indivíduos, sendo 15 do sexo feminino e 12 do sexo masculino, sendo que todos se encontravam inicialmente na fase de dentição mista, apresentavam uma oclusão satisfatória e não haviam sido submetidos a nenhum tipo de tratamento ortodôntico ou ortopédico prévio. As radiografias cefalométricas foram selecionadas de acordo com a maturação das vértebras cervicais, conforme os padrões estabelecidos por Hassel e Farman(1), em três fases: aceleração, transição e desaceleração, em que se mensurou 04 grandezas cefalométricas, que abrangeram os 03 planos espaciais, em cefalogramas obtidos em radiografias cefalométricas laterais e frontais. O crescimento foi estatisticamente significante em todas as grandezas estudadas, quando consideramos o crescimento na fase de aceleração até a fase de desaceleração. Porém, não foram encontradas diferenças estatísticas quando comparadas as fases: aceleração à transição e transição à desaceleração. Ao avaliarmos o crescimento maxilar, tendo como parâmetros os 03 planos espaciais, verificamos que ele é maior no sentido vertical, seguido pelo sagital e transversal, não se verificou diferenças entre os indivíduos do sexo masculino e do feminino.

This present study has as a goal contribute with maxillar growth studies on the vertical, sagittal and transversal planes, intertwining them, giving this way a tridimensional view of the mandible growth. Twenty-seven individuals were studied, fifteen females and twelve males. All of them were at the mixed dentition phase; they had a satisfactory occlusion and hadn’t been under any kind of previous orthopedic or orthodontic treatment. The cephalometric radiographs were selected according to the cervical vertebra maturation, in accordance with Hassel and Farman(1), in three phases: acceleration, transition, and deceleration on which four cephalometric greatnesses were measured that included the three spatial planes, in cephalograms obtained from lateral and front cephalometric radiographs. The growth was statistically significant in all the studied greatnesses, when considered the growth in the acceleration phase to the deceleration one. However, statistic differences were not found when acceleration was compared to transition and when transition was contrasted with deceleration. When we evaluated the maxillar growth, having as parameter the three spatial planes, we verified it is bigger vertically, sagittally and then transversally. It was not verified differences between sexes.