Cefalometrijska analiza srednjeg dela lica kod osoba sa mandibularnim prognatizmom

  • Tatjana Čutović Department of Orthodontics, Military Medical Academy, Belgrade, Serbia
  • Nebojša Jović Department of Maxillofacial Surgery, Military Medical Academy, Belgrade, Serbia
  • Ružica Kozomara Department of Maxillofacial Surgery, Military Medical Academy, Belgrade, Serbia
  • Julija Radojičić Department of Orthodontics, Faculty of Medicine, University of Niš, Niš, Serbia
  • Mirjana Janošević Department of Orthodontics, Faculty of Medicine, University of Niš, Niš, Serbia
  • Irena Mladenović Department of Prosthodontics, Faculty of Medicine, University of East Sarajevo, Bosnia and Herzegovina
  • Stevo Matijević Department of Oral Surgery, Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/4527
Ključne reči: prognathism||, ||prognatizam, mandible||, ||mandibula, malocclusion||, ||malokluzija, angle class III||, ||klase III, cephalometry||, ||kefalometrija, maxilla||, ||maksila, face||, ||lice, orthodontics||, ||ortodoncija,

Sažetak


Uvod/Cilj. Srednji masiv lica, odnosno maksila, skoro uvek se pominje kao mogući etiološki faktor skeletne klase III.  Međutim, značaj odnosa retropozicije maksile u odnosu na kranijalnu bazu, mada dosta proučavan, još uvek je nejasan.  Cilj ovog istraživanja bio je da se kefalometrijski analiziraju morfološke karakteristike maksile kao i celog srednjeg masiva lica kod pacijenata sa divergentnim i konvergentnim oblikom mandibularnog prognatizma, kao i da se ustanove razlike između njih. Metode. Analizirani su rendgenkefalometrijski snimci ukupno 90 pacijenata Klinike za stomatologiju Vojnomedicinske akademije, Beograd, Srbija. Svi pacijenti bili su muškog pola, starosti od 18 do 30 godina i nisu ranije bili ortodontski lečeni. Pacijenti su prema dentoskeletnim odnosima vilica i zuba svrstani u tri grupe: grupu P1 (pacijenti sa divergentnim mandibularnim prognatizmom), P2 (pacijenti sa konvergentnim mandibularnim prognatizmom) i grupu E (kontrolna grupa ili grupa pacijenata sa normalnom okluzijom). Izmereno je i analizirano 9 kefalometrijskih parametara koji su se odnosili na srednji masiv lica: dužina tvrdog nepca (SnaSnp), dužina korpusa maksile (AptmPP), dužina mekog nepca, ugao između mekog i tvrdog nepca (SnaSnpUt), ugao inklinacije maksilarnog alveolarnog procesusa, inklinacija gornjih frontalnih zuba, efektivna dužina maksile (CoA), posteriorna maksilarna hiperplazija (U6PP) i ugao maksilarnog prognatizma. Rezultati. Dobijeni rezultati su pokazali da su CoA, AptmPP, kao i SnaSnp, značajno kraći kod pacijenata sa divergentnim oblikom mandibularnog prognatizma u odnosu na pacijente sa konvergentnim, a takođe i kod obe eksperimentalne grupe pacijenata u odnosu na kontrolnu. SnaSnp značajno je kraća kod pacijenata sa divergentnim oblikom mandibularnog prognatizma nego kod pacijenata kontrolne grupe, dok je SnaSnpUt značajno manji kod pacijenata sa konvergentnim oblikom mandibularnog prognatizma u nego kod pacijenata kontrolne grupe. Takođe, postoji izražena dentoalveolarna incizalna kompenzacija skeletne disharmonije kod obe grupe pacijenata sa mandibularnim prognatizmom u vidu značajne protruzije gornjih frontalnih zuba, ali bez značajne razlike među grupama, dok je retrognatizam maksile prisutan kod većine pacijenata obe eksperimentalne grupe. Izražena UGPP ustanovljena je samo kod pacijenata sa divergentnim tipom mandibularnog prognatizma. Zaključak. Gornja vilica svakako je jedan od bitnih faktora koji doprinose dijagnozi ali pre svega donošenju plana terapije kod mandibularnog prognatizma. Tačna procena ispoljenosti anomalije, lokalizacija skeletnog problema i razumevanje biološkog potencijala glavni su faktori postojanosti rezultata ortodontskohirurške terapije tog deformiteta.

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Objavljeno
2015/04/24
Broj časopisa
Vol. 71 Br. 11 (2014)
Rubrika
Originalni članak