Estabilidad de los puntos de referencia craneales utilizados en los análisis cefalométrico de Jarabak y Ricketts, durante el crecimiento activo
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2013
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Universidad Andrés Bello
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Licencia CC
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Resumen
El objetivo de este estudio analítico de cohorte, es evaluar el desplazamiento de los puntos
craneales utilizados como referencia en los análisis cefalométricos de Jaraback y Ricketts
durante el crecimiento activo.
Para su realización se seleccionó una muestra por conveniencia de 60 pares de
teleradiografías de pacientes atendidos en una Clínica Privada de Ortodoncia y en el
postgrado de Ortodoncia de la Universidad Nacional Andrés Bello, que tengan al menos dos
telerradiografías de perfil tomadas con un intervalo de tiempo mínimo de 1 año (T1 y T2),
en donde T1 se encuentra antes del pick de crecimiento según el Estado de maduración
Vertebra Cervical (CVMS) 1 , 11 ó 11 según Baccetti y T2 en estadio CVM IV,V,VI (despues
del pick de crecimiento). Se excluyeron a aquellos pacientes que hubiesen recibido
tratamiento de ortopedia o presentaran alguna malformación cráneo facial o síndrome.
Las telerradiografías seleccionadas fueron digitalizadas y escaladas. Un examinador
previamente calibrado, definió los puntos craneales y trazó los planos que fueron utilizados
en la medición de las variables cefalométricas. Los puntos a evaluados fueron: Silla(S)
Nasión(Na), Basión(Ba), Porion(Po), Orbitario(Or) y Pterigoídeo (Pt); se utilizaron dos
planos de referencia construidos en base al Punto T y lámina cribosa del Etmoides,
estructuras que se consideran estables a partir de los 5 años de edad. Para evaluar el
desplazamiento de los puntos, se realizó la comparación de los resultados de T1 vs T2
utilizando los test t para variables pareadas o wilcoxon según la distribución de los datos.
Adicionalmente se comparó la muestra por sexo (test t), CVM inicial y CVM final utilizando
el test ANOVA o sus equivalente no paramétrico según la distribución de las variables. Para
todos los análisis se trabajó con un nivel de significacia de 95%.
Dados los resultados se pudo concluir que todos los puntos craneales utilizados como
referencia en los análisis cefalométricos de Jaraback y Ricketts durante el pick de
crecimiento, el punto Basion y Orbitario son los puntos de referencia que sufren mayor
desplazamiento y que no existen diferencias estadísticamente significativas en la magnitud
del desplazamiento de los puntos de referencia craneales, según género. Es por ello que es
necesario analizar las implicancias de estas variaciones en los resultados obtenidos del
análisis cefalométrico y evaluar la necesidad de utilizar puntos de referencia alternativos.
The objective of this analytical cohort study is to evaluate the displacement of cranial points used as reference in the cephalometric analysis of Jaraback and Ricketts during active growth. To accomplish this, we selected a convenience sample of 60 pairs of radiographs of treated patients from a Private Clinic of Orthodontics and from the Universidad Andrés Bello National University graduate school of orthodontic, who have at least two profile radiographs taken with a minimum interval of 1 year (T1 and T2), where T1 is befare the peak of growth according to The Cervical Vertebral MaturationJ.CVMS) 1, 11 or 11 proposed by Baccetti and T2 at CVM stage IV, V, VI (after the peak of growth). Patients who had received orthopedic treatment or submit a craniofacial malformation or syndrome were excluded. The selected radiographs were digitized and scaled. A previously calibrated examiner defined the cranial points and drew the plans that were used in the measurement of cephalometric variables. The evaluated points were: Sella (S)_nasion (Na), basion (Ba), Porion (Po), Orbital (Or) and pterygoid (Pt); two reference plans were used, built over the T point and cribriform plate of the_Ethmoid, structures that are considered stable starting from 5 years of age. To evaluate the displacement of the points, a comparison between the results of T1 vs. T2 was made using a paired-samples t-test or wilcoxon according to the data distribution. Additionally we compared the sample by sex (t-test), initial CVM and final CVM using the ANOVA test or its nonparametric equivalent according to the distribution of the variables. Far all analyzes, a 95% level of significance was used. Given the results it was concluded that all cranial points used as reference in cephalometric analysis of Jaraback and Ricketts suffers displacement during the peak of growth, that Basion and Orbital reference points suffers a greater displacement and that there is no statistically significant difference in the magnitude of the cranial reference points by gender. That is why it is necessary to analyze the implications of these variations in the obtained results of cephalometric analysis and to evaluate the need for alternative reference points
The objective of this analytical cohort study is to evaluate the displacement of cranial points used as reference in the cephalometric analysis of Jaraback and Ricketts during active growth. To accomplish this, we selected a convenience sample of 60 pairs of radiographs of treated patients from a Private Clinic of Orthodontics and from the Universidad Andrés Bello National University graduate school of orthodontic, who have at least two profile radiographs taken with a minimum interval of 1 year (T1 and T2), where T1 is befare the peak of growth according to The Cervical Vertebral MaturationJ.CVMS) 1, 11 or 11 proposed by Baccetti and T2 at CVM stage IV, V, VI (after the peak of growth). Patients who had received orthopedic treatment or submit a craniofacial malformation or syndrome were excluded. The selected radiographs were digitized and scaled. A previously calibrated examiner defined the cranial points and drew the plans that were used in the measurement of cephalometric variables. The evaluated points were: Sella (S)_nasion (Na), basion (Ba), Porion (Po), Orbital (Or) and pterygoid (Pt); two reference plans were used, built over the T point and cribriform plate of the_Ethmoid, structures that are considered stable starting from 5 years of age. To evaluate the displacement of the points, a comparison between the results of T1 vs. T2 was made using a paired-samples t-test or wilcoxon according to the data distribution. Additionally we compared the sample by sex (t-test), initial CVM and final CVM using the ANOVA test or its nonparametric equivalent according to the distribution of the variables. Far all analyzes, a 95% level of significance was used. Given the results it was concluded that all cranial points used as reference in cephalometric analysis of Jaraback and Ricketts suffers displacement during the peak of growth, that Basion and Orbital reference points suffers a greater displacement and that there is no statistically significant difference in the magnitude of the cranial reference points by gender. That is why it is necessary to analyze the implications of these variations in the obtained results of cephalometric analysis and to evaluate the need for alternative reference points
Notas
Tesis (Odontología)
Palabras clave
Anatomía Humana, Maxilares, Cráneo, Tratamiento y Diagnóstico, Análisis Cefalométrico