Abstract
OBJETIVO: avaliar as alterações cefalométricas em pacientes com perda bilateral do primeiro molar inferior permanente. MÉTODOS: foram analisadas 68 telerradiografias laterais de pacientes de consultórios particulares. A amostra foi dividida em dois grupos pareados quanto ao sexo e idade - 34 indivíduos sem perdas (grupo controle) e 34 com perda bilateral do primeiro molar inferior permanente (grupo com perda). Foram excluídos da amostra pacientes que haviam perdido outros dentes que não o primeiro molar inferior, casos de agenesia e pacientes com menos de 16 anos de idade. Buscou-se avaliar somente indivíduos que tivessem relatado a perda há pelo menos 5 anos. RESULTADOS: demonstraram que a perda bilateral do primeiro molar inferior permanente leva ao suave fechamento do ângulo GnSN (P=0,05), um giro anti-horário do plano oclusal (P=0,0001), uma suave diminuição da altura facial anteroinferior (P=0,05), uma acentuada inclinação lingual (P=0,04) e retrusão dos incisivos inferiores (P=0,03). Por outro lado, a perda bilateral do primeiro molar inferior permanente não foi capaz de influenciar a relação maxilomandibular no sentido anteroposterior (P=0,21), a quantidade de mento (P=0,45), a inclinação dos incisivos superiores (P=0,12) e a posição anteroposterior dos incisivos superiores (P=0,46). CONCLUSÃO: a perda bilateral dos primeiros molares inferiores é capaz de produzir alterações marcantes no posicionamento dos incisivos inferiores e no plano oclusal, além de uma suave redução vertical da face
Highlights
The OclSN angle, which defines the occlusal plane from the cranial base, showed a mean of 12.6° (SD=6.6) in the control group, and 5.6o (SD=5.7°) in the loss group, demonstrating that bilateral loss of first molars causes a nearly 6o (P=0.0001) counterclockwise rotation of the occlusal plane
lower anterior face height (LAFH), which is the linear expression of lower face height, where the mean value obtained for the control group was 70.8 mm (SD = 5.6 mm), and for the loss group, 68.6 mm (SD = 5.7 mm), revealed that bilateral loss of first molars causes a mild, statistically significant (P = 0.048) decrease in LAFH
While little has been assessed regarding morphological changes in the dental arches arising from missing lower first permanent molars, almost nothing seems to have been reported regarding dentoskeletal changes resulting from these losses in facial morphology
Summary
This study was developed through the analysis of 68 lateral cephalometric X-rays from routine orthodontic records. The sample was divided into two groups matched for gender and age: a control group (no loss), consisting of 34 radiographs, 8 men and 26 women, whose mean age was 19.5 years (16-26.2), and another group with bilateral loss of first permanent molars, consisting of 34 radiographs, 8 men and 26 women with a mean age of 24.6 years (16-36). Patients who had lost teeth other than the first molar, cases of agenesis and patients under 16 years of age were excluded from the sample. Information regarding age and gender was collected directly from the patients’ dental records. Despite the authors’ efforts, it was not possible to accurately determine the time at which the molars were lost. The patients who were able to determine it reported having lost them at least 5 years earlier. Patients who reported a recent loss were excluded from the sample
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