Aplicação de modelos digitais e tomografias computadorizadas na odontologia

Abstract

The constant evolution of virtual tools in the field of Dentistry provides professionals with resources to improve diagnosis, treatment planning, and analysis of results. The objective of the present work was to study the new technologies associated with Orthodontics, such as the use of Cone-Beam Computed Tomography (CBCT), digital models, orthodontic aligners, and the Surgery-First aproach. Thus, this study was divided into 3 parts. In the first, a systematized review of the literature was carried out on Surgery-First with orthodontic aligners, in the PubMed, Cochrane, and Embase databases (ARTICLE 1). In the second part of the study, a new protocol was presented, established in the disciplines of Orthodontics and Oral and Maxillofacial Surgery at the School of Health and Life Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), reporting how the diagnosis and planning should be carried out with digital models and CBCT for use in Surgery-first approach associated with orthodontic aligners, as a predictable and effective alternative when performed judiciously (ARTICLE 2). In the third part of the study, the stability of palatal rugae, after maxillary expansion, was evaluated in digital models with 3 different protocols. A total of 110 models of the upper arch were scanned and analyzed, from 55 patients, divided into 4 groups, according to the procedure: Control (without intervention); Rapid maxillary expansion (RME); Expansion and constriction (Alt-Ramec), and Expansion with a removable orthodontic appliance (ROA). The models were obtained at two different timepoints: initial (T0) and 1 year after maxillary expansion or follow-up (T1). Based on the evaluated sample and with this study design, it was concluded that, in the control group, in growing children, without intervention, the most medial point of the first and third rugae showed stability after one year follow-up and can be used as stable references. In the groups undergoing expansion, there seemed to be differences in the response of the palatal rugae, according to the expansion protocol employed. Thus, as long as these differences are not completely clarified, it is not recommended to consider the palatal rugae as stable references, in cases of maxillary expansion.