Tomografia computadorizada de feixe cônico na análise dos limites da osteotomia horizontal da técnica sagital em cirurgias ortognáticas

Abstract

Mandibular branch sagittal osteotomy (MBSO) is a technique used in orthognathic surgeries. In this technique, a horizontal osteotomy of the medial face of the mandibular ramus (HOMR) is the most delicate one, that high or incomplete cuts in areas with reduced amounts of spongy bone, which can cause undesirable fractures and injuries to the lower alveolar nerve. MBSO's preoperative planning is essential to reduce these accidents. Conical beam computed tomography (CBCT) is a resource used in planning that allows the prediction of these complications from the morphometric analysis of the interest area. It is essential to guarantee the accuracy of this resource in relation to the morphometry of the anatomical landmarks used during the procedure. Our aim was to analyze the accuracy of the CBCT through the morphometric analysis in dry human mandibles and their tomographic sections. 43 mandibular branches were selected and used in the CBCT, then the data was analyzed statistically. Our results corroborate with the literature regarding the limits of osteotomy and point out that the CBCT is accurate in the analysis of the vertical limits of HOMR (p <0.0001). Proper planning allows you to minimize transoperatives accidents during orthognathic surgery. CBCT and a morphometric analysis of the mandibular branch gives a good surgical predictability.