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A Importância da Postura Cervical em Ortodontia

sob orientação do Mestre Nelso Alves Reis
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Alexandra Pires

on 23 October 2012

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Transcript of A Importância da Postura Cervical em Ortodontia

Importância da Postura Cervical em Ortodontia sob orientação do Mestre Nelso Alves Reis MEDICINA BASEADA NA EVIDÊNCIA Identificar o mecanismo pelo qual interagem a morfologia dento e craniofacial e a coluna cervical Alexandra Emília Ançã Pires
Porto, 2012 Abril 2011
Junho 2012 cephalometry
craniofacial morphology
dental occlusion
malocclusion
dentofacial morphology
craniocervical angle
head posture
cervical vertebrae
cervical column
postural disorders
abnormal posture
craniovertebral junction POSTURA Korbmacher et al., 2004 "posição inicial para movimentos activos" Solow e Sandham, 2002 Os mecanismos que provocam distúrbios morfológicos e funcionais no aparelho estomatognático actuam a nível macroscópico Utilização e manipulação pelo Ortodontista Equilíbrio Coordenação neuromuscular Eficácia Biomecânica Armijo-Olivo et al., 2006 Postura Cervical
Posição Mandibular
Má Oclusão Schwarz (1926)
cit. in Korbmacher et al., 2004 Balters (1964)
cit. in Huggare, 1998 Von Treuenfels (1984) relaciona postura da cabeça
com a coluna cervical inclinação cervical quanto à
horizontal verdadeira inclinação da cabeça mirror position Silva, 2005 verificação da legitimidade da PNC fotografia de perfil self-balance position PNC propriocepção/ equilibrio estimulação visual Mecânicas Anomalias Morfológicas achados radiográficos que não requerem tratamento Agenesia da apófise odontóide
Ausência de fusão da apófise odontóide com a áxis patologias
vertebrais Não-mecânicas Ombregt et al. (2001) FUSÃO Aumento da mobilidade cervical Solow cit. in Sonnesen e Bakke (2005) Existe predomínio muscular sobre os comandos genéticos de crescimento e desenvolvimento ósseo Salagnac cit. in Karlsen (2004) O crescimento facial coincide com o pico de crescimento em altura McCane e Kean (2011) Se o crescimento ocorrer numa determinada região e no seu homólogo, no mesmo sentido e na mesma intensidade, então haverá equílibrio HIPÓTESE DO ESTIRAMENTO MUSCULAR Solow & Kreiborg (1977) O crescimento vertical tem elevada correlação com a puberdade.
Existe uma relação anatómica mútua entre a coluna cervical e terço inferior da face. Karlsen (2004) Quanto maior a lordose cervical, maior a tendência para o crescimento vertical Obstrução aérea extensão crânio-cervical
(feedback neuromuscular) Solow e Sandham, 2002
Sonnesen, 2010 CAPACIDADE PREDITIVA DO CRESCIMENTO Solow e Siersbaek-Nielsen (1992) POSTURA OCLUSÃO
DENTÁRIA Rocabado et al. (1982
Solow e Sonnesen (1998)
Motoyoshi (2000 e 2002) Alinhamento da coluna é influenciado pela oclusão D' Attílio et al. (2005) Festa et al. (1997) Em ORC existe o máximo de equilíbrio neuromuscular Gangloff et al. (2000)
Shimazaki et al. (2003)
Festa et al. (2003)
Tardieu et al. (2007)
Armstrong (2008) AFERÊNCIA TRIGEMINAL PROPRIOCEPTIVA FUSÃO CLASSE III CLASSE II DIV. 2 CLASSE II DIV. 1 Retromaxilia Retromandibulia Sonnesen e Kjaer (2007) Sonnesen e Kjaer (2007) Sonnesen e Kjaer (2008) Diminuição da lordose cervical Anteriorização da cabeça A coluna vertebral e o viscerocrânio têm a mesma origem embrionária Sonnesen (2010) Apinhamento dentário Solow e Sonnesen (1998) Pachì et al. (2009) AlKofide e AlNamakani (2007) Apesar da etiologia multifactorial... um ângulo crâniocervical aumentado... PNC é um método reprodutível que aumenta a fiabilidade documental da telerradiografia craniofacial de perfil o especialista em Ortodontia é crucial no despiste de achados radiográficos e encaminhamento médico A evidência científica aponta a avaliação postural como elemento auxiliar de diagnóstico em Ortodontia Leonardi cit. in Ciancaglini et al. (2009) São necessários mais estudos sobre esta temática daí que o tratamento ortodôntico deva ser de "baixo risco e elevada prudência" Tetradis et al. 2003 adaptado de Sonnesen, 2010 adaptado de Tetradis et al., 2003 adaptado de Tetradis et al., 2003 adaptado de Solow e Kreiborg, 1977 adaptado de Pollmann, 1997 adaptado de Solow e Sandham, 2002 adaptado de Sonnesen, 2010 adaptado de Neiva et al., 2009 adaptado de Armijo-Olivo et al., 2006 adaptado de Solow e Sandham, 2002 Solow e Tallgren (1971)
Silva (2005) adaptado de McCane e Kean, 2011 adaptado de Naini, 2008 adaptado de Naini, 2008 adaptado de Naini, 2008 Özbek cit. in Watanabe et al., 2010
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