AVALIAÇÃO RADIOMORFOMÉTRICA DE PESSOAS COM DESORDENS PSIQUIÁTRICAS: UM ESTUDO POR EXAME DE TOMOGRAFIA COMPUTADORIZADA

Abstract

Introduction: Psychiatric disorders have been associated to decrease in bone mineral density. It occurs due to use of medication and lifestyle, in relation to psychopathology. Imaging techniques in Dentistry, such as computed tomography scan (CT scan), have been used as an indicator of bone mineral density. Objective: To evaluate bone quality in individuals diagnosed with psychiatric diseases, through radiomorphometric indices, obtained through CT Scan. Method: Face and mandible CTs were selected from patients diagnosed with psychiatric disorder undergoing treatment in an university hospital, during 2010-2022, and they composed the test group. Control group was constituted from face/mandible CTs of patients without psychiatric disorders that were matched by sex and age (+3 years). Analytics were made in DentalSlice® software, by which was obtained a standardized panoramic curve and mental foramen area. Total of 5 different tomography indicators were selected: computed tomography mental index (CTMI), computed tomography mandibular index superior (CTI(S)), computed tomography mandibular index inferior (CTI(I)) and index of mandibular alveolar bone resorption; they were measured bilaterally and averaged. Computed tomography cortical index (CTCI) was used for qualitative assessment of cortical mandibular. Analysis was made by a single trained examiner who performed measurements. Descriptive and exploratory analysis were made. Confirmation of pairing between test and control groups was performed by Student's t-test for age, Fisher's exact test for age range, and Chi-square test for gender and number of teeth. Comparisons between test and control groups for IMTC, ITC and IROAM were performed by generalized linear models. Analysis of association between CITC and group were performed by Fisher's exact test. Analysis were performed in R Core Team program (R Foundation for Statistical Computing, Vienna, Austria, 2022), with a significance level of 5%. Results: 67 CT’s were evaluated in test group and 56 in control group. Within the test group, 76.1% used antipsychotics, 40.3% used antidepressants and 23.9% used lithium. Individuals with psychiatric disorders have lower IMTC and ITC (I) values than patients without psychiatric disorders (p<0.05). There was a lower percentage of individuals in C1 category of ICTC among patients in psychiatric disorder group (16,4%) than in control group (44,6%), p<0.05. Regarding the use of psychotropic medications, ITC (S) and ITC (I) were significantly higher among those using antipsychotics (p<0,05), while in individuals who used antidepressants, the ITC (S) and the ITC (I) were significantly lower (p<0.05). Regarding ICTC, there were only cases of category C1 among those using antipsychotics (p<0.05). Conclusions: It was observed that individuals with psychiatric disorders tended to have lower bone mineral density, and that most individuals with psychiatric disorders taking antidepressants or antipsychotics had thin and porous mandibular cortices.