Aspectos craniofaciais de pessoas com doença falciforme: uma avaliação radiomorfométrica tridimensional

Abstract

The objective of this research was to perform a three-dimensional assessment of craniofacial features on subjects with sickle cell disease. On this behalf, 70 TC face scans of individuals with diagnosed SCD (test group), attending Dental Sevice at Edgard Santos University Hospital (UFBA, Brazil). Those scans were paired up with clinically normal patients (control group) regarding age and sex, on a 1:1 proportion. All images were assessed using Dolphin Imaging® software version 11.5 Premium (Dolphin Imaging & Management Solutions, Chatsworth, California, EUA) and we performed mandibular and condylar, linear and volumetric, measurements on the 3D module; condyle qualitative assessment on multiplanar reconstructions; evaluation of the skeletal pattern, through linear and angular values, on cephalometric reformations; besides upper airways volume, area and linear measurements. Results showed a very strong intra-examiner agreement (intraclass correlation coefficient of 0,998; p<0,0001) and statistically significant differences for condyle heights (p=0,02), Go-Gn and Cou-Go (p= 0,008 and p< 0,0001, respectively), with differences also for Cop-Gn (p= 0,008) for men while no statisticaly significant differences were found for women. On cephalometric analysis, both SN-GoGn (p= 0,02) and Co-A (p= 0,0011) values were increased whilst the latter kept statistically significant in women (p= 0,001) when evaluation was made according to the patient’s gender. Evaluation of the upper airways showed significant smaller measurements for volume and area (p= 0,007 and p= 0,02 respectively) on test group. One can conclude that these results indicate a tendency of a lower mandibular and condylar growth, especially in men affected with SCD, which, combined with cephalometric finds cope with a vertical growth resultant associated with maxillary protrusion, representing a hyperdivergent Class II skeletal pattern. Upper airways are diminished on SCD subjects, which is in accordance with the presented skeletal pattern.