Avaliação clínica e tomográfica de indivíduos submetidos à cirurgia de enxerto ósseo autógeno tridimensional em mandíbula posteriormente atrófica

Abstract

The aim of this study was to evaluate the bone condition, pain and anxiety in individuals submitted to three-dimensional autologous bone graft surgery in the posterior mandible from the external oblique line. Bone graft height and width, bone volume and quality of the recipient region were measured before and after the graft installation in two moments, through softwares and tomographic images. Additionally, self-report of the patients was obtained through an anxiety questionnaire (IDATE T-S) and pain perception (VAS) during the treatment and 14 days postoperative. Some clinical variables of interest in the surgical treatment, limitation of daily activities, as well as postoperative symptoms were collected, respectively, during, and in the postoperative period of 14 days. This is a prospective, almost experimental, cohort study of a non-probabilistic sample with 15 selected individuals. The study was divided into four stages. The results of the linear analysis of the receptor area at the different moments of the evaluation showed a significant difference, resulting in a mean bone gain of 0.3 mm (} 1.3). for width, and 1.7 mm (} 0.94) for height, the fractal analysis did not observe a significant difference for bone trabeculation between the differentmoments of evaluation. However, a significant difference could be observed between the results of the bone volume of the initial recipient area in relation to the final one, with gain in bone volume of 3,412 mm3 (} 1,55), a rate of 71.6%. The average resorption of the graft volume obtained a rate of 14.4%, corresponding to the mean of 0.688 mm3 (} 1.48). There was no significant association between the majority of daily activities / postoperative symptoms and pain perception, as well as between clinical characteristics and levels of anxiety (STD), in the third stage of the study (P> 0.05). As an exception, a significant association between halitosis and IDATE-Estado can be observed in the thirdstage (P = 0.014). No significant difference was observed between the levels of anxiety (IDATE) obtained between the 3 moments of evaluation (P> 0.05). Crosscorrelation analysis did not present a causal relationship between anxiety-state responses and pain perception (P> 0.05). There was only a positive correlation (P = 0.044) between the perception of pain on the day of surgery and the IDATET in the postoperative period of 14 days. It is concluded that the reconstruction of vertical defects of posterior atrophic mandibles by the three-dimensional technique, provided adequate healing with low complications and minimal bone resorption, favoring vertical bone gain. The self-assessment of the patient seems to indicate that the level of pain and anxiety manifested during the treatment,however it may not be directly associated with the surgical procedure. It was not possible to prove the causality that the pain predicts the anxiety of the patients in this treatment.