Estudo morfométrico do processo coronóide da mandíbula por meio da tomografia computadorizada de feixe cônico

Abstract

Most hyperplasias of the coronoid process are late diagnosed, when there is already a marked restriction of mandibular movements, thus requiring surgical treatment. The objective is to present a protocol capable of determining, by means of cone beam computed tomography, not only the height and thickness of the coronoid process, but also its distance in relation to the zygomatic bone. A cross-sectional study was performed with cone beam computed tomography scans of 343 patients, analyzing the coronoid height, condylar height, coronoid width and coronoid-zygomatic distance. Hyperplasias were defined when the coronoid/condylar process height ratio was greater than 1.15. The average of the results between two previously calibrated evaluators was used, with the help of Student's t test, ANOVA and Tukey for symmetrical measurements, and the Mann Whitney, Kruskal Wallis and Bonferroni tests for asymmetrical measurements. The analysis was performed in SPSS 15.0, with a significance level of 5%. Measurements of the coronoid/condylar height ratio and the distance from the coronoid process to the zygomatic arch were greater in males, while the thickness of the coronoid process showed higher values in females. The prevalence of coronoid processes with hyperplasia was 21%. Only 6.7% of patients had bilateral hyperplasia. There was no statistical association between coronoid process hyperplasia and sex, side and age group. The tomographic protocol showed strong inter-examiner agreement for the diagnosis of coronoid process hyperplasia.