Terapia de Tração Extraoral Cervical no Tratamento Precoce da Maloclusão Classe II. Uma revisão sistemática
DOI:
https://doi.org/10.21615/cesodon.32.2.2Palavras-chave:
tração extraoral cervical, má oclusão classe II, tratamento precoceResumo
Introdução e objetivo: A tração cervical tem sido utilizada como tratamento da má oclusão de classe II. Embora os efeitos tenham sido relatados anteriormente, eles são contraditórios. O objetivo foi determinar as evidências científicas disponíveis que suportam os parâmetros de uso clínico para terapia com tração extraoral cervical no tratamento precoce da má oclusão de classe II. Materiais e métodos: Uma pesquisa sistemática foi realizada usando Medline, Google Scholar, Cochrane e Lilacs. Foram incluidos artigos em inglês, espanhol, português e alemão, usando termos MeSH selecionados anteriormente e termos de texto livre. A pesquisa incluiu artigos que tratavam do tratamento da tração extraoral cervical, revisões sistemáticas, meta-análise, ensaios clínicos e estudos de coorte, caso-controle e transversais. A qualidade metodológica foi avaliada usando várias escalas de acordo com o tipo de estudo. Resultados: a busca gerou 334 artigos, 259 foram eliminados por serem duplicados e 34 foram eliminados por não atenderem aos critérios de inclusão. 41 artigos foram avaliados em texto completo, 21 foram excluídos por não atenderem aos critérios de inclusão, totalizando 20 artigos. Conclusões: Os artigos oferecidos apresentaram recomendações variadas, porém claras. De acordo com a literatura e o julgamento clínico, o momento do tratamento é recomendado durante o surto de crescimento puberal. A força mais eficiente é de 450 a 500g por lado, durante 12 a 14 horas por dia. Um arco externo longo e dobrado de 15 graus deve ser usado em pacientes com padrões normais e hipodivergentes. O controle do crescimento maxilar depende da idade, força, duração do tratamento, etc. Alterações no overjet podem ser esperadas devido a alterações na inclinação dentária, crescimento ou uso de aparelhos adicionais; uma distalização molar média de 1 mm a 2 mm pode ser alcançada.
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