Evaluation the scanning accuracy of Blue-Light laboratory scanners in complete edentulous Maxilla with multiple implants with titanium scan bodies / Evaluación de la precisión de escaneado de los escáneres de laboratorio de luz azul en maxilares desdentados completos con implantes múltiples con cuerpos de escaneado de titanio

Abstract To evaluate the accuracy of complete arch scanning with multiple implant titanium scan bodies using laboratory scanners. A master model of an edentulous maxillary arch with 6 implants was fabricated. Titanium scan bodies were inserted into the model. Three laboratory scanners were used: D2000 (3Shape), Vinyl High Resolution (Smart Optics), and inEos X5 (Dentsply Sirona). The master model was consecutively scanned ten times using dental laboratory scanners (LS) without detaching and repositioning the scan bodies. Linear and angular accuracy between adjacent implants was measured using inspection software (Control X, Geomagic). The accuracy of the complete arch scans was calculated. Implant regions were defined as; parallel (R1: #24-26 and #16-14), angled (R2: #22-24 and #14-12), angled to occlusal plane (R3: #12-22), and cross-arch (R4: #16-26). The effect of LS and implant region on accuracy was compared using two-Way ANOVA (α=0.05). Significant greater linear distortion was noted in R4 (61.2±17.9µm) compared to R1 (23.4±15.5µm) and R2 (26±17.7µm) (p<0.01). Greater linear distortions were noted in R4 with D2000 (0.07±0.016 degrees) and Vinyl High Resolution (0.067±0.02 degrees) than inEos X5 (0.032±0.021 degrees) (p>0.05). Greater mean linear precisions were noted in R1 (9±8µm) and R3 (9.3±8.3µm) than R4 (12.6±10.3µm) (p<0.05). The highest linear precision was noted in D2000 (7.2±7.6µm) (p<0.05). The angular precision of D2000 (0.02±0.015 degrees) was the highest (p<0.01). The angular precisión of R4 (0.036±0.018 degrees) was the lowest (p<0.01). This study revealed that the trueness was affected by the implant region and the precision was affected by both LS and implant region.

Resumen Evaluar la precisión del escaneado de la arcada completa con cuerpos de escaneado de titanio de múltiples implantes utilizando escáneres de laboratorio. Se fabricó un modelo maestro de una arcada maxilar edéntula con 6 implantes. Se insertaron cuerpos de escaneo de titanio en el modelo. Se utilizaron tres escáneres de laboratorio: D2000 (3Shape), Vinyl High Resolution (Smart Optics) e inEos X5 (Dentsply Sirona). El modelo maestro se escaneó consecutivamente diez veces usando escáneres de laboratorio dental (LS) sin separar y reposicionar los cuerpos de escaneo. La precisión lineal y angular entre implantes adyacentes se midió utilizando un software de inspección (Control X, Geomagic). Se calculó la precisión de los escaneos completos del arco. Las regiones del implante se definieron como; paralelo (R1: #24-26 y #16-14), angulado (R2: #22-24 y #14-12), angulado al plano oclusal (R3: #12-22) y cruzado (R4: #16-26). El efecto de LS y la región del implante en la precisión se comparó mediante ANOVA de dos vías (α=0,05). Se observó una distorsión lineal significativamente mayor en R4 (61,2±17,9µm) en comparación con R1 (23,4±15,5µm) y R2 (26 ±17,7µm) (p<0,01). Se observaron mayores distorsiones lineales en R4 con D2000 (0,07±0,016 grados) y vinilo de alta resolución (0,067±0,02 grados) que en inEos X5 (0,032±0,021 grados) (p>0,05). Se observaron precisiones lineales medias mayores en R1 (9±8µm) y R3 (9,3±8,3µm) que en R4 (12,6±10,3µm) (p<0,05). La mayor precisión lineal se observó en D2000 (7,2±7,6 µm) (p<0,05). La precisión angular de D2000 (0,02±0,015 grados) fue la más alta (p<0,01). La precisión angular de R4 (0,036±0,018 grados) fue la más baja (p<0,01). Este estudio reveló que la veracidad se vio afectada por la región del implante y la precisión se vio afectada tanto por LS como por la región del implante.

Configurações dentárias reduzidas no contexto de estudos epidemiológicos: associação com desfechos de saúde e validação de critério diagnóstico / Shortened dental configurations in the context of epidemiological studies: association with health outcomes and validation of diagnostic criteria

Objetivou-se mapear os conceitos de configuração dentária reduzida empregados em estudos epidemiológicos associados com desfechos em saúde (estudo 1), bem como avaliar a validade de uma configuração utilizada em estudos epidemiológicos (pares de dentes antagonistas) (Estudo 2). Para o estudo 1 realizou-se uma revisão de literatura do tipo Scoping review com busca nas bases de dados PubMed/Medline, Scopus, Web of Science, Scielo e Cochrane. Dois pesquisadores treinados realizaram a seleção e extração de dados de estudos que avaliaram a associação entre configuração dentária reduzida (exposição) e desfechos em saúde clínicos e centrados na pessoa (saúde geral e saúde bucal), relacionados ao comportamento em saúde (padrões de dieta), além de mortalidade. Desfechos foram classificados de acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde e com a Classificação Internacional de Doenças da Organização Mundial de Saúde (OMS). Configurações dentárias reduzidas basearam-se na contagem de dentes presentes, na posição dos dentes considerando estética, oclusão dentária e condições periodontais. A busca inicial resultou em 12525 referências, sendo 283 incluídos. A atualização da busca incluiu 117 artigos (ntotal=400). Saúde geral (n=186) e saúde bucal (n=192) foram abordadas em número semelhante de estudos. A maioria dos desfechos foram clínicos de saúde geral (n=169), sendo as doenças endócrinas, nutricionais ou metabólicas (n=55) frequentes. Em 144 estudos foram abordadas medidas centradas na pessoa, sendo a qualidade de vida relacionada a saúde bucal (QRSB) a mais frequente (n=60). Os desfechos clínicos de saúde bucal foram predominantemente relacionados às funções de ingestão (n=42) e doenças ou distúrbios do complexo orofacial (n=23). Padrões de dieta (n=39) e mortalidade (n=34) também foram estudados. A configuração dentária reduzida definida como meta pela OMS foi a mais frequente (n=181). Para o estudo 2 avaliou-se a acurácia de pares de dentes antagonistas para mensurar a presença de pares de pré-molares e molares em contato oclusal e a concordância entre a prevalência de Arco Dental Reduzido (ADR) e Dentição funcional (DF) quando unidades oclusais dentárias (UOs)/pares de oclusão posterior (POPs) foram definidas por pares de dentes antagonistas ou pares de dentes em contato oclusal. Dados obtidos em inquérito epidemiológico de saúde bucal realizado em município de Minas Gerais, Brasil. UOs e POPs foram definidos pelo critério epidemiológico (condição da coroa dentária) ou critério clínico "padrão ouro" (registro em papel carbono dos contatos oclusais durante a máxima intercuspidação habitual). Foram calculados sensibilidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN) e acurácia do critério epidemiológico. Sensibilidade, especificidade, VPP e VPN foram 88,5, 87,9, 92,5 e 81,9%, respectivamente, e acurácia foi de 88,3%. Os resultados sobre a concordância observada, coeficientes Kappa e valores estatísticos ß em relação à prevalência de ADR e DF (antagonista e contato oclusal) variaram de 0,82 a 0,98, indicando alto índice de concordância. Efeitos das configurações dentárias reduzidas têm sido investigados principalmente em relação às doenças endócrinas, nutricionais ou metabólicas e medidas de QVRSB. Há diversidade de desfechos em saúde. Critério epidemiológico mostrou-se válido e pode ser utilizado em estudos epidemiológicos para calcular a prevalência de configurações dentárias reduzidas que consideram POPs.

This study mapped definitions of shortened dental configurations and health outcomes employed in association studies (Study 1), as well as to evaluate the validity of a configuration used in epidemiological studies (pairs of antagonistic teeth) (Study 2). For study 1, a literature review of the Scoping review type was carried out with a search in PubMed/Medline, Scopus, Web of Science, Scielo and Cochrane databases. Two trained researchers performed the selection and data extraction of studies that evaluated the association between reduced tooth configuration (exposure) and clinical and person-centered health outcomes (general health and oral health), related to health behavior (dietary patterns), in addition to mortality. Outcomes were classified according to the International Classification of Functioning, Disability and Health and the International Classification of Diseases of the World Health Organization (WHO). Shortened dental configurations were based on the number of teeth present, the position of the teeth regarding esthetics, dental occlusion and periodontal conditions. The initial search resulted in 12525 references, 283 of which were included. The search update included 117 articles (ntotal=400). General health (n=186) and oral health (n=192) were addressed in a similar number of studies. Most outcomes were general health clinics (n=169), with endocrine, nutritional or metabolic diseases (n=55) being frequent. In 144 studies, person-centered measures were addressed, with oral healthrelated quality of life (OHQoL) being the most frequent (n=60). Clinical oral health outcomes were predominantly related to eating functions (n=42) and diseases or disorders of the orofacial complex (n=23). Diet patterns (n=39) and mortality (n=34) were also studied. The shortened dental configuration defined as a goal by the WHO was the most frequent (n=181). For study 2, the accuracy of pairs of antagonistic teeth was evaluated to measure the presence of pairs of premolars and molars in occlusal contact and the agreement between the prevalence of Shortened Dental Arch (SDA) and Functional Dentition (FD) when units occlusal (UOs)/posterior occlusion pairs (POPs) were defined by pairs of antagonistic teeth or pairs of teeth in occlusal contact. Data obtained from an epidemiological survey of oral health carried out in the municipality of Minas Gerais, Brazil. UOs and POPs were defined by epidemiological criteria (condition of the dental crown) or clinical "gold standard" criteria (carbon paper recording of occlusal contacts during maximum habitual intercuspation). Sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of the epidemiological criterion were calculated. Sensitivity, specificity, PPV and NPV were 88.5, 87.9, 92.5 and 81.9%, respectively, and accuracy was 88.3%. The results on observed agreement, Kappa coefficients and ß statistical values in relation to the prevalence of SDA and FD (antagonist and occlusal contact) ranged from 0.82 to 0.98, indicating a high level of agreement. Effects of reduced tooth configurations have been investigated mainly in relation to endocrine, nutritional or metabolic diseases and OHQoL measures. There is a diversity of health outcomes. Epidemiological criteria proved to be valid and can be used in epidemiological studies to calculate the prevalence of reduced dental configurations that consider POPs.

Surgical effects of rehabilitation protocols on dental arch occlusion of children with cleft lip and palate

Aim: to evaluate the surgical effects of two rehabilitation protocols on dental arch occlusion of 5-year-old children with or without cleft lip and palate. Methods: this is a retrospective longitudinal study the sample comprised 45 digitized dental casts divided into followed groups: Group 1 (G1) ­ children who underwent to cheiloplasty (Millard technique) at 3 months and to one-stage palatoplasty (von Langenbeck technique) at 12 months; Group 2 (G2) ­ children who underwent to cheiloplasty (Millard technique) and two-stage palatoplasty (Hans Pichler technique for hard palate closure) at 3 months and at 12 months to soft palate closure (Sommerlad technique); and Group 3 (G3) ­ children without craniofacial anomalies. Linear measurements, area, and occlusion were evaluated by stereophotogrammetry software. Shapiro-Wilk test was used to verify normality. ANOVA followed by posthoc Tukey test and Kruskal-Wallis followed by posthoc Dunn tests were used to compared groups. Results: For the measures intercanine distance (C-C'), anterior length of dental arch (I-CC'), and total length of the dental arch (I­MM'), there were statistical differences between G1x G3 and G2xG3, the mean was smaller for G1 and G2. No statistically significant differences occurred in the intermolar distance and in the dental arch area among groups. The occlusion analysis revealed significant difference in the comparison of the three groups (p=0.0004). Conclusion: The surgical effects of two rehabilitation protocols affected the occlusion and the development of the anterior region of the maxilla of children with oral clefts when compared to children without oral clefts.

Dental arch characteristics among South Indian twins - A morphometric study

Genetic and environmental factors are essential in occlusal variations and malocclusion and have been of considerable interest to orthodontists. Studies on twin pairs are one of the most effective methods for investigating genetically determined occlusal variables. Many studies have focused on distances between first molars or between canines but malocclusions can also occur in other regions of the dental arch. Aim: To evaluate the characteristics of the dental arch between pairs of Monozygotic (MZ) and Dizygotic (DZ) twins from Southern India. Methods: A random sample of 51 twin pairs (12­18years old) participated in this study. The zygosity of twin pairs was recorded by facial appearance. The occlusion of the first permanent molars was recorded according to Angle's classification. Study models were prepared to assess dental arch characteristics (i.e., arch form, arch perimeter, arch length; intercanine, intermolar width, and teeth size discrepancy). The obtained data was statistically analyzed using SPSS software 19.0. The student's t-test (two-tailed, independent) and Chi-square test was used to determine the significance of studied parameters. Results: Angle's Class I molar relation was more commonly observed followed by the Class II molar relationship among twins. The measured dental arch dimensions did not show a statistically significant difference among twin pairs. The ovoid arch form was commonly observed among Monozygotic and Dizygotic Twins. There was a similarity among MZ and DZ twins in the anterior and overall Bolton's ratio. Conclusion: There were similar occurrences of measured parameters among twins, which showed genetic predominance in the expression of measured dental arch traits

Evaluation of palatal volume in children with cleft lip and palate: a comparison of two surgical protocols / Avaliação volumétrica do palato em crianças com fissura labiopalatina: comparação de dois protocolos cirúrgicos

Objective: Compare the palatal volume in children with unilateral cleft lip and palate before and after two surgical protocols. Material and Methods: Retrospective data collection was performed in a specialized hospital. The sample comprised 120 digitized dental models divided into, Group 1 (G1) ­ participants submitted to cheiloplasty at 3 months (Millard technique) and one-step palatoplasty at 12 months (von Langenbeck technique); Group 2 (G2) ­ participants submitted to cheiloplasty (Millard technique) and hard palate closure (Hans Pichler technique) at 3 months and soft palate closure at 12 months (Sommerlad technique). The dental models were evaluated at Time 1 (T1): before primary plastic surgeries, Time 2 (T2): 1st post-surgical phase, and Time 3 (T3): 2nd post-surgical phase. The volume was measured through stereophotogrammetry system software. Parametric and non-parametric statistical tests were applied (α=5%). Results: The intragroup analysis revealed that G1 had a statistically significant increase in volume at T2 followed by a reduction at T3 (p=0.003); G2 showed a statistically significant increase of dental arch volume between T1 and T2 (p=0.001). There was no statistically significant difference in the intergroup and gender analyses (p>0.05). Conclusion: The surgical protocol influenced the palatal volume of children with unilateral cleft lip and palate. This study suggested that two-step palatoplasty protocol has a tendency to be more appropriate.(AU)

Objetivo: Comparar o volume palatino em crianças com fissura unilateral de lábio e palato antes e após dois protocolos cirúrgicos. Material e Métodos: A coleta de dados retrospectiva foi efetuada em um hospital especializado. A amostra foi composta por 120 modelos dentários digitalizados divididos em, Grupo 1 (G1) ­ participantes submetidos a queiloplastia aos 3 meses de vida (técnida de Millard) e a palatoplastia em única etapa aos 12 meses (técnica de von Langenbeck); Grupo 2 (G2) ­ participantes submetidos a queiloplastia (técnica de Millard) e fechamento do palato duro (técnica de Hans Pichler) aos 3 meses de vida e fechamento do palate mole aos 12 meses (técnica de Sommerlad). Os modelos dentários foram avaliados em Tempo 1 (T1): antes das cirurgias plásticas primárias, Tempo 2 (T2):1ª fase pós-cirúrgica e Tempo 3 (T3): 2ª fase pós-cirúrgico. O volume foi mensurado por meio do software do sistema de estereofotogrametria. Testes estatísticos paramétricos e não-paramétricos foram utilizados (α=5%). Resultados: As análises intragrupos indicaram que G1 apresentou aumento estatisticamente significante em T2 seguido de redução em T3 (p=0.003). G2 apresentou crescimento estatisticamente significativo do volume palatino entre T1 e T2 (p=0.001). Não houve diferença estatisticamente significante nas análises intergrupos e entre gêneros (p>0.05). Conclusão: O protocolo cirúrgico influenciou o volume palatino das crianças com fissura unilateral de lábio e palato. Este estudo sugeriu que o protocolo da palatoplastia em duas etapas possui uma tendência de ser mais apropriado.(AU)

Brazilian Adults Believe that Complete Dentures would be the Solution to the Oral Impacts Caused by Reduced Dentition

Abstract Objective: To evaluate the direct and oral impact-mediated association between reduced dentitions and the self-perceived need for complete dentures (CD) in dentate adults. Material and Methods: Data from the Brazilian Oral Health Survey (2010) were analyzed. The outcome was self-perceived need for CD. Functional dentition (FDClassV) was defined by the presence of the following criteria: level I - ≥1 tooth in each arch, level II - 10 teeth in each arch, level III - 12 anterior teeth, level IV - ≥ 3 posterior occluding pairs (POPs) of premolars and level V - ≥1 bilateral POPs of molars. Oral impacts were assessed with Oral Impacts on Daily Performances scale. Results: FDClassV was associated with a less self-perceived need for CD both directly and mediated by oral impacts. Dentitions without level V were associated with the outcome mediated by oral impacts. Between individuals with 10 teeth in each arch, self-perceived need for CD was similar for those who had or not anterior teeth and POPs. Individuals with <10 teeth in each arch and level III did not have a higher frequency of self-perceived need for CD compared to those with level II. Conclusion: Oral impacts mediated the association between reduced dentitions and self-perceived need for CD. Individuals with tooth loss may report need for CD, even when they have dental configurations compatible with functionality.

Forma del arco dentario en estudiantes de Medicina / Shape of the dental arch in medicine students

Introducción: Por varios siglos ha sido estudiada la forma y el tamaño de la arcada dental del ser humano. Los huesos de la mandíbula y el maxilar, la posición de los dientes, la musculatura perioral y las fuerzas funcionales intraorales determinan la forma del arco dental. Objetivo: Describir la forma de los arcos dentarios de los estudiantes de la carrera de Medicina de la Universidad Nacional de Chimborazo, durante el periodo abril-agosto de 2019. Métodos: Estudio descriptivo, transversal y cuantitativo. La muestra quedó conformada por 60 estudiantes de ambos sexos. Se realizó, en alginato y vaciados en yeso extraduro, la toma de impresiones del maxilar y la mandíbula, para identificar el tipo de arco dentario según la tabla determinada por Chuck. Resultados: En el maxilar predominó la forma cuadrara (48,30 por ciento); seguida de la ovoide (38,30 por ciento) y, por último, la estrecha (13,30 por ciento). En la mandíbula la forma predominante fue la estrecha (36,70 por ciento). Conclusiones: La mayoría de los arcos dentarios en el maxilar fueron de forma cuadrada, mientras que en el arco mandibular fueron de forma estrecha(AU)

Introduction: In humans, the shape and size of the dental arc has been studied for several centuries. The bones of the jaw and maxilla, the position of the teeth, the perioral musculature and the intraoral functional forces determine the shape of the dental arch. Objective: To determine the shape of the dental arcs in students of the School of Medicine of Universidad Nacional de Chimborazo during the period April-August 2019. Methods: A descriptive, cross-sectional and quantitative study is presented; with a universe of 320 students and the sample was formed by 60 of both sexes (female and male), who signed the informed consent. Maxillary and jaw impressions were taken using alginate and made with extra hard Dental Stone in order to identify the type of dental arc according to the table determined by Chuck. Results: In the maxilla, the square shape was observed in 48.30 percent; continue the ovoid with 38.30 percent and narrow with 13.30 percent. In the jaw the narrow shape (36.70 percent), the ovoid (35.00 percent) and the square (28.30 percent). Conclusions: Most of the dental arcs in the maxilla are square; as well as in the mandibular arc the narrow shape. In both cases, the ovoid form continued(AU)

Sex estimation from maxillary arch measurements in Egyptian populations: cross-sectional study / Estimación sexual a partir de mediciones del arco maxilar en poblaciones egipcias: estudio transversal

SUMMARY: Sex estimation is an essential step in personal identification and a cornerstone for developing biological profile from skeletal remains. The present study aimed to evaluate the role of maxillary arch widths and lengths as unique parameters in the estimation of sex in Egyptian populations. Maxillary arch measurements were collected from 1410 subjects where palatal impressions were obtained from each participant. Fourteen maxillary inter-teeth widths and lengths that excluded teeth dimensions were included The current study revealed that among the studied population, Egyptian men showed significant differences (p34.57 mm, it could predict the sex with sensitivity of 69.8 %, specificity of 58.8 % and p<0.05. The first molar could be considered as one of the most valid and reliable teeth in estimating sex in Egyptian populations. These measurements may be used as a reference in different populations in cases of mass disaster or relevant events.

RESUMEN: La estimación del sexo es un aspecto esencial en la identificación personal para desarrollar el perfil biológico a partir de restos óseos. El presente estudio tuvo como objetivo evaluar el papel del ancho y longitud del arco maxilar como parámetros únicos en la estimación del sexo en poblaciones egipcias. Se obtuvieron medidas del arco maxilar de 1410 sujetos, además de las impresiones palatinas de cada participante. El estudio actual reveló que entre la población estudiada, los hombres egipcios mostraron diferencias significativas (p 34,57 mm, podría predecir el sexo con sensibilidad de 69,8 %, especificidad de 58,8 % y p <0,05. El primer molar podría considerarse como uno de los dientes más confiables para estimar el sexo en las poblaciones egipcias. Estas mediciones se pueden utilizar como referencia en diferentes poblaciones en casos de desastres masivos o eventos relevantes.

Aplicabilidad del método Tanaka-Johnston para la estimación del diámetro mesiodistal de caninos y premolares en pacientes de 12-18 Años / Applicability of the Tanaka-Johnston method for the estimation of the mesiodistal diameter of canines and premolars in patients of 12-18 years old

El método Tanaka-Johnston es utilizado mundialmente para predecir el diámetro de caninos y premolares no erupcionados por la conveniencia de no necesitar tablas ni radiografías para su uso. Sin embargo, durante los últimos años investigadores de varios países han demostrado que al ser utilizado en una población diferente para la que fue diseñado, puede sobrestimar o subestimar los valores. En Cuba, donde el patrón facial de la población difiere del ideal para este método, ha sido muy empleado, pero prácticamente no existen estudios donde se valide la confiabilidad o exactitud de las predicciones de este. Por tanto, el objetivo de esta investigación es determinar la aplicabilidad del método Tanaka-Johnston para la estimación del diámetro mesiodistal de caninos y premolares en pacientes de 12-18 años. Se desarrolló un estudio descriptivo y transversal desde junio de 2019 hasta enero de 2020 con una población de 140 pacientes de ambos sexos de entre 12 y 18 años de Cuba. Se efectuaron las mediciones de los anchos mesiodistales de los incisivos inferiores, todos los caninos y premolares. Se realizaron distribuciones de frecuencia a las variables estudiadas y los resultados se presentaron en tablas estadísticas. Para comprobar la existencia de diferencias significativas se utilizó la prueba estadística t-Student. Los resultados principales obtenidos fueron que el método Tanaka-Johnston tiende a sobrestimar los valores para el sexo femenino y subestimarlos para el masculino, ambos entre los 0,2 y 0,3 mm, pero esta diferencia no resulta significativa. Se concluye que el método Tanaka-Johnston puede ser aplicado en la población estudiada para la predicción del ancho mesiodistal de caninos y premolares no erupcionados.

The Tanaka-Johnston method is used worldwide to predict the diameter of canines and premolars not erupted for the convenience of not needing boards or x-rays for use. However, in recent years researchers from several countries have shown that when used in a different population for which it was designed, it can overestimate or underestimate the values. In Cuba, where the facial pattern of the population differs from the ideal for this method, it has been highly used, but there are very few studies where the reliability or accuracy of the predictions of the same is validated. Therefore, the objective of this research is to determine the applicability of the Tanaka-Johnston method for estimating the mesiodistal diameter of canines and premolars in patients aged 12-18 years. A descriptive and cross-cutting study was conducted from June 2019 to January 2020 with a population of 140 patients of both sexes between 12 and 18 years of age from Cuba. Measurements were made of the mesiodistal widths of the lower incisors, all canines, and premolars. Frequency distributions were made to the variables studied and the results were presented in statistical tables. The t-Student statistical test was used to verify significant differences. The main results obtained were that the Tanaka-Johnston method tends to overestimate the values for the female sex and underestimate them for the male, both between 0,2 and 0,3 mm, but this difference is not significant. It is concluded that the Tanaka-Johnston method can be applied in the population studied for the prediction of the mesiodistal width of unerupted canines and premolars.

Influência do banda-alça na manutenção de espaço do arco inferior após a perda precoce de molares decíduos: um estudo piloto / Influence of loop band on mandibular arch space maintenance after early loss of deciduous molars: a pilot study

Objetivo: Avaliar a influência do dispositivo banda-alça na perda de espaço após exodontia precoce de molares decíduos inferiores em escolares, em um período de 3 meses. Materiais e métodos: Trata-se de um estudo piloto de ensaio clínico randomizado, com dois grupos paralelos. A amostra incluiu 25 crianças, entre 6 e 9 anos, com indicação clínica e radiográfica de exodontia unilateral de um molar decíduo inferior. Estes foram divididos em Grupo Controle (G1): sem intervenção; e Grupo Intervenção (G2): com instalação de banda-alça. Todos os pacientes foram moldados antes do procedimento de exodontia (T1) e no acompanhamento de 3 meses (T2). Um avaliador cego quanto aos grupos e tempo realizou as medidas estabelecidas nos modelos de gesso. A análise estatística foi realizada por meio dos testes T pareado e T de Student nos casos de distribuição normal dos dados e testes não-paramétricos Wilcoxon e Mann-Whitney para distribuição não normal. Resultados: Todos os participantes foram classificados como Classe I, com overjet de até 3mm e padrão facial mesocéfalo. A maioria (64%) teve o segundo molar decíduo perdido. Após 3 meses, o G1 perdeu, em média, 0,75mm a mais na distância linear do espaço de extração comparado ao G2 (P<0,05). Conclusão: Concluiu-se que, embora os dois grupos apresentaram perda de espaço, o G1 (sem intervenção) apresentou uma perda de espaço maior no período de acompanhamento de 3 meses.

Objective: To evaluate the influence of the band and loop space maintainer on space loss after the early extraction of mandibular primary molars in schoolchildren, over a period of 3 months. Materials and Methods: a pilot study of a randomized clinical trial was carried out, with two parallel groups. The sample included 25 children, aged between 6 and 9 years, with clinical and radiographic indication for unilateral extraction of a mandibular primary molar. The patients were divided into Control Group (G1): with no intervention; and Intervention Group (G2): with the installation of the space maintainer. A dental cast was obtained before the extraction procedure (T1) and at the 3-month followup (T2). An evaluator, blinded to the groups and time, performed the established measures in the dental casts. Statistical analysis was performed using Paired Sample T test and Student's T test in cases of normal data distribution, and nonparametric Wilcoxon and Mann-Whitney tests for non-normal distribution. Results: All participants were classified as Class I, with an overjet of up to 3 mm and a mesocephalic facial pattern. The majority (64%) had a lost second deciduous molar. After 3 months, the G1 lost, on average, 0.75mm more in the linear distance from the extraction space (P<0.05). Conclusion: It was concluded that, although the two groups showed space loss, G1 (without intervention) showed a greater loss of space in the 3-month follow-up period.

3D technology to measure dental arches and create a template for lingual brackets technique

ABSTRACT Objective: This study aims at identifying anatomical dimensions of dental arches, based on landmarks currently used in the lingual orthodontic technique, and create an archwire form template to be used in orthodontic clinics. Methods: Maxillary and mandibular dental casts of 140 Caucasian individuals with natural and normal occlusion were digitized (3D), and the images were analyzed with Delcam Power ShapeTM 2010 software. The dental arch shapes and sizes were obtained from 14 landmarks selected on the lingual surface of the teeth. Points and segments defined by the software were used to create an archwire form template. Results: Various dental arch patterns were found for both maxilla and mandible. The smallest sizes were found in females, and the largest were found in male subjects. Six categories were defined for each gender, three for the maxilla and three for the mandible (Small, Medium and Large). A template was created with eighteen anatomic lingual archwire designs, nine for the maxilla and nine for the mandible, for both genders. Conclusions: Landmarks evaluated in this study showed dental arch differences between genders. This information enables making orthodontic lingual archwires that are more compatible with the anatomical forms and sizes of the maxilla and mandible. The findings also allowed the creation of a template for an anatomic lingual metallic archwire form to be used in the lingual technique.

RESUMO Objetivo: O presente estudo tem como objetivo encontrar as formas anatômicas e dimensões das arcadas dentárias com base em pontos de referência utilizados na técnica ortodôntica lingual, e criar um diagrama com um maior número de arcos metálicos para serem utilizados na clínica ortodôntica. Métodos: 140 modelos de indivíduos caucasianos com oclusão normal e natural foram digitalizados (3D) e as imagens, analisadas com o software Delcam Power ShapeTM 2010. A determinação das formas e tamanhos das arcadas dentárias foi obtida a partir de 14 pontos selecionados na superfície lingual dos dentes. Outros pontos e segmentos foram utilizados, com o auxílio do software, para definir um diagrama. Resultados: Foram encontrados diferentes tamanhos de arcadas dentárias linguais, tanto para a maxila quanto para a mandíbula. Os menores tamanhos foram os femininos, e os maiores, os masculinos. Definiram-se seis tamanhos para cada sexo, sendo três para a maxila e três para a mandíbula, nomeados como P, M e G. Foi criado um diagrama com dezoito desenhos de arcos linguais anatômicos, nove para a maxila e nove para a mandíbula, para ambos os sexos. Conclusões: A posição dos pontos de referência nesse estudo evidenciou diferenças entre os sexos, o que permitiu a criação de arcos mais compatíveis com as formas e dimensões anatômicas da maxila e mandíbula. A diferença entre os tamanhos das arcadas dentárias linguais possibilitou a criação de um diagrama com formas de arcos metálicos linguais anatômicos para serem utilizados na técnica lingual, para auxiliar o profissional a criar os seus próprios arcos.

Correlation Between Mesio-Distal Teeth Diameters and Arch Width

ABSTRACT Objective: To verify the existence of a correlation between the mesio-distal size of teeth and the arch width by analyzing the data separately for maxillary and mandibular arch in patients with ideal occlusion Material and Methods: 58 patients with ideal occlusion were studied, for a total of 276 files analyzed. Dental casts were then scanned using a professional scanner (Epson Perfection v 330) and images were obtained in TIFF format at 600 dpi. All single teeth measurements were carried out for all teeth of both arches using the VAM software (Vectra, Canfield Scientific, Fairfield, NJ, USA). The repeatability and reproducibility of the measurement method were evaluated using the Gauge R&R method. In case a correlation between tooth size and arch size is found to be significant, a linear regression analysis can be applied through the following statistical relationship: y=a+b*x, where y is the result (inter-molar distance "AvgB66" or inter-canine distance "Cusp 33"), and x the specific tooth. The a and b respectively represent the intercept (point of intersection between the line and the y axis) and the slope of the line that describes the regression ratio. Results: The statistical analysis highlights a significant correlation (p<1%) between the results of the mesio-distal measurements of each tooth and the two variables considered to define the size of each arch ("AvgB66" and "Cusp 33"). Based on these results, a numerical relationship "y=a+b*x" has been extrapolated. Thus, it is possible to calculate the estimated inter-molar or inter canine distance necessary to have the teeth aligned. Conclusion: The inter-canine and inter-molar distances can be estimated starting from measuring the mesio-distal diameter of a single tooth.

Valoración de las dimensiones del paladar y su relación con alteraciones verticales / Avaliação das dimensões do palato e sua relação com alterações verticais / Assessment of palate dimensions and its relation with vertical alterations

Objetivos: La presente investigación tuvo como objetivo establecer la correlación entre la presencia de maloclusiones a nivel vertical con el índice del paladar y con la altura palatina. Materiales y Métodos: Estudio de tipo transversal. La población de estudio fue conformada por 134 modelos de yeso con dentición mixta, 81 mujeres y 53 hombres, seleccionados por conveniencia y obtenidos desde el 2014 hasta el 2018 del área de clínica de odontopediatría y ortodoncia en la Escuela Nacional de Estudios Superiores Unidad León. La muestra de estudio fue dividida en 3 categorías según la oclusión; mordida abierta (37), mordida profunda (32) y normoclusión (65). Se realizaron mediciones del ancho intermolar y altura del paladar con el uso de un calibrador digital, posteriormente se obtuvo el índice del paladar y se correlacionó con los parámetros expuestos por Korkhaus mediante la prueba estadística de Spearman. Resultados: La prueba estadística de Spearman refleja que no hay correlación entre la magnitud de los valores del índice del paladar propuestos por Korkhaus con la presencia de maloclusiones a nivel vertical. De igual manera las pruebas estadísticas indican que no existe correlación notable entre la altura del paladar y la oclusión en relación vertical. Conclusiones: El resultado obtenido al usar el índice del paladar no fue capaz de corresponder a los parámetros propuestos por Korkhaus como normales, posiblemente al ser usado durante la etapa de la dentición mixta pues durante este periodo suceden cambios constantes relacionados al crecimiento.

Objetivos: Os objetivos a presente investigação buscou valor uma correlação entre a presença de más oclusões em nível vertical com o índice do palato e com a altura palatina. Materiais e Métodos: Estudo do tipo transversal. A população do estudo foi composta por 134 modelos de gesso com dentição mista, 81 mulheres e 53 homens, selecionados por conveniência e obtidos de 2014 a 2018 na área de Odontopediatria e Ortodontia na Escola Nacional de Ensino Superior Unidade de León. A amostra do estudo foi dividida em 3 categorias de acordo com a oclusão; mordida aberta (37), mordida profunda (32) e normoclusão (65). A medida da largura intermolar e da altura do palato foi feita com o uso de um paquímetro digital, o índice de palato foi posteriormente obtido e relacionado aos parâmetros expostos por Korkhaus por meio do teste estatístico de Spearman. Resultados: O teste estatístico de Spearman mostra que não há correlação entre a magnitude dos valores do índice de palato proposta por Korkhaus e a presença de más oclusões verticais. Da mesma forma, os testes estatísticos indicam que não há correlação notável entre a altura do palato e a oclusão na relação vertical. Conclusões: O resultado obtido com o uso do índice de palato não foi capaz de corresponder aos parâmetros propostos por Korkhaus como normais, possivelmente quando usado durante o estágio de dentição mista, porque durante este período há mudanças constantes relacionadas ao crescimento

Purpose: The aim of the present study is to assess the relation between vertical malocclusions with palatal index and palatal height. Materials and Methods: Transversal study. The sample consisted in 134 stone models within mixed dentition, 81 females and 53 males, they were convenience selected and obtained from the pediatric and orthodontic dentistry medical center at the National School for Superior Studies Unit León since 2014 to 2018. The stone models were divided into three categories according to their kind of occlusion: open bite (37), deep bite (32) and normal bite (65). Palatal width and height were measure by using a digital caliper. Subsequently the palatal index was obtained and it was related with the parameters exposed by Korkhaus using the Spearman statistical test. Results: The Spearman statistical test indicated there is no a clearly relationship between palatal index values exposed by Korkhaus with the presence of vertical malocclusions and in the same way there is no a relationship between palatal height and vertical malocclusions.Conclusions: The result obtained by using the palatal index was no able to indicate an agreement with Korkhaus parameters. Probably this disagreement was due to the constant changes that occur during the period of the mixed dentition.

In Vitro Study of Tooth Surfaces After Interproximal Enamel Reduction: Extraoral Scanner and SEM Analysis

ABSTRACT Objective To perform a morphological evaluation concerning the extent of interproximal enamel reduction (IPR) with different manual instruments in different types of teeth and a qualitative analysis of enamel surface characteristics at the contact point before and after IPR. Material and Methods 40 freshly extracted, caries-free, and intact human teeth were used for the study (20 bicuspids and 20 incisors) and performed IPR just on the mesial surface. The morphological variation of contact point was evaluated by superimposed the stl file, obtained thanks to an extraoral scanner, at T0 and T1 for each tooth. Two types of strip were used, Intensiv Manual Ortho Strips Coarse/Medium and Steelcarbo Horico Strips. Teeth were then cut lengthwise, removed the most apical root portion and the mesial and distal halves were gilded and observed at different magnifications. Results The morphological variation following stripping mainly depends on the extent of the stripping, while the diameter, the type of strip and the shape of the tooth itself do not appear to be relevant. The 500X and 1500X magnifications allowed to appreciate better the characteristics of the surface of the stripped enamel and the differences with the intact enamel. All teeth treated, independently from the kind of strip used, shows deep marks and grooves in the direction of stripping. In both cases, the enamel appears significantly damaged at great magnifications. Conclusion Stripping always and inevitably leads to a change in the shape of the contact point and is directly correlated to the amount of stripping performed. The use of polishing after the removal of enamel interproximal is necessary in all cases.

Associação entre hábitos orais e má oclusão com problemas respiratórios em escolares de 5 anos / Association between oral habits and malocclusion with respiratory problems in 5-year-old schoolchildren

Introdução Toda má oclusão apresenta origem multifatorial, e dentre os fatores que a desencadeiam estão os hábitos. O surgimento de um hábito pode estar relacionado com o emocional, o fisiológico ou com o aprendizado condicionado do indivíduo. Objetivo Analisar as relações entre hábitos e más oclusões associado a problemas respiratórios em escolares de 5 anos. Material e método Foi realizado um estudo transversal com uma amostra de 753 crianças pertencentes à rede municipal de ensino da cidade de Araraquara, SP. Foram realizados exames clínicos para avaliação da má oclusão (Foster & Hamilton), além de aplicado questionários aos pais para avaliação de condição socioeconômica e demográfica, qualidade de vida relacionada à saúde bucal (ECOHIS) e hábitos. A análise dos dados foi feita pela análise bivariada por teste qui-quadrado seguida de modelo de regressão logística múltipla considerando nível de significância de 5%. Resultado A prevalência de crianças com problemas respiratórios e/ou alergias foi de 46,9%, com má oclusão foi de 58,7% e com algum tipo de hábito oral deletério foi de 12,0%. Apresentaram mais chance de ter problemas respiratórios e/ou alergias crianças do sexo masculino (1,40 vezes mais) e crianças com algum hábito oral deletério (1,95 vezes mais). Conclusão Observou-se que apresentaram maior chance de problemas respiratórios e/ou alergias as crianças do sexo masculino, crianças com algum hábito oral deletério e que apresentavam bruxismo.

Introduction All malocclusion has a multifactorial origin, and among the factors that trigger it are the habits. The appearance of a habit can be related to the emotional, physiological or conditioned learning of the individual. Objective Evaluate the relationship between habits and malocclusions associated with respiratory problems in 5-year-old students. Material and method A cross-sectional study were carried out with a sample of 753 children belonging to the municipal education network of the city of Araraquara-SP. Clinical exams were performed for malocclusion evaluation (Foster & Hamilton), applying questionnaires to the parents for evaluation of socioeconomic and demographic condition, oral health related quality of life (ECOHIS) and habits. Data analysis was performed by bivariate analysis using chi-square test followed by multiple logistic regression model considering 5% significance level. Result The prevalence of children with respiratory problems and/or allergies was 46.9%, with malocclusion was 58.7% and with some type of deleterious oral habit was 12.0%. Male children were 1.40 times more likely to present respiratory problems or allergies and children with some deleterious oral habits were 1.95 times more likely to present respiratory problems or allergies. Conclusion It was observed that male children, children that presented deleterious oral habits, and children with bruxism are more likely to have respiratory problems and/or allergies.

Modified Arnold expander: an alternative for mandibular arch expansion

ABSTRACT Introduction: Due to the anatomical constraints of the mandible, mandibular dental arch usually serves as a guideline to determine the required changes in the maxillary transverse dimension. The Schwarz appliance and the Lip Bumper are the traditional orthodontic appliances for mandibular arch expansion in patients with borderline amounts of crowding, and/or transverse discrepancy. However, they often require patient cooperation, which may be a concern for orthodontists in daily practice. Objectives: This article illustrates a simple fixed orthodontic device as an alternative to achieve mandibular arch expansion in patients with moderate tooth-size/arch-length discrepancy. The four reported cases refer to 8 to 10-year-old patients in the mixed dentition, with an Angle Class I or Class II malocclusion, transverse deficiency in both arches, moderate crowding and/or posterior crossbite, combined with compromised smile aesthetics. The patients were treated with rapid maxillary expansion (RME) using Hass expander appliance and the modified Arnold expander (MAE). Conclusion: This low-cost compliance-free orthodontic appliance provided dentoalveolar decompensation by means of uprighting the posterior teeth, with minimal or no adjustments during treatment. The final results were achieved in only three to four months, and fulfilled all treatment objectives, such as an increase in the arch perimeter and width, and a better teeth alignment.

RESUMO Introdução: Devido aos limites anatômicos da mandíbula, a arcada dentária inferior geralmente serve como guia para determinar as alterações necessárias na dimensão transversal da maxila. O aparelho de Schwarz e o Lip Bumper são os aparelhos usados tradicionalmente para expansão da arcada inferior em pacientes com quantidades limítrofes de apinhamento e/ou discrepância transversal. No entanto, eles requerem a cooperação do paciente, o que pode ser uma preocupação para os ortodontistas na prática diária. Objetivos: O presente artigo ilustra uma alternativa diferente de aparelho fixo para se obter a expansão da arcada inferior em pacientes com discrepância moderada de tamanho dentário e/ou comprimento da arcada. Os quatro casos relatados referem-se a pacientes com 8 a 10 anos de idade, na dentição mista, com má oclusão de Classe I ou II de Angle, deficiência transversal em ambas as arcadas, apinhamento moderado e/ou mordida cruzada posterior, apresentando comprometimento da estética do sorriso. Os pacientes foram tratados com expansão rápida da maxila (ERM), usando aparelho expansor de Hass, e expansor Arnold modificado (EAM). Conclusão: O EAM, que é um aparelho de baixo custo e não depende da colaboração do paciente, promoveu uma descompensação dentoalveolar por meio da verticalização dos dentes posteriores, necessitando de mínimo ou nenhum ajuste durante o tratamento. Os resultados pretendidos foram alcançados em três a quatro meses e cumpriram todos os objetivos do tratamento, como aumento do perímetro e largura da arcada, assim como o melhor alinhamento dos dentes.

Influence of the palatine tonsil grade on the morphology of the maxillary and mandibular dental arches / Influencia del grado de las tonsilas palatinas en la morfología de los arcos dentales maxilar y mandibular

SUMMARY: Enlarged palatine tonsils and adenoids are thought to cause obstruction of the upper airway, triggering changes in breathing patterns, which in turn lead to dentofacial alterations, including malocclusions. The object of the present study was to correlate the size (grade) of the palatine tonsil with measurements of the maxillary and mandibular dental arches in children. This was an observational cross-sectional study carried out in 35 children aged between 6 and 11 years. The inter- and intra-arch parameters were measured (horizontal, vertical and sagittal analyses) by making plastercasts and then taking measurements with callipers. The tonsil size was classified in 5 grades from 0-4, using the Brodsky tonsil grading scale. The researcher was calibrated prior to carrying out the measurements. Pearson's chi-squared test was used and Pearson's correlation coefficient was calculated. The SPSS v.22.0 software was used, with a significance threshold of 5 %. Six patients were classified as grade 1, sixteen grade 2, eleven grade 3, two grade 4 and none of the patients presented grade 0.A low positive association was found between tonsil grade and the total length of the mandibular arch, a very low positive association between tonsil grade and maxillary inter-first premolar distance, total length of the maxillary arch and depth of the palatine recess.A very low negative association was found for tonsil grade and overjet, overbite, mandibular inter-permanent first molar distance, mandibular inter-first premolar distance, and mandibular and maxillary intercanine widths. No statistically significant correlation was observed for any of the measurements. No association was found between the tonsil grade and Angle's Classification, canine relationship, overjet and overbite. According to the results of this study there is no significant correlation between the dental arches and the tonsil grade.

RESUMEN: Se ha considerado que el grado del tamaño de las tonsilas palatinas y los adenoides pueden ser factores que generan obstrucción de la vía aérea superior, desencadenando cambios en el patrón de respiración, lo que provoca alteraciones dentofaciales, entre ellas, maloclusiones. El objetivo del presente estudio fue correlacionar el grado tonsilar palatino con medidas de los arcos dentales maxilar y mandibular en niños. Se realizó un estudio observacional de corte transversal. Fueron incluidos 35 niños entre 6 y 11 años de edad. Fueron medidos parámetros interarco e intra-arco (análisis transversal, vertical, sagital). Para eso fueron tomados modelos de yeso y luego las medidas fueron realizadas con un caliper. El grado tonsilar fue clasificado en 5 grados (0-5), de acuerdo a la escala de graduación de Brodsky. Para la realización de las mediciones el evaluador fue previamente calibrado. Se realizó la prueba Chi-cuadrado de Pearson, y coefi- ciente de correlación de Pearson. Se utilizó el software SPSS 22.0, considerándose umbral de significación de 5 %. Seis pacientes fueron clasificados en grado 1, dieciséis grado 2, once grado 3, dos grado 4 y ningún paciente presentó grado 0. Se encontró una asociación positiva baja entre grado tonsilar y la longitud total del arco mandibular, positiva muy baja entre grado tonsilar y distancia inter-primer premolar maxilar, longitud total del arco maxilar y profundidad de la bóveda palatina. Una asociación negativa muy baja fue encontrada para el grado tonsilar y overjet, overbite, distancia inter-primer molar permanente mandibular, distancia inter- primer premolar mandibular, ancho intercanino mandibular y maxilar. Se observó ausencia de correlación estadísticamente significativa para todas las medidas. No se encontró asociación entre el grado tonsilar y clase molar de Angle, relación canina, overjet y overbite. Según los resultados de este estudio no se aprecia una correlación significativa entre los arcos dentales y el grado tonsilar.

Diagnóstico precoz de la estrechez del maxilar superior en la dentición mixta / Early diagnosis of the maxillary´s narrowness in the mixed dentition

Las compresiones del maxilar superior son alteraciones transversales por discrepancia óseo-dentaria. .En la dentición mixta temprana puede establecerse la estrechez mediante índices que relacionan el tamaño dental con el ancho transversal del arco dentario. Se analizaron 33 modelos superiores de niños en el tercer período de desarrollo clínico según Barnett. Se estableció la estrechez realizando el análisis métrico del arco dental mediante el índice de Pont. Se describió la anomalía de posición anterior según las siguientes variables: A) Apiñamiento dentario: 1-Escalón de los dientes anterosuperiores; 2-Rotación mesial de los cuatro incisivos; 3-Rotación mesial de los incisivos centrales y rotación distal de los incisivos laterales y 4-Rotación distal de los incisivos centrales. B) Ausencia de apiñamiento: 1-Reabsorción atípica y 2- Ausencia de reabsorción atípica. Las anomalías de posición y/o reabsorciones atípicas anteriores en este período de desarrollo clínico se asocian a estrechez transversal del maxilar superior Siendo la malposición más frecuente la rotación mesial de los cuatro incisivos, siguiendo las reabsorciones atípicas y el escalón de los dientes anterosuperiores, luego la rotación mesial de los incisivos centrales y distal de los laterales y por último la rotación distal de los incisivos centrales (AU)

Inside the traverse alteration of the maxillary the compressions are described as uni or bilateral where an imbalance is settled down between the dental size and the size of the maxillary causing alterations in the position of the teeth. In the early mixed teething the narrowness of the maxillary can be settled by means of indexes that relate the dental size with the traverse width of the dental arch. Thirty models of the maxillary of children according to Barnett's third development period were analyzed. The metrical analysis of the dental arch form was carried out through Pont's index. The theoretic values were compared with the real ones establishing the deviations of the norm that is to say the narrow nest. Out of the 30 cases analyzed, 40% presented mesial rotation of the 4 incisors; 27% showed a stop of the front teeth; 27% atypical reabsorption; 20% mesial rotation of the central incisors and distal rotation of the lateral incisors and the 10% presented a distal rotation of the central incisors. With regard to the front atypical discrepancy 36.66% of the cases had a discrepancy above 6 mm and the 23.33% below 3 mm (AU)

Apicotomia associada ao tracionamento ortocirúrgico em dente com dilaceração radicular / Apicotomy associated with orto-surgical treatment in tooth with a root dilaceration

Introdução: A apicotomia é uma técnica, que vem sendo utilizada em dentes com dilaceração radicular acentuada, com o intuito de liberar a porção do dente impactada e, dessa forma, permitir seu reposicionamento na arcada dentária. Este trabalho tem como objetivo apresentar um relato de caso clínico do manejo ortocirúrgico de tracionamento ortodôntico associado à apicotomia em dente incluso com dilaceração radicular acentuada. Relato de caso: O paciente foi encaminhado para o serviço de bucomaxilofacial para exodontia do elemento incluso após insucesso de tracionamento ortocirúrgico, em que se verificou, ao exame radiográfico periapical, dente incluso com dispositivo ortodôntico e dilaceração radicular importante. Diante disso, realizou-se, sob anestesia local, a apicotomia e instalação do dispositivo ortodôntico. O paciente evoluiu bem, e, após 8 meses, o elemento dentário encontrava-se em posição oclusal e em função mastigatória. Considerações finais: Assim, a técnica da apicotomia mostra-se eficaz como alternativa ao insucesso do tracionamento ortodôntico tradicional, sendo uma técnica mais conservadora que a exodontia, necessitando de conhecimento teórico e domínio técnico do profissional... (AU)

Introduction: Apichotomy is a technique that has been used in teeth with severe root laceration in order to release the impacted tooth portion and thus allow its repositioning of the tooth in the dental arch. The aim of this paper is to present a clinical case report of orthosurgical orthodontic traction management associated with apichotomy in an included tooth with severe root laceration. Case report: The patient was referred to the Oral and Maxillofacial Service for extraction of the included element after ortho-surgical traction failure, which was verified by periapical radiographic examination, tooth included with orthodontic device and significant root laceration. Thus, under local anesthesia, apichotomy and orthodontic device installation were performed. The patient progressed well, and after 8 months the dental element was in occlusal position and in masticatory function. Final considerations: Thus, the apichotomy technique is effective as an alternative to the failure of traditional orthodontic traction, being a more conservative technique than extraction and requiring theoretical knowledge and technical mastery of the Professional... (AU)