Have orthodontists changed their retention and follow-up protocols due to contemporary orthodontics? An online survey.

Background: With advancements in orthodontic technology, treatment durations have shortened, often concluding at earlier ages. This shift prompts scrutiny of contemporary retention and post-treatment protocols. The study aimed to assess current professional preferences, compare them against patient age and treatment duration, and investigate the potential impacts of reduced treatment times on professional protocols, particularly when treatment concludes before pubertal growth. Methods: A questionnaire comprising 12 multiple-choice questions focused on active treatment and retention phases was developed using an online survey platform. It was distributed to licensed orthodontists engaged in patient treatment. Bivariate analysis was conducted using ANOVA and the Kruskal-Wallis test, with pairwise comparisons facilitated by the Dwass-Steel-Critchlow-Fligner method. Results: Of 743 respondents, representing a 32% response rate, approximately 70% reported initiating treatment with fixed appliances in pre-pubertal patients. The most prevalent treatment combination involved commencing treatment during early permanent dentition and lasting between 12 to 24 months, resulting in treatment completion before full growth maturation. No discernible individualization was observed in retention protocols or post-retention follow-ups. Traditional retainer prescription post-orthodontic therapy was unanimous among respondents. Notably, experienced orthodontists tended to prefer regular patient visits for follow-up, while less experienced counterparts discharged patients after 12 months. Conclusion: Contemporary orthodontic treatments are characterized by shorter durations, yet orthodontists have not adopted retention and post-treatment follow-up practices accordingly. There is a pressing need for evidence-based guidelines to develop protocols tailored to the shorter treatment durations and the increasing prevalence of younger patients completing treatment.

Does the composite attachment of clear aligners compromise the effectiveness of dental bleaching? An in vitro study.

INTRODUCTION: This study aimed to evaluate the effectiveness of dental bleaching with hydrogen peroxide 35% on the surface below the attachments. METHODS: Twenty-four blocks of bovine incisors were equally divided into 2 groups. The control group comprises the enamel surface free of attachments, whereas the attachment group comprises the enamel surface with attachment. Initial staining of samples was performed with black tea for 7 days; then, an attachment was made in the attachment group with Z250 resin and new staining for another 7 days in all samples. After staining, in-office bleaching was performed in both groups, and the attachments from the attachment group were removed. Color reading was performed with a spectrophotometer at all stages: initial (baseline), after 7 days of staining, after 14 days of staining, after immediate bleaching, and after 24 hours of bleaching. The color difference was calculated, and data analysis was performed using the t test for intergroup analysis. RESULTS: The results showed effective bleaching in both groups; however, there was a statistically significant difference in color change between them 24 hours after bleaching. CONCLUSION: It was concluded that the presence of attachment did not impair the action of the bleaching agent on the tooth surface.

Assessment of the bone thickness of the palate on cone-beam computed tomography for placement of miniscrew-assisted rapid palatal expansion appliances.

INTRODUCTION: The correction of maxillary transverse discrepancy is achieved by means of rapid maxillary expansion, which may be performed by conventional or surgically-assisted rapid maxillary expansion, and more recently, by miniscrew-assisted rapid palatal expansion (MARPE). This study assessed the bone thickness of the palate on cone-beam computed tomography (CBCT) images for placement of mini-implants and anchorage of MARPE. METHODS: The sample consisted of 223 CBCT scans from patients of both genders (137 females and 86 males) aged ≥18 years. By using the Image Studio software (Anne Solutions, São Paulo, Brazil), measurements of the bone thickness of the palate were performed bilaterally, as follows: in the axial plane, the bone thicknesses were determined in the anterior region (distal face of the first premolars) and the posterior region (distal face of the first molars), at 3 mm and 6 mm laterally to the midpalatal suture. So in the sagittal plane, the bone thicknesses of the palate were measured in these placements from the palatal cortical to the nasal floor cortical in the anterior region at 30°, 45°, and 90°. In the posterior region, the bone thickness was determined only at 90°. The statistical tests used were the Kruskal-Wallis H test (analysis of variance on ranks) with Dunn's post-hoc test and Mann-Whitney U test (P <0.05). RESULTS: The bone thickness of the palate in the anterior region varied from 8.57 mm in women to 11.28 mm in men at 3 mm from the midpalatal suture and from 7.99 mm in women to 10.47 mm in men at 6 mm for 30°; from 6.35 mm in women to 9.28 mm in men at 3 mm from the midpalatal suture and from 6.20 mm in women to 8.88 mm in men at 6 mm for 45°; from 4.51 mm in women to 6.85 mm in men at 3 mm from the midpalatal suture and from 4.29 mm in women to 6.64 mm in men at 6 mm for 90°. In the posterior region, the bone thickness varied from 2.93 mm (3 mm from the suture) to 1.78 mm (6 mm from the suture) for women and from 3.24 mm (3 mm from the suture) to 1.99 mm (6 mm from the suture) for men. In general, the bone thickness of the palate is greater in the anterior region at 3 mm from the midpalatal suture at 30°. CONCLUSIONS: There was high variability in the bone thickness of the palate among patients and in different areas. Therefore, it is necessary to make an individualized diagnosis of the patient and manufacture the MARPE appliance carefully by performing a prior evaluation of the palatal bone thickness by means of CBCT to determine the ideal sites and inclinations for placement of mini-implants.

Analysis of the Changes in Occlusal Plane Inclination in a Class II Deep Bite "Teen" Patient Treated with Clear Aligners: A Case Report.

Background: Optimal management of hypodivergent growing patients demands a strict control of vertical dimension and to exploit the growth potential. If a deep bite malocclusion causes a traumatic contact between the upper and lower incisors and affects the facial appearance, an early interceptive treatment is recommended. The aim of this case report is to outline the clinical management of the occlusal plane of a growing Class II division 1 deep bite patient treated with aligners and Class II elastics. Methods: The treatment lasted 11 months and was divided into two phases. Treatment goals included improvement of the soft tissue profile and basal bone relationships through an increase in the mandibular third of the face and a sagittal advancement of the mandible. The correction of the curve of Spee involved intrusion of the mandibular incisors and extrusion of the mandibular premolars. Results: The cephalometric analysis at the end of the treatment displayed significant differences in the skeletal and occlusal pattern along with aesthetic improvements. Conclusion: The final cephalogram showed a consistency between the planned tooth movement and the clinical results. Although definitive recommendations must be withheld until longer follow-up is available, the patient presented here shows that the treatment protocol yielded positive mandibular growth.

Utilização dos elásticos intermaxilares nos estágios iniciais do tratamento ortodôntico / Use of intermaxillary elastics in early treatment stages

A Ortodontia contemporânea tem aumentado, substancialmente, a utilização de fios superelásticos durante o alinhamento e nivelamento dentário e a sua permanência tem alcançado estágios avançados do tratamento, com a premissa de trabalhar, o máximo possível, com forças de baixa intensidade. Essa mudança de protocolo tem desafiado os ortodontistas a criar mecanismos de controle de movimentação dentária e de efeitos colaterais indesejados, que comumente são atribuídos a esses fios, em razão da sua alta flexibilidade e baixa resistência à expressão dos momentos da força, gerados, por exemplo, por acessórios como os elásticos intermaxilares. O objetivo desse trabalho é descrever, ilustrando com casos clínicos, a viabilidade e aplicabilidade desses acessórios na correção das relações anteroposteriores ainda em estágios iniciais do tratamento, com fios superelásticos, com ou sem propriedade de transformação térmica (AU)

Contemporary orthodontics has considerably increased the use of superelastic wires during teeth alignment and leveling and their permanence has reached advanced stages of treatment with the premise of working as much as possible with low levels of force. This protocol change has been challenging orthodontists to create mechanisms to control tooth movement and unwanted side effects that are commonly attributed to these wires, due to their great flexibility and their low resistance to the expression of moments of force generated, for example, by accessories like intermaxillary elastics. The objective of this article is to describe, using clinical cases to illustrate, the viability and applicability of intermaxillary elastics in anteroposterior relationships correction during early stages of treatment with superelastic wires with or without heat activating properties.(AU)

Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets.

OBJECTIVE: The aim of the present study was to evaluate, comparatively, the periodontal response during orthodontic treatment performed with self-ligating and conventional brackets. METHODS: Sixteen Caucasian individuals of both sexes, aged between 12 and 16 years old and in permanent dentition were selected. Eight individuals were treated with conventional brackets installed on the lower dental arch and self-ligating brackets on the upper arch. Another eight individuals received self-ligating brackets in the lower arch and conventional brackets in the upper arch. The subjects received material and instructions for oral hygiene. Visible plaque index (VPI), gingival bleeding index (GBI) and clinical attachment level (CAL) were evaluated just after installation of orthodontic appliances, and 30, 60 and 180 days later. Mann-Whitney test was used to compare differences between groups (self-ligating and conventional), two-way ANOVA followed by Tukey's test was used to assess CAL at each site of each tooth. Significance level was set at 5%. RESULTS: No significant changes were found with regard to the assessed parameters (VPI, GBI and CAL) in either one of the systems. CONCLUSION: No significant changes were found with regard to the periodontal response to orthodontic treatment for the variables assessed and between subjects receiving passive self-ligating and conventional brackets. All individuals had received oral hygiene instructions and had their periodontal conditions monitored.

Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets

OBJECTIVE: The aim of the present study was to evaluate, comparatively, the periodontal response during orthodontic treatment performed with self-ligating and conventional brackets. METHODS: Sixteen Caucasian individuals of both sexes, aged between 12 and 16 years old and in permanent dentition were selected. Eight individuals were treated with conventional brackets installed on the lower dental arch and self-ligating brackets on the upper arch. Another eight individuals received self-ligating brackets in the lower arch and conventional brackets in the upper arch. The subjects received material and instructions for oral hygiene. Visible plaque index (VPI), gingival bleeding index (GBI) and clinical attachment level (CAL) were evaluated just after installation of orthodontic appliances, and 30, 60 and 180 days later. Mann-Whitney test was used to compare differences between groups (self-ligating and conventional), two-way ANOVA followed by Tukey's test was used to assess CAL at each site of each tooth. Significance level was set at 5%. RESULTS: No significant changes were found with regard to the assessed parameters (VPI, GBI and CAL) in either one of the systems. CONCLUSION: No significant changes were found with regard to the periodontal response to orthodontic treatment for the variables assessed and between subjects receiving passive self-ligating and conventional brackets. All individuals had received oral hygiene instructions and had their periodontal conditions monitored. .

OBJETIVO: o objetivo do presente estudo foi avaliar, comparativamente, a resposta periodontal durante o tratamento ortodôntico realizado com braquetes autoligáveis e convencionais. MÉTODOS: dezesseis indivíduos, leucodermas, em dentição permanente, de ambos os sexos, com idades de 12 a 16 anos, foram selecionados. Oito foram tratados com braquetes convencionais instalados na arcada inferior, e braquetes autoligáveis na arcada superior. Os outros oito indivíduos receberam braquetes autoligáveis na arcada inferior e braquetes convencionais na arcada superior. Os pacientes receberam materiais e instruções sobre higiene bucal. O índice de placa visível (IPV), o índice de sangramento gengival (ISG) e o nível de inserção clínica (NIC) foram avaliados logo após a instalação do aparelho e 30, 60 e 180 dias mais tarde. Para comparar as diferenças entre os grupos (braquetes autoligáveis e convencionais), foi utilizado o teste Mann-Whitney; para analisar o NIC em cada local de cada dente, foi utilizada a análise de variância de duas vias, seguida do teste de Tukey, com nível de significância a 5%. RESULTADOS: não houve alteração significativa nos parâmetros avaliados (IPV, ISG e NIC), em nenhum dos dois sistemas. CONCLUSÃO: a resposta periodontal ao tratamento ortodôntico não apresentou diferenças significativas, para nenhuma das variáveis analisadas, entre os indivíduos tratados com braquetes autoligáveis passivos e braquetes convencionais, os quais receberam instruções quanto à adequada higienização bucal e foram submetidos ao monitoramento das condições periodontais. .

Tratamento ortodôntico com o sistema autoligável: quando a extração é necessária / Orthodontic treatment with self-ligating brackets: when extraction is needed

O presente artigo tem o propósito de discutir os fatores determinantes na indicação de extração dentária pra correção de apinhamento no tratamento ortodôntico com o sistema autoligável. Métodos: realizou-se um levantamento bibliográfico sobre as indicações de extração e seus efeitos no tratamento ortodôntico, bem como utilizou-se de casos clínicos, sendo discutidos os aspectos que mais influenciaram na decisão de extração. Resultados: pode-se observar que até mesmo pacientes com características indicativas de tratamento com extração puderam ser tratados sem a obtenção prévia do espaço quando essas características apresentavam-se isoladas. Conclusão: a principal característica que determina a necessidade do tratamento ortodôntico com extrações dentárias diante de más oclusões com discrepância osseodentária negativa, mesmo com braquetes autoligáveis, foi a protrusão dentaria.

Leitura de torque no bráquete straight wire: uma proposta realista de individualização / Torque expression of straightwire brackets: a realistic proposal for individualization

Desde que foi introduzido na Ortodontia, o bráquete pré-ajustado tem recebido diferentes propostas de prescrição baseadas em experiências clínicas, com expectativa de que os valores embutidos de torque e angulação sejam lidos pelos fios ortodônticos conforme o calibre é aumentado ou com objetivo de criar movimentações radiculares para corrigir efeitos de angulação e inclinação decorrente da mecânica ortodôntica, incapaz de realizar movimentos de corpo. Entretanto, a folga entre fio e canaleta não tem permitido que a teoria se aplique na prática e as prescrições, no que se refere especificamente ao torque, normalmente são subutilizadas ou nem mesmo fazem diferença na finalização dos casos. Esse artigo tem o objetivo de propor uma nova forma de pensar em prescrição e racionalizar o seu uso para que possamos usar de forma realista as prescrições disponíveis, aproveitando as suas vantagens.

Since it was introduced in orthodontics, the straightwire bracket has received different proposals of prescription, based on clinical experience, with the expectation that the built-in torque and angulation values are read by orthodontic wires as its size is increased or in order to create root compensation to correct inclination effects resulting from orthodontic mechanics, that is unable to perform body movements. However, the slot play has not allowed the theory to be applyed in practice, especially as regards to torque and frequently the bracket prescription is underutilized or even negligible on orthodontic treatment finishing. This article aims to propose a new way of thinking about prescription and rationalize its use so that we can in fact take advantages of the use of a straightwire appliance.

Is there any association between facial type and mandibular dental arch form in subjects with normal occlusion? / Existe alguma associação entre o tipo facial e a forma do arco dental mandibular em indivíduos com oclusão normal?

The aim of this study was investigate the association between the mandibular arch morphology and the facial type of Brazilian Caucasians with natural normal occlusion. For this, we used a sample comprised of lateral radiographs and respective dental casts of 51 individuals (21 male and 30 female), presenting at least 4 of the 6 Andrews' keys to normal occlusion without previous orthodontic treatment. Angle's first molar relationship was considered indispensable for the sample. The facial type was defined by two cephalometric measurements (SN.SGn and SN.GoGn). After scanning the models (3D) and radiographs, the images were evaluated by 12 orthodontists. A modified Kappa test evaluated the agreement between examiners to classify the morphology of the dental arch. The chi-square test was used to verify the association between the facial type (dolichofacial, mesofacial, or brachyfacial) and the dental arch morphology (square, oval, or tapered), using significance level of 5%. Casual and systematic errors (p > 0.05) showed no significant results and the Kappa test showed significant agreement among examiners for the dental arch form (0.55) with a p < 0.001, considered as 'moderate'. The chi-square test indicated no significant association. The null hypothesis was accepted, as the facial type was not associated with dental arch morphology in individuals with normal occlusion.

O objetivo do presente estudo foi verificar a associação entre a morfologia do arco dental mandibular e o tipo facial de brasileiros, leucodermas, com oclusão normal natural. Para isso, utilizou-se uma amostra consistiu de telerradiografias obtidas em norma lateral e os respectivos modelos em gesso de 51 indivíduos (21 do sexo masculino e 30 do feminino), com pelo menos quatro das seis chaves para oclusão normal de Andrews, sem histórico de tratamento ortodôntico prévio. A relação molar de Angle foi considerada indispensável para a amostra. O tipo facial foi definido por duas grandezas cefalométricas (SN.SGn e SN.GoGn). Depois de digitalizar os modelos (3D) e as radiografias, as imagens foram avaliadas por 12 ortodontistas. Para verificar a concordância entre os examinadores, quanto à classificação da morfologia do arco dental, foi utilizado o teste Kappa. O teste do qui-quadrado foi utilizado para verificar a associação entre o tipo facial (dolicofacial, mesofacial ou braquifacial) e a morfologia do arco dental mandibular (quadrangular, ovalar ou triangular), utilizando nível de significância de 5%. Erros casuais e sistemáticos (p > 0,05) não mostraram resultados significativos, e o teste Kappa mostrou concordância significativa entre os examinadores para a forma do arco dental (0,55), com p < 0,001, considerado como 'moderado'. O teste do qui-quadrado mostrou não haver associação estatisticamente significativa entre as variáveis. A hipótese nula foi aceita, já que o tipo facial não apresentou associação com a morfologia do arco dental em indivíduos com oclusão normal.

Transversal changes in dental arches from non-extraction treatment with self ligating brackets.

OBJECTIVE: The present study aimed at analyzing, with the use of dental casts, the transverse changes of the upper and lower dental arches, after non-extraction orthodontic treatment, with self-ligating brackets. METHODS: The sample comprised 29 patients, all presenting Class I malocclusion with upper and lower crowding of at least 4 mm and treated only with a fixed appliance, without stripping, extraction or distalization. The dental casts were obtained before and after leveling with 0.019 x 0.025-in stainless steel archwires. CONCLUSIONS: The results indicated that the majority of transverse changes occurred at the premolar areas, both the first and the second, as well as on the upper and lower dental arches. The intercanine distance increased 0.75 mm, on average, in the upper arch and 1.96 mm in the lower arch. The molars also demonstrated a tendency towards an increase in their transverse dimension, however, at a lower intensity comparing to premolars. All measurements presented statistically significant differences with the exception of the maxillary second molars.

Transversal changes in dental arches from non-extraction treatment with self ligating brackets

OBJECTIVE: The present study aimed at analyzing, with the use of dental casts, the transverse changes of the upper and lower dental arches, after non-extraction orthodontic treatment, with self-ligating brackets. METHODS: The sample comprised 29 patients, all presenting Class I malocclusion with upper and lower crowding of at least 4 mm and treated only with a fixed appliance, without stripping, extraction or distalization. The dental casts were obtained before and after leveling with 0.019 x 0.025-in stainless steel archwires. CONCLUSION: The results indicated that the majority of transverse changes occurred at the premolar areas, both the first and the second, as well as on the upper and lower dental arches. The intercanine distance increased 0.75 mm, on average, in the upper arch and 1.96 mm in the lower arch. The molars also demonstrated a tendency towards an increase in their transverse dimension, however, at a lower intensity comparing to premolars. All measurements presented statistically significant differences with the exception of the maxillary second molars.

OBJETIVO: o presente estudo teve por objetivo avaliar, em modelos de gesso, as alterações dimensionais transversais das arcadas dentárias, decorrentes do tratamento ortodôntico sem extração, com braquetes autoligáveis. MÉTODOS: a amostra constou de 29 pacientes que apresentavam má oclusão de Classe I, com apinhamento superior e inferior mínimo de 4mm, que foram tratados unicamente com aparelho fixo, sem desgastes, extração ou distalização dentária. Os modelos de gesso foram obtidos antes e ao final do tratamento. CONCLUSÃO: os resultados indicaram que as maiores alterações transversais ocorreram na região dos pré-molares, tanto dos primeiros como dos segundos, e tanto na maxila como na mandíbula. A distância intercaninos teve aumento, em média, de 0,75mm na arcada superior, e de 1,96mm na inferior. Os molares também demonstraram tendência de aumento das dimensões transversais, porém em menor intensidade que os pré-molares. Todas as medidas denotaram diferença estatisticamente significativa, com exceção dos segundos molares superiores.

Tratamento compensatório limitado de adulto com assimetria e má oclusão do padrão III / Limited compensatory treatment in adult with asymmetry and Pattern III malocclusion

O presente relato de caso clínico ilustra o tratamento compensatório de uma paciente adulta portadora de laterognatismo suave, limítrofe para Padrão III por deficiência maxilar relativa. A paciente procurou tratamento com a queixa principal relacionada a desgastes, além de diastemas nos dentes anteriores, e espaços associados a sequelas de exodontias efetuadas em tratamento ortodôntico prévio. Os problemas oclusais envolviam os três planos de espaço: mordida cruzada posterior, ausência de trespasses horizontal e vertical, com pouca exposição de incisivos, tanto com o lábio em repouso como no sorriso. A mecânica assimétrica minimalista proposta resgatou, de modo compensatório, a forma das arcadas dentárias e, associada à reanatomização dentária e ao procedimento reabilitador, permitiu alcançar relações oclusais satisfatórias, em um contexto consciente do prognóstico limitado.

Tratamento das más oclusões do padrão face longa: a agradabilidade facial definindo metas terapêuticas / The long face patterm malocclusions treatment: the facial pleasantness defining therapeutic goals

No caso de pacientes com deformidades dentoesqueléticas, a agradabilidade facial é o fator primário que irá determinar se o tratamento será de caráter compensatório ou cirúrgico. Portanto, o diagnóstico deverá priorizar a face, identificando a localização e gravidade do problema, de acordo com o sexo, idade e etnia. Sendo assim, o tratamento ortodôntico cirúrgico das más oclusões do Padrão Face Longa tem como objetivo corrigir não somente a oclusão, mas especialmente o erro facial. A ação descompensatória exige uma atenção maior no planejamento de movimentações vestibulolinguais dos dentes anteriores superiores e inferiores, pois esses exibem uma relação exígua com suas respectivas bases ósseas. Esse artigo tem por objetivo ilustrar, por meio de um caso clínico, essa perspectiva de tratamento, onde a Ortodontia descompensatória eliminou a excrescência dentária localizada e a essência do problema — o erro esquelético — foi corrigida por meio de cirurgia ortognática.

Desmistificando a utilização dos stops no sistema autoligado / Desmystifying the use of stops in the self-ligating systems

Desde a introdução do Sistema Autoligado, o emprego dos stops tem sido necessário devido ao baixo atrito conferido aos braquetes — o qual, na fase inicial do alinhamento e nivelamento, permite o deslize e deslocamento do fio, fazendo-o faltar de um lado e sobrar do outro, ferindo a mucosa bucal do paciente. A perspectiva de que o stop, uma vez posicionado no arco, impede que esse deslize faz suscitar questionamentos sobre onde posicioná-lo. Por isso, aqui serão relatadas diferentes formas de utilizá-los para potencializar o alinhamento e nivelamento, de forma a tirar vantagem desse dispositivo, imprescindível nos primeiros fios, facilitar a mecânica ortodôntica e reduzir procedimentos complementares (o que pode reduzir, também, o tempo de tratamento).

Tratamento ortodôntico cirúrgico da birretrusão associado à SAOS: relato de caso / Surgical-orthodontic treatment of biretrusion associated with osas: case report

A SAOS é um distúrbio respiratório que afeta até 40% da população mundial. Entre as possíveis modalidades terapêuticas a cirurgia ortognática de avanço maxilomandibular (AMM) tem sido relatada na literatura como uma opção eficiente, de baixa morbidade e com índices de sucesso próximos ao absoluto. Esse fato faz da Ortodontia peça fundamental na reabilitação de seus portadores, a partir de um preparo ortodôntico condizente com as necessidades cirúrgicas de cada um. O presente relato busca esclarecer os parâmetros etiológicos desse distúrbio, enfatizando o papel do ortodontista no diagnóstico e elaboração do plano de tratamento, assim como na mecânica ortodôntica utilizada com o objetivo de restabelecimento da função respiratória.

Obstructive sleep apnea syndrome is a breathing disorder that affects up to 40% of the world population. Among the various therapies for its treatment orthognathic surgery of maxillomandibular advancement (MMA) has been reported in the literature as an effective therapy with low morbidity, and with success rates close to absolute. This fact makes Orthodontics a cornerstone in rehabilitation of patients with OSAS, by means of an orthodontic preparation consistent with these patients’ surgical needs. This report seeks to clarify the etiology of this disorder parameters, emphasizing the role of the orthodontist in the diagnosis and treatment plan development, as well as the orthodontic mechanics used in order to restore respiratory function.

Efeitos do laser de baixa intensidade na sensibilidade dolorosa durante a movimentação ortodôntica / Effects of low intensity laser on pain sensitivity during orthodontic movement

OBJETIVO: avaliar a eficiência do laser diodo, infravermelho, na redução da dor no período pós-ativação da retração de caninos com molas fechadas de NiTi. MÉTODOS: doze pacientes que necessitavam de retração de caninos foram selecionados. Os caninos foram retraídos por meio de molas fechadas de NiTi, com força de 150g/lado. Um canino de cada paciente foi selecionado aleatoriamente para ser irradiado com laser, imediatamente após as ativações e depois de 3 e 7 dias. Os caninos homólogos foram utilizados como grupo controle e foi realizada somente a simulação de aplicação do laser. O laser irradiado foi o de diodo (ArGaAl), a um comprimento de onda de 780nm e uma potência de 20mW, densidade de energia na superfície do tecido alvo de 5J/cm², durante 10s por ponto, resultando numa energia de 0,2J por ponto e energia total (Et) de 2J. Para avaliação do efeito analgésico, foi utilizada a escala visual análoga (VAS), na qual os pacientes marcavam de 0 a 10, em consonância com a dor experimentada nos tempos de 12, 24, 48 e 72 horas pós ativação das molas e aplicação do laser.Todo o procedimento foi novamente realizado um mês depois, no momento da reativação da retração dos caninos. RESULTADOS E CONCLUSÕES: não houve diferença estatisticamente significativa entre os lados irradiado (GL) e controle (GC). Portanto, o laser de diodo infravermelho (780nm), no protocolo de aplicação utilizado, não foi eficiente em termos estatísticos para a diminuição da sensibilidade dolorosa provocada pela movimentação ortodôntica.

OBJECTIVE: To evaluate the efficiency of infrared diode laser on pain reduction during canine initial retraction. METHODS: Twelve patients in need of canine retraction were selected. The canines were retracted with closed NiTi coil springs activated to 150g per side. One canine of each patient was randomly selected for laser irradiation immediately after activation and after 3 and 7 days. The contralateral canines were taken as control group and were submitted only to simulation of laser application. Diode laser (ArGaAl) was employed at wavelength of 780nm, power of 20mW and energy density in the target tissue of 5J/cm², for 10 seconds per point, delivering an energy of 0.2J per point and total energy (TE) of 2J. The analgesic effect was evaluated with aid of a visual analogue scale (VAS), on which the patients indicated 0 to 10 according to the pain experienced at 12, 24, 48 and 72 hours after coil spring activation and laser application. The procedure was repeated after one month, upon reactivation of canine retraction. RESULTS AND CONCLUSIONS: There was no statistically significant difference between irradiated side (LG) and control side (CG). Thus, utilization of infrared diode laser (780nm) according to the present protocol was not statistically effective to reduce pain sensitivity caused by orthodontic movement.

Ortodontia lingual: evolução da técnica e os braquetes autoligados / Lingual orthodontics: evolution of technique and self-ligating brackets

A Ortodontia Lingual iniciou-se por meio do Dr. Craven Kurz utilizando braquetes da técnica Edgewise colados nas superfícies linguais dos dentes, com a intenção de se obter um tratamento estético e praticamente invisível. Como a estética é sempre um tema atual e a procura por ela é grande, a Ortodontia Lingual continuou evoluindo. Muitas empresas avançaram em pesquisas e desenvolveram diversos tipos de braquetes para serem utilizados na nova técnica. Este trabalho propõe discorrer sobre a história da Ortodontia Lingual e sua evolução nesses anos, como também sobre a introdução dos primeiros braquetes autoligados linguais, o seu desenvolvimento, surgimento e utilização, uma vez que esta é uma tendência na Ortodontia convencional por vestibular.