RESUMO
INTRODUCTION: In this study, we aimed to compare the incidence of new demineralized lesions and bond failures between 2 groups of participants wearing fixed orthodontic appliances bonded with either light-cured resin-modified glass ionomer cement or light-cured composite. METHODS: This trial was a multicenter (6 centers: 2 teaching hospitals, 4 specialist orthodontic practices), single-blinded, randomized controlled trial with 2 parallel groups. Patients aged 11 years or older, in the permanent dentition, and about to start fixed orthodontic treatment in these 6 centers were randomly allocated to have either resin-modified glass ionomer cement or light-cured composite for bonding brackets, forward of the first molars. Pretreatment and day-of-debond digital photographic images were taken of the teeth and assessed by up to 5 clinical and 3 lay assessors for the presence or absence of new demineralized lesions and the esthetic impact. The assessors were masked as to group allocation. RESULTS: We randomized 210 participants, and 197 completed the trial. There were 173 with complete before-and after-digital images of the teeth. The incidence of new demineralized lesions was 24%; but when the esthetic impact was taken into account, this was considerably lower (9%). There was no statistically significant difference between the bracket adhesives in the numbers with at least 1 new demineralized lesion (risk ratio,1.25; 95% confidence interval, 0.74-2.13; P = 0.403) or first-time bracket failure (risk ratio,0.88; 95% confidence interval, 0.67-1.16; P = 0.35). There were no adverse effects. CONCLUSIONS: There is no evidence that the use of resin modified glass ionomer cement over light-cured composite for bonding brackets reduces the incidence of new demineralized lesions or bond failures. There might be other reasons for using resin modified glass ionomer cement. REGISTRATION: This trial was registered at ClinicalTrials.govNCT01925924. PROTOCOL: The protocol is available from the corresponding author on request.
Assuntos
Resinas Compostas , Fluoretos Tópicos/administração & dosagem , Cimentos de Ionômeros de Vidro , Braquetes Ortodônticos , Desmineralização do Dente/prevenção & controle , Adolescente , Criança , Resinas Compostas/efeitos adversos , Colagem Dentária/métodos , Falha de Equipamento , Cimentos de Ionômeros de Vidro/efeitos adversos , Cimentos de Ionômeros de Vidro/química , Humanos , Braquetes Ortodônticos/efeitos adversos , Método Simples-Cego , Desmineralização do Dente/etiologiaAssuntos
Distinções e Prêmios , Má Oclusão Classe II de Angle/terapia , Desenho de Aparelho Ortodôntico/métodos , Aparelhos Ortodônticos Funcionais , Ortodontia Corretiva/métodos , Adolescente , Criança , Feminino , Humanos , Masculino , Planejamento de Assistência ao Paciente , Resultado do Tratamento , Adulto JovemRESUMO
Deep overbite is frequently seen in the adult dentition. Although the condition is usually asymptomatic, certain factors may lead to the development of deep traumatic overbite, and in partially dentate patients loss of posterior occlusal support may be a contributory factor. Several treatment modalities, including orthodontics, orthognathic surgery and prosthodontics have been used but, as some adult patients with this problem are unwilling to avail themselves of treatment involving either orthodontics or orthognathic surgery, a restorative approach using a combination of fixed and removable restorations may provide a satisfactory solution. This paper details a case report on the restorative management of a partially dentate adult patient with a deep traumatic overbite.