Dental and skeletal effects of combined headgear used alone or in association with rapid maxillary expansion.

OBJECTIVE: The aim of this study was to assess the effects of combined headgear used alone or in association with rapid maxillary expansion, as the first step for Class II malocclusion treatment. METHODS: The sample comprised 61 patients divided into three groups: Group 1, combined headgear (CH); Group 2, CH + rapid maxillary expansion (CH + RME); and Group 3, control (CG). In Group 1, patients were treated with combined headgear until Class I molar relationship was achieved. In Group 2, the protocol for headgear was the same; however, patients were previously subject to rapid maxillary expansion. RESULTS: Results showed distal displacement of maxillary molars for both experimental groups (p < 0.001), with distal tipping only in Group 1 (CH) (p < 0.001). There was restriction of forward maxillary growth in Group 2 (CH + RME) (p < 0.05) and clockwise rotation of the maxilla in Group 1 (CH) (p < 0.05). CONCLUSION: Based on the results, it is possible to suggest that treatment with both protocols was efficient; however, results were more significant for Group 2 (CH + RME) with less side effects.

Dental and skeletal effects of combined headgear used alone or in association with rapid maxillary expansion

Objective: The aim of this study was to assess the effects of combined headgear used alone or in association with rapid maxillary expansion, as the first step for Class II malocclusion treatment.Methods:The sample comprised 61 patients divided into three groups: Group 1, combined headgear (CH); Group 2, CH + rapid maxillary expansion (CH + RME); and Group 3, control (CG). In Group 1, patients were treated with combined headgear until Class I molar relationship was achieved. In Group 2, the protocol for headgear was the same; however, patients were previously subject to rapid maxillary expansion.Results:Results showed distal displacement of maxillary molars for both experimental groups (p < 0.001), with distal tipping only in Group 1 (CH) (p < 0.001). There was restriction of forward maxillary growth in Group 2 (CH + RME) (p < 0.05) and clockwise rotation of the maxilla in Group 1 (CH) (p < 0.05).Conclusion: Based on the results, it is possible to suggest that treatment with both protocols was efficient; however, results were more significant for Group 2 (CH + RME) with less side effects.

Objetivos: a finalidade do presente estudo foi verificar os efeitos do aparelho extrabucal de tração combinada, associado ou não à expansão rápida da maxila, como primeiro passo do tratamento da má oclusão de Classe II.Métodos: a amostra consistiu de 61 indivíduos divididos em três grupos: Grupo 1 = extrabucal de tração combinada (TC); Grupo 2 = tração combinada + expansão rápida da maxila (TC +ERM); Grupo 3 = controle (GC). No Grupo 1 os indivíduos foram tratados com extrabucal de tração combinada até a relação molar ficar em Classe I. No Grupo 2, o protocolo foi o mesmo, entretanto, os indivíduos receberam, previamente, expansão maxilar rápida.Resultados: os resultados mostraram deslocamento distal dos molares superiores em ambos os grupos experimentais (p < 0,001), com inclinação distal somente no Grupo 1 (TC) (p < 0,001). Houve restrição de crescimento anterior da maxila no Grupo 2 (TC + ERM) (p < 0,5) e rotação horária da maxila no Grupo 1 (TC) (p< 0,5).Conclusão:baseado nos resultados, é possível concluir que o tratamento com ambos os protocolos foi eficiente; entretanto, os resultados foram mais significativos para o Grupo 2 (TC + ERM), e com menos efeitos colaterais.

Orthodontic treatment of a mandibular incisor fenestration resulting from a broken retainer.

This article describes the orthodontic relapse with mandibular incisor fenestration in a 36-year-old man who had undergone orthodontic treatment 21 years previously. The patient reported that his mandibular 3 × 3 bonded retainer had been partially debonded and broken 4 years earlier. The mandibular left lateral incisor remained bonded to the retainer and received the entire load of the incisors; consequently, there was extreme labial movement of the root, resulting in dental avulsion. As part of the treatment, the root was repositioned lingually using a titanium-molybdenum segmented archwire for 8 months, followed by endodontic treatment, an apicoectomy, and 4 months of alignment and leveling of both arches. The treatment outcomes were excellent, and the tooth remained stable, with good integrity of the mesial, distal, and lingual alveolar bones and periodontal ligament. The 1-year follow-up showed good stability of the results.

Absence of multiple premolars and ankylosis of deciduous molar with cant of the occlusal plane treated using skeletal anchorage.

Ankylosis and the absence of premolars are two relatively common conditions encountered in the field of orthodontics. However, the absence of multiple premolars, particularly two adjacent premolars, along with ankylosis of deciduous teeth, is unusual. Herein, we present a case report and discuss some aspects related to these abnormalities. A 15-year-old boy was missing the upper right first and second premolars and the lower right and left second premolars. In addition, the deciduous lower left second molar was ankylosed and in infraocclusion, causing canting of the occlusal plane. The patient was treated with a mini-implant to correct the Class II malocclusion on the left side and a miniplate to correct the cant of the occlusal plan. After treatment, the upper right space was kept closed, with the canine in contact with the first molar, and the lower left space was opened to an implant-prosthetic rehabilitation.

Assessment of the mechanical properties of glass ionomer cements for orthodontic cementation

OBJECTIVE: To evaluate the mechanical properties of three glass ionomers cements (GICs) used for band cementation in Orthodontics. METHODS: Two conventional glass ionomers (Ketac Cem Easy mix/3M-ESPE and Meron/Voco) and one resin modified glass ionomer (Multi-cure Glass ionomer/3M-Unitek) were selected. For the compressive strength and diametral tensile strength tests, 12 specimens were made of each material. For the microhardness test 15 specimens were made of each material and for the shear bond strength tests 45 bovine permanent incisors were used mounted in a self-cure acrylic resin. Then, band segments with a welded bracket were cemented on the buccal surface of the crowns. For the mechanical tests of compressive and diametral tensile strength and shear bond strength a universal testing machine was used with a crosshead speed of 1,0 mm/min and for the Vickers microhardness analysis tests a Microdurometer was used with 200 g of load during 15 seconds. The results were submitted to statistical analysis through ANOVA complemented by Tukey's test at a significance level of 5%. RESULTS: The results shown that the Multi-Cure Glass Ionomer presented higher diametral tensile strength (p < 0.01) and compressive strength greater than conventional GICs (p = 0.08). Moreover, Ketac Cem showed significant less microhardness (p < 0.01). CONCLUSION: The resin-modified glass ionomer cement showed high mechanical properties, compared to the conventional glass ionomer cements, which had few differences between them.

OBJETIVO: avaliar as propriedades mecânicas de três cimentos de ionômero de vidro (CIVs) utilizados para cimentação de anéis ortodônticos. MÉTODOS: foram utilizados dois CIVs convencionais (Ketac Cem Easy mix/3M-ESPE e Meron/Voco) e um CIV modificado por resina (Multi-Cure Glass ionomer/3M-Unitek). Para os testes de resistência à compressão e tração diametral, foram confeccionados 12 corpos de prova de cada material. Para os testes de microdureza, foram confeccionados 15 corpos de prova de cada material; para os testes de resistência de união ao cisalhamento, foram utilizados 45 dentes bovinos incluídos em resina acrílica, sobre os quais foi cimentada uma lâmina de anel ortodôntico com braquete soldado a ela para a realização dos ensaios. Para os testes de compressão, tração diametral e cisalhamento, foi utilizada uma máquina universal de ensaios a uma velocidade de 1mm/min; para os testes de microdureza Vickers, foi utilizado um microdurômetro com 200g de carga durante 15 segundos. Os resultados foram submetidos à análise estatística ANOVA, complementada pelo teste de Tukey ao nível de significância de 5%. RESULTADOS: os resultados demonstraram que o Multi-Cure Glass Ionomer apresentou resistência à tração diametral significativamente maior (p < 0,01) e maior resistência à compressão (p = 0,08) em relação aos CIVs convencionais. Além disso, o Ketac Cem apresentou microdureza significativamente maior que os demais materiais (p < 0,01). CONCLUSÃO: o CIV modificado por resina apresentou propriedades mecânicas superiores às dos CIVs convencionais, que, por sua vez, apresentaram poucas diferenças entre si.

Can we add chlorhexidine into glass ionomer cements for band cementation?

OBJECTIVE: To test if the addition of chlorhexidine digluconate (CHD) might influence the mechanical properties and antibacterial properties of two different conventional glass ionomer cements (GICs) used for band cementation. MATERIALS AND METHODS: Two commercial brands of conventional GICs were used: Ketac Cem Easymix (3M/ESPE, St Paul, Minn) and Meron (Voco, Cuxhaven, Germany). The cements were manipulated in their original composition and also with 10% and 18% CHD in the liquid to create a total of six groups. Diametral tensile strength, compressive strength, microhardness, shear bond strength, and antibacterial effects in 5, 45, and 65 days against Streptococcus mutans were tested in all groups, and the data were submitted to statistical analyses. RESULTS: There were no significant differences between the groups of the same material in diametral tensile, compressive strength, and shear bond strength (P > .05). There was significant improvement in the microhardness to the Ketac Cem Easymix (P < .001). GICs with the addition of CHD showed significant inhibition of S. mutans growth in comparison with the control groups at the three time points evaluated (P < .001). The addition of 18% CHD resulted in higher bacterial inhibition (P < .001). CONCLUSIONS: The addition of chlorhexidine digluconate to conventional GICs does not negatively modify the mechanical properties and may increase the antibacterial effects around the GICs even for relatively long periods of time.

Strategies to finish orthodontic treatment with a Class III molar relationship: three patient reports.

The purpose of this article is to review treatment concepts for patients with congenitally missing teeth in the mandible, for patients in whom teeth in only the mandibular arch were extracted, or for patients with Class III camouflage treatment. The therapy result in these situations is a Class III molar relationship. With this type of intercuspation, esthetic and functional aspects must be observed.

Surgically assisted rapid maxillary expansion combined with maxillary protraction in an adult: a patient report.

The aim of this article is to discuss an alternative treatment for adult patients who have a dental or skeletal Class III relationship. A 20-year-old woman presented with a dental and skeletal Class III relationship and a transverse maxillary deficiency. Surgically assisted rapid maxillary expansion was followed by maxillary protraction with a face mask and orthodontic treatment with standard edgewise technique. At the end of treatment, a Class I molar and canine relationship was attained with an adequate transverse intercuspation and improvement of the patient's facial profile.