In vitro assessment of dental erosion caused by clear aligners.

The primary objective of this in vitro study was to investigate the erosive potential of enamel under the use of clear aligners (CA), by simulating in vivo conditions experienced by patients who do not remove their CA during the consumption of acidic beverages. In addition, the difference in erosion protection conferred by artificial and human saliva was also evaluated. Sound-extracted human premolars (n = 20) had half of their surfaces protected with acid-resistant nail polish and were randomly distributed into two experimental groups (n = 10): teeth immersed in human saliva or artificial saliva. All teeth had half of their lingual surfaces enclosed by a CA device. The erosive challenges consisted of individual immersion of each sample in citrus acid three times a day, intermediated by immersion in human saliva or artificial saliva for 2 h, during ten days of the erosive protocol. The enamel mineral content was analyzed by high-resolution microtomography. The differential mineral concentration profiles were obtained by subtracting the profile of the mineral concentration of the exposed area and enamel under the CA area from the respective sound area (control). In addition, enamel wear and enamel volume loss were measured. Scanning electron microscopy (SEM) was also performed to analyze the enamel surface. Data were analyzed by two-way ANOVA, followed by the Student-Newman-Keuls test. The enamel wear was higher in teeth immersed in artificial saliva, when compared to human saliva (p < 0.001). The volume loss of the exposed enamel area was lower for tooth immersed in human saliva than in artificial saliva (p < 0.001), during the acid challenge protocol. The use of CA during acid challenges promoted wear and mineral loss of dental enamel, being these changes more pronounced on the enamel surface under the CA. These results open a new path for the development of further studies adopting clinical protocols that promote more accurate responses in the clinical practice during orthodontic treatment.

Saving teeth: Revisited. Esthetic improvement and long-term periodontal stability of a pathologic tooth migration case: An 84-month follow-up.

INTRODUCTION: Advances in implant dentistry, often influence our clinical treatment planning and steer us as periodontists from our fundamental values of preserving teeth. Pathologic tooth migration (PTM) of maxillary anterior teeth is a common sequela of periodontitis in patients and results in significant esthetic and functional problems. Patients' growing concern about the esthetics of their teeth and their fears of losing teeth are often reasons for them to seek treatment. We commonly assign a hopeless prognosis to these pathologically migrated teeth because of the significant loss of periodontal support and go with the "safer" choice of replacing them with implants. The purpose of this case report is to present the long-term (7-year) periodontal stability of compromised teeth and to emphasize the successful outcomes achieved when orthodontics, non-surgical periodontal, and restorative treatments are combined. METHODS AND RESULTS: A 38-year-old, otherwise healthy male with compromised function and esthetics, PTM, periodontal disease, and missing teeth presented to our clinic. Primary treatment objectives were to 1) eliminate the periodontal inflammation and 2) restore and stabilize the occlusion by employing non-surgical periodontal treatment, adult orthodontics, and prosthodontics. Following interdisciplinary treatment, clinical and radiographic re-evaluation revealed significant clinical attachment gain, reduction in tooth mobility, favorable esthetics, and better overall prognosis. At an 84-month follow-up, the patient was periodontally healthy and retained his natural dentition. CONCLUSIONS: Interdisciplinary collaboration along with patient compliance may increase the longevity of periodontally compromised teeth and improve esthetics for periodontitis patients who suffer from PTM. Such long-term favorable outcomes reaffirm the value of classic periodontal treatment and the success of multidisciplinary treatment to save teeth as a viable alternative to the extraction of teeth and the placement of implant retained restorations.

Effects of the photobiomodulation using different energy densities on the periodontal tissues under orthodontic force in rats with type 2 diabetes mellitus.

To evaluate the impact of the GaAlAs diode laser with energy densities of 160 J/cm2, 320 J/cm2, and 640 J/cm2 on the periodontal tissues under continuous orthodontic force application and on the rate of orthodontic tooth movement in rats with type-2 diabetes mellitus. The intensity of primary alveolar bone formation was also investigated through the immune-positive osteocytes for OPN antibody. Forty adult male Wistar rats were divided into eight groups of 5 rats: normoglycemic (N), 160 J-laser-normoglycemic (160 J-LN), 320 J-laser-normoglycemic (320 J-LN), 640 J-laser-normoglycemic (640 J-LN), diabetic (D), 160 J-laser-diabetic (160 J-LD), 320 J-laser-diabetic (320 J-LD), and 640 J-laser-diabetic (640 J-LD) rats. Diabetes mellitus was induced by a single intravenous injection of 40 mg/kg monohydrated-alloxan. An orthodontic force magnitude of 20cN was applied. The laser parameters were continuous emission of 780-nm wavelength, output power of 20mW, and fiber probe with a spot size of 0.04 cm in diameter. Radiographic, histomorphological, and immunohistochemical analysis were performed after a period of 21 days. The photobiomodulation using the energy density of 640 J/cm2 strongly stimulated the alveolar bone formation and contributed the reorganization of the soft periodontal tissues, followed by the 320 J/cm2. Extensive alveolar bone loss, intense infiltration of inflammatory cells, and degradation of the PDJ tissue were mainly found in the D and 160 J-LD groups. The rate of orthodontic tooth movement was represented by the interdental distance between the cementoenamel junctions of the right mandibular first and second molars . This distance was larger in the diabetic groups (D: 39.98±1.97, 160 J-LD: 34.84±6.01, 320 J-LD: 29.82±1.73, and 640 J-LD: 35.47±4.56) than in the normoglycemic groups (N: 21.13±1.19; 160 J-LN: 22.69±0.72, 320 J-LN: 22.28±0.78, and 640 J-LN: 24.56±2.11). The number of osteopontin-positive osteocytes was significantly greater in the 640 J-LD (14.72 ± 0.82; p < 0.01) and 640 J-LN (13.62 ± 1.33; p < 0.05) groups than with D (9.82 ± 1.17) and 160 J-LD (9.77 ± 1.10) groups. Therefore, the energy density of 640 J/cm2 provided the best maintenance and integrity of the periodontal tissue microarchitecture under continuous orthodontic force when compared with the other dosages, mainly in the uncontrolled diabetic rats. The interdental distance was greater in the D and 160 J-LD groups due to presence of severe periodontitis caused by diabetes plus the mechanical stress generated by continuous orthodontic forces, implying, thus, an insufficient biostimulatory effect for the dosage of 160 J/cm2.

Effects of the photobiomodulation using different energy densities on the periodontal tissues under orthodontic force in rats with type 2 diabetes mellitus

Abstract To evaluate the impact of the GaAlAs diode laser with energy densities of 160 J/cm2, 320 J/cm2, and 640 J/cm2 on the periodontal tissues under continuous orthodontic force application and on the rate of orthodontic tooth movement in rats with type-2 diabetes mellitus. The intensity of primary alveolar bone formation was also investigated through the immune-positive osteocytes for OPN antibody. Forty adult male Wistar rats were divided into eight groups of 5 rats: normoglycemic (N), 160 J-laser-normoglycemic (160 J-LN), 320 J-laser-normoglycemic (320 J-LN), 640 J-laser-normoglycemic (640 J-LN), diabetic (D), 160 J-laser-diabetic (160 J-LD), 320 J-laser-diabetic (320 J-LD), and 640 J-laser-diabetic (640 J-LD) rats. Diabetes mellitus was induced by a single intravenous injection of 40 mg/kg monohydrated-alloxan. An orthodontic force magnitude of 20cN was applied. The laser parameters were continuous emission of 780-nm wavelength, output power of 20mW, and fiber probe with a spot size of 0.04 cm in diameter. Radiographic, histomorphological, and immunohistochemical analysis were performed after a period of 21 days. The photobiomodulation using the energy density of 640 J/cm2 strongly stimulated the alveolar bone formation and contributed the reorganization of the soft periodontal tissues, followed by the 320 J/cm2. Extensive alveolar bone loss, intense infiltration of inflammatory cells, and degradation of the PDJ tissue were mainly found in the D and 160 J-LD groups. The rate of orthodontic tooth movement was represented by the interdental distance between the cementoenamel junctions of the right mandibular first and second molars . This distance was larger in the diabetic groups (D: 39.98±1.97, 160 J-LD: 34.84±6.01, 320 J-LD: 29.82±1.73, and 640 J-LD: 35.47±4.56) than in the normoglycemic groups (N: 21.13±1.19; 160 J-LN: 22.69±0.72, 320 J-LN: 22.28±0.78, and 640 J-LN: 24.56±2.11). The number of osteopontin-positive osteocytes was significantly greater in the 640 J-LD (14.72 ± 0.82; p < 0.01) and 640 J-LN (13.62 ± 1.33; p < 0.05) groups than with D (9.82 ± 1.17) and 160 J-LD (9.77 ± 1.10) groups. Therefore, the energy density of 640 J/cm2 provided the best maintenance and integrity of the periodontal tissue microarchitecture under continuous orthodontic force when compared with the other dosages, mainly in the uncontrolled diabetic rats. The interdental distance was greater in the D and 160 J-LD groups due to presence of severe periodontitis caused by diabetes plus the mechanical stress generated by continuous orthodontic forces, implying, thus, an insufficient biostimulatory effect for the dosage of 160 J/cm2.

Bacterial adhesion on conventional and self-ligating metallic brackets after surface treatment with plasma-polymerized hexamethyldisiloxane.

INTRODUCTION:: Plasma-polymerized film deposition was created to modify metallic orthodontic brackets surface properties in order to inhibit bacterial adhesion. METHODS:: Hexamethyldisiloxane (HMDSO) polymer films were deposited on conventional (n = 10) and self-ligating (n = 10) stainless steel orthodontic brackets using the Plasma-Enhanced Chemical Vapor Deposition (PECVD) radio frequency technique. The samples were divided into two groups according to the kind of bracket and two subgroups after surface treatment. Scanning Electron Microscopy (SEM) analysis was performed to assess the presence of bacterial adhesion over samples surfaces (slot and wings region) and film layer integrity. Surface roughness was assessed by Confocal Interferometry (CI) and surface wettability, by goniometry. For bacterial adhesion analysis, samples were exposed for 72 hours to a Streptococcus mutans solution for biofilm formation. The values obtained for surface roughness were analyzed using the Mann-Whitney test while biofilm adhesion were assessed by Kruskal-Wallis and SNK test. RESULTS:: Significant statistical differences (p< 0.05) for surface roughness and bacterial adhesion reduction were observed on conventional brackets after surface treatment and between conventional and self-ligating brackets; no significant statistical differences were observed between self-ligating groups (p> 0.05). CONCLUSION:: Plasma-polymerized film deposition was only effective on reducing surface roughness and bacterial adhesion in conventional brackets. It was also noted that conventional brackets showed lower biofilm adhesion than self-ligating brackets despite the absence of film.

Bacterial adhesion on conventional and self-ligating metallic brackets after surface treatment with plasma-polymerized hexamethyldisiloxane

ABSTRACT Introduction: Plasma-polymerized film deposition was created to modify metallic orthodontic brackets surface properties in order to inhibit bacterial adhesion. Methods: Hexamethyldisiloxane (HMDSO) polymer films were deposited on conventional (n = 10) and self-ligating (n = 10) stainless steel orthodontic brackets using the Plasma-Enhanced Chemical Vapor Deposition (PECVD) radio frequency technique. The samples were divided into two groups according to the kind of bracket and two subgroups after surface treatment. Scanning Electron Microscopy (SEM) analysis was performed to assess the presence of bacterial adhesion over samples surfaces (slot and wings region) and film layer integrity. Surface roughness was assessed by Confocal Interferometry (CI) and surface wettability, by goniometry. For bacterial adhesion analysis, samples were exposed for 72 hours to a Streptococcus mutans solution for biofilm formation. The values obtained for surface roughness were analyzed using the Mann-Whitney test while biofilm adhesion were assessed by Kruskal-Wallis and SNK test. Results: Significant statistical differences (p< 0.05) for surface roughness and bacterial adhesion reduction were observed on conventional brackets after surface treatment and between conventional and self-ligating brackets; no significant statistical differences were observed between self-ligating groups (p> 0.05). Conclusion: Plasma-polymerized film deposition was only effective on reducing surface roughness and bacterial adhesion in conventional brackets. It was also noted that conventional brackets showed lower biofilm adhesion than self-ligating brackets despite the absence of film.

RESUMO Introdução: a deposição de filme de polímero a plasma foi criada para modificar as propriedades de superfície dos braquetes ortodônticos metálicos, com o intuito de inibir a adesão bacteriana. Métodos: filmes finos de polímero de hexametildisiloxano (HMDSO) foram depositados em braquetes ortodônticos de aço inoxidável convencionais (n = 10) e autoligáveis (n = 10), utilizando a técnica de radiofrequência PECVD (Plasma-Enhanced Chemical Vapor Deposition). As amostras foram divididas em dois grupos, de acordo com o tipo de braquete, e dois subgrupos após o tratamento de superfície. A microscopia eletrônica de varredura (MEV) foi realizada para avaliar a presença de adesão bacteriana sobre as superfícies das amostras (região de ranhura horizontal e aletas) e a integridade da camada de filme. A Interferometria Confocal (CI) avaliou a rugosidade, e a molhabilidade superficial foi avaliada por goniometria. Para análise de adesão bacteriana, as amostras foram expostas durante 72 horas a uma solução de Streptococcus mutans, para formação de biofilme. Os valores obtidos para a rugosidade da superfície foram analisados pelo teste de Mann-Whitney, enquanto a adesão do biofilme foi avaliada pelos testes de Kruskal-Wallis e SNK. Resultados: observaram-se diferenças estatisticamente significativas (p <0,05) para a rugosidade superficial e redução da adesão bacteriana em braquetes convencionais após o tratamento da superfície, e entre braquetes convencionais e autoligáveis. Não foram observadas diferenças estatísticas significativas entre os grupos autoligáveis (p> 0,05). Conclusão: a deposição de polímero a plasma só foi efetiva na redução da rugosidade superficial e adesão bacteriana em braquetes convencionais. Observou-se, também, que os braquetes convencionais apresentaram menor adesão ao biofilme do que os braquetes autoligáveis, apesar da ausência de filme.

Effects of the GaAlAs diode laser (780 nm) on the periodontal tissues during orthodontic tooth movement in diabetes rats: histomorphological and immunohistochemical analysis.

The purposes of the present study are to assess the effects of the GaAlAs diode laser on the periodontal tissues and to investigate its action on the alveolar bone remodeling process during orthodontic tooth movement in normoglycemic and diabetic rats. Sixty adult male Wistar rats were divided into four groups of 15 rats: normoglycemic (N), diabetic (D), laser-normoglycemic (LN), and laser-diabetic (LD) rats. Diabetes mellitus was induced by a single intravenous injection of 40 mg/kg monohydrated alloxan. The orthodontically moved tooth underwent a force magnitude of 20 cN. The laser irradiation with a continuous emission of a 780-nm wavelength, an output power of 20 mW, and a fiber probe with a spot size of 0.04 cm in diameter and an area of 0.00126 cm2 were used. Moreover, an energy density of 640 J/cm2 was applied in an exposition time of 40 s. Histomorphological and immunohistochemical analysis was performed. The photobiomodulation (PBM) strongly stimulated the periodontal tissue response, establishing mainly the balance between the bone formation and resorption. Intense inflammatory cell infiltration and extensive loss of bone tissue were mainly found in the D group from 14 days. The number of osteopontin-positive osteocytes was significantly greater in the LN group, followed by the LD, especially at 7 and 14 days, whereas osteoprotegerin-positive osteoblasts were significantly higher in the LN and LD groups than in the N and D groups, respectively, in all periods. The PBM strongly stimulated the alveolar bone remodeling and favored the continuous reorganization of the soft periodontal tissues, leading to the maintenance and integrity of the periodontal microstructure under orthodontic force, especially in uncontrolled diabetic rats.

Avaliação do comportamento biomecânico dos clipes de braquetes autoligantes interativos: parte 1 / Evaluation of the biomechanical behavior of self ligating interactive bracket's clips: part 1

o objetivo do estudo foi avaliar a perda de potencial dedevolução de esforço mecânico dos clipes de braquetes autoligantesinterativos. Foram analisados seis grupos de acessórios de distintosfabricantes (n=8): quatro grupos de braquetes metálicos: SLI Morelli(Morelli, Brasil), In-Ovation R (GAC, Estados Unidos), Bio Quick (Forestadent,Alemanha), Empower (American Orthodontics, Estados Unidos);dois grupos de acessórios cerâmicas: InOvation C (GAC, EstadosUnidos) e Quick Clear (Forestadent, Alemanha). Os grupos foram submetidosa três momentos de testes (M1 , M2 e M3). Após ensaios deforça e deformação aferidos por uma máquina de teste EMIC DL2000(Tese 3.01 e 3.05), os grupos testados apresentaram perda de forçadevolvida pelos respectivos clipes. Utilizando um segmento de fio ortodônticode aço inox 0.016" X 0.022", foi aferida a força que o clipeexerce sobre o fio ao ser tracionado (momento 1). Em seguida, osclipes foram submetidos à força constante de pul/ out com magnitudede 20N, por um período de duas horas (momento 2) e, finalmente, foirepetido o momento 1 para aferição da força que o clipe exerce apóster sofrido os dois momentos anteriores (momento 3). Na avaliação dosníveis de força no momento 1, os maiores valores foram encontradosno grupo In-Ovation R. Após serem submetidos ao momento 2, osmenores valores de perda em gramas-Força (gF) foram encontradosno grupo SLI Morelli, e os menores valores de perda percentual foramencontrados no grupo In-Ovation C.

The aim of this investigation was to evaluate the amountof loss strength in clips of six types of interactive self-ligating bracketsof upper lirst premolars (slots dimensions 0022" X 0028") after beingsubmitted to three moments of testing. The bracketsjbrands testedwere: In Ovation R, Bio Quick, Empower, SLI Morelli, In-Ovation Cand Quick Clear. The strength and also the plastic deformation wasmeasured by a test machine EMIC DL2000 (Tese program version3.01 and 3.05), which showed 1055 of load strength by the respectiveclips. Using a wire segment of orthodontic stainless steel rectangularsection of dimensions 0.016 "X 0022", was initially measured thestrength that the clip exerts on the wire to be pulled up to the stop(slot blocker) that prevents the clip to open (moment 1). Then, theclips were subjected to a constant "pull out" force with magnitude of20N for a period of two hours (moment 2). Finally was repeated themoment 1 to measure the force that the clip exerts after suffering twoprevious moments (moment 3). In the evaluation of strength levels atthe moment 1, the highest values were found in the group In-OvationR. After being subjected to the moment 2, the lowest values of 1055 ingrams-Force (gF) were found in the group SLI Morelli, and lower valuesof percentage loss were found in the group In-Ovation C.

Profile of the orthodontist practicing in the State of São Paulo--part 2.

INTRODUCTION: The choice of brackets, bands and wires is a very important aspect of orthodontic treatment. Stainless steel prevailed for a long time, but new alloys and resources have emerged to diversify the orthodontic wire mechanics. OBJECTIVE: This study aimed to investigate the profile and materials used by orthodontists practicing in the State of São Paulo, Brazil. METHODS: A questionnaire was sent to 2,414 specialists in Orthodontics and Dentofacial Orthopedics registered with the Regional Board of Dentistry of São Paulo State (CRO-SP). To assess the association between qualitative variables, the Chi-square association test was employed at 5% significance level. RESULTS: Five hundred and ninety-three (24.65%) questionnaires were completed and sent back. Efficiency was the key reason given by the professionals for choosing a particular material. The majority showed a preference for metal brackets (98%), followed by ceramics (32%) and polycarbonate (7.8%). The most widely used brackets had 0.022 x 0.028-in slots (73.2%). Regarding orthodontic wires, 88.2% employed round steel wires and conventional round NiTi wires, while 52.6% used round heat-activated NiTi and 46.5% rectangular TMA wires. Elastics (92.9%) were the most widely used method to tie the orthodontic archwire to the bracket. CONCLUSIONS: In this survey, the orthodontists claimed that efficiency was the major motivator for choosing orthodontic materials. Conventional brackets tied with conventional elastic ligatures are still the most used by the professionals. Among steel and conventional Nitinol wires, round wires ranked first. The use of resources recently available to Brazilian orthodontists, such as self-ligating brackets and mini-implants, was not significant.

Profile of the orthodontist practicing in the State of São Paulo - Part 2

INTRODUCTION: The choice of brackets, bands and wires is a very important aspect of orthodontic treatment. Stainless steel prevailed for a long time, but new alloys and resources have emerged to diversify the orthodontic wire mechanics. OBJECTIVE: This study aimed to investigate the profile and materials used by orthodontists practicing in the State of São Paulo, Brazil. METHODS: A questionnaire was sent to 2,414 specialists in Orthodontics and Dentofacial Orthopedics registered with the Regional Board of Dentistry of São Paulo State (CRO-SP). To assess the association between qualitative variables, the Chi-square association test was employed at 5% significance level. RESULTS: Five hundred and ninety-three (24.65%) questionnaires were completed and sent back. Efficiency was the key reason given by the professionals for choosing a particular material. The majority showed a preference for metal brackets (98%), followed by ceramics (32%) and polycarbonate (7.8%). The most widely used brackets had 0.022 x 0.028-in slots (73.2%). Regarding orthodontic wires, 88.2% employed round steel wires and conventional round NiTi wires, while 52.6% used round heat-activated NiTi and 46.5% rectangular TMA wires. Elastics (92.9%) were the most widely used method to tie the orthodontic archwire to the bracket. CONCLUSIONS: In this survey, the orthodontists claimed that efficiency was the major motivator for choosing orthodontic materials. Conventional brackets tied with conventional elastic ligatures are still the most used by the professionals. Among steel and conventional Nitinol wires, round wires ranked first. The use of resources recently available to Brazilian orthodontists, such as self-ligating brackets and mini-implants, was not significant.

INTRODUÇÃO: a escolha do tipo de braquetes, ligaduras e fios são fatores importantes no tratamento ortodôntico. O aço inoxidável predominou por muito tempo, mas novas ligas metálicas diversificaram o universo de fios disponíveis, assim como surgiram outros recursos. OBJETIVO: analisar o perfil do ortodontista do estado de São Paulo em relação aos materiais que utiliza. MÉTODOS: foi enviado um questionário a 2414 especialistas em Ortodontia e Ortopedia Facial inscritos no Conselho Regional de Odontologia do estado de São Paulo. Para avaliar a associação entre as variáveis qualitativas, foi utilizado o teste qui-quadrado, ao nível de significância de 5%. RESULTADOS: houve o retorno de 593 (24,65%) questionários preenchidos. A eficácia do material ortodôntico foi o principal motivo alegado para sua escolha. A maioria demonstrou preferência por braquetes metálicos (98%), cerâmicos (32%) e de policarbonato (7,8%). O slot mais citado foi o de 0,022" x 0,028" (73,2%). Sobre os fios ortodônticos, 88,2% empregam fio de aço redondo e o NiTi convencional redondo; 52,6% o NiTi termoativado redondo e 46,5% o TMA retangular. A ligadura elástica foi a forma mais empregada (92,9%) para fixar o arco ortodôntico ao braquete. CONCLUSÕES: os ortodontistas analisados alegaram ser a eficácia o principal motivo de escolha do material; os braquetes convencionais unidos com ligaduras elásticas ainda são os mais utilizados. Entre os fios ortodônticos, os de secção redonda apareceram em primeiro lugar, tanto os de aço como os de nitinol convencional. Recursos recentes na Ortodontia brasileira, como os braquetes autoligáveis e os mini-implantes, não apresentaram uso significativo.

Low-level laser therapy for treatment of pain associated with orthodontic elastomeric separator placement: a placebo-controlled randomized double-blind clinical trial.

OBJECTIVE: The objective of this study was to evaluate the effectiveness of the use of irradiation with a low-level laser therapy (LLLT), wavelength 830 nm, for treating pain inherent to tooth movement caused by orthodontic devices, simulated by positioning interdental elastomeric separators. METHODS: Sixty orthodontic patients were randomly assigned to two groups: GA (ages 12-25 years; mean 17.1 years) was the control, and GB (ages 12-26 years; mean 17.9 years) the intervention group. All patients received elastomeric separators on the mesial and distal surfaces of one of the lower first molars, and immediately after insertion of the separators received irradiation as randomly indicated. The intervention group (GB) received irradiation with LLLT (aluminum gallium arsenide diode), by a single spot in the region of the radicular apex at a dose of 2 J/cm(2) and application along the radicular axis of the buccal surface with three spots of 1 J/cm(2) (wavelength 830 nm; infrared). Control group (GA) received irradiation with a placebo light in the same way. This was a double-blind study. All the patients received a questionnaire to be filled out at home describing their levels of pain 2, 6, and 24 h and 3 and 5 days after orthodontic separator placement, in situations of relaxed and occluded mouth. RESULTS: The patients in the intervention group (LLLT) had lower mean pain scores in all the measures. The incidence of complete absence of pain (score=0) was significantly higher the intervention group. CONCLUSIONS: Based on this study, authors concluded that single irradiation with LLLT of wavelength 830 nm efficiently controlled the pain originating from positioning interdental elastomeric separators, to reproduce the painful sensation experienced by patients when fixed orthodontic devices are used.

Profile of the orthodontist practicing in the state of São Paulo - Part 1

INTRODUCTION: Orthodontics is no different from other sciences to the extent that it is a field in constant evolution and development. Nowadays, given the availability of a wide range of materials and biomechanical resources, as well as the development of new diagnostic capabilities, new methods to manage orthodontic treatment have emerged. Furthermore, due to the proliferation of postgraduate programs, it is increasingly important to gain insight into the profile of these specialists and the resources they use. OBJECTIVE: Examine the profile of orthodontists practicing in the State of São Paulo. The questions were prepared to evaluate different aspects of orthodontic practice. METHODS: A questionnaire was sent to 2.414 specialists in Orthodontics and Dentofacial Orthopedics registered with the Regional Board of Dentistry of São Paulo State (CRO-SP). To assess the association between qualitative variables, the Chi-square association test was employed at 5% significance level. RESULTS: Five hundred ninety-three (24.65%) questionnaires were completed and returned. The sample profile consisted of males (54.3%), aged between 41 and 50 (40.5%), who had been registered with the São Paulo Regional Board of Dentistry (CRO-SP) for 6 to 10 years (29.3%). The three most widely mentioned cephalometric analyses were standard USP (71.5%), McNamara (59.2%) and Ricketts (52.8%). CONCLUSIONS: Based on a statistical analysis of the data one can conclude that the Straight-Wire technique was used most often (74.5%), and this technique is associated with orthodontists who have been specialists for less than 10 years. Most people surveyed (52.4%) routinely make use of functional orthopedic resources in their daily practice.

INTRODUÇÃO: a Ortodontia, como toda ciência, é um campo em permanente evolução e desenvolvimento. No panorama atual, devido à oferta de diversos tipos de materiais e das opções biomecânicas existentes, além do desenvolvimento de novos recursos de diagnóstico, surgiram novas possibilidades de se abordar o tratamento ortodôntico. Em adição, com o aumento dos cursos de pós-graduação, torna-se importante conhecer o perfil do especialista e os recursos de sua preferência. OBJETIVO: analisar o perfil do ortodontista que atua no estado de São Paulo, por meio de questões elaboradas com o objetivo de avaliar aspectos relacionados à prática ortodôntica. MÉTODOS: foi enviado um questionário a 2.414 especialistas em Ortodontia e Ortopedia Facial inscritos no Conselho Regional de Odontologia do estado de São Paulo. Para avaliar a associação entre as variáveis qualitativas, foi utilizado o teste de associação Qui-quadrado, ao nível de significância de 5%. RESULTADOS: foram devolvidos 593 (24,65%) questionários preenchidos. O perfil da amostra foi sexo masculino (54,3%), faixa etária entre 41 e 50 anos (40,5%) e com tempo de inscrição no CRO-SP de 6 a 10 anos (29,3%). As três análises cefalométricas mais citadas foram o padrão USP (71,5%), McNamara (59,2%) e Ricketts (52,8%). CONCLUSÕES: com base na análise estatística dos dados, pode-se concluir que a técnica Straight-Wire foi a mais empregada (74,5%), a qual está associada a ortodontistas com menos de 10 anos de especialidade. A maioria da população pesquisada (52,4%) utiliza, de forma rotineira, recursos ortopédicos funcionais no seu dia a dia.

Influência do modelo do bráquete no movimento ortodôntico de rotação: estudo comparativo / Influence of the model of the bracket in the orthodontic movement of rotation: comparative study

O objetivo do estudo foi comparar a eficiência e o desempenho de bráquetes frente ao movimento de rotação. O método utilizou bráquetes convencionais Ovation® (GAC, Bohemia, NY, USA) ligados por amarrilho metálico e por ligante elastomérico, bráquetes autoligantes interativos In-Ovation R® (GAC, Bohemia, NY, USA) e bráquetes autoligantes passivos Damon 2® (ORMCO, Orange, CA, USA). Para padronizar o experimento foi criado um simulador de movimento dentário rotacional, composto por três pinos metálicos, dois fixos e um móvel, imersos em cera, aos quais foram encaixados corpos de prova com os bráquetes. O pino móvel foi rotacionado 30 graus. A simulação da correção da rotação dentária foi realizada com o fio 0,016’’ NiTi e na sequência com o fio 0,018’’ NiTi. As amostras foram testadas individualmente com temperatura externa constante e de forma idêntica, repetindo 10 vezes para cada amostra, registrando a quantidade de rotação em relação ao tempo. Os resultados foram tratados, estatisticamente, através da análise de variância, utilizando delineamento em medidas repetidas, complementado pelo Teste de Comparações Múltiplas de Tukey ao nível de significância de 5%. Os resultados demonstram maior controle e eficiência na correção da rotação dentária através dos bráquetes autoligantes em comparação com os convencionais. Entre os autoligantes, o resultado foi melhor com o sistema interativo, sendo que nos bráquetes convencionais com ligante elastomérico obteve-se a menor correção angular, considerando o mesmo espaço de tempo. Os acessórios autoligantes mostram a grande vantagem de um sistema de baixo atrito e com excelente gerenciamento no controle do movimento.

This study compared brackets efficiency and performance regarding rotational movements. Therefore, conventional Ovation® (GAC, Bohemia, NY, USA), brackets with archwires attached by both elastomeric and metallic ligatures, interactive self ligating In-Ovation R® (GAC, Bohemia, NY, USA) and passive self ligating Damon 2® (ORMCO, Orange, CA, USA) were used. To standardize the experiment a simulator of rotational, composed dental movement was created for three metallic bolts, two fixtures and furniture, immersed in wax, which had been incased bodies of test with the different types of brackets. The mobile bolt was rotational 30 degrees. The simulation of the correction of the dental rotation was carried through initially with the wire 0,016’’ NiTi and in the sequence with the 0,018’’ wire NiTi. The samples had been tested individually with constant external temperature and of identical form, being that the tests had been repeated 10 times for each sample, with the amount of rotation in registered relation to the time. The harvested results had been dealt with statistical through the analysis variance using the delineation in repeated measures, complemented for the Test of Multiple Comparisons of Tukey to the level of significance of 5%. The results of the study demonstrate greater have controlled and efficiency in the correction of the dental rotation through brackets self ligating, in the comparison with the conventional. Between the self ligating, the result was better with the interactive system, being that in brackets conventional with elastomeric ligating it was gotten lesser angular correction, considering the same time space. These results demonstrated the advantages of a system that works due to friction control that brings a better control over the dental movement.

Estudo comparativo do movimento de torque induzido pelos sistemas autoligantes e convencionais / Comparative study of the movement of torque induced by systems selfligation and conventional

Este estudo teve como objetivo comparar diferentes tipos de sistemas de bráquetes com seus diferentes sistemas de ligações, quanto à eficiência no controle do movimento de terceira ordem, o torque. Foram analisados 4 grupos (n=10): Ligação Passiva - com o bráquete autoligante Damon® 3MX(Ormco, Orange, California, EUA); Ligação Interativa - com o bráquete autoligante In-Ovation® R(GAC, Bohemia, NI, EUA) e Ligação Elástica e Metálica – com bráquete convencional Ovation® (GAC, Bohemia, NI, EUA). Foi desenvolvido um dispositivo que simula um tratamento ortodôntico a partir da utilização de uma sequência de fios ortodônticos (0,017”x0,025”; 0,018”x0,025”; 0,019”x0,025”; 0,021”x0,025”), medindo a evolução do movimento de torque em graus. Utilizando o fio 0,017”x0,025”, o grupo Ligação Passiva apresentou 0% de correção, o grupo Ligação Interativa 76,82%, o grupo Ligação Metálica mostrou 86,36% e o grupo Ligação Elástica 51,36% de correção do torque. Colocando o fio 0,018”x0,025”, o grupo Ligação Passiva passou apresentar 1,11% de correção, o grupo Ligação Interativa 92,73%, o grupo Ligação Metálica 95,45% e o grupo Ligação Elástica 71,82% de correção do torque. Posicionando o fio 0,019”x0,025”, o grupo Ligação Passiva apresentou 30,56% de correção, Ligação Interativa com 100%, Ligação Metálica com 100% de e o grupo Ligação Elástica 85,45% de correção do torque. Finalmente, fixando o fio 0,021”x0,025”, o grupo Ligação Passiva resultou em 63,33% de correção, Ligação Interativa 100%, Ligação Metálica 100% e o grupo Ligação Elástica 95,45% de correção do torque. Conclui-se que os grupos Ligação Interativa e Ligação Metálica apresentaram as maiores porcentagens de correção do torque, atingindo a totalidade da prescrição incorporada ao bráquete com o fio 0,019”x0,025”. Os grupos Ligação Passiva e ligação elástica apresentaram porcentagens de correção de torque aquém da prescrição, mesmo com o fio 0,021”x0,025”

The aim of this study was to compare different types of bracket systems with their different ligation systems related to efficiency in controlling the third order movement, torque. Four groups were analyzed (n=10): Passive Ligation - with self-ligating bracket Damon® 3MX (Ormco, Orange, California, USA); Interactive Ligation - with self-ligating bracket In-Ovation® R (GAC, Bohemia, NY, USA), and Elastic and Metallic Ligation - with conventional bracket Ovation® (GAC, Bohemia, NY, USA). A device was developed to simulate an orthodontic treatment from the use of a sequence of orthodontic wires (0.017”x0.025”; 0.018”x0.025”; 0.019”x0.025”; 0.021”x0.025”), measuring the torque motion evolution in degrees. Using Wireless 0.017 “x0.025” Passive Ligation group had 0% correct, the group presented Interactive Ligation 76.82% accuracy, the group presented the Metal Ligation 86.36% and the group Elastic Ligation 51.36 % correction of torque. Placing the wire 0.018 “x0.025” Passive Ligation group showed 1.11% accuracy, the Interactive Ligation 92.73%, the Metal Ligation 95.45% and the group Elastic Ligation 71,82% correction of torque. Positioning the wire 0.019 “x0.025” Passive Ligation group showed 30.56% accuracy, the Interactive Ligation with 100%, the Metal Ligation with 100% and the group Elastic Ligation 85.45% of correction of torque. Finally, setting the thread 0.021 “x0.025” Passive Ligation group showed 63.33% accuracy, the Interactive Ligation with 100%, the Metal Ligation with 100% and the group Elastic Ligation 95.45 % correction of torque. The self-ligating bracket with Interactive Ligation and the conventional bracket with Metallic Ligation had higher percentages of correct torque. The self-ligating bracket with Passive Ligation had the lowest percentages of correct torque. The conventional bracket with Elastic Ligation developed percentages of correct torque that can be considered satisfactory.

Avaliação da força liberada por fios ortodônticos de níquel-titânio associados a bráquetes autoligante / Avalied of the deactivated force by termoatived nickel-titanium wire associated with self-ligation brackets

O presente estudo teve como objetivo avaliar a força liberada por fios ortodônticos de Níquel-Titânio (Niti) termoativados de secção redonda 0,016¨, quando submetidos a deflexões de 4, 3,5, 3, 2,5, 2, 1,5, 1, 0,5 e 0 mm. Foram selecionadas seis diferentes marcas comerciais de fios (GAC®, Ormco®, Morelli®, Aditek®, US Company® e 3M®, para cada marca comercial foram realizados dez ensaios. Para a realização dos ensaios foi desenvolvido um protótipo, com braquetes autoligantes GAC®, onde o fio ortodôntico foi adaptado. Esse sistema foi colocado em uma máquina de ensaios (EMIC DL 2000), calibrada em 5Kgf e com velocidade de 1mm/min. Todos os ensaios foram realizados em temperatura constante. Por meio de um software os valores de desativação (g) foram registrados e demonstrados através de gráficos de força em função da deflexão, finalizando 60 ensaios. As variáveis foram submetidas á análise de variância e ao teste de Turkey para determinar as diferenças entre as marcas comerciais testadas adotando um nível de significância de 5%. Os resultados demonstraram que na desativação de 4mm para 3mm todos os fios apresentaram redução acentuada de força, característica comum dos fios termoativados e que todas as marcas comerciais estudadas apresentaram liberação de força relativamente constante.

The purpose of this study was to evaluate the deactivation force of Nickel-Titanium termoatived wire with round diameter of 0.016¨, when put into 4; 3.5; 3; 2.5; 2; 1.5, 1, 0.5 and 0 mm deflections. For this purpose was used six different wire trade make ( Gac® ,Ormco® ,Morelli® ,Aditek®Us Company®and 3M®)for each trade make was done ten rehearsals. For the test a prototype was developed, with self-ligation brackets GAC®, where orthodontic wire was adapted. The system was adapted in a Universal rehearses machine (EMIC DL 2000) adjusted in 5kgf and with speed of 1mm/min. All the rehearsals were done in constant temperature. Through software the activation values (g) were registered and showed by the power graphics in relation to the deflection, totalizing 60 rehearsals. The variables were subjected to the analysis of variance and test of Turkey to determine the differences between trademarks tested by adopting a significance level of 5%. The result showed that the deactivation of 4mm to 3mm all wires showed severe redution in force, a common characteristic of thermal activated wires and all trademarks studied had relatively constant release of force.

Terapia LED de baixa intensidade no tratamento da dor durante movimento ortodôntico - Estudo Clínico / Low intensity LED therapy in pain treatment during orthodontic movement ? Clinical Study

Introdução: A terapia com LED de baixa intensidade tem sido reportada por seu efeito analgésico e anti-inflamatório. Objetivo: Analisar a sintomatologia dolorosa após movimentação ortodôntica associada ou não à terapia não-coerente. Método: Vinte nove voluntários (19,8±7,9 anos) selecionados foram divididos em três grupos: controle (n=10), placebo (n=9) e LED (n=10, InGaAlP, 630±10nm, 14J/cm2, 0,10W, 70s). Os participantes tiveram os molares separados ortodonticamente e receberam orientação para anotar o nível de dor entre o momento da separação e 168 horas experimentais. Resultados: O grupo LED apresentou redução (p<0,01) da dor em relação aos grupos controle (2 horas) e placebo (72 horas). O grupo placebo mostrou diminuição (p<0,01) da dor em relação ao grupo controle (6h e 120 horas). Conclusão: Houve efeito positivo da fototerapia nos momentos iniciais da movimentação ortodôntica, sem variações no decorrer do período experimental.

Introduction: Therapy with low intensity LED has been reported for its analgesic and anti-inflammatory effect. Objective: Analyze the pain symptoms after orthodontic tooth movement associated or not to coherent and non-coherent phototherapy. Method: Twenty nine volunteers (19.8±7.9 years) were divided into three groups: control (n=10), placebo (n=9) and LED (n=10, InGaAlP, 630±10nm, 14 J/cm2, 0.10W, 70s). The participants? molars were orthodontically separated, and they were instructed to write down pain level using a visual analog scale between the separator placement and 168 experimental hours. Results: The LED group showed reduction in pain at two hours compared to the control group (72 hours). The placebo group presented a decrease of pain levels in relation the control group (6 and 120 hours). Conclusion: There was positive effect of phototherapy in the early stages of orthodontic movement without variation during the experimental period.

A ressonância magnética das ATMs: recurso diagnóstico de última geração / The magnetic resonance of MRIs: resource diagnosis of latest generation

É sabido que a análise do estado do disco articular, bem como seu posicionamento, constitui-se na chave para o tratamento das desordens craniomandibulares. A proposta deste trabalho é apresentar ao clínico relacionado ao estudo e tratamento das disfunções craniomandibulares (DCMs), o uso das Imagens de Ressonância Magnética das ATMs (MRIs), como único e excelente recurso para visualização do estado e posicionamento do disco articular. O estudo das condições de normalidade ou anormalidade do côndilo articular através da avaliação de seu contorno e da análise da diferença da intensidade de sinal entre suas porções cortical e medular também se torna possível pela avaliação das MRIs das ATMs. Quanto às alterações de outros tecidos moles (músculos, cápsula, ligamentos), as MRIs mostram-se um interessante aliado na comprovação de processos metabólicos inerentes às DCMs, tais como os processos inflamatórios. Serão discutidos os fenômenos físicos que regem a geração das MRIs. Os métodos para a obtenção das imagens serão explanados. A interpretação das MRIs será discorrida, tanto para imagens que refletem condições de normalidade quanto para algumas das patologias articulares mais freqüentes.

Tratamento alternativo de Classe II divisäo - 1ª - utilizaçäo conjugada de aparatologia fixa e removível / Class II division 1 alternative treatment - fixed and removable appliances simultaneous utilization

O presente trabalho tem por objetivo apresentar o uso de aparatologia removível conjugada à aparelhos fixos da técnica Edgewise ou Straight Wire para a correçäo de Classe II com retrusäo mandibular e maxila bem posicionada em relaçäo à base craniana. Para tanto, considera o aspecto estético através de análise de Perfil mole, questiona os parâmetros da cefalometria e aborda detalhes da mecanoterapia com relaçäo às forças indesejáveis resultantes deste tipo de tratamento

Manequim ortodôntico "Termo-Wax": um novo conceito na simulação da mecanoterapia em Typodont / \"Termo-Wax\" orthodontic models: a new concept in simulating Typodont mechanotherapy

Este trabalho tem por objetivo apresentar um novo conceito para o treinamento da mecanoterapia ortodôntica com manequins tipo "typodont", utilizados em cursos práticos e ensino laboratorial da especialidade. Decorre das limitações dos manequins tradicionais metálicos atualmente empregados para tal fim. É proposto um "typodont" denominado TERMO-WAX©, com design inovador confeccionado em plástico e composto por três partes: (a) estrutura plástica articulada; (b) bases de cera com cristais metálicos e (c) dentes plásticos com pinos apicais. Por seu tamanho mais reduzido e possibilidade de inclusão em cabeçote, também é confeccionado um novo cabeçote de fibra (d) com adaptações específicas. Este manequim prima ao mesmo tempo pela praticidade, baixo custo e possibilidade de simulações mais detalhadas de alguns procedimentos fundamentais no ensino da Ortodontia: colocação do manequim em cabeçote com haste fixada na bancada, colagem direta de acessórios/braquetes, aplicação de forças extra bucais e melhor simulação ergonômica da realidade clínica