Evaluation of the suture ossification level according to age and sex in children, adolescents, and adults. A cross-sectional and observational 3D study.

OBJECTIVE: To determine the ossification level of the midpalatal suture (MPS) in children, adolescents and adults from a Peruvian sample; according to the method proposed by Angelieri et al. with cone-beam computed tomographies (CBCTs). MATERIAL AND METHODS: The sample consisted of 315 CBCTs of 168 females and 147 males. The total sample was divided into 3 groups according to age and sex: children (n=77), adolescents (n=113) and adults (n=125). The images were mainly assessed in the axial plane using the Real Scan 2.0 software. The different periods of ossification of the MPS at the level of the vertical half of the palate was defined according to the five stages of Angieleri method (from A to E). The Student t-Test, Chi-square test, Kruskal-Wallis test and Spearman's Rho test were applied. RESULTS: Chi2 test results showed that the stages of MPS ossification depended on the age of the patient by age ranges (P<0.005). Multiple comparison tests affirmed that male and female subjects in the children group had fewer ossification stages than the adolescent and adult groups (P<0.001). Meanwhile, there were no statistically significant differences between the two older age groups. Finally, there was a moderate positive correlation between the stages of ossification of the MPS and the age in the male group (Rho=0.511). CONCLUSIONS: The onset of MPS ossification was significantly related to subjects up to 12 years of age and more frequently in stages B and C in both sexes. There was no difference in MPS ossification in adolescents and adult subjects.

Estudio de la longitud y diámetro radicular de incisivos laterales primarios utilizando la tomografía computarizada cone beam: un estudio in vitro

Objetivo: Determinar la longitud y el diámetro radicular de los incisivos laterales superiores deciduos a través de la Tomografía Computarizada Cone Beam. Metodología: Estudio descriptivo y transversal. Se recolectaron 20 incisivos deciduos laterales superiores recién extraídos o avulsionados de la clínica odontológica de la Universidad Nacional Mayor de San Marcos, en el año 2016. Los dientes fueron escaneados utilizando la Tomografía Cone Beam, se empleó el equipo OP300 Maxio, Orthopantomograph ®. Las imágenes resultantes fueron analizadas en el software de análisis de imagen ONDEMAND3DDENTAL. Se midió el eje axial, la longitud de la corona, raíz y la longitud total de la pieza dentaria. Para el análisis estadístico se utilizó el software Stata v14 (Stata Corporation College Station, Texas), previo al análisis los datos obtenidos fueron sometidos a la prueba de normalidad de Shapiro-Wilk, cumpliendo con esto, se usaron las pruebas paramétricas ANOVA y T de Student. Resultados: El 100% de los incisivos laterales superiores deciduos presentó un único canal radicular. La longitud promedio de la corona y de la raíz fue de 3.8mm y 11,86mm respectivamente. El diámetro medio del canal radicular según profundidad fue de 1.11 mm a nivel cervical, de 0.94 mm a nivel medio y de 0.74 mm a nivel apical, estos mostraron diferencias estadísticamente significativas (p<0.05).Conclusiones: La longitud promedio de los incisivos laterales superiores deciduos fue de 15,68mm y el diámetro radicular disminuyo de cervical a apical.

Tratamento da má-oclusão de classe II divisão 1 de Angle, com aparelho de Herbst splint metálico seguido de aparelho fixo, na dentição permanente / Treatment of class II division 1 Angle malocclusion with Herbst splint metallic appliance followed bu fixed appliances, in the permanent dentition

O aparelho de Herbst é um dos aparelhos mais usado na atualidade para correçãoda Classe II divisão 1 com retrusão mandibular. Quando utilizado no surto, ou logoapós o surto de crescimento, pode ocorrer algum ganho esquelético, favorável à correçãoda discrepância anteroposterior de forma efetiva e com resultados estáveis. O presenteartigo teve como objetivo relatar um caso clínico de uma paciente portadora de má-oclusãode Classe II divisão 1 com retrusão mandibular, associada à protrusão maxilar, tratada emduas fases: com o aparelho de Herbst splint metálico seguido de tratamento ortodônticocom aparelho lixo.

The Herbst appliance is currently one of the most used appliances for thecorrection of Class II division 1 with mandibular retrusion. When used in peak, ot just afterthe peak of growth it can result in some skeletal gain, which is favorable to the correction ofanteroposterior discrepancy with effective and stable results. This article aims to report acase of a patient with malocclusion Class II division 1 with mandibular retrusion, associatedwith maxillary protusion, treated in two stages: with Herbst splint metallic appliance followedby fixed appliance orthodontic treatment.

Tratamiento de maloclusión clase II división 1 con el aparato de herbst tipo férula, después del pico de crecimiento puberal / Treatment of Class II Division 1 malocclusion with the Herbst appliance type splint, after the pubertal growth spurt

La maloclusión clase II-1, es representada por una alta prevalencia en Brasil, siendo su presencia rutinaria en el consultorio ortodóntico. Una de las principales características de esta maloclusión es la retrusión mandibular, por lo que innumerables aparatos de avance mandibular son presentados en la literatura, siendo uno de ellos el aparato de Herbst; el cual es un aparato funcional fijo idealizado por Emil Herbst (1905) y actualizado por Hans Pancherz en la década del 80. Este aparato se caracteriza por: mantener el avance mandibular de manera continua, y presentar un tiempo menor de tratamiento activo, lo que propicia un impacto estético inmediato, además de no precisar la colaboración del paciente. Con el objetivo de mejorar el anclaje y evitar la rotura de este aparato, se creó la última versión modificada por el Dr Raveli; citado como aparato de Herbst tipo férula metálica. Recientes investigaciones indican el uso de este aparato después del pico de crecimiento puberal, creando una adecuada respuesta condilar. El objetivo de este trabajo es mostrar al ortodoncista una opción de cómo utilizar el aparato de Herbst en maloclusiones clase II-1

Malocclusion class II-1, is represented by a high prevalence in Brazil, being something common in orthodontic practice. One of the main characteristics of this malocclusion is jaw retrusion , By what many devices of jaw advance are presented in the literature. Being one of them Herbst's device, which is a functional and fixed device created by Emil Herbst (1905) and updated by Hans Pancherz in the decade of 80s.This device is characterized by keeping the jaw advance in a continuous way, while presenting a less active treatment, leading to an immediate aesthetic impact, and the patient cooperation is not required. To improve the anchoring and prevent the collapse of the apparatus was set up last amended version of it by Dr Raveli quoted as Herbst splint. Recent research indicates the use of this device after the peak pubertal growth, creating an appropriate response condylar. The aim of this work is to show the orthodontist a choice of how to use the splint Herbst in Class malocclusions II-1

Tomografia computadorizada de feixe cônico para avaliação do tratamento da classe II divisão 1ª com o aparelho Herbst no espaço aéreo faríngeo / Cone beam computed tomography to evaluate the effect of Herbst appliance in the pharyngeal airway space in patients Class II division 1

As mudanças nos padrões de respiração nasal afetam profundamente o crescimento craniofacial. Avanços tecnológicos, como a tomografia computadorizada de feixe cônico (TCFC), têm sido utilizados com o propósito de se observar tridimensionalmente, o crânio, a face e o espaço aéreo faríngeo, sendo possível a avaliação das mudanças do espaço aéreo induzidas pelos aparelhos ortopédicos propulsores mandibular. O intuito deste estudo é apresentar um método de avaliação das vias aéreas de fácil reprodutibilidade, e avaliar, mediante a TCFC, os efeitos do aparelho de Herbst bandado no espaço aéreo orofaríngeo (EAOF), nasofaríngeo (EANF) e faríngeo superior (EAFS), em indivíduos com má oclusão classe II divisão 1ª. A amostra foi composta por imagens digitais de 15 indivíduos (idade média inicial de 15,7 anos ± 1.7, após surto de crescimento pubertário) com má oclusão classe II divisão 1ª, tratados com aparelho Herbst bandado (8 meses). Os exames tomográficos foram realizados antes (T1) e após (T2) o tratamento. A fase inicial foi realizada com a orientação do nos planos; axial, coronal e sagital. Foram mensurados: comprimento no software Dolphin 3D ®: comprimento, maior área no corte coronal, maior área no corte sagital, área mínima da secção transversal e volume, de EANF, EAOR e EAFS (orofaringe e nasofaringe). Dois avaliadores previamente calibrados mensuraram duas vezes apenas um tempo das tomografias, para observar a reprodutibilidade (inter-examinador) e replicabilidade (intraexaminador). Sendo confirmada a reprodutibilidade do método, foi avaliado o efeito do aparelho Herbst, analisando os períodos pré (T1) e pós (T2) tratamento ortopédico. A análise estatística dos dados foi realizada em duas etapas. Primeira etapa, a confiabilidade das medidas apresentaram boa replicabilidade (intra-examinador) (ICC ≥ 0,984) e boa reprodutibilidade (inter-examinador) (ICC ≥ 0,911) para todas as medidas com exceção da área mínima de secção transversal de todas as regiões, que apresentou variabilidade. Segunda etapa, uma vez confirmada a confiabilidade das medidas, foi aplicado o teste T de Student, ao nível de significância de 5%. Os resultados mostram significância para o volume (p=0,007) e maior área do corte coronal (p=0,009) de EANF, e o comprimento (p=0,033) do EAFS. Acredita-se que os indivíduos tratados com o propulsor mandibular tipo Herbst, avaliados com a TCFC apresentaram aumento do volume aéreo da nasofaringe e no comprimento da faringe superior

Changes in nasal breathing patterns profoundly affects the craniofacial growth. Technological advances, such as cone beam computed tomography (CBCT), have been used in order to observe threedimensionally: the skull, face and pharyngeal airway space, with possible assessment of airspace changes induced by orthopedic activators. The purposes of this study are to present a method for assessing airway that is easily reproducted, and evaluate through the CBCT the effects of banded Herbst appliance in the oropharyngeal airspace (EAOF), nasopharyngeal (EANF) and upper pharynx (EAFS) in individuals with malocclusion class II division 1. The sample consisted of digital images of 15 individuals (initial age of 15.7 years ± 1.7, after pubertal growth spurt) with malocclusion class II division 1, treated with banded Herbst appliance (8 months). CBCT scans were performed before (T1) and after (T2) treatment. The initial phase was conducted with the guidance of planes: axial, coronal and sagittal. The following were measured: the largest area in the coronal and sagittal, minimum cross-sectional area and volume of EANF, and EAOR EAFS (oropharynx and nasopharynx) by length in Dolphin 3D® software. Two calibrated evaluator mesured twice time of CBCT to observe the reproducibility (inter-examiner) and repeatability (intra-examiner). Once the reproductability of the method was coinfirmed, the effect of the Herbst applicance was evaluated before (T1) and after (T2) the orthodontic treatment. The statistical analysis was performed in two steps. First step, the reliability of the measurements showed good repeatability (intraexaminer) (ICC ≥ 0.984) and good reproducibility (inter-examiner) (ICC ≥ 0.911) for all measures except the minimum area of cross section of all regions, which showed variability. Second step, once confirmed the reliability of the measuremens, Student t test was appleid, significance whit level of 5%. The results show a statistically significant difference for volume (p = 0.007) and greater area of the coronal section (p = 0.009) of EANF, and length (p = 0.033) of EAFS. It is believed that individuals treated with the Herbst appliance, evaluated with the present CBCT increase in air volume of the nasopharynx and the length of the upper pharynx