Midpalatal suture bone repair after miniscrew-assisted rapid palatal expansion in adults.

BACKGROUND: Midpalatal suture (MPS) repair in growing patients after RPE has been previously reported. However, differences between young and adult patients for timing and pattern of MPS repair after rapid maxillary expansion are expected. The aim of this study was to evaluate the midpalatal suture repair pattern after miniscrew-assisted rapid palatal expansion (MARPE) in adult patients. MATERIALS AND METHODS: The study included 21 patients (six males, 15 females) successfully treated with MARPE with a mean initial age of 29.1 years of age (SD = 8.0; range = 20.1-45.1). MPS repair was evaluated using maxillary axial and coronal sections derived from CBCT exams taken 16 months after the expansion (SD = 5.9). Objective and subjective assessments of MPS repair were performed. Objective assessments were performed measuring MPS bone density at anterior, median and posterior region of hard palate. Pre-expansion and post-retention bone density changes were evaluated using paired t tests (p < 0.05). Midpalatal suture bone repair was scored 0 to 3 considering, respectively, the complete absence of bone repair in the MPS, the repair of less than 50% of the MPS, the repair of more than 50% of the MPS and the complete repair of the MPS. Intra- and interexaminer reliability evaluation were assessed using Kappa coefficient. RESULTS: The objective evaluation showed a significant higher bone density at the pre-expansion stage in all palatal regions. The reliability of the subjective method was adequate with intra- and interexaminer agreements varying from 0.807 to 0.904. Scores 1, 2 and 3 were found in 19.05%, 38.09% and 42.86% of the sample, respectively. The most common region demonstrating absence of bone repair was the middle third. The anterior third of the midpalatal suture was repaired in all patients. CONCLUSIONS: A decreased bone density was observed after the retention period when compared to pre-expansion stage. Most adult patients demonstrated incomplete repair of the midpalatal suture 16 months after MARPE. However, adequate bone repair covering more than half of the hard palate extension was observed in 80.95% of the patients.

Concerns of orthodontic patients during the COVID-19 quarantine period.

INTRODUCTION: Quarantine protocols for coronavirus disease 2019 (COVID-19) pandemic has modified orthodontic appointments. OBJECTIVE: to evaluate self-reported experience and needs of orthodontic patients during the quarantine period without in-person appointments. METHODS: Thirty patients, aged 8 to 21 years, under active orthodontic treatment were randomly selected. A phone call questionnaire including questions on physical and emotional impacts of the quarantine of COVID-19 was applied during the second month of Brazilian quarantine. RESULTS: Sixteen percent of the patients reported pain related to the orthodontic appliance. Appliance breakage was observed in 23.33%. Twenty percent felt the need of an emergency orthodontic appointment and 3.33% visited a private practice. Moreover, 23% reported that even in an emergency need, they would not search for an appointment, preferring to communicate with the orthodontist by WhatsApp. Oral hygiene self-perception status showed improvement in 36.67% and worsening in 6.67% of the patients, while 56.66% reported maintenance of the same hygiene status. Sixty percent were concerned about the orthodontic treatment. General concerns were primary related to health and a possible extension of the quarantine time. CONCLUSIONS: During COVID-19 quarantine, orthodontic patients demonstrated a low frequency of orthodontic appliance interference in daily life, and most of them reported a maintenance of oral hygiene habits. The frequency of appliance related pain and breakage was 16.67% and 23.33%, respectively. Patients' main concern during the quarantine period was the fear of getting sick and the uncertainness about the extension of the quarantine period.

Mesioangulation of mandibular second molars: A case report.

This case report describes a simple alternative for treatment of mesioangulation of mandibular second molars. An 11-year-old girl was diagnosed with unilateral posterior crossbite, moderate incisor crowding and mesioangulation of the right mandibular second molar. The ectopic second molar was uprighted using a modified lingual arch with a distal hook and elastic chains. Orthodontic traction began after appliance installation and was activated once per month using 120 g of force. After six months, the right mandibular second molar was in an upright position. Orthodontic treatment continued with teeth levelling and alignment until acceptable occlusal and aesthetic results were achieved. Adequate stability was observed one year after debonding. The modified mandibular lingual arch with a distal hook is a simple and effective alternative to manage mesioangulation of mandibular second molars with minimum adverse effects and stable outcomes.

McNamara analysis cephalometric parameters in White-Brazilians, Japanese and Japanese-Brazilians with normal occlusion.

INTRODUCTION: McNamara's Jr. cephalometric analysis is a tool to diagnose dental and skeletal discrepancies and is widely used, guiding diagnosis for surgical procedures to be performed or for the use of functional devices. Few studies have shown that different ethnic groups have different cephalometric patterns. Thus, single characteristics should be respected to support the diagnosis and to help the treatment plan for different ethnic groups and their different patterns of miscegenation. OBJECTIVE: Obtain normal values for McNamara's cephalometric analysis for adolescent Japanese-Brazilian descents with normal occlusion, as well as to compare this sample with similar samples of White-Brazilian and Japanese. METHODS: Lateral headfilms from 40 White-Brazilian, 33 Japanese and 32 Japanese-Brazilian descents were selected. The three groups were composed by individuals with normal occlusion, well-balanced profiles and were separated by sex. The data were statistically analyzed with ANOVA, t-test, ANCOVA and MANCOVA tests. RESULTS: White-Brazilian males had significantly greater nasolabial angle than Japanese males. Japanese-Brazilian displayed an intermediate value between White-Brazilian and Japanese. CONCLUSION: White-Brazilian, Japanese and Japanese-Brazilian present different cephalometric characteristics of McNamara analysis. Japanese males have a significantly more acute nasolabial angle than White-Brazilian subjects.

McNamara analysis cephalometric parameters in White-Brazilians, Japanese and Japanese-Brazilians with normal occlusion

ABSTRACT Introduction: McNamara's Jr. cephalometric analysis is a tool to diagnose dental and skeletal discrepancies and is widely used, guiding diagnosis for surgical procedures to be performed or for the use of functional devices. Few studies have shown that different ethnic groups have different cephalometric patterns. Thus, single characteristics should be respected to support the diagnosis and to help the treatment plan for different ethnic groups and their different patterns of miscegenation. Objective: Obtain normal values for McNamara's cephalometric analysis for adolescent Japanese-Brazilian descents with normal occlusion, as well as to compare this sample with similar samples of White-Brazilian and Japanese. Methods: Lateral headfilms from 40 White-Brazilian, 33 Japanese and 32 Japanese-Brazilian descents were selected. The three groups were composed by individuals with normal occlusion, well-balanced profiles and were separated by sex. The data were statistically analyzed with ANOVA, t-test, ANCOVA and MANCOVA tests. Results: White-Brazilian males had significantly greater nasolabial angle than Japanese males. Japanese-Brazilian displayed an intermediate value between White-Brazilian and Japanese. Conclusion: White-Brazilian, Japanese and Japanese-Brazilian present different cephalometric characteristics of McNamara analysis. Japanese males have a significantly more acute nasolabial angle than White-Brazilian subjects.

RESUMO Introdução: A análise cefalométrica de McNamara Jr. é uma ferramenta amplamente utilizada para o diagnóstico das discrepâncias dentárias e esqueléticas, principalmente porque fornece um diagnóstico que orienta os procedimentos cirúrgicos a serem realizados ou a utilização de aparelhos funcionais. Estudos têm demonstrado que diferentes grupos étnicos apresentam padrões cefalométricos distintos. Portanto, as características próprias dos indivíduos devem ser respeitadas, para suportar o diagnóstico e facilitar o plano de tratamento, entre as diferentes etnias e seus diferentes padrões de miscigenação. Objetivo: Determinar os valores médios de normalidade das grandezas cefalométricas relacionadas à análise de McNamara em jovens mestiços nipo-brasileiros, com oclusão normal, descendentes de japoneses e brasileiros, e comparar os resultados das variáveis com amostras de jovens brasileiros leucodermas e xantodermas que apresentem as mesmas características. Métodos: Foram selecionadas 40 telerradiografias de jovens leucodermas, 33 de xantodermas e 32 de nipo-brasileiros. As três amostras foram constituídas de indivíduos com oclusão normal e face bem balanceada, e foram divididas por sexo. Os dados foram estatisticamente analisados utilizando ANOVA, teste t, ANCOVA e MANOVA. Resultados: Os leucodermas apresentaram o ângulo nasolabial significativamente maior, comparados aos japoneses, no sexo masculino; enquanto os nipo-brasileiros apresentaram um valor intermediário entre os leucodermas e xantodermas. Conclusão: Os grupos de leucodermas, xantodermas e nipo-brasileiros apresentaram diferentes características cefalométricas da análise de McNamara. Os xantodermas no sexo masculino tiveram o ângulo nasolabial significativamente mais agudo, quando comparados com os leucodermas.