Efectos del tratamiento temprano en variables morfológicas, cinco años después de su aplicación / Effects of early treatment on morphological variables five years after application

Introducción: las pautas del tratamiento temprano propician una respuesta de desarrollo del sistema estomatognático. Objetivo: evaluar los efectos del tratamiento temprano en variables morfológicas, con técnicas de la rehabilitación neuro oclusal, cinco años después de ser aplicado durante la dentición temporal. Métodos: investigación de desarrollo, longitudinal y descriptiva, entre los años 2001 y 2010, en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Villa Clara. Universo: 2 215 niños de cinco años de edad perteneciente a instituciones infantiles de la ciudad de Santa Clara (2001-2002). Se utilizó un método estratificado por etapas. Las variables de estudio se analizaron en tres etapas evolutivas: inicial, intermedia y final. La muestra fue de 59 niños con interferencias oclusales durante la dentición temporal que fueron tratados con terapias funcionales, durante el año 2002 y evaluados un año después (primera etapa). La segunda etapa se desarrollo durante los años 2007-2010; la muestra fue de 46 niños con diez años de edad. Se diseñó un modelo de consentimiento informado que estableció el compromiso de colaboración de los niños seleccionados. Se realizaron pruebas estadísticas: test de Friedman, Wilcoxon, Fisher y medida clásica de chi cuadrado. Resultados: se observó un aumento del resalte en 33 de los casos y predominó el escalón mesial (87 por ciento) al final del estudio. Se mantuvo la tendencia al aumento en la anchura intermolar temporal. Los valores medios a nivel de los primeros molares permanentes se comportaron similares a la norma descrita por Mayoral (47 mm). Conclusiones: los cambios favorables observados en las variables morfológicas objeto de estudio, cinco años después de ser aplicado el tratamiento temprano con técnicas de la rehabilitación neuro oclusal, corroboran que los cinco primeros años de la vida del niño constituye la etapa ideal para comenzar a tratar las alteraciones del sistema estomatognático(AU)

Introduction: early treatment typically obtains an adequate developmental response from the stomatognathic system. Objective: evaluate the effects of early treatment on morphological variables using neuro-occlusal rehabilitation techniques five years after application during primary dentition. Methods: adevelopmental longitudinal descriptive study was conducted from 2001 to 2010 at the School of Dentistry of the University of Medical Sciences of Villa Clara. The study universe was 2 215 five-year-old children from educational institutions of the city of Santa Clara (2001-2002). A staged stratified method was applied. Study variables were analyzed along three evolution stages: initial, intermediate and final. The study sample was composed of 59 children with occlusal interferences during primary dentition, which were treated with functional therapies in 2002 and evaluated one year later (first stage). The second stage extended from 2007 to 2010. The sample consisted of 46 ten-year-old children. An informed consent form was developed to record the commitment of the children selected with the study. The statistical tests performed were Friedman's, Wilcoxon's, Fisher's and classical chi-square measure. Results: increased overjet was found in 33 of the cases, with a predominance of the mesial step (87 percent) at the end of the study. A tendency to increased temporary intermolar width was observed throughout the study. Mean values for the first permanent molars were similar to the standard described by Mayoral (47 mm). Conclusions: the favorable changes found in the morphological variables under study five years after application of early treatment with neuro-occlusal rehabilitation confirm that the first five years in the life of a child are the ideal stage to start treating alterations of the stomatognathic system(AU)

[The suitability of orthodontical groups of indications (OGI) for preventive dental examinations of the public health service]. / Die Eignung der "Kieferorthopädischen Indikationsgruppen" (KIG) für die zahnärztliche Vorsorgeuntersuchung des Offentlichen Gesundheitsdienstes (OGD).

In the context of the dental preventive medical examinations of the public health service, the orthodontical data-gathering in children's day-care centre and schools, in contrast to the diagnoses of caries disease, was made was based so far on a non-uniform methodology. In order to provide in future, also in the orthodontical sector, data material that is usable for comparative national and local health reporting, a uniform methodology should form the basis for the data acquisition. The present study makes a contribution to this objective. A goal of the work was to test two different collection instruments for their suitability as objective tools in the context of the preventive dental medical examinations. The occurrence and the severity level of dentofacial anomalies as well as the orthodontic treatment status of Thuringian school children of defined age groups (9 to 11 years old, 12 to 13 years old) were recorded and the orthodontic treatment need was determined. In the younger age group valid the orthodontical groups of indications (OGI) were found for the first time in Germany; in the older group we tested the already long established Dental Aesthetic Index (DAI) and equipment application recommended by the World Health Organization (WHO). The work was a component of the task spectrum of the WHO Collaboration Centre "Prevention of Oral disease" of the Health Centre for Preventive Dentistry at the Centre for Tooth, Mouth and Jaw Dentistry of the Friedrich Schiller University of Jena in Thuringia. As investigation region, a rural area ("Landkreis Eichsfeld") of Thuringia was choosen. The study was arranged into a sociological and a clinical-epidemiological part. Altogether 1845 pupils were recruited from national schools. The questionnaire was based on the WHO-initiated "International Collaborative Study of Oral Health Outcomes" (ICS II study). The investigations took place in the context of the preventive medical examinations of the public health service. The results were based on the answers and findings of 691 probants of the group of the 9-11 years old (AG 1) and 774 probants of the group of the 12-13 years old (AG 2). The sociological results of both age groups reflected social restrictions regarding the presence of dentofacial anomalies in an order of magnitude of 20% in the AG 1 and 7.3% in the AG 2. In the AG 1 11.4% confirmed an orthodontical treatment and 47.9% of the probants examined indicated a desire for treatment. On the other hand, the proportion of orthodontically treated in AG 2 amounted to 31.1% and 37.8% expressed a desire for treatment. Dentofacial anomalies determined with the help of the OGI in the AG 1 as the most frequent were in the form of a distal bite (sagittal stage/group of D) with 55.5% of the examined pupils being documented. However here severity development stages 1 and 2 outweighed. Proportionally followed: confining (group E) with 21% and the vertical stage/deep bite (group T) with 7.8%. All other groups were represented by only small proportions, craniofacial anomalies (group A) were not diagnosed. Anomalies with severity development 1 and 2 were determined in 64.1% of the examined children. In the AG 2 examined with the DAI, the anomalies of space conditions with 58% exceeded anomalies of occlusion conditions with 38.9% and anomalies of dentition with 9.8%. An urgent orthodontical treatment need was determined in the AG 1 with 35.9% of the probants (severity development 3 to 5) and in the AG 2 with 16.8% (DAI values over 32). In the AG 2 too, over 60% DAI values from 13 to 25 were determined, 26% exhibited DAI values between 26 and 31. During the statistic evaluation the "Statistical Package found for Social Sciences (SPSS)" version 11.51 S with a significant level of 5% was used. Derived from the results of our analysis, the recommendation can be made that the methodology of the Orthodontical Groups of Indications for the employment is to be regarded as a possibility with dental preventive medical examinations in the public health service as a suitable equipment and so far allows the subjective estimate of the orthodontical treatment necessity to be made.

[Dento-stomato-facial rehabilitation of young patients. Practical alternatives]. / Alternative practice de reabilitare dento-somato-faciala la tineri.

The design conception and the technological achievement of every gnato-prosthetic device are conditioned by a minute evaluation of the biological and morphological individualities of each case, the social level of the patient, corroborated with the technological supply. In our study we evaluated different modalities of dento-stomato-facial rehabilitation of young patients with partially reduced maxillary or mandibular dentition. The study was carried out on a group of 12 young patients, 5 males and 7 females, aged between 16-24 years, who presented at the clinic for the treatment of complex functional disorders that occurred as a consequence of the dentition. The fixed mixed gnatoprosthetic therapy for the young patients and teenagers has to be adapted to the surveyed clinical individuality. The success of the therapy is assured by the accurate application of the gnatoprosthetic principles, the accurate achievement of the technological steps, the use of compatible biomaterials according to the dento-stomato-facial features of this age category.

A guia anterior no estudo da oclusäo / Anterior guidance in the study of occlusion

A guia anterior é a relaçäo dinâmica do contorno lingual dos seis dentes antero-superiores sobre as bordas dos seis antero-inferiores quando estes se tocam na oclusäo cêntrica e durante os movimentos protrusivos, laterais ou látero-protrusivos normalemnte observada na dentiçäo natural. As quatro funçöes da guia anterior säo a incisäo de alimentos, fonética, estética e proteger os dentes posteriores pela desoclusão posterior que realiza durante a mastigaçäo. Dada a sua importância, os autores apresentam vários aspectos importantes da guia anterior no estudo da oclusäo, justificando porque ela seja talvez o fator mais importante na reconstruçäo total ou parcial do sistema estomatognático