Growth Outcomes Audit for Unilateral Cleft Lip and Palate (UCLP) After 2-stage Palate Repair.

PURPOSE: To assess the impact of 1 and 2-stage palatoplasty protocol on the dental arch relationships in unilateral cleft lip and palate (UCLP) in a single center. METHODS: Our study consisted of 349 individuals divided into 2 groups according to the palatoplasty protocol. Two-stage group comprised 169 subjects with UCLP (mean age: 6.9 y, 110 male and 59 female) who underwent lip, nasal ala, and anterior palate repair with vomer flap from 3 to 6 months (first surgery stage). Soft palate repair occurred from 12 to 18 months (second surgery stage). The one-stage group comprised 180 subjects with UCLP (mean age: 7.2 y, 108 male and 72 female) who underwent 1-stage palatoplasty. Dental models were evaluated by 3 experienced orthodontists applying Goslon Yardstick and the 5-year-old index (FYOI). The influence of the palatoplasty technique and surgeon factor on the interarch relationship was evaluated. The weighted Kappa was used to assess intraexaminer and interexaminer agreements for comparisons of dental arch relationships. Intergroup comparisons were conducted using the χ 2 test ( P <0.05). RESULTS: The intraexaminer reliability was very good (0.81 to 0.98) and interexaminer reliability varied from satisfactory to very good (0.56 to 0.83). The mean occlusal index of the 2-stage and 1-stage groups was 2.77 and 3.03, respectively. The variability of the mean index between surgeons varied from 2.38 to 3.2 in the 2-stage group and 2.91 to 3.2 in the 1-stage group. There were significant differences in the frequency of Goslon 5 index ( P =0.002) between groups, with the 2-stage group presenting less cases (1.18%) than the group 1-stage (11.11%). CONCLUSION: The interarch relationship was similar for both palate repair protocols. Two-stage palatoplasty showed a decreased prevalence of Goslon index 5.

A Cleft-Customized Occlusal Rating System to Assess Orthodontic Occlusal Improvement in Patients With Unilateral Cleft Lip and Palate.

OBJECTIVE: This study aimed to develop a new method to quantify occlusal improvement in patients with unilateral cleft lip and palate (UCLP) who had undergone orthodontic treatment and to evaluate its reproducibility. DESIGN: A panel of orthodontists decided on the relevance of different occlusal features to score initial and final 3-dimensional study models and panoramic radiographs. A subsequent subjective analysis was later performed by a local orthodontic panel. SETTING: The sample was obtained from the orthodontic clinical archives of a hospital known for the treatment of patients with craniofacial differences. PATIENTS: Thirty-one nonsyndromic patients, 17 males and 14 females, were randomly selected according to preestablished inclusion/exclusion criteria. INTERVENTIONS: The records corresponded to the period during which the patients were treated with conventional multibracket mechanics and adjunctive restorative procedures. MAIN OUTCOME/MEASURES: The intraclass correlation coefficient measured intraexaminer and interexaminer agreements. The Spearman correlation test assessed the relationship between the local orthodontic panel perception and the improvement scores. RESULTS: Inter- and intra-rater ICCs varied between fair/good to excellent. There was a strong correlation between the Cleft-Customized Occlusal Rating system classification of occlusal improvement and the local orthodontic panel's perception, thereby enabling the utilization of the interpretation scale by the panel. CONCLUSIONS: The method showed to be a useful tool in quantifying and classifying occlusal improvement in this specific population. As any other method, some limitations apply and need to be accounted for.

Is the early mixed dentition dental arch relationship related to the anteroposterior alignment of the maxillary segments in infants with CUCLP?

OBJECTIVE: Midface retrusion is a concern in patients with complete unilateral cleft lip and palate (CUCLP). Maxillary segment alignment may influence the prognosis after corrective surgery. This study assessed the association between maxillary segment alignment and interarch relationship observed in the early mixed dentition. The null hypothesis was that there is no relation between the initial alignment of cleft segments and the width of the cleft in the infant, and the early mixed dentition interarch relationship. SETTING AND SAMPLE POPULATION: The sample consists of 352 children with CUCLP treated at the Hospital for Rehabilitation of Craniofacial Anomalies/USP. MATERIAL AND METHODS: Dental models were obtained before lip repair at three months and at the age of six. Based on the first, the sample was then divided into two groups: anteroposterior aligned and anteroposterior misaligned maxillary segments. They were also divided into 4 groups according to the cleft width (Narrow, Medium, Wide and Very Wide). Interarch relationship was graded using the 5-year-old index. The statistical association was evaluated using the chi-squared test (P < .05). RESULTS: Cleft width was inversely related to interarch relationship in the early mixed dentition phase. Interarch relationship at the age of six was more favourable in children with misaligned maxillary segments than in children with aligned segments (P = .048). CONCLUSION: Five-year interarch relationship in patients with CUCLP is related to the anteroposterior relationship of infant maxillary segments and initial cleft width before primary surgeries. Wide alveolar clefts and sagittally aligned maxillary segments showed a worse interarch relationship in the early mixed dentition.

Efficacy of Rapid Maxillary Expansion Associated With Maxillary Protraction in Patients With Unilateral Complete Cleft Lip and Palate.

OBJECTIVE: To evaluate the efficacy of rapid maxillary expansion (RME) and maxillary protraction (MP) in patients with unilateral complete cleft lip and palate (UCLP) using the Goslon yardstick index. DESIGN: Retrospective study. PATIENTS: Dental casts of 34 Goslon 3 (G3) and Goslon 4 (G4) patients treated with RME and MP were evaluated which composed the treated sample (S1). The dental cast were taken before the RME (T1) and immediately after the use of face mask for MP was suspended (T2). In order to verify the stability of the treatment, dental casts of 17 of these patients were evaluated 1 year after the treatment was finished (T3). For the control sample (S2), dental casts of 20 untreated G3 and G4 patients were evaluated. RESULTS: At T2, 85.7% of study sample patients initially G3 and 70% of patients initially G4 obtained improvement in occlusal index. At T3, the majority of patients initially classified as G3 and G4 returned to the same classification as in the beginning of the treatment. The evaluation of the control sample showed that patients initially classified as G3, 55.6% continued at this initial index, and 44.4% had it worsened. Those initially G4, 100%, continued at this initial index. CONCLUSION: The immediate result of RME and MP was satisfactory, and despite the instability of these results, the outcome of this treatment option was better than the untreated sample.

Assessment of Orthodontic Burden of Care in Patients With Unilateral Complete Cleft Lip and Palate.

OBJECTIVE: To assess the orthodontic burden of care of patients from a Brazilian rehabilitation center (Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo [HRAC-USP]). DESIGN: Retrospective. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo. INTERVENTIONS: One hundred files of unilateral complete cleft lip and palate patients who had consecutively finished orthodontic rehabilitation at HRAC-USP were evaluated from January 2011 to January 2013. The duration of orthodontic treatment, number of visits, kilometers traveled, number of appliances and surgical procedures performed were recorded. The sample was divided into 2 subgroups according to severity the interarch relation (Goslon Yardstick score) at the beginning of orthodontic treatment. Mann-Whitney test was applied for intergroup comparison ( P < .05). RESULTS: For the total sample (n = 100), the mean time of orthodontic treatment was 140.2 months, the mean number of orthodontic appointments was 61.8, the mean number of appliances was 10, the mean number of surgical procedures was 6.2, and the mean distance traveled to attend the center for orthodontic appointments was 38,978.5 km. The subgroup with the most severe malocclusion (Goslon yardsticks scores 4 and 5) showed a longer orthodontic treatment length, greater number of surgical procedures, and longer distance traveled than those presenting Goslon yardstick scores 1, 2, and 3. CONCLUSION: Patients with greater severity of the initial malocclusion experienced a higher burden of care than patients with less severity of the initial malocclusion. To reduce the burden of care, research and efforts should focus on minimizing maxillary growth deficiency related to primary surgery.

Facial and Nasolabial Aesthetics of Complete UCLP Submitted to 2-Stage Palate Repair With Vomer Flap.

OBJECTIVE: To evaluate the aesthetics of nasolabial appearance and facial profile of children with unilateral cleft lip and palate (UCLP) submitted to 2-stage palate repair with vomerine flap. DESIGN: Retrospective. SETTING: Single center. PATIENTS: Forty patients with UCLP, mean age of 7.81 years of both sexes, rehabilitated at a single center by 1 plastic surgeon. INTERVENTIONS: Lip and anterior palate repair with nasal alar repositioning was performed at 3 to 6 months of age by Millard technique and vomer flap, respectively. Posterior palate was repaired at 18 months by Von Langenbeck technique. MAIN OUTCOME MEASURE(S): Four cropped digital facial photographs of each patient were evaluated by 3 orthodontists to score the nasolabial aesthetics and profile. Frequencies of each score as well means and medians were calculated. Kappa test was used for evaluating inter- and intrarater reproducibility. RESULTS: The nasal form and deviation was scored as good/very good in 70%, fair in 22.5%, and poor in 7.5% of the sample. The nasal-subnasal aesthetic was considered good/very good in 55%, fair in 30%, and poor in 15% of the sample. The lip vermilion border and the white part of surgical scar aesthetics were good/very good in 77.5% and 80%, fair in 17.5% for both categories, and poor in 5% and 2.5% of the cases, respectively. In all, 67.5% showed convex facial profile, 20% was straight, and 12.5% was concave profile. CONCLUSIONS: Two-stage palatoplasty presented an adequate aesthetical results for the majority of patients with UCLP in the mixed dentition.

Rapid Maxillary Expansion After Alveolar Bone Grafting With rhBMP-2 in UCLP Evaluated by Means of CBCT.

OBJECTIVE: To demonstrate the feasibility of rapid maxillary expansion (RME) after alveolar bone grafting (ABG) in complete unilateral cleft lip, alveolus and palate (UCLP) without damage to the grafted area. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo, Department of Orthodontics. PATIENT: A case report of a 10-year-old boy with a complete UCLP who was treated with RME after secondary ABG procedure. RME was performed 1.3 years after the bone grafting with rhBMP-2 in collagen membrane. RESULT: Postexpansion cone-beam computed tomography (CBCT) axial and coronal sections demonstrated the opening of the midpalatal suture in the premaxilla without damages to the alveolar bone grafting region. Postretention CBCT images showed bone formation at the split midsuture of the premaxilla. CONCLUSION: Rapid maxillary expansion performed after ABG with rH-BMP2 led to complete opening of the premaxillary midline suture without compromising the integrity of the grafted alveolar cleft.

Correction of Class II malocclusion with Class II elastics: a systematic review.

INTRODUCTION: Although Class II elastics have been widely used in the correction of Class II malocclusions, there is still a belief that their side effects override the intended objectives. The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment. METHODS: A search was performed on PubMed, Scopus, Web of Science, Embase, Medline, and Cochrane databases, complemented by a hand search. Study eligibility criteria were the application of Class II elastics in Class II malocclusion treatment and the presentation of dental or skeletal outcomes of treatment. All age groups were included. RESULTS: The search identified 417 articles, of which 11 fulfilled the inclusion criteria. Four studied the isolated effects of Class II elastics, and 7 were comparisons between a single use of elastics and another method for Class II malocclusion correction. Because of the differences in treatment modalities in these articles, a meta-analysis was not possible. CONCLUSIONS: Based on the current literature, we can state that Class II elastics are effective in correcting Class II malocclusions, and their effects are primarily dentoalveolar. Therefore, they are similar to the effects of fixed functional appliances in the long term, placing these 2 methods close to each other when evaluating treatment effectiveness. Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment.

Effects of modifying the bonding protocol on the shear bond strength of metallic and ceramic orthodontic brackets.

The purpose of this study was to evaluate the in vitro shear bond strength and failure site of metallic and ceramic orthodontic brackets with modified bonding protocols. Sixty bovine mandibular incisors with similar anatomy were selected and divided into six groups (n = 10). In the first protocol, metallic and ceramic brackets were bonded according to the manufacturers' directions (controls); in the second protocol, the step of photocuring with the primer agent was eliminated; and in the third protocol, the primer agent was applied on the tooth and on the bracket base, followed by application of the composite adhesive on the bracket base, with one-step photocure. The same orthodontic adhesive was used for all groups. Shear bond strengths were measured and adhesive remnant index scores (ARI) were determined after bracket failure. The results demonstrated similar shear bond strengths in the protocols but presented significantly greater values for the metallic groups (two-way ANOVA, P < 0.05). ARI scores were compared with chi-square tests, and the ceramic brackets had significantly greater ARI scores compared to the metallic brackets. Based on these results, the manufacturer's bonding protocol can be modified to save clinical time without compromising adhesion of the brackets.

Evaluation of deflection forces of orthodontic wires with different ligation types.

The aim of this study was to evaluate deflection forces of orthodontic wires of different alloys engaged into conventional brackets using several ligation types. Stainless steel, conventional superelastic nickel-titanium and thermally activated nickel-titanium archwires tied into conventional brackets by a ring-shaped elastomeric ligature (RSEL), a 8-shaped elastomeric ligature (8SEL) and a metal ligature (ML) were tested. A clinical simulation device was created especially for this study and forces were measured with an Instron Universal Testing Machine. For the testing procedure, the block representing the maxillary right central incisor was moved 0.5 and 1 mm bucco-lingually at a constant speed of 2 mm/min, and the forces released by the wires were recorded, in accordance with the ISO 15841 guidelines. In general, the RSEL showed lighter forces, while 8SEL and ML showed higher values. At the 0.5 mm deflection, the 8SEL presented the greatest force, but at the 1.0 mm deflection the ML had a statistically similar force. Based on our evaluations, to obtain lighter forces, the thermally activated nickel-titanium wire with the RSEL are recommended, while the steel wire with the 8SEL or the ML are recommended when larger forces are desired. The ML exhibited the highest force increase with increased deflections, compared with the elastomeric ligatures.

Evaluation of force released by deflection of orthodontic wires in conventional and self-ligating brackets.

INTRODUCTION:: The aim of the study was to evaluate deflection forces of rectangular orthodontic wires in conventional (MorelliTM), active (In-Ovation RTM) and passive (Damon 3MXTM) self-ligating brackets. MATERIAL AND METHODS:: Two brands of stainless steel and nickel-titanium (NiTi) wires (MorelliTM and GACTM), in addition to OrmcoTM copper-nickel-titanium wires were used. Specimens were assembled in a clinical simulation device especially designed for this study and tested in an Instron universal testing machine. For the testing procedures, an acrylic structure representative of the maxillary right central incisor was lingually moved in activations of 0 to 1 mm, with readings of the force released by deflection in unloading of 0.5, 0.8 and 1 mm at a constant speed of 2 mm/min. Inter-bracket forces with stainless steel, NiTi and CuNiTi were individually compared by two-way ANOVA, followed by Tukey's tests. RESULTS:: Results showed that there were lower forces in conventional brackets, followed by active and passive self-ligating brackets. Within the brands, only for NiTi wires, the MorelliTM brand presented higher forces than GACTM wires. CONCLUSIONS:: Bracket systems provide different degrees of deflection force, with self-ligating brackets showing the highest forces.

Dual embryonic origin of maxillary lateral incisors: clinical implications in patients with cleft lip and palate.

INTRODUCTION: Cleft lip and palate are craniofacial anomalies highly prevalent in the overall population. In oral clefts involving the alveolar ridge, variations of number, shape, size and position are observed in maxillary lateral incisors. The objective of this manuscript is to elucidate the embryonic origin of maxillary lateral incisors in order to understand the etiology of these variations.Contextualization: The hypothesis that orofacial clefts would split maxillary lateral incisor buds has been previously reported. However, recent studies showed that maxillary lateral incisors have dual embryonic origin, being partially formed by both the medial nasal process and the maxillary process. In other words, the mesial half of the lateral incisor seems to come from the medial nasal process while the distal half of the lateral incisor originates from the maxillary process. In cleft patients, these processes do not fuse, which results in different numerical and positional patterns for lateral incisors relating to the alveolar cleft. In addition to these considerations, this study proposes a nomenclature for maxillary lateral incisors in patients with cleft lip and palate, based on embryology and lateral incisors position in relation to the alveolar cleft. CONCLUSION: Embryological knowledge on the dual origin of maxillary lateral incisors and the use of a proper nomenclature for their numerical and positional variations renders appropriate communication among professionals and treatment planning easier, in addition to standardizing research analysis.

Comparative study of dental cephalometric patterns of Japanese-Brazilian, Caucasian and Mongoloid patients.

INTRODUCTION: The objective of this study was to identify the patterns of dental variables of adolescent Japanese-Brazilian descendants with normal occlusion, and also to compare them with a similar Caucasian and Mongoloid sample. METHODS: Lateral cephalometric radiographs were used to compare the groups: Caucasian (n = 40), Japanese-Brazilian (n = 32) and Mongoloid (n = 33). The statistical tests used were one-way ANOVA and ANCOVA. The cephalometric measurements used followed the analyses of Steiner, Tweed and McNamara Jr. RESULTS: Statistical differences (P < 0.05) indicated a smaller interincisal angle and overbite for the Japanese-Brazilian sample, when compared to the Caucasian sample, although with similar values to the Mongoloid group. CONCLUSION: The dental patterns found for the Japanese-Brazilian descendants were, in general, more similar to those of the Mongoloid sample.

Facial height in Japanese-Brazilian descendants with normal occlusion.

OBJECTIVE: The aim of this study was to determine the standards of facial height in 30 young (14-year-old) Japanese-Brazilian descendants with normal occlusion, and assess whether sexual dimorphism is evident. METHODS: The cephalometric measurements used followed the analyses by Wylie-Johnson, Siriwat-Jarabak, Gebeck, Merrifield and Horn. RESULTS: Results showed dimorphism for total anterior facial height (TAFH), lower anterior facial height (LAFH), anterior facial height (AFH), total posterior facial height (TPFH) and upper posterior facial height (UPFH) measurements. CONCLUSIONS: The standards of facial heights in young Japanese-Brazilian descendants with normal occlusion were observed. Sexual dimorphism was identified in five out of thirteen evaluated variables at this age range.

Comparison of mesiodistal tooth widths in Caucasian, African and Japanese individuals with Brazilian ancestry and normal occlusion.

OBJECTIVE: To observe the presence of sexual dimorphism and compare the mesiodistal width of the teeth in Caucasian, African and Japanese individuals with Brazilian ancestry not orthodontically treated and with normal occlusion. METHODS: One hundred pairs of dental casts were used. It was measured, from first molar to first molar in both arches, the teeth's mesiodistal widths, using a digital caliper. For the statistical analysis of results Kolmogorov-Smirnov, t test, ANOVA and Tukey's test (p < 0.05) were used. RESULTS: Sexual dimorphism occurred on the three evaluated groups, and the highest mesiodistal widths were found in males. There was statistically significant difference between racial groups in all evaluated teeth in males. However, in females, this same difference was found only on upper lateral incisor and first molar; and lower lateral incisor, canine, first premolar and first molar. CONCLUSIONS: Most of mesiodistal measures present particular characteristics in relation to gender, with higher values for males, and to race, with a tendency for African to present greater mesiodistal distance of the teeth, followed by Japanese and Caucasians, respectively, important for the correct diagnosis and orthodontic planning.

Comparative study of the soft tissue of young Japanese-Brazilian, Caucasian and Mongoloid patients.

OBJECTIVE: To determine the normality mean values in the soft tissue cephalometric measurements of young Japanese-Brazilian, with normal occlusion and to compare the results of the variables with compatible samples of young Caucasians and Mongoloids. METHODS: Forty radiographs of young Caucasians, 32 of Japanese-Brazilians and 33 of Mongoloids were used. The three samples presented individuals with normal occlusion and well-balanced face. The samples were divided by gender due to the soft tissue characteristics and to facilitate comparison. The following statistical tests were performed: Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) with p < 0.05. RESULTS: The Japanese-Brazilian sample of females showed thinner soft tissues in the nasion region and smaller nose when compared to the Caucasians. The Mongoloid sample showed thinner tissues in the supramentonian and pogonion regions. In males, the Japanese-Brazilians had thinner tissues in the nasion region; thicker lower lip and supramentonian region in comparison to the Caucasian sample. For the Mongoloid, soft tissue was thicker in the glabella and ANS-Sn regions. CONCLUSIONS: It is necessary to use specific soft tissue standards for this mixed race.

Evaluation of deflection forces of orthodontic wires with different ligation types

Abstract The aim of this study was to evaluate deflection forces of orthodontic wires of different alloys engaged into conventional brackets using several ligation types. Stainless steel, conventional superelastic nickel-titanium and thermally activated nickel-titanium archwires tied into conventional brackets by a ring-shaped elastomeric ligature (RSEL), a 8-shaped elastomeric ligature (8SEL) and a metal ligature (ML) were tested. A clinical simulation device was created especially for this study and forces were measured with an Instron Universal Testing Machine. For the testing procedure, the block representing the maxillary right central incisor was moved 0.5 and 1 mm bucco-lingually at a constant speed of 2 mm/min, and the forces released by the wires were recorded, in accordance with the ISO 15841 guidelines. In general, the RSEL showed lighter forces, while 8SEL and ML showed higher values. At the 0.5 mm deflection, the 8SEL presented the greatest force, but at the 1.0 mm deflection the ML had a statistically similar force. Based on our evaluations, to obtain lighter forces, the thermally activated nickel-titanium wire with the RSEL are recommended, while the steel wire with the 8SEL or the ML are recommended when larger forces are desired. The ML exhibited the highest force increase with increased deflections, compared with the elastomeric ligatures.

Influence of orthodontic treatment, midline position, buccal corridor and smile arc on smile attractiveness.

OBJECTIVE: To assess the scientific evidence of the influence of some variables on smile attractiveness: orthodontic treatment, midline position, axial midline angulation, buccal corridor, and smile arc. MATERIALS AND METHODS: Literature was searched through PubMed, Web of Science, Embase, and All EBM Reviews. The inclusion criteria consisted of studies written in English; published in the past three decades; concerning the influence of orthodontic treatment, midline position, axial midline angulation, buccal corridor, and smile arc on smile esthetics; and judged by a minimum of 10 raters. Quality features evaluated were adequate description of samples, absence of confounding factors, and description of methods used to evaluate the smiles and statistical analyses. RESULTS: Initially, 203 articles were retrieved. Of these, 20 abstracts met the initial inclusion criteria and were selected. Thirteen articles were classified as high quality, seven as average, and none as low quality. CONCLUSION: Four-premolar extraction or nonextraction treatment protocols seem to have no predictable effect on overall smile esthetics, meaning that if well indicated, extraction in orthodontics does not necessarily have a deleterious effect on facial esthetics. The selected articles recommend that a small dental midline deviation of 2.2 mm can be considered acceptable by both orthodontists and laypeople, whereas an axial midline angulation of 10° (2 mm measured from the midline papilla and the incisal edges of the incisors) is already very apparent, and considering studies dealing with real smiles, buccal corridor sizes and smile arc alone do not seem to affect smile attractiveness.

Evaluation of force released by deflection of orthodontic wires in conventional and self-ligating brackets

ABSTRACT Introduction: The aim of the study was to evaluate deflection forces of rectangular orthodontic wires in conventional (MorelliTM), active (In-Ovation RTM) and passive (Damon 3MXTM) self-ligating brackets. Material and Methods: Two brands of stainless steel and nickel-titanium (NiTi) wires (MorelliTM and GACTM), in addition to OrmcoTM copper-nickel-titanium wires were used. Specimens were assembled in a clinical simulation device especially designed for this study and tested in an Instron universal testing machine. For the testing procedures, an acrylic structure representative of the maxillary right central incisor was lingually moved in activations of 0 to 1 mm, with readings of the force released by deflection in unloading of 0.5, 0.8 and 1 mm at a constant speed of 2 mm/min. Inter-bracket forces with stainless steel, NiTi and CuNiTi were individually compared by two-way ANOVA, followed by Tukey’s tests. Results: Results showed that there were lower forces in conventional brackets, followed by active and passive self-ligating brackets. Within the brands, only for NiTi wires, the MorelliTM brand presented higher forces than GACTM wires. Conclusions: Bracket systems provide different degrees of deflection force, with self-ligating brackets showing the highest forces.

RESUMO Objetivo: o objetivo deste estudo foi avaliar as forças de deflexão de fios ortodônticos retangulares em braquetes convencionais (MorelliTM) e autoligáveis ativos (In-Ovation RTM ) e passivos (Damon 3MXTM). Material e Métodos: foram utilizadas duas marcas comerciais (MorelliTM e GACTM) de fios de aço inoxidável e de níquel-titânio (NiTi), além do fio de NiTi com adição de cobre (OrmcoTM). Os espécimes foram montados em um dispositivo de simulação clínica especialmente desenhado para esse estudo e testado em uma máquina universal de ensaios Instron. Para o procedimento dos testes, a peça representativa do incisivo central superior direito foi movida no sentido vestibulolingual em ativações de 0 a 1 mm, com leituras da força liberada pela deflexão em 0,5; 0,8 e 1 mm, em uma velocidade constante de 2 mm/min. As forças interbraquetes com os fios de aço, de NiTi e NiTi com adição de cobre foram individualmente comparadas pelo teste de ANOVA a dois critérios, seguido pelo teste de Tukey. Resultados: houve menor liberação de forças nos braquetes convencionais, seguidos pelos braquetes autoligáveis ativos e passivos. Entre as marcas comerciais, somente houve diferença para o fio de NiTi, onde a marca MorelliTM apresentou maiores forças do que a GACTM. Conclusão: os braquetes promovem diferentes graus de forças de deflexão, sendo que os braquetes autoligáveis liberam as maiores forças.

Class II malocclusion occlusal severity description.

OBJECTIVES: It is well known that the efficacy and the efficiency of a Class II malocclusion treatment are aspects closely related to the severity of the dental anteroposterior discrepancy. Even though, sample selection based on cephalometric variables without considering the severity of the occlusal anteroposterior discrepancy is still common in current papers. In some of them, when occlusal parameters are chosen, the severity is often neglected. The purpose of this study is to verify the importance given to the classification of Class II malocclusion, based on the criteria used for sample selection in a great number of papers published in the orthodontic journal with the highest impact factor. MATERIAL AND METHODS: A search was performed in PubMed database for full-text research papers referencing Class II malocclusion in the history of the American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO). RESULTS: A total of 359 papers were retrieved, among which only 72 (20.06%) papers described the occlusal severity of the Class II malocclusion sample. In the other 287 (79.94%) papers that did not specify the anteroposterior discrepancy severity, description was considered to be crucial in 159 (55.40%) of them. CONCLUSIONS: Omission in describing the occlusal severity demands a cautious interpretation of 44.29% of the papers retrieved in this study.