Factors influencing the effective dose associated with CBCT: a systematic review.

INTRODUCTION: Due to potential impact of the effects of ionizing radiation used in medical and dental examinations on public health in recent years, many studies are being conducted to quantify the radiation dose values, evaluate scanners, and indicate factors that could influence or reduce radiation doses. OBJECTIVES: This study aimed to evaluate, by a systematic review, the factors that influence the effective radiation dose associated with cone beam computed tomography and respective effects, and compared the effective dose of different cone beam computed tomography (CBCT) scanners with similar exposure parameters. MATERIALS AND METHODS: A search was conducted on five databases from 2007 to 2015. RESULTS: The search identified 741 abstracts, among which 44 eligible articles were retrieved in full text. Twenty-three studies met the inclusion criteria and were included. Additional copper filter was evaluated in one study, patient size in 2 studies, region of interest in 1 study, use of a thyroid shield in 2 studies, scan angle in 3 studies, exposure time in 10 studies, FOV diameter in 17 studies, FOV height in 17 studies, kV in 16 studies, mA in 18 studies, mAs in 13 studies, voxel in 8 studies, and resolution in 3 studies. When similar exposure parameters were evaluated, it was observed that CBCT scanner with lower effective dose was Kodak® 9000C 3D (mean 21.2 µSv) in selected studies. CONCLUSIONS: Thirteen factors were related to changes in the effective dose emitted by different scanners. More studies are needed to identify the image quality requirements in addition to measure the radiation. CLINICAL RELEVANCE: Studies that give more information for professionals who request and interpret the exams and for technicians who perform 3D images about effective radiation dose associated with CBCT are necessary.

Dentoskeletal changes induced by the Jasper jumper and the activator-headgear combination appliances followed by fixed orthodontic treatment.

INTRODUCTION: The aim of this study was to compare the dentoskeletal changes of patients with Class II Division 1 malocclusion treated with either the Jasper jumper appliance or the activator-headgear combination, both associated with fixed appliances. METHODS: The sample comprised 72 subjects with Class II Division 1 malocclusion divided into 3 groups: group 1 included 25 subjects treated with fixed appliances and the force modules of the Jasper jumper at an initial mean age of 12.72 years, group 2 included 25 subjects treated with the activator-headgear combination followed by fixed appliances at an initial mean age of 11.07 years, and group 3 included 22 untreated subjects at an initial mean age of 12.67 years. Initial cephalometric characteristics and dentoskeletal changes were compared with analysis of variance. RESULTS: Both experimental groups had similar dentoskeletal changes: restrictive effect on the maxilla, clockwise mandibular rotation and a slight increase in anterior face height, retrusion of the maxillary incisors, distalization of the maxillary molars, protrusion of the mandibular incisors, extrusion of the mandibular molars, and significant improvements of the maxillomandibular relationship, overjet, overbite, and the molar relationship. CONCLUSIONS: The effects of the Jasper jumper and the activator-headgear combination followed by fixed orthodontic appliances were similar in Class II malocclusion treatment.

Evaluation of the maximum tongue and lip pressure in individuals with Class I, II, or III Angle malocclusions and different facial types.

PURPOSE: To compare the maximum anterior and posterior tongue pressure, tongue endurance, and lip pressure in Class I, II, and III malocclusions and different facial types. METHODS: A cross-sectional observational analytical study was carried out in 55 individuals (29 men and 26 women) aged between 18 and 55 years. The participants were divided into groups according to Angle malocclusion (Class I, II, and III) and facial type. The maximum anterior and posterior tongue pressure, tongue endurance, and maximum lip pressure were measured using the IOPI (Iowa Oral Performance Instrument). To determine the facial type, the cephalometric analysis was accomplished using Ricketts VERT analysis as a reference. RESULTS: There was no statistically significant difference when comparing the maximum pressure of the anterior and posterior regions of the tongue, the maximum pressure of the lips, or the endurance of the tongue in the different Angle malocclusion types. Maximum posterior tongue pressure was lower in vertical individuals than in mesofacial individuals. CONCLUSION: Tongue and lips pressure, as well as tongue endurance in adults was not associated with the type of malocclusion. However, there is an association between facial type and the posterior pressure of the tongue.

Effect of Orthodontic Treatment on Tooth Autotransplantation: Systematic Review of Controlled Clinical Trials.

This systematic review was focused on evaluating tooth autotransplantation, considering its impacts on the teeth, bone, soft tissues, and aesthetics in orthodontic patients. A bibliographic search was conducted without limitations on year of publication or language in the databases of PubMed, Web of Science, Scopus, Medline Complete, Cochrane, Clinical Trials, and Trials Central. For triage of articles, indications, surgical planning, orthodontic movement, risk factors for treatment, and long-term follow-ups were considered. For outcomes, the results with reference to teeth, alveolar bone, periodontal tissues, and esthetic satisfaction were considered. Risk of bias was evaluated using the methodological index for nonrandomized studies-MINORS. The results showed 10 controlled clinical trials, and no randomized clinical trials were found. The selected studies included 715 patients and 934 autotransplanted teeth among which there were premolars, molars, and anterior teeth evaluated in the long term, indicating that orthodontics associated with autotransplantation indicated a result that was generally clinically acceptable. The quality of the set of evidence was considered medium due to the presence of different methodological problems, risk of bias, and significant heterogeneity in the evaluated studies. There was a sufficient body of evidence that justified autotransplantation in patients who needed orthodontic movement. In teeth, there was an increase in root resorption influenced by orthodontics, but without impacting on the general clinical result in the long term. Bone and periodontal tissue do not appear to be affected by orthodontics. The patient's aesthetic satisfaction was not considered in the studies.

Comparison of the accuracy of virtual and direct bonding of orthodontic accessories.

INTRODUCTION: Conventional direct and indirect bonding techniques fail to obtain the ideal bracket position. OBJECTIVE: To compare the accuracy of virtual and conventional direct bonding of orthodontic accessories. METHODS: A single virtual configuration (dental mannequin with Class I malocclusion) served as basis for generating the reference model (treated virtually) and the intervention models (10 digital models and 10 solid models, obtained by means of prototyping). A total of 560 teeth were then equally distributed between a group of orthodontists (Group I, direct bonding; and Group II, virtual bonding), working in two different time intervals. The individual positions of the accessories were measured after three-dimensional superimposition with customized software. The Student's-t test for paired samples, and Chi-square tests were used for statistical analysis, both at the level of significance of 5%. RESULTS: In comparison of the errors in raw values, there were significant differences only in the vertical (p< 0.001) and horizontal dimensions (p< 0.001). Considering the groups of ranges by clinical limits of the deviations, these differences were significant in the three dimensions, vertical (p< 0.001), horizontal (p= 0.044) and angular (p= 0.044). CONCLUSION: Virtual bonding made it possible to obtain more precise/accurate positioning of the orthodontic accessories. The potential accuracy of this method brings new perspectives to refining the indirect bonding protocols.

Influence of heat treatment on the mechanical properties of CrNi stainless steel orthodontic wires.

INTRODUCTION: The heat treatment of stainless steel wires is a routine clinical procedure adopted by many dentists in order to relieve the stress caused after performing bends in the archwire. OBJECTIVE: This study aimed to evaluate the influence of heat treatment of stainless steel archwires with a rectangular section of 0.016 x 0.022'-in. METHODS: For analysis of the dimensional stability, the anterior and posterior dimensions of forty 0.016 x 0.022-in stainless steel orthodontic archwires without heat treatment and 30 days after heat treatment were evaluated. For analysis of the mechanical properties, 12 stainless steel wire segments with the same rectangular section without heat treatment and 30 days after heat treatment were tested through tensile strength and strain tests. To evaluate if there were differences between the anterior and posterior dimensions, the results were analyzed by the Student's t-test. To compare the tensile strength and strain between the groups, the ANOVA test was used. The level of significance adopted was 95% (p< 0.05). RESULTS: The heat treatment did not stop the expansion of archwires 30 days after their preparation, and there was no statistical difference in the tensile strength and strain tests with and without heat treatment. CONCLUSION: From the findings of this study, it can be conclude that the mechanical behavior of heat-treated stainless steel archwires is similar to that of archwires not subjected to heat treatment.

Occlusal outcomes and efficiency of 1- and 2-phase protocols in the treatment of Class II Division 1 malocclusion.

INTRODUCTION: The purpose of this study was to compare the occlusal outcomes and the efficiency of 1-phase and 2-phase treatment protocols in Class II Division 1 malocclusions. Treatment efficiency was defined as a change in the occlusal characteristics in a shorter treatment time. METHODS: Class II Division 1 subjects (n = 139) were divided into 2 groups according to the treatment protocol for Class II correction. Group 1 comprised 78 patients treated with a 1-phase treatment protocol at initial and final mean ages of 12.51 and 14.68 years. Group 2 comprised 61 patients treated with a 2-phase treatment protocol at initial and final mean ages of 11.21 and 14.70 years. Lateral cephalometric radiographs were taken at the pretreatment stage to evaluate morphological differences in the groups. The initial and final study models of the patients were evaluated by using the peer assessment rating index. Chi-square tests were used to test for differences between the 2 groups for categorical variables. Variables regarding occlusal results were compared by using independent t tests. A linear regression analysis was completed, with total treatment time as the dependent variable, to identify clinical factors that predict treatment length for patients with Class II malocclusions. RESULTS: Similar occlusal outcomes were obtained between the 1-phase and the 2-phase treatment protocols, but the duration of treatment was significantly shorter in the 1-phase treatment protocol group. CONCLUSIONS: Treatment of Class II Division 1 malocclusions is more efficient with the 1-phase than the 2-phase treatment protocol.

Evaluation of the maximum tongue and lip pressure in individuals with Class I, II, or III Angle malocclusions and different facial types / Avaliação da pressão máxima da língua e dos lábios em indivíduos com má oclusão Classe I, II e III de Angle e diferentes padrões faciais

ABSTRACT Purpose To compare the maximum anterior and posterior tongue pressure, tongue endurance, and lip pressure in Class I, II, and III malocclusions and different facial types. Methods A cross-sectional observational analytical study was carried out in 55 individuals (29 men and 26 women) aged between 18 and 55 years. The participants were divided into groups according to Angle malocclusion (Class I, II, and III) and facial type. The maximum anterior and posterior tongue pressure, tongue endurance, and maximum lip pressure were measured using the IOPI (Iowa Oral Performance Instrument). To determine the facial type, the cephalometric analysis was accomplished using Ricketts VERT analysis as a reference. Results There was no statistically significant difference when comparing the maximum pressure of the anterior and posterior regions of the tongue, the maximum pressure of the lips, or the endurance of the tongue in the different Angle malocclusion types. Maximum posterior tongue pressure was lower in vertical individuals than in mesofacial individuals. Conclusion Tongue and lips pressure, as well as tongue endurance in adults was not associated with the type of malocclusion. However, there is an association between facial type and the posterior pressure of the tongue.

RESUMO Objetivo comparar a pressão máxima anterior e posterior da língua, a resistência da língua e a pressão labial em indivíduos com más oclusões Classe I, II e III e diferentes tipos faciais. Método foi realizado um estudo analítico observacional transversal em 55 indivíduos (29 homens e 26 mulheres) com idades entre 18 e 55 anos. Os participantes foram divididos em grupos de acordo com a classificação de Angle para má oclusão (Classe I, II e III) e tipo facial. A pressão máxima anterior e posterior da língua, a resistência da língua e a pressão máxima dos lábios foram medidas usando o IOPI (Iowa Oral Performance Instrument). Para determinar o tipo facial, a análise cefalométrica foi realizada utilizando como referência a análise Ricketts VERT. Resultados não houve diferença estatisticamente significativa ao comparar a pressão máxima das regiões anterior e posterior da língua, a pressão máxima dos lábios ou a resistência da língua nos diferentes tipos de má oclusão. A pressão máxima posterior da língua foi menor em indivíduos com tipo facial vertical do que nos indivíduos mesofaciais. Conclusão a pressão de língua e lábios, assim como a resistência de língua em adultos não foi associada ao tipo de má oclusão. No entanto, existe uma associação entre o tipo facial e a pressão posterior da língua.

Stability of Class II, division 1 treatment with the headgear-activator combination followed by the edgewise appliance.

This study assessed the stability of the headgear-activator combination treatment, followed by edgewise mechanotherapy, 5.75 years after treatment. The experimental group consisted of 23 patients who were evaluated during treatment and after treatment. Two compatible control groups consisting of 15 Class II, division 1 patients and 24 normal occlusion individuals were used. This enabled us to evaluate the changes during treatment and after treatment, respectively. Results showed that the anteroposterior dentoalveolar changes and the maxillary and the mandibular positions remained stable in the long term. However, there was a slight relapse of the maxillomandibular relationship probably because the maxilla resumed its normal development and the mandibular growth rate was smaller than in the control group. The overbite demonstrated a statistically significant relapse that was directly proportional to the amount of its correction. There were low but significant inverse correlations between the changes in Go-Gn during and after treatment. These included the uprighting of the maxillary incisors, labial tipping of the mandibular incisors, and the amount of molar relationship correction during treatment and their stability. Active retention time, length of posttreatment period, initial Class II malocclusion severity (ANB and Wits), and initial molar relationship did not present any correlation with molar relationship and overjet relapse. However, the initial overjet presented a low but statistically significant correlation with molar relationship relapse and overjet relapse.

Treatment effects of the Jasper Jumper and the Bionator associated with fixed appliances.

BACKGROUND: The aim of this study was to evaluate the effects of Class II malocclusion treatment with the Jasper Jumper and the Bionator, associated with fixed appliances. METHODS: The sample comprised 77 young individuals divided into 3 groups: Group 1 consisted of 25 patients treated with the Jasper Jumper appliance associated with fixed appliances for a mean period of 2.15 years; group 2 had 30 patients, treated with the Bionator and fixed appliances, for a mean treatment time of 3.92 years; and the control group included 22 subjects followed for a mean period of 2.13 years. The initial and final lateral cephalograms of the patients were evaluated. Intergroup comparison at the initial stage and of the treatment changes were performed by analysis of variance. RESULTS: Their effects consisted in a restrictive effect on the maxilla, a slight increase in anterior face height, retrusion and extrusion of the maxillary incisors, labial tipping and protrusion of the mandibular incisors in both groups and intrusion with the Jasper Jumper appliance, maxillary molar distalization with the Jasper Jumper, extrusion and mesialization of the mandibular molars, both appliances provided significant improvement of the maxillomandibular relationship, overjet, overbite and molar relationship. CONCLUSIONS: The effects of both appliances in class II malocclusion treatment are similar; however, treatment with the Jasper Jumper was shorter than with the Bionator.

Influence of heat treatment on the mechanical properties of CrNi stainless steel orthodontic wires

ABSTRACT Introduction: The heat treatment of stainless steel wires is a routine clinical procedure adopted by many dentists in order to relieve the stress caused after performing bends in the archwire. Objective: This study aimed to evaluate the influence of heat treatment of stainless steel archwires with a rectangular section of 0.016 x 0.022'-in. Methods: For analysis of the dimensional stability, the anterior and posterior dimensions of forty 0.016 x 0.022-in stainless steel orthodontic archwires without heat treatment and 30 days after heat treatment were evaluated. For analysis of the mechanical properties, 12 stainless steel wire segments with the same rectangular section without heat treatment and 30 days after heat treatment were tested through tensile strength and strain tests. To evaluate if there were differences between the anterior and posterior dimensions, the results were analyzed by the Student's t-test. To compare the tensile strength and strain between the groups, the ANOVA test was used. The level of significance adopted was 95% (p< 0.05). Results: The heat treatment did not stop the expansion of archwires 30 days after their preparation, and there was no statistical difference in the tensile strength and strain tests with and without heat treatment. Conclusion: From the findings of this study, it can be conclude that the mechanical behavior of heat-treated stainless steel archwires is similar to that of archwires not subjected to heat treatment.

RESUMO Introdução: o tratamento térmico de fios de aço inoxidável é um procedimento clínico rotineiro adotado por muitos cirurgiões-dentistas para aliviar o estresse causado após a confecção de dobras no fio. O presente estudo avaliou a influência do tratamento térmico em fios de aço inoxidável com secção retangular de 0,016'' x 0,022''. Métodos: para análise da estabilidade dimensional, foram avaliadas as dimensões anteriores e posteriores de 40 arcos ortodônticos de aço inoxidável de 0,016'' x 0,022'' sem tratamento térmico e 30 dias após o tratamento térmico. Para análise das propriedades mecânicas, 12 segmentos de fio de aço inoxidável com a mesma secção retangular sem tratamento térmico e 30 dias após o tratamento térmico foram analisadas por testes de resistência à tração e tensão. Para verificar se houve diferenças entre as dimensões anteriores e posteriores, os resultados foram analisados pelo teste t de Student. Para comparar a resistência à tração e tensão entre os grupos, foi utilizado o teste ANOVA. O nível de significância adotado foi 95% (p< 0,05). Resultados: o tratamento térmico não interrompeu a expansão dos fios 30 dias após seu preparo, e não houve diferença estatística nos testes de resistência à tração e tensão com e sem o tratamento térmico. Conclusão: pelos achados desse estudo, conclui-se que o comportamento mecânico de fios submetidos a tratamento térmico é semelhante ao de fios de aço não submetidos ao tratamento térmico.

Long-term stability of maxillary anterior alignment in non-extraction cases.

OBJECTIVE: The purpose of this retrospective study was to evaluate long-term stability of maxillary incisors alignment in cases submitted to non-extraction orthodontic treatment. METHODS: The sample comprised 23 patients (13 female; 10 male) at a mean initial age of 13.36 years (SD = 1.81 years), treated with fixed appliances. Dental cast measurements were obtained at three different time points (T1 - pretreatment, T2 - posttreatment and T3 - long-term posttreatment). Variables assessed in maxillary arch were Little Irregularity Index, intercanine, interpremolar and intermolar widths, arch length and perimeter. The statistical analysis was performed by one-way ANOVA and Tukey tests when necessary. Pearson' correlation coefficients were used to investigate possible associations between the evaluated variables. RESULTS: There was no significant change in most arch dimension measurements during and after treatment, however, during the long-term posttreatment period, it was observed a significant maxillary incisors crowding relapse. CONCLUSIONS: The maxillary incisors irregularity increased significantly (1.52 mm) during long-term posttreatment. None of the studied clinical factors demonstrated to be predictive of the maxillary crowding relapse.

Influence of fixed appliances on two-phase orthopedic-orthodontic treatment

Aim: The purpose of this retrospective study was to investigate the effects of phase 2 with fixed appliances, after phase 1 Bionator treatment of Class II division 1 malocclusion, as compared to a matching control group. Methods: The experimental group consisted of 20 patients who were evaluated after orthodontic treatment with fixed appliances subsequently to functional therapy with the Bionator in phase 1. A control group consisting of 20 Class II, division 1 individuals. Results: During phase 1 there was significant forward growth restriction in the maxillary complex, improvement of the maxillomandibular relationship and decrease in facial convexity. There was also significant reduction of the maxillary incisor proclination and protrusion, protrusion of the mandibular incisors, and vertical development of the mandibular molars. The overjet was significantly reduced and the molar relationship was significantly improved. Treatment during phase 2, with fixed appliances, resulted in significant maxillary forward growth restriction and facial convexity reduction. Conclusion: Major Class II skeletal and dentoalveolar anteroposterior correction was obtained during phase 1, with the Bionator. Phase 2, with fixed appliances only produced a significant maxillary forward growth restriction and facial convexity reduction, without any significant dentoalveolar change

Class II malocclusion treatment using Jasper Jumper appliance associated to intermaxillary elastics: a case report.

INTRODUCTION: Skeletal, dental and profile discrepancies can be amended by using functional orthodontic appliances. OBJECTIVE: This study is a report of the treatment of a patient, 11 years and 4 months old, with Class II, division 1, malocclusion, convex profile, protrusion of upper incisors, pronounced overjet and overbite, and mild crowding. METHODS: The patient was treated with a Jasper Jumper associated to fixed appliances for 6 months and Class II intermaxillary elastics (3/16-in) during the last 4 months. After debonding, a Hawley retainer was used during daytime and a modified Bionator for night use during one year. In the lower dental arch a bonded lingual retainer was used. This treatment combination improved the profile, as well as the overjet, overbite and molar relation. RESULTS: There was clockwise mandibular rotation and increase of lower anterior facial height. The lower incisors were protruded and extruded and the lower molars were extruded. The centric occlusal relation was checked and it was coincident to the maximum usual intercuspation. CONCLUSIONS: It was demonstrated that the Jasper Jumper is an efficient alternative to Class II malocclusion treatment, providing improvement in the facial profile, although the changes are more dentoalveolar than skeletal.

Validação de um software para a estimação da idade óssea por meio das vértebras cervicais / Validation of software for a bone age patient through the cervical vertebrae

Objetivo: o objetivo deste estudo é a validação de um software (Easy Age) para avaliar a maturação óssea por meio das vértebras cervicais, demonstrando sua aplicabilidade e reprodutibilidade. Métodos: a amostra constou de 500 telerradiografias em norma lateral de pacientes de ambos os sexos, dos 7 aos 15 anos de idade, que foram examinadas por 3 avaliadores, duas vezes para o método visual e duas vezes com o software. Resultados: para avaliar a concordância inter e intra-examinador, aplicou-se o teste de concordância Kappa, que mostrou um nível substancial de concordância para a avaliação visual das vértebras cervicais, enquanto que para a avaliação das vértebras cervicais por meio do software, mostrou um nível quase perfeito de concordância para todos os avaliadores. No teste de Friedman, aplicado para comparar as avaliações entre o 1º e o 2º exame visual e entre o 1º e o 2º exame por meio do software, não houve diferenças significativas. Para validação do software foi realizada a comparação entre os resultados obtidos pelo método visual e pelo software, pelo teste de correlação de Spearman, e os valores entre o 1º e o 2º exame visual e entre o 1º e o 2º exame software mostraram correlação forte, estatisticamente significante, entre as medições dos exames visuais e do software. Conclusão: conclui-se assim que o software é válido e melhorou a aplicabilidade e a reprodutibilidade do método de estimação da idade óssea.(AU)

Aim: The present study aimed to validate a software (Easy Age) to assess skeletal maturation by cervical vertebrae, demonstrating its applicability and reproducibility. Methods: For this, the sample consisted of 500 lateral radiographs of patients of both genders, from 7 to 15 years of age, who were examined by three evaluators, twice for the visual method and twice with the software. To evaluate the inter- and intra-examiner agreement, the Kappa test was applied, which showed a substantial level of agreement for the visual assessment of the cervical vertebrae, while the evaluation of the cervical vertebrae through the software showed a level that presented almost perfect agreement for all evaluators. Friedman's test was applied to compare the ratings between the 1st and 2nd visual examinations and between the 1st and 2nd examinations using the software, which presented no significant differences. To validate the software, a comparison was performed between the results obtained by the visual method and those obtained by the software, using the Spearman correlation test. Results: The results showed a strong, statistically significant correlation between the measurements from the visual examination and those from the software evaluation. Conclusion: It can therefore be concluded that the software is valid and improved the applicability and reproducibility of the method of estimating skeletal age.(AU)

Long-term stability of maxillary anterior alignment in non-extraction cases

OBJECTIVE: The purpose of this retrospective study was to evaluate long-term stability of maxillary incisors alignment in cases submitted to non-extraction orthodontic treatment. METHODS: The sample comprised 23 patients (13 female; 10 male) at a mean initial age of 13.36 years (SD = 1.81 years), treated with fixed appliances. Dental cast measurements were obtained at three different time points (T1 - pretreatment, T2 - posttreatment and T3 - long-term posttreatment). Variables assessed in maxillary arch were Little Irregularity Index, intercanine, interpremolar and intermolar widths, arch length and perimeter. The statistical analysis was performed by one-way ANOVA and Tukey tests when necessary. Pearson' correlation coefficients were used to investigate possible associations between the evaluated variables. RESULTS: There was no significant change in most arch dimension measurements during and after treatment, however, during the long-term posttreatment period, it was observed a significant maxillary incisors crowding relapse. CONCLUSION: The maxillary incisors irregularity increased significantly (1.52 mm) during long-term posttreatment. None of the studied clinical factors demonstrated to be predictive of the maxillary crowding relapse.

OBJETIVO: o presente estudo avaliou, por meio de uma análise retrospectiva, a estabilidade pós-tratamento do alinhamento dos incisivos anterossuperiores de pacientes submetidos ao tratamento ortodôntico sem extrações. MÉTODOS: a amostra foi constituída de 23 pacientes (13 do sexo feminino e 10 do sexo masculino), com idade inicial de 13,36 ± 1,81 anos. Mediu-se nos modelos de estudo das fases inicial (T1), final (T2) e pós-tratamento (T3) de aproximadamente de 5 anos, a irregularidade dos incisivos superiores, as distâncias intercaninos e entre os primeiros e segundos pré-molares, a distância intermolares, o comprimento e o perímetro da arcada superior. Após a obtenção dos dados, realizou-se a análise estatística. Para a análise das alterações ao longo dos três tempos estudados, utilizou-se a análise de variância (ANOVA) a um critério de seleção e, em caso de resultado significativo, o teste de Tukey. Para verificar a presença de correlação entre a recidiva do apinhamento anterossuperior e a recidiva das variáveis distâncias intercaninos, interpré-molares, intermolares, comprimento e perímetro da arcada, utilizou-se o teste de correlação de Pearson. RESULTADOS: os resultados não evidenciaram alterações dimensionais significativas ao final do tratamento; entretanto, durante o período de pós-tratamento, foram observadas alterações significativas em relação à quantidade de irregularidade dos incisivos superiores. CONCLUSÃO: concluiu-se que houve recidiva estatisticamente significativa (+1,52mm) na irregularidade anterossuperior durante o período de pós-tratamento. Entretanto, nenhuma das variáveis aferidas nos modelos pôde ser clinicamente associada à recidiva anterossuperior.

Class II malocclusion treatment using Jasper Jumper appliance associated to intermaxillary elastics: a case report

INTRODUCTION: Skeletal, dental and profile discrepancies can be amended by using functional orthodontic appliances. OBJECTIVE: This study is a report of the treatment of a patient, 11 years and 4 months old, with Class II, division 1, malocclusion, convex profile, protrusion of upper incisors, pronounced overjet and overbite, and mild crowding. METHODS: The patient was treated with a Jasper Jumper associated to fixed appliances for 6 months and Class II intermaxillary elastics (3/16in) during the last 4 months. After debonding, a Hawley retainer was used during daytime and a modified Bionator for night use during one year. In the lower dental arch a bonded lingual retainer was used. This treatment combination improved the profile, as well as the overjet, overbite and molar relation. RESULTS: There was clockwise mandibular rotation and increase of lower anterior facial height. The lower incisors were protruded and extruded and the lower molars were extruded. The centric occlusal relation was checked and it was coincident to the maximum usual intercuspation. CONCLUSION: It was demonstrated that the Jasper Jumper is an efficient alternative to Class II malocclusion treatment, providing improvement in the facial profile, although the changes are more dentoalveolar than skeletal.

INTRODUÇÃO: discrepâncias esqueléticas, dentárias e de perfil podem ser melhoradas com a utilização de aparelhos ortopédicos funcionais. OBJETIVO: esse artigo tem o objetivo de relatar o tratamento de um paciente de 11 anos e 4 meses de idade com má oclusão de Classe II divisão 1, ½ cúspide bilateral, alteração de perfil, protrusão dos incisivos superiores, overjet e overbite acentuados e apinhamento suave. MÉTODOS: o paciente foi tratado por meio do Jasper Jumper associado ao aparelho fixo por 6 meses e elásticos intermaxilares de Classe II (3/16") nos últimos 4 meses. Após a remoção do aparelho fixo, foram utilizadas as contenções, a placa de Hawley para uso diurno e o Bionator modificado para uso noturno, por um ano. No arcada inferior, foi utilizada contenção 3x3 fixa colada de canino a canino. Essa combinação de tratamento melhorou o perfil, bem como os trespasses horizontal e vertical, além da relação molar. RESULTADOS: houve rotação mandibular no sentido horário e aumento da altura facial anteroinferior. Os incisivos inferiores foram protruídos e extruídos, e os molares inferiores sofreram extrusão. A relação cêntrica oclusal foi checada e era coincidente com a máxima intercuspidação habitual. CONCLUSÃO: comprovou-se que o Jasper Jumper é uma alternativa eficiente para o tratamento da Classe II, proporcionando melhoras no perfil facial, embora as alterações sejam mais dentoalveolares do que esqueléticas.

Tratamento ortodôntico em pacientes com periodontite agressiva: considerações clínicas / Orthodontic treatment in patients with aggressive periodontitis: clinical considerations

O objetivo desse trabalho foi confrontar as abordagens dos tratamentos envolvendo periodontite agressiva e ortodontia através de uma revisão de literatura baseada em artigos de condutas clínicas. Foi realizada uma busca na base de dados PubMed, retroativa a 10 anos e utilizando palavras-chave Mesh. Ao final da seleção, resultaram 13 artigos de casos clínicos e um artigo com uma série de casos. A maioria envolveu pacientes jovens e mulheres, e todos realizaram tratamento periodontal e ortodôntico para controle da periodontite agressiva. A perda óssea severa não contraindica o uso de aparelho ortodôntico, e a movimentação dentária associada com um intenso controle periodontal apresenta-se como uma forma de sucesso no tratamento da doença.

The aim of this study was to elucidate treatment approaches involving aggressive periodontitis and orthodontics through a literature review based on articles of clinical procedures. A search was conducted in PubMed database using MeSH key words and limited to the past 10 years. The appropriate studies were selected and resulted in 13 papers of single case reports and one paper including four case reports. The majority of the cases involved young patients and women, and all underwent orthodontic and periodontal treatment to control aggressive periodontitis. Severe bone loss does not contraindicate the use of braces and tooth movement together with an appropriate periodontal control presents a way to successfully treat the disease.

Autopercepção da criança e do adolescente em relação à má oclusão e sua motivação para o tratamento ortodôntico / Child/adolescent's self-perception of malocclusion and motivation for orthodontic treatment

Objetivo: Comparar a autopercepção da criança e do adolescente em relação à má oclusão e sua motivação ao tratamento ortodôntico. Material e métodos: A amostra de 216 jovens foi dividida em dois grupos: Grupo 1 (136 crianças com idade entre 8 e 10,9 anos) e Grupo 2 (80 adolescentes de 11 a 14 anos de idade). A autopercepção e o nível de necessidade de tratamento foram avaliados por meio do Componente Estético (AC) e do Componente de Saúde Dentária (DHC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN). A motivação para o tratamento ortodôntico foi avaliada por meio de questionários. Os dados foram analisados estatisticamente por meio dos testes Qui-quadrado e Mann-Whitney. Resultados: As crianças apresentaram um escore de IOTN-AC estatisticamente maior do que o dos adolescentes. A oclusão foi avaliada pelo IOTN-DHC e mostrou que a maioria dos jovens apresentou necessidade definida de tratamento ortodôntico no Grupo 1 (55%) e no Grupo 2 (43%). As principais razões citadas pelos grupos avaliados para justificar o uso do aparelho foram: "Acho bonito usar aparelho" e "Meus pais acham importante usar aparelho". Conclusão: As crianças foram mais críticas com a autoimagem que os adolescentes e a motivação para tratamento estava relacionada à estética e à opinião dos pais.(AU)

Objective: To compare child and adolescent's self-perception of malocclusion and their motivation for orthodontic treatment. Material and methods: A sample of 216 individuals was divided into two groups: Group 1 (136 children aged from 8 to 10.9 years) and Group 2 (80 adolescents aged from 11 to 14 years). Self-perception and treatment need level were evaluated using Aesthetic Component (AC) and Dental Health Component (DHC) of the Orthodontic Treatment Need Index (IOTN). Motivation for orthodontic treatment was evaluated through questionnaires. Data were statistically analyzed through Chi-square and Mann-Whitney tests. Results: Child group presented an IOTN-AC score statistically higher than the adolescents. Occlusion was assessed by IOTN-DHC and showed that the majority of the children presented definitive orthodontic treatment need in Group 1 (55%) and Group 2 (43%). The main reasons mentioned by both groups to justify the orthodontic appliance use were: "I think it is beautiful to wear orthodontic appliance" and "My parents think it is important to use orthodontic appliance". Conclusion: Children were more critical about their self-perception than adolescents, and the motivation for orthodontic treatment was related to aesthetics and parents' opinions.(AU)