Hyoid Bone Position and Head Posture in Patients With Richieri-Costa Pereira Syndrome (EIF4A3 Mutations).

Robin sequence with cleft mandible and limb anomalies, known as Richieri-Costa-Pereira syndrome (RCPS), is an autosomal recessive acrofacial dysostosis characterized by mandibular cleft and other craniofacial anomalies and respiratory complications. The aim of this cross-sectional study was to describe the hyoid and head posture of 9 individuals with RCPS using cephalometric measurements and provide a discussion about its implications in obstructive sleep apnea syndrome (OSAS). The study was conducted on lateral cephalograms of patients with RCPS and 9 selected age-matched controls in tertiary cleft center in Brazil. The cephalograms were digitized and analyzed on a software to obtain the vertical and horizontal hyoid position, its relationship with the mandible and the relation of the cranial base and postvertebral line. The t test was used for analysis of means and Levene's test for equality of variances.Cephalometric measurements H-S (vertical distance between hyoid bone and sella) (Supplemental Digital Content, Figure 1, http://links.lww.com/SCS/B247) and H-C4lp (horizontal position of the hyoid in relation to the post-pharyngeal space) showed statistically significant difference compared to controls (P < 0.05). Therefore, the hyoid bone was more inferiorly and posteriorly positioned in the study group compared with the control group. The vertebrae measurements did not present differences compared to controls. The described position of hyoid bone could be involved in the severe OSAS of RCPS patients.

Cephalometric Findings in Nine Individuals With Richieri-Costa-Pereira Syndrome.

The Richieri-Costa-Pereira syndrome (RCPS) is an autosomal-recessive acrofacial dysostosis caused by mutations in EIF4A3, characterized by mandibular cleft comprising other craniofacial anomalies and limb defects such as cleft palate/Robin Sequence, microstomia, absence of mandibular central incisors, minor ear anomalies, clubfeet and first and 5 ray defects. The findings from this study are useful for better understanding the morphological consequences of disorders of EIF4A3, and having a better picture of the anatomic characteristics of the syndrome for a better therapeutic planning. Twenty-four angular and linear variables were measured to assess anteroposterior and vertical (superior-inferior) position of the cranial base, maxilla, mandible, and facial profile. The cephalometric radiographic analysis was performed on 9 individuals with RCPS, obtained at a mean age of 10.3 years, and compared with randomly selected age-matched 9 controls, without clefts and with well-balanced faces, with mean age of 10.6 years (both groups range 8.1 to 13.7 years). t test was used for analysis of means and Levene test for equality of variances. The syndrome group presented severe mandibular hypoplasia and retrognathism (P = 0.009, P = 0.001), greater facial convexity (N'PnPog and N'SnPog, P < 0.05) in syndrome group compared with the control group (P = 0.003, P = 0.004). In conclusion, in the RCPS group, most craniofacial defects affect the lower facial third, considering the severely affected mandible.

Effect of temporomandibular joint articular disc repositioning on anterior open-bite malocclusion: An orthodontic-surgical approach.

An anterior open bite is a challenge to orthodontic treatment; it has a multifactorial etiology and a wide range of intervention options. Temporomandibular joint (TMJ) disorders are a risk factor for the development of malocclusions such as the anterior open bite, especially in patients who have TMJ osteoarthritis with disc displacement. Articular disc repositioning surgery is an available option for treating this pathology, and it contributes to maintaining the condyles in a more stable position. The aim of this article was to report the case of a 20-year-old woman diagnosed with anterior open bite and TMJ osteoarthritis with bilateral disc displacement. The patient received both orthodontic treatment and TMJ disc repositioning surgery. Cone-beam computed tomography was used to create 3-dimensional models of the condyles with regional superposition, and assessment of bone remodeling was performed at different time intervals. Complete orthodontic and surgical treatment time was approximately 12 months. The results provided a stable correction of the patient's anterior open bite with a 2-year follow-up and favorable bone remodeling of the condyles due to functional improvement of the TMJ.

Comparison of linear measurements and analyses taken from plaster models and three-dimensional images.

Digital models are an alternative for carrying out analyses and devising treatment plans in orthodontics. The objective of this study was to evaluate the accuracy and the reproducibility of measurements of tooth sizes, interdental distances and analyses of occlusion using plaster models and their digital images. Thirty pairs of plaster models were chosen at random, and the digital images of each plaster model were obtained using a laser scanner (3Shape R-700, 3Shape A/S). With the plaster models, the measurements were taken using a caliper (Mitutoyo Digimatic(®), Mitutoyo (UK) Ltd) and the MicroScribe (MS) 3DX (Immersion, San Jose, Calif). For the digital images, the measurement tools used were those from the O3d software (Widialabs, Brazil). The data obtained were compared statistically using the Dahlberg formula, analysis of variance and the Tukey test (p < 0.05). The majority of the measurements, obtained using the caliper and O3d were identical, and both were significantly different from those obtained using the MS. Intra-examiner agreement was lowest when using the MS. The results demonstrated that the accuracy and reproducibility of the tooth measurements and analyses from the plaster models using the caliper and from the digital models using O3d software were identical.

Impact of body and orofacial appearance on life satisfaction among Brazilian adults.

AIMS: 1. to elaborate a general model of physical appearance taking into account body image (BI) and orofacial appearance (OA) components; and 2. to evaluate the impact of BI and OA on life satisfaction among Brazilian adults. METHODS: This is a cross-sectional observational study. The cognitive, behavioral, affective, and satisfaction/dissatisfaction aspects of BI, the satisfaction and psychosocial impact of OA, and life satisfaction were evaluated by self-reported psychometric scales. Principal Component Analysis and Parallel Analysis were performed. Structural equation models were elaborated to estimate the impact of BI and OA on life satisfaction. The fit of the models was verified and the significance of the path estimates (ß) was evaluated using z-tests (α = 5%). RESULTS: A total of 1,940 individuals participated in the study (age: mean = 24.8, standard deviation = 5.7 years; females = 70.1%). In the male sample, three physical appearance factors were retained (OA, cognitive and behavioral components of BI, and affective and satisfaction/dissatisfaction components of BI). In the female sample, two factors were retained (OA and all components of BI). All factors had significant impact on life satisfaction (ß = |0.26|-|0.48|, p<0.001) in both samples. Individuals dissatisfied with BI and OA had lower levels of life satisfaction. For men, the affective and satisfaction components of BI had a greater impact on life satisfaction (ß = 0.48, p<0.001) than the other factors (ß =] -0.30;-0.25[, p<0.001). For women, both BI and OA had a similar impact (BI: ß = -0.30, p<0.001; OA: ß = -0.32, p<0.001). CONCLUSION: BI and OA formed distinct clusters in the physical appearance evaluation. Physical appearance was perceived differently by men and women, fostering discussion about the sociocultural construction of the body. BI and OA had a significant impact on life satisfaction and should be considered in assessment and treatment protocols.

Comparison of anterior retraction and anchorage control between en masse retraction and two-step retraction: A randomized prospective clinical trial.

OBJECTIVES: The purpose of this two-arm parallel trial was to compare en masse (ER) and two-step retraction (TSR) during space closure. MATERIALS AND METHODS: Forty-eight adult patients with bimaxillary protrusion who were planned for treatment with extraction of four first premolars were enrolled. All patients were randomly allocated in a 1:1 ratio to either the ER (n = 24) group or the TSR (n = 24) group. The main outcome was the amount of posterior anchorage loss in the molars and the retraction of the incisors between ER and TSR; the difference in incisor and molar inclination was a secondary outcome. Lateral cephalometric radiographs and oblique cephalometric radiographs at 45° were taken before retraction (T1) and after space closure (T2). Cephalograms were digitized and superimposed on the anatomic best fit of the maxilla and mandible by one operator who was blinded to the treatment group. RESULTS: Neither incisor nor molar crown movements showed any significant differences between the ER and TSR. There were no significant differences in the tipping of incisors and molars between the two groups. CONCLUSIONS: No significant differences existed in the amount of retraction of incisors and anchorage loss of molars between ER and TSR. Changes in incisor and molar tipping were similar, with the crowns showing more movement than the apex.

Molar Uprighting: A Considerable and Safe Decision to Avoid Prosthetic Treatment.

BACKGROUND: Tipped lower molar over edentulous space is very common in orthodontics practice when adults seek treatment. The segmented arch technique features a predictable force system that provides a controlled release of force that can produce light and continuous tooth movement. CASE DESCRIPTION: A female adult patient, who lost a permanent lower first molar, needed correction of the position of her permanent first molar place. Instead of making space for rehabilitation, it was closed after second molar uprighting and a balanced interdigitation was created without prosthetics. The patient was successfully treated with segmented arch technique using root correction spring activated with geometry VI to promote uprighting of a tipped molar and Niti spring coil to promote space closure. PRACTICAL IMPLICATIONS: Segmented arch technique is known to provide predictable light and continuous forces, which is very much indicated in adult treatment. There are several things to consider when orthodontically treating adult patients. Their periodontal conditions might not be ideal, less bone apposition may occur, and side effects of orthodontic tooth movement are expected. Thus, a predictable and controlled orthodontic treatment is needed.

Differences in bite force between dolichofacial and brachyfacial individuals: Side of mastication, gender, weight and height.

PURPOSE: Due to the bite force importance in functionality of the masticatory system, this study aimed to characterize it in dolichofacial and brachyfacial individuals. METHODS: A sample comprised by 190 patients was divided into two groups: 90 severe dolichofacial, and 100 severe brachyfacial individuals classified according to the VERT index and the face height ratio (Jarabak quotient). Bite force was measured by using an adjusted digital dynamometer and proper methodology. RESULTS: The sample met the parametric assumptions and presented statistical significance when right and left sides of dolichofacial and brachyfacial individuals were compared. However, within the same group, no differences between the left and right sides were found. Generally, bite force was higher for male, left masticator, age between 41-50 years, weighing over 100kg and between 1.81 and 1.90m tall. CONCLUSIONS: Based on the results of this cross-sectional study, it was possible to conclude that the bite force in severe brachyfacial individuals was significantly higher than in severe dolichofacial individuals, being influenced by gender, weight and height.

Esthetic influence of negative space in the buccal corridor during smiling.

The purpose of this study was to measure and verify the esthetic influence of the bilateral spaces between maxillary teeth and lip corners, called negative space (NS), during smile. The sample was comprised of 60 smile photographs obtained from 60 individuals (30 men and 30 women) aged 18 to 25 years old. Two orthodontists and two lay people evaluated these pictures regarding esthetics by a visual analogue scale. In each picture, the right and left NS were measured in millimeters and in proportion to the smile width (SW). Data were analyzed for statistical significance (P = .05). The mean NS of the sample was 6.68 +/- 1.99 mm, and the NS proportion in relation to the SW was 9.6 +/- 2.56%, for both sides of the arch. No significant asymmetries were observed between the right and left sides. The NS was significantly larger in men than in women when measured in millimeters (P = .028) (7.08 +/- 2.24 mm in men vs 6.28 +/- 1.62 mm in women), but the NS proportion to the SW was similar (9.94 +/- 2.24% in men vs 9.26 +/- 1.61% in women). When the 12 individuals with the smallest NS in proportion to SW were compared with the 12 individuals with the largest NS in proportion to SW, there was no statistical difference regarding the esthetic evaluation (P = .11). It was concluded that the NS did not influence the esthetic evaluation of smile photographs in the sample in this study, for both orthodontists and lay people.

Analysis of the smile photograph.

Optimal facial esthetics is one of the objectives in orthodontic treatment and an important issue in modern society. In this context, orthodontic treatment permits individuals with dental malpositions to achieve improved dentofacial esthetics. To reach this result, the orthodontist needs to recognize the characteristics considered normal and pleasant in dental arches and smiles. The objective of this article is to review and discuss criterion adopted by dental literature to technically analyze the smile, such as dental midline, smile line, dental exposure, negative space, dental proportion, and symmetry. This article proposes a way to visualize an ideal smile for each patient.

Upper lip changes correlated to maxillary incisor retraction--a metallic implant study.

The soft tissue changes after the extraction of maxillary first premolars and subsequent anterior tooth retraction were evaluated for 16 Class II, division 1 patients. Pre- and posttreatment lateral head cephalograms were evaluated using superimpositions on Björk-type metallic implants in the maxilla. The patient sample was divided into group I patients, those who did exhibit lip seal at rest in the pretreatment cephalogram and group II patients, those who did not exhibit lip seal at rest in the pretreatment cephalogram. Upper incisor retraction was followed by a similar ratio of upper lip retraction in both the lip seal and nonsealed groups (1:0.75 and 1:0.70 mean ratios, respectively). However, those without lip seal did demonstrate more retraction at stomion (USt). The final upper lip position (Ls) was reasonably correlated with retraction of the cervical maxillary incisor point (cU1) with determination coefficients of 63.6% in the lip sealed and 68.5% in the lip incompetent groups. Although labial and nasolabial angles tended to open after incisor retraction, there was little predictability for this response.

Efeito da escovação e das bebidas na rugosidade superficial de bráquetes cerâmicos / Effect of brushing and beverages on surface roughness of ceramic brackets

Introdução: Quando introduzidos no meio bucal, os bráquetes cerâmicos podem sofrer alterações em sua estrutura provocadas pelo processo de degradação química e mecânica do material. Objetivo: Este estudo avaliou a rugosidade superficial de bráquetes cerâmicos e se eles sofreram alteração com a escovação dentária e a imersão em bebidas com diferentes pH. Material e método: Foram testados sete bráquetes cerâmicos de incisivo central superior direito de quatro marcas comerciais (duas marcas de bráquete monocristalino e duas de policristalino). Os bráquetes foram imersos em soluções de café, vinho tinto, Coca-Cola, chá preto e saliva artificial durante 21 dias. Outros sete bráquetes de cada marca comercial foram imersos nas mesmas soluções e no mesmo tempo, porém com intervalos de escovação diários realizados por uma máquina de escovação. A rugosidade (Ra) foi obtida por meio de um rugosímetro (Surftest SJ-400, Mitutoyo®) antes e após 24 horas, 7, 14 e 21 dias. Os dados foram avaliados pela análise de perfis multivariados, análise de variância (ANOVA) e teste de comparação múltipla de médias. Resultado: Os resultados da rugosidade e de sua alteração após 21 dias foram: média Ra do Allure = 0,277 μm (alteração = 0,002 μm), Inspire Ice = 0,262 μm (alteração = 0,013 μm), Radiance = 0,177 μm (alteração = 0,009 μm) e Transcend = 0,367 μm (alteração = 0,019 μm). Conclusão: A rugosidade superficial dos bráquetes cerâmicos aumentou após 21 dias de imersão nas soluções, sendo o tempo de imersão um fator significante. No entanto, essa alteração da rugosidade no tempo é semelhante nos bráquetes monocristalinos e policristalinos, assim como nas diferentes soluções. A escovação dentária não produziu alteração na rugosidade superficial de bráquetes cerâmicos.

Introduction: When introduced into the oral environment, the ceramic brackets may undergo change their structure caused by the process of chemical and mechanical degradation of the material. Objective: This study evaluated the surface roughness of ceramic brackets and whether it is altered by toothbrushing process and diet solutions. Material and method: Seven ceramic brackets of four commercial brands were tested: two monocrystalline and two polycrystalline. The brackets were immersed in solutions of coffee, red wine, Coke, black tea and artificial saliva for 21 days. Another group of brackets of each brand were also immersed in the same solutions and for an equal time, but with daily brushing performed by a toothbrushing machine. The surface roughness (Ra) was analyzed by a Roughness Tester (Surftest SJ-400,Mitutoyo®) before and after 24 hours, 7, 14 and 21 days. The data were evaluated by the Analysis of Multivariate Profiles, Analysis of Variance (ANOVA), multiple comparison test of means. Result: The results of Ra and its change after 21 days were: Ra mean of Allure = 0.277μm (change = 0.002μm), Inspire Ice = 0.262μm (change = 0.013μm), Radiance = 0.177μm change = 0.009μm), Transcend = 0.367μm (change = 0.019μm). Conclusion: the surface roughness of the ceramic brackets increased after 21 days of immersion in the solutions, and the immersion time was a significant factor. However, this change in the surface roughness was similar for the monocrystalline and polycrystalline brackets, as well as for the different solutions. Brushing did not change the surface roughness of ceramic brackets.

Transverse maxillary and mandibular growth during and after bionator therapy: study with metallic implants.

INTRODUCTION: This study evaluated posteroanterior cephalograms before and after treatment and long term follow-up of Class II division 1 patients treated with bionator. OBJECTIVE: The objective was to demonstrate the transverse growth of maxilla and mandible during and after bionator therapy. METHODS: Measurement of transverse dimensions between posterior maxillary and mandibular implants, as well as the distances between the buccal, gonial and antegonial points were recorded. Measurements were analyzed at three periods: T1 - before bionator therapy, T2 - after bionator therapy and T3 - 5.74 years after T2. RESULTS: There was statistically significant transverse increase due to growth and/or treatment for all variables, except for the distance between the anterior maxillary implants. CONCLUSIONS: During the study period only the anterior maxillary area did not show transverse growth.

Effects of age and gender on upper airway, lower airway and upper lip growth.

The aim of the present retrospective study was to evaluate the influence of age and gender on upper and lower airway width and upper lip length. In this study, 390 lateral cephalograms were divided into 13 age groups (ranging from 6 to 18 years) and were analyzed. The intergroup differences were analyzed using a MANOVA (Multivariate Analysis of the Variance), and the intragroup differences were analyzed using an ANOVA (Analysis of the Variance) and Tukey's test. The results of the present study indicated that although the airway width and the upper lip length increased with age, the lower airway width exhibited variable growth between the ages of six and eighteen years. The airway width was significantly greater in females than males, whereas the upper airway width was similar between these two genders. The lip length was significantly shorter in females than males. The lower airway width and upper lip length were significantly different between males and females, whereas the upper airway width was similar for the genders. The upper airway width and upper lip exhibited incremental growth between the ages of six and eighteen years. The upper lip closely followed the growth pattern of the upper airway width; the growth plateaued between the ages of 6 and 9 years, increased from 9 to 16 years and plateaued from 16 to 18 years.

Occurrence of skeletal malocclusions in Brazilian patients with dentofacial deformities.

In this study, a survey was conducted on the occurrence of skeletal malocclusions presented by patients of the Center for Research and Treatment of Buccofacial Deformities (CEDEFACE) in the city of Araraquara, SP, Brazil. The clinical charts of 381 patients with dentoskeletal deformities, who underwent combined orthodontic-surgical treatment in the period between 2000 and 2006, were reviewed. After sample selection (convenience method), based on the data of the pre- and post-surgical documentation, the number of patients was reduced to 171. For classification of the survey, the anteroposterior discrepancy (Class I, II and III), race, age, gender, absence or presence of asymmetry, vertical maxillary excess and maxillary biprotrusion were considered, in addition to determining in which bony base the surgical procedure was performed. Patients' documentations were analyzed by one examiner previously calibrated by repetition of the process until the method was considered adequate (intraclass correlation coefficient > 0.94). Patients' mean age was 23.59 (SD 6.93) years, the majority (102 patients) were women, and Caucasians (160 patients). Class III malocclusion was the most prevalent (81 patients). Asymmetry, vertical maxillary excess and biprotrusion were present in 54, 33, and 7 patients, respectively. The majority of surgeries for correction of dentoskeletal deformities were combined, involving the maxilla and mandible. In conclusion, Class III was the most prevalent skeletal deformity and Class I was the least prevalent; in general, the prevalence of skeletal deformities was higher in women; in the majority of patients with skeletal malocclusions there was a combination of maxillary and mandibular problems, which interferes directly in the decision regarding the most adequate treatment plan, and a higher incidence of asymmetry was observed in skeletal Class III; vertical excess occurred in a similar manner in Class II and III and there was a low incidence of biprotrusion among the malocclusions evaluated.

Skeletal and dental changes induced by bionator in early treatment of class II / Alterações esqueléticas e dentárias induzidas pelo bionator no tratamento precoce da classe II

The purpose was to investigate the amount of skeletal and dentoalveolar changes after early treatment of Class II, Division 1 malocclusion with bionator appliance in prepubertal growing patients. Forty Class II patients were divided in two groups. Treated group consisted of 20 subjects treated consecutively with bionator. Mean age at the start of treatment (T0) was 9.1 years, while it was 10.6 years at the end of treatment (T1). Mean treatment time was 17.7 months. Pretreatment and post-treatment cephalometric records of treated group were evaluated and compared with a control group consisted of 20 patients with untreated Class II malocclusion. Intergroup comparisons were performed using Student's t-tests and chi-square test with Yates' correction at a significance level of 5 per cent. Bionator appliance was effective in generating differential growth between the jaws. Cephalometric skeletal measurements ANB, WITS, Lafh, Co-A and dental L6-Mp, U1.Pp, IsIi, OB, OJ showed statistically significantly different from the control. Bionator induced more dentoalveolar changes than skeletal during treatment in prepubertal stage.

Este estudo quantificou as alterações esqueléticas e dentoalveolares no período pré-puberal de crescimento após o tratamento da má oclusão de classe II, divisão 1 com bionator. Quarenta pacientes classe II foram divididos em dois grupos. Um grupo com 20 pacientes tratados consecutivamente com bionator. A média de idade no início do tratamento (T0) foi de 9,1 anos, enquanto ao final (T1) foi de 10,6 anos. O tempo médio de tratamento foi de 17,7 meses. Os dados cefalométricos antes e após o tratamento foram avaliados e comparados com um grupo controle de 20 pacientes com má oclusão de classe II, divisão 1 não tratada. A comparação intergrupo foi realizada pelo teste t de Student e teste qui-quadrado com correção de Yates para um nível de significância de 5 por cento. O aparelho foi efetivo em gerar diferencial de crescimento entre os arcos dentários. As medidas cefalométricas esqueléticas ANB, WITS, Lafh, Co-A e as dentárias L6-Mp, U1.Pp, IsIi, OB, OJ demonstraram diferença estatística significante entre os grupos. O bionator induziu maiores alterações dentoalveolares que esqueléticas no tratamento da classe II, divisão 1 durante o período pré-puberal.

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion

INTRODUCTION: This study assessed the three-dimensional changes in the dental arch of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusions at three different periods. METHODS: Landmarks previously identified on upper and lower dental casts were digitized on a three-dimensional digitizer MicroScribe-3DX and stored in Excel worksheets in order to assess the width, length and depth of patient's dental arches. RESULTS: During orthodontic preparation, the maxillary and mandibular transverse dimensions measured at the premolar regions were increased and maintained throughout the follow-up period. Intercanine width was increased only in the upper arch during orthodontic preparation. Maxillary arch length was reduced during orthodontic finalization, only. Upper and lower arch depths were stable in the study periods. Differences between centroid and gingival changes suggested that upper and lower arch premolars buccaly proclined during the pre-surgical period. CONCLUSIONS: Maxillary and mandibular dental arches presented transverse expansion at premolar regions during preoperative orthodontic preparation, with a tendency towards buccal tipping. The transverse dimensions were not altered after surgery. No sagittal or vertical changes were observed during the follow-up periods. .

INTRODUÇÃO: esse estudo avaliou as alterações tridimensionais ocorridas na morfologia das arcadas dentárias de pacientes submetidos ao tratamento ortodôntico-cirúrgico para a correção da má oclusão de Classe II, em três períodos distintos: (T1) modelos iniciais, (T2) modelos pré-cirúrgicos imediatos (de 1 a 15 dias antes da cirurgia) e (T3) modelos pós-cirúrgicos (mínimo de 6 meses após a remoção do aparelho ortodôntico). MÉTODOS: pontos previamente demarcados em cada modelo foram digitalizados por meio do digitalizador tridimensional MicroScribe-3DX, cujas coordenadas, armazenadas em planilhas do programa Excel, deram origem a valores que possibilitaram a avaliação da largura, comprimento e profundidade das arcadas dentárias. RESULTADOS: durante o preparo ortodôntico, houve aumentos nas distâncias transversais superiores e inferiores medidas na região de pré-molares que se mantiveram no período total de acompanhamento. Apenas a distância intercaninos superior apresentou alterações de aumento durante o preparo ortodôntico, assim como a largura da arcada superior, que diminuiu durante a fase de finalização. A profundidade de ambas as arcadas manteve-se estável nas fases avaliadas. Diferenças entre as mudanças dos pontos centroide e gengival sugerem que os pré-molares superiores e inferiores inclinaram para vestibular durante o preparo ortodôntico pré-cirúrgico. CONCLUSÇÕES: conclui-se que as arcadas dentárias superiores e inferiores sofreram expansão transversal na região de pré-molares durante o preparo ortodôntico pré-cirúrgico, com tendência à inclinação vestibular de todos os dentes posteriores. Após a cirurgia, as dimensões transversais ...

Expansão rápida da maxila osseossuportada: um relato de caso e passo a passo laboratorial / Rapid bone-borne maxillary expansion: a case report and laboratorial step-by-step

A expansão rápida da maxila osseossuportada tem sido amplamente utilizada na clínica ortodôntica, entretanto ainda existem dúvidas em relação ao planejamento e efeitos do tratamento. É objetivo do presente artigo relatar um caso clínico descrevendo passo a passo as etapas de planejamento, confecção e instalação do aparelho. Paciente com mordida cruzada posterior, 11 anos de idade foi indicada para tratamento com aparelho. Inicialmente, foi realizada tomografia computadorizada de feixe cônico a fim de planejar o local ideal de instalação de 4 mini-implantes considerando a disponibilidade óssea no palato. Imediatamente após a instalação dos mini-implantes foi realizada moldagem, adaptação de mini-implantes de latão no alginato e confeccionado modelo de trabalho. O disjuntor em acrílico, apoiado apenas nos mini-implantes, foi adaptado em boca e a paciente instruída a ativar o torno expansor » de volta pela manhã e a noite durante 14 dias. Após esse período nova tomografia foi realizada, assim como após o tempo de contenção de 4 meses. Mensurações nas tomografias mostraram expansão maxilar sem efeitos de vestibularização de molares. Após 4 meses foi observada leve redução da expansão esquelética e inclinação lingual dos dentes posteriores. Pode ser concluído que o tratamento foi bem sucedido, resultando em correção da mordida cruzada posterior sem efeitos colaterais nos dentes posteriores.(AU)

Rapid bone-borne maxillary expansion has been widely used in orthodontic clinic, however there are still some doubts about its planning and treatment effects. The aim of this paper is to report a case describing step-by-step planning, manufacturing and installation of the appliance. Patient with posterior crossbite, 11 years-old was indicated to treatment with this appliance. A cone bean computed tomography was achieved to plan the ideal site for installing 4 miniscrews, considering bone availability of the palatal area. Immediately after miniscrews insertion, an impression was taken and miniscrews were inserted in the alginate to obtain the cast model. The acrylic appliance, supported exclusively on miniscrews, was adapted and the patient instructed to activate » turn twice a day for 14 days. After this period a new tomography was obtained and also after a 4-month retention period. Tomography measurements showed maxillary expansion with no molars vestibularization. After 4 months there was a slight decrease on maxillary expansion and molars lingual tipping. It can be concluded that the treatment was successful with correction of the crossbite and no deleterious effects in the posterior teeth.(AU)

Effects of age and gender on upper airway, lower airway and upper lip growth

The aim of the present retrospective study was to evaluate the influence of age and gender on upper and lower airway width and upper lip length. In this study, 390 lateral cephalograms were divided into 13 age groups (ranging from 6 to 18 years) and were analyzed. The intergroup differences were analyzed using a MANOVA (Multivariate Analysis of the Variance), and the intragroup differences were analyzed using an ANOVA (Analysis of the Variance) and Tukey's test. The results of the present study indicated that although the airway width and the upper lip length increased with age, the lower airway width exhibited variable growth between the ages of six and eighteen years. The airway width was significantly greater in females than males, whereas the upper airway width was similar between these two genders. The lip length was significantly shorter in females than males. The lower airway width and upper lip length were significantly different between males and females, whereas the upper airway width was similar for the genders. The upper airway width and upper lip exhibited incremental growth between the ages of six and eighteen years. The upper lip closely followed the growth pattern of the upper airway width; the growth plateaued between the ages of 6 and 9 years, increased from 9 to 16 years and plateaued from 16 to 18 years.

Fotocatálise heterogênea de Enterococcus faecalis e Pseudomonas aeruginosa desencadeada pela ação da luz UV e branca em espátulas com revestimento de nanopartículas TiO2 e Ag / Heterogeneous photocatalysis of Enterococcus faecalis and Pseudomonas aeruginosa activated by the action of UV and visible light on dental instruments with TiO2 and Ag nanoparticles coating

Nanotecnologia, ciência do minúsculo, gera produtos capazes de manipular átomos e moléculas com aplicação no processo de esterilização de instrumentais odontológicos. Objetivo: Avaliar a ação autolimpante e esterilizante do processo de fotocatálise heterogênea desencadeado pela ação da luz UV e branca sobre o recobrimento de instrumentos odontológicos com nanopartículas de TiO2 e Ag. Material e método: Foram realizados testes bacteriológicos em espátulas odontológicas revestidas com nanopartículas de TiO2 e Ag (uma ou três camadas) e contaminadas com 10 mcrl dos microrganismos Enterococcus faecalis e Pseudomonas aeruginosa. Após contaminação, as espátulasforam expostas à luz UV e branca por 120 minutos, transferidas para tubos contendo meio BHI e incubadas a 35-37 °C. Foram feitas leituras em intervalos de 24, 48, 72 e 96 horas para verificação do crescimento das bactérias e testes de controle e recuperação. Resultado: A Pseudomonas aeruginosa foi inativada após exposição de 120 minutos à luz UV, indicando a ocorrência do processo de fotocatálise heterogênea no recobrimento de nanopartículas de TiO2 e Ag das espátulas. A Pseudomonas aeruginosa não foi inativada pela exposição à luz branca e o Enterococcus faecalis não foi inativado pela exposição à luz UV e à branca nas espátulas de cimento odontológico recobertas com nanopartículas de TiO2 e Ag, nas leituras de até 96 horas, ocorrendo o crescimento bacteriano. Conclusão: Não houve influência do revestimento das espátulas com uma ou três camadas de nanopartículas de TiO2 e Agnos resultados. A fotocatálise heterogênea da Pseudomonas aeruginosa foi confirmada pela exposição à luz UV da espátula com revestimento de TiO2 e Ag, mas não pela luz branca. A fotocatálise heterogênea do Enterococcus fecalis não foi confirmada tanto pela exposição do TiO2 e Ag à luz UV como à branca.

Nanotechnology, the science of minuscule, has developed products which are able t o manipulate atoms and molecules that could be applied in the sterilization process of dental instruments. Objetives: The objective of the present study was to evaluate the self-cleaning action of TiO2 and Ag nanoparticles coating on dental instruments by the photocataliys process under UV and visible light irradiation. Material and method: Microbiologic tests were done using dental cement spatulas coated with TiO2 and Ag nanoparticles (one or three layers), and contaminated with 10 mcrl of Pseudomonas aeruginosa and Enterococcus faecalis, respectively. After contamination, they were exposed to ultraviolet light and visible light for 120 minutes. Next, they were transferred to and stored in test tubeswith BHI (Brain Heart Infusion) and incubated in 35 to 37 °C. Checking times for bacterial growth and for control and retrieval tests were done at: 24, 48, 72 and 96 hours. Result: The Pseudomonas aeruginosa was inactive after120 minutes of ultraviolet light irradiation, thus confirming the heterogeneous photocatalytic activity of TiO2 and Ag. The Pseudomonas aeruginosa was not inactivated under visible light irradiation and the Enterococcus faecalis was not inactivated under UV and visible light irradiation of the dental cement spatulas coated with TiO2 and Agnanoparticles in the readings to 96 hours, showing bacterial growth. Conclusion: There were no influence of one or three layers of TiO2 and Ag nanoparticles coating of the spatulas in the results. The heterogeneous photocatalysis activity of TiO2 and Ag under UV light irradiation was confirmed for Pseudomonas aeruginosa but not under visible light. Enterococcus faecalis did not confirmed the photocatalytics activity of TiO2 and Ag under UV light irradiation and visible lights irradiation.