The influence of orotracheal intubation on the oral tissue development in preterm infants.

PURPOSE: Preterm children may not be prepared for extra-uterine life and thus need neonatal intensive care, such as artificial ventilation through orotracheal intubation. Oral tissue development changes as a result of the use of an orotracheal tube and its mechanical influence in preterm neonates has not been intensively studied. The purpose of the present study was to determine the association of orotracheal intubation with incidence of oral alterations in preterm infants. MATERIALS AND METHODS: A retrospective cohort of 117 subjects who were born during the period 2002-2003 in Brazil were evaluated and the data were analysed using the Fisher and Mann-Whitney exact tests. A 95% confidence interval was calculated for observed oral conditions. RESULTS: The cohort revealed that the most frequent oral conditions included anterior crossbite, superior alveolar contour and palatal deformation. CONCLUSIONS: The association between the intubated-infant group and the non-intubated-infant group suggested that mechanical trauma had an influence on the oral structure development.

Three-dimensional facial surface analysis of patients with skeletal malocclusion.

Three-dimensional (3D) laser surface scanning analysis has taken hold in orthodontics, as well as craniomaxillofacial and plastic surgery as a new tool that can navigate away from the limitations of conventional two-dimensional methods. Various techniques for 3D reconstruction of the face have been used in diagnosis, treatment planning and simulation, and outcomes follow-up. The aim of the current prospective study was to present some technical aspects for the assessment of facial changes after orthodontic and orthognathic surgery treatment using 3D laser surface scanning. The technique proposed for facial surface shape analysis represented three-dimensionally the expected surgical changes, and the reduction of the postoperative swelling was verified. This study provides technical information from the data collection to the 3D virtual soft-tissue analysis that can be useful for diagnostic information, treatment planning, future comparisons of treatment stability or facial postoperative swelling, and soft-tissue profile assessment.

Three-dimensional cephalometric study of upper airway space in skeletal class II and III healthy patients.

Because the pharynx and the dentofacial structures have close relationship, a mutual interaction can be expected to occur between them. The literature presents skeletal malocclusion as etiology for airway morphology changes and/or vice versa. The present three-dimensional cephalometric study from computed tomography scans was carried out to investigate upper airway space in normal nasal breathing patients presenting skeletal pattern of classes II and III. In addition, the statistical analysis was done according to gender criterion. The results revealed that the majority of the airway measurements have not been affected by type of malocclusion. The three-dimensional technology used in this study also allowed the volume and surface area calculations, and no statistical significance was found. The retroglossal width and posterior nasal cavity height mean were larger in males than females in the class II group, but volume and cross-section area were not statistically significant. However, in class III group, although the differences in linear and angular measures means were not significant, the retropalatal volume and retroglossal volume and cross-section area were larger in males. The authors highlight that the evaluation of upper airway space should be an integral part of diagnosis and treatment planning to achieve functional balance and stability of the results.

Surface roughness of acrylic resins after different curing and polishing techniques.

OBJECTIVE: To conduct a laboratory evaluation of the surface roughness of self-curing acrylic resin after different curing and polishing techniques. MATERIALS AND METHODS: Sixty specimens were separated into four groups. The conventional curing process was followed by a second curing cycle in a microwave oven to decrease the residual monomer levels in two groups. After curing, two groups received manual polishing and the other groups underwent chemical polishing at 70 degrees C for 10 seconds. Roughness analysis was performed in a mechanical and laser profilometer. Analyses by Bartlett, Shapiro-Wilk, and Dunnett tests were used to compare whether the mean of the response variable was the same in all groups. RESULTS: The results suggested greater influences from the polishing method than the curing method and showed that the chemical polishing method yielded the highest surface roughness. CONCLUSIONS: The average pattern of roughness of the self-curing acrylic resin was statistically the same in the groups with different curing methods. However, chemical polishing increases the average pattern of roughness.

Orthodontic treatment of patients with sickle-cell anemia.

Sickle-cell anemia is a genetic blood disease characterized by a hemoglobin gene mutation. The genetic failure is basically constituted by replacement of the hemoglobin beta chain in the sixth position so that the amino acid valine is encoded instead of glutamic acid. As a result, the erythrocytes have their normal biconcave discoid shape distorted, generally presenting a sicklelike shape, which reduces both their plasticity and lifetime. Because a complete blood supply is so important during application of both intraoral and extraoral forces, this article addresses the general and oral aspects associated with sickle-cell anemia. This will guide the clinician regarding such patients who seek orthodontic treatment by making references to literature on multidisciplinary management.

A protocol for cranial base reference in cephalometric studies.

Establishment of the cranial base references and the coordinate system is important for measurement of events occurring on the face. The literature suggests that the horizontal axis is obtained by tracing a line in clockwise direction at seven degrees from the Sella-Nasion line, and the vertical axis is perpendicular to this former axis passing through the Sella point. However, could this standardization better represent the angle between the Sella-Nasion line and Frankfort Horizontal Plane in a Brazilian population and be employed in cephalometric studies? Thus, the present study had two purposes: to identify the cranial base inclination in adult patients presenting with intermaxillary anteroposterior skeletal disharmony and to evaluate the reliability of a protocol to reproduce the cranial base reference. Lateral cephalograms of three different times were traced: T0) onset of orthodontic treatment and immediately before the orthognathic surgery, T1) six months after surgery, and T2) one year after surgery. The results displayed a mean cranial base inclination of 7.91 degrees. Variation of the intraindividual data allowed the conclusion that the protocol proposed by utilization of an individual template of the cranial base reference was effective for the exactness of measurements in cephalometric studies.

Arthrogryposis: diagnosis and therapeutic planning for patients seeking orthodontic treatment or orthognathic surgery.

Arthrogryposis is the name given to a group of musculoskeletal disorders characterized by multiple joint contractures through the body that are present at birth. There are many causes for congenital limitations of the range of motion of a joint. However, the most common form of arthrogryposis, present in 40% of cases, is a condition called amyoplasia. In many cases, abnormal nerve, muscle, and connective tissue development is involved. Hands, wrists, elbows, shoulders, hips, feet, knees, back, and jaws are affected. Because of the complexity of tissue alterations and implications in normal facial growth, the authors of this article address the aspects related to clinical manifestations and therapeutic planning for patients with this condition who seek orthodontic treatment or orthognathic surgery.

Atendimento multidisciplinar do paciente ortodôntico com epidermólise bolhosa / Multidisciplinary management of the orthodontic patient with epidermolysis bullosa

O termo epidermólise bolhosa descreve um grupo variado de doenças hereditárias, crônicas, não inflamatórias, epiteliais e da mucosa, que são caracterizadas por excepcional fragilidade e reduzida resistência após trauma moderado. Esta doença é classificada em forma simples, juncional ou distrófica, com pelo menos 23 subtipos, e é uma doença rara que afeta toda a população, qualquer grupo racial e igualmente homens e mulheres. OBJETIVO: os autores relatam problemas sistêmicos e bucais associados à epidermólise bolhosa, norteando atitudes clínicas multidisciplinares quando o paciente necessita de tratamento ortodôntico.

The term epidermolysis bullosa describes a varied group of hereditary, chronic, non-inflammatory diseases of the skin and mucosa, which are characterized by remarkable skin fragility and reduced resistance after moderate trauma. This disease is classified as simple, junctional or dystrophic form, with at least 23 subtypes, and is a rare disease found in all populations and racial groups, equally affecting males and females. AIM: the authors reports systemic and oral problems associated with epidermolysis bullosa, guiding the multidisciplinary clinical attitudes when the patient needs orthodontic treatment.

Hiperplasia gengival no paciente ortodôntico: conduta clínica / Gingival hyperplasia in the orthodontic patient: clinic conducts

Este relato de caso apresenta as condutas clínicas realizadas em paciente ortodôntico com hiperplasia gengival, história de respiração bucal e higiene bucal deficiente. O tratamento ortodôntico foi interrompido provisoriamente e foram realizados a remoção cirúrgica do excesso de tecido gengival e a aplicação tópica de clorexidina gel 1%. A integração entre Ortodontia e Periodontia mostrou eficácia com respeito à promoção de saúde e maior compatibilidade para aplicação de forças e resposta dos tecidos de suporte dentário.

Movimento distal de molares usando o Sliding-Jig / Distal movement of molars using the Sliding-Jig

Rotineira possibilidade de tratamento de desarmonia dento-esquelética envolve a distalização dos molares superiores ou inferiores. Movimento distal dos dentes posteriores favorece casos de deficiência no comprimento do arco e necessidade de ganho para correção de giros, overjet e relação de molares. Vários são os dispositivos mecânicos indicados para este fim, dependendo ou não da cooperação do paciente. Sob princípios da técnica Edgewise, o uso de arcos retangulares, ancoragem e Sliding-Jig associado a mecânica de elásticos inter maxilares, mostrou-se eficaz na obtenção de Classe I e manutenção durante as fases seguintes do tratamento ortodôntico