Escobar Syndrome-An Multidisciplinary Approach for an Excellent Outcome With 3 Years of Follow-Up.

This case report intends to provide the facial characteristics of Escobar syndrome and to describe the orthodontic treatment of a 12-year-old female patient diagnosed with it. Escobar syndrome, a variant of the multiple pterygium syndrome, is a rare disorder with many systemic, facial, and oral manifestations.The patient presented with mixed dentition, severe dolichofacial pattern, increased lower facial height, convex profile, severe anterior open bite, maxillary hypoplasia, and mandibular retrognatism. The multidisciplinary approach included soft cleft palate repair, orthodontic treatment, orthognathic surgery, restorative cosmetic dentistry, speech therapy, and physiotherapy. Despite the limitations imposed by the syndrome, this report illustrates how the multidisciplinary treatment approach aided in the correction of occlusal function and facial esthetics and improvement in the quality of life of the patient with Escobar syndrome.

Systemic levels of metallic ions released from orthodontic mini-implants.

INTRODUCTION: Orthodontic mini-implants are a potential source of metallic ions to the human body because of the corrosion of titanium (Ti) alloy in body fluids. The purpose of this study was to gauge the concentration of Ti, aluminum (Al), and vanadium (V), as a function of time, in the kidneys, livers, and lungs of rabbits that had Ti-6Al-4V alloy orthodontic mini-implants placed in their tibia. METHODS: Twenty-three New Zealand rabbits were randomly divided into 4 groups: control, 1 week, 4 weeks, and 12 weeks. Four orthodontic mini-implants were placed in the left proximal tibia of 18 rabbits. Five control rabbits had no orthodontic mini-implants. After 1, 4, and 12 weeks, the rabbits were killed, and the selected tissues were extracted and prepared for analysis by graphite furnace atomic absorption spectrophotometry. RESULTS: Low amounts of Ti, Al, and V were detectable in the 1-week, 4-weeks, and 12-weeks groups, confirming that release of these metals from the mini-implants occurs, with diffusion and accumulation in remote organs. CONCLUSIONS: Despite the tendency of ion release when using the Ti alloy as orthodontic mini-implants, the amounts of metals detected were significantly below the average intake of these elements through food and drink and did not reach toxic concentrations.

Surface morphology changes of acrylic resins during finishing and polishing phases.

INTRODUCTION: The finishing and polishing phases are essential to improve smoothness and shining on the surface of acrylic resins used to make removable orthodontic appliances. A good surface finishing reduces roughness, which facilitates hygiene, prevents staining and provides greater comfort to the patients. OBJECTIVE: The aim of this paper was to analyze the changes on surface morphology of acrylic resins during finishing and polishing phases. METHODS: Thirty discs (10 mm in diameter and 5 mm in length) were made with acrylic resin and randomly divided into ten groups. The control group did not receive any treatment while the other groups received gradual finishing and polishing. The last group received the entire finishing and polishing procedures. Surface morphology was qualitatively analyzed through scanning electron microscopy and quantitatively analyzed through a laser profilometer test. RESULTS: The acrylic resin surfaces without treatment showed bubbles which were not observed in the subsequent phases. Wearing out with multilaminated burs, finishing with wood sandpaper and finishing with water sandpaper resulted in surfaces with decreasing irregularities. The surfaces that were polished with pumice and with low abrasive liquids showed high superficial smoothness. CONCLUSIONS: Highly smooth acrylic resin surfaces can be obtained after mechanical finishing and polishing performed with multilaminated burs, wood sandpaper, water sandpaper, pumice and low abrasive liquids.

Superficial morphology and mechanical properties of in vivo aged orthodontic ligatures.

INTRODUCTION: The degradation of elastic ligatures in the oral environment results in the need of periodic replacement to maintain the optimal force during the orthodontic treatment. The purpose of this study was to perform a clinical prospective randomized study of the degradation of orthodontic elastomeric ligatures in the oral environment by scanning electron microscopy (SEM) and tensile strength test. METHODS: Two hundred elastic ligatures were randomly selected and placed around the brackets of 5 volunteers and removed in groups of 10, at different times (1, 2, 3, and 4 weeks). The control group was performed by another fifty ligatures which were not submitted to the oral degradation. The analyses were done by scanning electron microscopy (SEM) and strength mechanical test. RESULTS: The tensile strength test results showed reduction in the ultimate strength values after four weeks ageing in the oral environment and no statistical difference in the yield strength values (p < 0.05). The orthodontic elastomeric ligatures surface was significantly degraded in the oral cavity after four weeks. The elastomeric degradation began in the first week when the increase in the roughness could be detected just in some areas. Afterwards, the surface became gradually rougher and, after 4 weeks, it was totally rough with some crack areas. CONCLUSIONS: The elastic ligatures aged in the oral environment showed higher superficial degradation and lower loss of mechanical properties after the maximum experimental period.