Genetic Polymorphisms of Estrogen Receptors α and ß are Associated with Craniofacial Measurements in Patients With Dentofacial Deformity.

Dentofacial deformities are characterized by abnormalities in craniofacial development that affects the individual's skeletal and occlusion, often causing functional and esthetic problems. In literature, there is an involvement of polymorphisms in estrogen receptor 1 (ESR1) and estrogen receptor 2 (ESR2) genes in craniofacial measurements. The aim of this study was to evaluate a possible association between polymorphisms in ESR1 (rs2234693 and rs9340799) and ESR2 (rs1256049 and rs4986938) genes with cephalometric measurements in individuals with dentofacial deformities. This cross-sectional study was performed with 158 individuals in the preoperative period of orthognathic surgery. The cephalometric measurements obtained through lateral cephalogram using Dolphin Imaging software. For genetic analysis, the DNA extracted from epithelial cells of the oral mucosa and were genotyped using the real-time polymerase chain reaction. The data found submitted to statistical analysis, through the Kolmogorov-Smirnov, Mann-Whitney, and Kruskal-Wallis tests, using the IBM SPSS software version 24.0. Considered a significance level of 0.05. We found association between polymorphisms and cephalometric measurements just in the female sex. The polymorphisms ESR1/rs9340799 ( P= 0.003), ESR1/rs2234693 ( P= 0.026), and ESR2/rs1256049 ( P= 0.046) were associated with the upper gonial angle (Ar-Go-N). The polymorphism ESR2/rs1256049 was also associated with the facial axis-rickets (NBa-PtGn) ( P= 0.004), anterior cranial base (SN) ( P= 0.036), and Y-axis (SGn-SN) ( P= 0.031).

Treatment of Class II malocclusion with a customized lingual appliance combined with a Class II corrector.

Correcting a complete Class II malocclusion in an adult patient can be quite difficult. If the patient has a large skeletal discrepancy, orthognathic surgery is the treatment of choice. However, if the discrepancy is small or if the situation is borderline and the mandibular incisors are retroclined, Class II correctors can be used. This clinical report presents the orthodontic treatment of a 24-year-old woman with Class II malocclusion. Clinically, her maxilla was slightly protruded, and the mandible was well-positioned. She had uprighted maxillary and mandibular anterior teeth and a deepbite, and she opted for a more esthetically appealing orthodontic appliance. The treatment plan included leveling and alignment of the teeth in both arches, Class II correction, establishing Class I molar and canine relationships, correction of overbite and overjet, adjustment of midlines, and improvement of facial and dental esthetics. Orthodontic treatment consisted of customized lingual appliances combined with a Class II fixed corrector.

Orthodontic Treatment of Ankylosed Maxillary Incisor through Osteogenic Distraction and Simplified Biomechanics.

Ankylosed teeth may have a significant esthetic and functional impact especially at the anterior segment of the upper arch. Treatment of ankylosed teeth is challenging. The objective of this case report is to describe a clinical case in which an ankylosed tooth was treated with the use of osteogenic distraction associated with simplified orthodontic biomechanics. A 17-year-old female Caucasian patient presented with a Class II malocclusion, severe maxillary dental crowding, moderate mandibular dental crowding, anterior open bite, upper midline deviation to the right, and upper right central incisor in infraocclusion due to ankylosis. Treatment involved the use of the ankylosed tooth as anchorage for the distalization of the right upper segment to correct the Class II malocclusion and to create space prior to surgery. After one week of surgical osteotomy, traction of the tooth and bone segment was initiated with the use of intermaxillary elastics. The ankylosed tooth was moved to the desired position. Bone formation and mucogingival tissue adaptation were observed. Thus, esthetic and functional improvement was achieved. Osteogenic distraction associated with simplified orthodontic biomechanics is an alternative to the treatment of ankylosed teeth which can replace the use of distractor screws, making treatment simpler and more accessible.

Three-dimensional airway changes after adenotonsillectomy in children with obstructive apnea: Do expectations meet reality?

INTRODUCTION: The assessment of the volumetric changes of the airways after adenotonsillectomy has gained popularity among orthodontists, but the validity of such evaluation is not clear. METHODS: Thirty patients with obstructive sleep apnea diagnosed with the use of polysomnography (PSG) were evaluated according to the Apnea and Hypopnea Index (AHI), the obstructive apnea index (OAI), the oxygen desaturation index (ODI), the lowest oxygen saturation (LSpO2), and the average oxygen saturation (ASpO2). The volume and the minimal cross-section of lower (oropharynx and velopharynx) and upper (nasopharynx) spaces of the airways were calculated. Patients were adenotonsillectomized; posttreatment data were collected after 12 months. Thirty comparison patients also had the volume of airways evaluated. RESULTS: A statistically significant improvement (P < 0.05) of most PSG parameters was observed after adenotonsillectomy: AHI from 14.5 to 5.2, OAI from 9.4 to 5.5, ODI from 14.6 to 6.5, and LSpO2 from 77% to 94%). A significant increase in airway volume of the lower space (from 2571.5 mm3 to 5276.3 mm3) and the upper space (from 726 mm3 to 1056.9 mm3), as well as in the minimal cross-section of the airways (from 98.5 mm2 to 335.8 mm2) was found in adenotonsillectomy patients. No significant volumetric changes of the airways were observed in the comparison patients. No significant correlation was found between PSG parameters and the dimensions of the airways before adenotonsillectomy. No significant correlation was found between changes of the PSG parameters and changes of the dimensions of the airways 12 months after the adenotonsillectomy. CONCLUSIONS: Adenotonsillectomy contributed to the increase of the airway volume and minimal cross-section, and to the improvement of the PSG parameters, but there was no correlation between the magnitude of the anatomic changes and the improvement of the breathing mode.

Dentoalveolar evaluation of lower incisors by cbct after treatment with herbst appliance

Abstract This study aimed to evaluate the effects of the Herbst appliance on the proclination and protrusion of the lower incisors, and to verify if the device causes alveolar bone loss in the anterior region of the mandible. This is a retrospective study. The sample consisted of 35 individuals. The treatment group consisted of 22 individuals (8 girls and 14 boys; initial mean age of 8.2 years) who used the Cantilever Herbst appliance for a period of 12 months. The control group consisted of 13 individuals (3 girls and 10 boys; initial mean age of 8.9 years) who received no treatment and were followed up for a period of approximately 18 months. Cone-beam computed tomography scans were performed at the beginning and at the end of the observational period. The medullary bone thickness (MT), buccal cortical bone thickness (BCT), lingual cortical bone thickness (LCT), and lower incisors proclination and protrusion were evaluated. Data were submitted to statistical analysis (ANCOVA and Student's t-test) with a significance level of 5%. There was no significant difference in MT, BCT, LCT and incisor proclination between groups. Incisor proclination increased in the treated group with no statistical significance. The treatment group showed a significant increase in the protrusion of the incisors (p = 0.02). The Herbst appliance promoted a small proclination and protrusion of the lower incisors, without relevant clinical implications. The Herbst appliance did not cause bone loss in the anterior region of the mandible during Class II treatment.

Resumo O objetivo deste estudo foi avaliar os efeitos do aparelho de Herbst na proclinação e protrusão dos incisivos inferiores, bem como verificar se o aparelho causa perda óssea alveolar na região anterior da mandíbula. Trata-se de um estudo retrospectivo. Foi utilizada uma amostra de 35 indivíduos. O grupo tratado foi formado por 22 indivíduos (8 meninas e 14 meninos; idade média inicial de 8,2 anos) que utilizaram o aparelho de Herbst com Cantilever por um período de 12 meses. O grupo controle foi composto por 13 indivíduos (3 meninas e 10 meninos; idade média inicial de 8,9 anos) que não receberam tratamento e foram acompanhados por um período de aproximadamente 18 meses. Exames de tomografia computadorizada de feixe cônico foram realizados no início e no final do período observacional. Foram avaliadas a espessura óssea medular (EM), espessura óssea cortical vestibular (ECV), espessura óssea cortical lingual (ECL), proclinação e protrusão dos incisivos inferiores. Os dados foram submetidos a análise estatística (ANCOVA e teste t de Student) com nível de significância de 5%. Não houve alteração estatisticamente significativa na EM, ECV, ECL e proclinação dos incisivos entre os grupos. Houve um aumento na proclinação dos incisivos no grupo tratado, sem significância estatística. O grupo tratado apresentou aumento significativo na protrusão dos incisivos (p=0,02). O aparelho de Herbst promoveu uma pequena proclinação e protrusão dos incisivos inferiores, sem implicações clínicas relevantes. O aparelho de Herbst não causou perda óssea na região anterior da mandíbula durante o tratamento da Classe II.

Twenty-year clinical experience with fixed functional appliances

ABSTRACT Introduction: Considering the large number of fixed functional appliances, choosing the best device for your patient is not an easy task. Objective: To describe the development of fixed functional appliances as well as our 20-year experience working with them. Methods: Fixed functional appliances are grouped into flexible, rigid and hybrid. They are different appliances, whose action is described here. Four clinical cases will be reported with a view to illustrating the different appliances. Conclusions: Rigid fixed functional appliances provide better skeletal results than flexible and hybrid ones. Flexible and hybrid appliances have similar effects to those produced by Class II elastics. They ultimately correct Class II with dentoalveolar changes. From a biomechanical standpoint, fixed functional appliances are more recommended to treat Class II in dolichofacial patients, in comparison to Class II elastics.

RESUMO Introdução: considerando-se o grande número de aparelhos propulsores mandibulares, não é uma tarefa fácil escolher o melhor deles para o seu paciente. Objetivo: descrever o desenvolvimento desses aparelhos e a experiência clínica de vinte anos dos autores na sua utilização. Métodos: os aparelhos funcionais fixos aqui apresentados foram classificados em flexíveis, rígidos e híbridos, e o modo de ação de cada um deles foi descrito e ilustrado por meio de quatro casos clínicos. Conclusões: os aparelhos propulsores rígidos fornecem mais resultados esqueléticos do que os flexíveis e os híbridos. Esses últimos têm efeito semelhante ao uso de elásticos com direção de Classe II e, basicamente, corrigem a má oclusão de Classe II com alterações dentoalveolares. Do ponto de vista biomecânico, os propulsores fixos estão mais indicados para tratar a Classe II em pacientes dolicofaciais do que os elásticos de Classe II.

Efeito de diferentes métodos de remoção de remanescente adesivo na rugosidade superficial do esmalte após descolagem de bráquetes / Effect of different methods of adhesive remaining removal on enamel surface roughness after bracket debonding

O objetivo deste estudo foi comparar diferentes métodos de remoção do remanescente adesivo após a descolagem de bráquetes em relação à rugosidade superficial do esmalte. Trinta pré-molares com superfície lingual íntegra e sem fraturas foram selecionados. Os dentes foram submetidos à profilaxia com pasta de pedra-pomes e água e fixados individualmente com auxílio de uma morsa à bancada de trabalho. A rugosidade superficial de cada espécime foi medida com auxílio de um rugosímetro. Foram efetuadas três leituras em posições diferentes e a média das leituras foi utilizada. Após a leitura inicial os bráquetes foram colados utilizando a resina Transbond XT, de acordo com as instruções do fabricante. Os espécimes foram armazenados em estufa a 37ºC e 100% de umidade por 24hs. Depois os bráquetes foram removidos e os espécimes foram aleatoriamente distribuídos em 3 grupos (n=10) de acordo com o sistema utilizado para remoção do remanescente adesivo: broca multilaminada 12 lâminas (Jet), pontas de óxido de alumínio (DHPRO) e pontas de fibra de vidro (Fiberglass). Uma segunda leitura de rugosidade foi realizada, seguindo os mesmos parâmetros descritos. Em seguida, os espécimes foram submetidos ao polimento com pasta de pedra-pomes e água e uma terceira leitura foi realizada. Os dados foram submetidos à análise estatística (ANOVA p<0,05). Não houve diferença estatística significativa nos valores de rugosidade superficial entre os grupos (p>0,05), independentemente do momento de avaliação. Conclui-se que os métodos avaliados não interferiram na rugosidade superficial do esmalte, sendo seguros para utilização na remoção do remanescente adesivo. (AU)

The objective of this study was to compare different methods of remaining adhesive removal after bracket debonding in relation to enamel surface roughness. Thirty premolars with intact lingual surface without fractures were selected. The teeth were submitted to prophylaxis with pumice paste and water and then set individually with the aid of a vise to the workbench. Surface roughness of each specimen was measured by a roughness meter. Three readings were performed in different positions and readings average was used as the roughness value for each specimen. After the initial reading brackets were bonded using the Transbond XT resin, according to the manufacturer's instructions. The specimens were stored at 37°C and 100% humidity for 24 hours. After the brackets were removed, the specimens were randomly divided into 3 groups (n=10) according to the system used to remove the remaining adhesive (laminated drill ­ Jet, aluminum oxide tips ­ DHPRO and fiberglass tips ­ Fiberglass). A second roughness reading was performed following the same parameters described. Then the specimens were polished with pumice paste and water and a third reading was performed. Data was subjected to statistical analysis (ANOVA p<0.05). No statistically significant differences in surface roughness values was found among the groups (p>0.05), regardless of evaluation time. It can be concluded that the methods evaluated did not affect the enamel surface roughness and are safe for use when removing the remaining adhesive.(AU)

Correção da má oclusão de Classe II assimétrica utilizando ancoragem absoluta / Asymmetrical Class II malocclusion correction using absolute anchorage

Objective: To evaluate the shear bond strength of passive self-ligating brackets (Tellus EX, Eurodonto) fixed to enamel using different materials and adhesive protocols. Materials and methods: Forty-eight bovine incisors were selected and divided into 6 groups according to the material and the adhesive protocol, as follows: G1 - Orthodontic resin Transbond XT, 3M Unitek (TB) associated to Single Bond 2 adhesive, 3M ESPE (SB2), G2 - TB associated with Ambar adhesive, FGM (AB), G3 - TB without application of adhesive, G4 - Orthodontic resin Orthocem, FGM (OC) associated with SB2, G5 - OC associated with AB and G6 - OC without adhesive application. The brackets were fixed following the manufacturers' instructions and stored in deionized water at 37°C for 24h. After that, the specimens were subjected to shear bond strength test (SBS) in a universal test machine (DL2000, Emic) with a crosshead speed of 0.5 mm/min and evaluated for adhesive remnant index (ARI). The data were submitted to ANOVA two criteria and Tukey's test (α = 0.05). Results: There was statistically significant difference between groups (p<0.05). The combination TB/SB2 (G1) showed significantly higher SBS values than TB/without adhesive (G3) and OC/SB2 (G4), not differing from the other groups. The lowest SBS values were observed for the TB group/without adhesive (G3), which did not differ from OC/SB2 groups (G4) and OC/without adhesive (G6). Conclusion: The use of adhesives before application of orthodontic resin promotes improvement in SBS values, except for the OC material, which can be used without adhesive association, without a significant adhesion reduction.(AU)

Objetivo: Avaliar a resistência de união ao cisalhamento de bráquetes autoligados passivos (Tellus EX, Eurodonto), fixados com diferentes materiais e protocolos adesivos. Material e metódos: Quarenta e oito incisivos bovinos foram selecionados e distribuídos em 6 grupos de acordo com o material e o protocolo adesivo, sendo: G1 - resina ortodôntica Transbond XT, 3M Unitek (TB) associada ao adesivo Single Bond 2, 3M ESPE (SB2), G2 - TB associado ao adesivo Ambar, FGM (AB), G3 - TB sem aplicação de adesivo, G4 - resina ortodôntica Orthocem, FGM (OC) associada a SB2, G5 - OC associado a AB e G6 - OC sem aplicação de adesivo. Os bráquetes foram fixados seguindo as instruções dos fabricantes e armazenados em água deionizada a 37ºC por 24h. Depois, os espécimes foram submetidos ao ensaio de resistência de união cisalhamento (RU) em máquina de ensaio universal (DL2000, Emic) à velocidade de 0,5 mm/min e avaliados quanto ao índice de remanescente adesivo (IRA). Os dados foram submetidos à análise de variância dois critérios e teste de Tukey (α=0,05). Resultados: Houve diferença estatística significativa entre os grupos (p<0,05). A combinação TB/SB2 (G1) apresentou significativamente maiores valores de RU do que TB/sem adesivo (G3) e OC/SB2 (G4), não diferindo dos demais grupos. Os menores valores RU foram observados para o grupo TB/sem adesivo (G3), o qual não diferiu dos grupos OC/SB2 (G4) e OC/sem adesivo (G6). Conclusão: O uso de adesivos antes da aplicação da resina ortodôntica promove melhora nos valores de RU, exceto para o material OC, o qual pode ser utilizado sem associação a adesivo, sem que haja redução significativa da adesão.(AU)

Ortodontia lingual x alinhadores removíveis: quando utilizar / Lingual orthodontics x removable aligners: when to use

A Ortodontia está passando por uma nova fase. Muitos pacientes adultos estão buscando o tratamento atualmente e não querem usar um aparelho convencional. Isso tem feito com que a Ortodontia desenvolva novos métodos de tratamento mais estéticos e também aprimore os já existentes. Duas modalidades de tratamento têm ganhado muito destaque nos últimos anos: a Ortodontia Lingual e os Alinhadores Removíveis. O objetivo deste artigo é descrever a técnica lingual Harmony e os alinhadores removíveis Essix e Clear Aligner, comparando-os e mostrando o tratamento de dois casos clínicos. Para o caso tratado com a técnica Lingual foi escolhido o aparelho Harmony devido à necessidade de grande controle de torque nos incisivos superiores. O caso tratado com alinhadores era um caso simples de recidiva pós-tratamento ortodôntico. Os casos clínicos descritos evidenciaram o papel importante que as novas modalidades de tratamento estético podem ter na Ortodontia contemporânea. Cabe ao ortodontista clínico conhecer essas ferramentas e as utilizar nos casos apropriados.(AU)

Orthodontics is going through a new phase. Many adult patients are currently seeking treatment and do not want to use a conventional device. This has led Orthodontics to develop new aesthetic treatment methods, as well as to improve existing ones. Two treatment modalities have gained much prominence in recent years: Lingual Orthodontics and Removable Aligners. The purpose of this article isx to describe the Harmony lingual technique and the Essix and Clear Aligner removable aligners, comparing them and showing the treatment of two clinical cases. For the case treated with the lingual technique, the Harmony device was chosen due to the need for great torque control in the upper incisors. The case treated with aligners was a simple case of orthodontic posttreatment relapse. The clinical cases described evidenced the important role that the new modalities of aesthetic treatment can have in contemporary Orthodontics. It is up to the clinical orthodontist to know these tools and use them in appropriate clinical cases.(AU)

Effect of Enamel and Dentin Surface Treatment on the Self-Adhesive Resin Cement Bond Strength

Abstract The aim of this study was to evaluate the effect of enamel and dentin surface treatment on the micro-shear bond strength of self-adhesive cement. Seventy-two extracted third molars had their crowns embedded in acrylic resin and worn to obtain a flat enamel or dentin surface. The enamel and dentin specimens were randomly assigned to 8 groups (n=12) that were based on surface treatment (11.5% polyacrylic acid solution or no treatment), substrate condition (wet or dry) and storage period (1 day or 90 days), and treated accordingly. Cylinders (1 × 1 mm) were fabricated using self-adhesive resin cement (RelyX U200) following the manufacturer's instructions. The specimens were stored in distilled water at 37 °C for either 1 day or 90 days and subjected to micro-shear bond strength test (EMIC DL 2000 at 0.5 mm/min). After this, the failure type of the specimens was determined. Data were subjected to statistical analysis (a=0.05). According to the results, the 11.5% polyacrylic acid application decreased the bond strength in both enamel and dentin samples. The moist groups showed higher bond strength than the dry ones, regardless of the substrate and surface treatment. Storage period did not influence bond strength. In conclusion, surface treatment with 11.5% polyacrylic acid and absence of moisture decreased the bond strength of the resin-cement (RelyU200), regardless of the storage period.

Resumo O objetivo do estudo foi avaliar o efeito de tratamentos de superfície em esmalte e dentina na resistência de união (RU) de um cimento auto-adesivo. As coroas de setenta e dois terceiros-molares foram incluídas em resina acrílica e desgastadas para obtenção de áreas planas em esmalte e dentina. Os espécimes de esmalte e dentina foram aleatoriamente distribuídos em 8 grupos (n=12) de acordo com: tratamento de superfície (sem tratamento ou aplicação de solução de ácido poliacrílico a 11,5%), condição do substrato (seco ou úmido) e período de armazenamento (1 dia ou 90 dias). Após, cilindros (1 x 1 mm) foram confeccionados na superfície dos espécimes utilizando cimento resinoso auto-adesivo (Rely X U200) segundo as instruções do fabricante. Os espécimes foram armazenados em água destilada a 37 oC por 1 dia ou 90 dias e submetidos ao ensaio mecânico de microcisalhamento (EMIC DL 2000 a 0,5 mm/min). O tipo de falha de cada espécime foi determinado após ensaio. Os dados foram submetidos à análise estatística (a=0,05). De acordo com os resultados, a aplicação de ácido poliacrílico a 11,5% diminuiu a RU em ambos substratos, esmalte e dentina. Os grupos mantidos úmidos mostraram maiores valores de RU do que os secos, independentemente do substrato ou tratamento de superfície. O período de armazenamento não influenciou nos valores de RU. Concluiu-se que o tratamento de superfície com ácido poliacrílico a 11,5% e a ausência de umidade no substrato diminuíram os valores de RU para o cimento resinoso auto-adesivo, independentemente do período de armazenamento.

Sclerotherapy and cryotherapy in the management of oral vascular lesions: a series of 10 cases.

Vascular anomalies such as hemangiomas or vascular malformations can produce negative esthetic effects in the maxillofacial region. These negative effects are the main complaints of patients. The clinical therapeutic efficacy of cryotherapy and sclerotherapy in the treatment of these lesions was evaluated in 10 patients who were clinically diagnosed with vascular lesions. Lesions were submitted to either cryotherapy or sclerotherapy, and follow-up showed that cryotherapy and sclerotherapy both were clinically effective in treating oral vascular lesions. Cryotherapy is an easy to perform method that requires only 1 session, but the high cost of the equipment is a limiting factor. Sclerotherapy is a noninvasive treatment widely accepted by patients, but more than 1 session is required.

Resistência de união ao microcisalhamento da interface esmalte dentário, adesivo ortodôntico e bráquetes cerâmicos / Micro-shear bond strength of orthodontic adhesives to different ceramic brackets and enamel

Bráquetes cerâmicos estéticos com diferentes microestruturas podem apresentar diferenças em relação à estabilidade da interface de união e remoção. Este estudo objetivou avaliar, por meio de teste de microcisalhamento, a resistência de união entre um adesivo resinoso ortodôntico, o esmalte dentário e dois tipos de bráquetes cerâmico (monocristalino e policristalino). Inicialmente o esmalte de molares humanos foi planificado e preparado para a adesão de cilindros (0,7 mm de diâmetro e 1 mm de altura) do adesivo resinoso Transbond XT (3M, n=10). Em seguida, cilindros do mesmo adesivo foram confeccionados sobre as bases dos dois tipos de bráquetes cerâmicos (Inspire-Ormco e ClarityAdvanced-3M, n=10). Todos os espécimes foram incluídos em cilindros de PVC com resina acrílica para serem submetidos ao ensaio de resistência de união por microcisalhamento em uma máquina de ensaios universal, com velocidade de travessa de 0,5 mm/min até a fratura. Posteriormente, os espécimes foram examinados para a análise de falha. Os resultados de resistência de união foram submetidos à análise de Kruskal-Wallis (α = 0,05). Não houve diferença estatística significante entre as médias dos grupos testados (p = 0,1657). O esmalte apresentou a maior média (10,81 ± 1,85MPa), seguido do ClarityAdvanced (9,35 ± 5,30 MPa) e Inspire (7,77 ± 4,04 MPa). Todos os grupos apresentaram predominantemente a falha do tipo adesiva. Concluiu-se que os bráquetes cerâmicos, independentemente da microestrutura, apresentaram resistência de união semelhante à obtida ao esmalte dentário...

Ceramic brackets with different microstructures may exhibit differences in stability of the bond and removal interface. The aim of this study was to evaluate, via a micro-shear test, the strength of the bond between an orthodontic resin adhesive, the dental enamel, and two types of ceramic brackets (monocrystalline and polycrystalline), respectively. The human molar enamel was flattened and prepared for the 0.7 mm (diameter) ´ 1 mm (height) cylinder adhesion of the resin adhesive Transbond XT (3M, n=10). Cylinders of the same type of adhesive were subsequently built from the two types of ceramic brackets (Inspire-Ormco and ClarityAdvanced-3M, n=10). All of the specimens were then inserted in PVC cylinders with acrylic resin and subjected to bond strength assay by micro-shear in a universal testing machine; loads were applied at a crosshead speed of 0.5 mm/min until the specimens fractured. Afterwards, the specimens were examined for the presence of cracks. The bond strength results were analyzed via the Kruskal-Wallis test (α= 0.05). No statistically significant difference was found among the groups tested (p = 0.1657). In fact, the enamel ClarityAdvanced and Inspire groups had mean bond strengths of 10.81 ± 1.85 MPa, 7.77 ± 4.04 MPa, and 9.35 ± 5.30 MPa, respectively, and all three groups exhibited mainly adhesive-type fractures. It was concluded that ceramic brackets, regardless of the microstructure, exhibit similar bond strength to that of dental enamel...

Reabilitação ortodôntica e protética na agenesia de incisivos laterais superiores com prótese adesiva de fibra de reforço associada ao cerômero – relato de caso / Orthodontic and prosthetic rehabilitation in agenesis of lateral incisors with adhesive reinforcement fiber denture associated with ceromer – case report

O tratamento reabilitador de agenesia de incisivos laterais superiores envolve, quase sempre, uma abordagem interdisciplinar. O presente artigo propõe-se a expor uma solução terapêutica conservadora, através de ortodontia e reabilitação protética, em um caso de agenesia congênita bilateral de incisivos laterais permanentes. A escolha da melhor opção terapêutica, o domínio da mecânica ortodôntica e a utilização da técnica reabilitadora adequada influenciaram na qualidade do resultado do tratamento.

The rehabilitation treatment of agenesis of upper lateral incisors almost always involves an interdisciplinary approach. This article aims to describe a conservative therapeutic solution through orthodontics and prosthetic rehabilitation in a case of congenital bilateral agenesis of permanent lateral incisors. The choice of the best therapeutic option, the handling of orth-odontic mechanics and the use of appropriate rehabilitative technique influenced the quality of treatment outcome.

Shear bond strength of brackets bonded with nanofilled flowable resins

Introduction and Objective : To evaluate the shear bond strength of brackets fixed with different materials (two light-cured nanofilled low-viscosity resins - Transbond Supreme LV and Flow Tain LV and two light-cured traditional resins - Transbond XT and Transbond Plus Color Change) after 10 min and 24 h, and to evaluate the type of failure. Material and methods : Eighty bovine incisors were selected and randomly divided into groups (n = 10) according to the material and fixation period. The brackets were bonded following the manufacturer's instructions and stored in deionized water at 37oC for 10 min or 24 h. After, the specimens were submitted to shear bond strength test at 0.5 mm/min and evaluated for adhesive remnant index (ARI). The data were submitted to Kruskal Wallis and Wilcoxon tests (p < 0.05) and the ARI scores to Chi-Square test. Results: There was a significant difference among the materials (p < 0.05) (after 10 min - Transbond XT > Transbond Plus Color Change > Transbond Supreme LV = Flow Tain LV and after 24 h - Transbond XT > Transbond Plus Color Change = Transbond Supreme LV = Flow Tain LV). There was no significant difference in resistance values between 10 min and 24 h, except for Transbond Plus Color Change. Most groups showed adhesive remaining adhered to the enamel (scores 2 and 3) without statistical significant difference (p > 0.05). Conclusion: The light-cured traditional resins showed higher resistance than the nanofilled materials. The period of fixation had no influence on the resistance for different materials, except for Transbond Plus Color Change.

Effect of Different Surface Treatments for Ceramic Bracket Base on Bond Strength of Rebonded Brackets

The aim of this study was to evaluate the shear bond strength of rebonded ceramic brackets after subjecting the bracket base to different treatments. Seventy-five premolars were selected and randomly distributed into five groups (n=15), according to the type of the bracket surface treatment: I, no treatment, first bonding (control); II, sandblasting with aluminum oxide; III, sandblasting + silane; IV, silica coating + silane; and V, silicatization performed in a laboratory (Rocatec system). The brackets were fixed on an enamel surface with Transbond XT resin without acid etching. The brackets were then removed and their bases were subjected to different treatments. Thereafter, the brackets were fixed again to the enamel surface and the specimens were subjected to shear bond strength (SBS) test. The adhesive remnant index (ARI) was then evaluated for each specimen. Data were subjected to ANOVA and Tukey's tests (α=0.05). A statistically significant difference was observed only between Rocatec and the other groups; the Rocatec group showed the lowest SBS values. The highest SBS values were observed for group 1, without any significant difference from the values for groups II, III and IV. Most groups had a higher percentage of failures at the enamel-resin interface (score 1). It was concluded that the surface treatments of rebonded ceramic brackets were effective, with SBS values similar to that of the control group, except Rocatec group.

O objetivo do estudo foi avaliar o efeito de tratamentos da base de bráquetes cerâmicos monocristalinos na resistência de união ao esmalte após recolagem. Setenta e cinco pré-molares foram selecionados e aleatoriamente distribuídos em 5 grupos (n=15) de acordo com o tratamento da base do bráquete: I - sem tratamento, primeira colagem (controle), II - jateamento com óxido de alumínio, III - jateamento seguido da aplicação de silano, IV - jateamento com partículas de dióxido de sílica (silicatização) seguido de silano, V - silicatização realizada em laboratório (Sistema Rocatec). Os bráquetes foram colados no esmalte com Transbond XT sem condicionamento ácido. Em seguida, os bráquetes foram removidos e suas bases foram submetidas aos diferentes tratamentos. Os bráquetes foram recolados, armazenados por 24 h e submetidos ao ensaio mecânico de cisalhamento com velocidade de 0,5 mm/min. Após, o índice de remanescente adesivo (IRA) foi avaliado em cada espécime. Os dados foram submetidos à análise de variância e teste de Tukey (α=0,05). Pode-se observar que houve diferença significativa apenas entre o sistema Rocatec e os demais grupos, o qual apresentou os menores valores de resistência. Os maiores valores de resistência foram observados para o grupo I (controle), sem diferença significativa dos grupos II, III e IV. A maioria dos grupos apresentou maior porcentagem de falhas na interface esmalte/resina (escore 1). Pode-se concluir que os tratamentos da base do bráquete cerâmico foram efetivos, apresentando valores similares ao grupo controle, exceto para o grupo em que foi usado Rocatec.

Efeitos do aparelho de Herbst: avaliação em 3D / Effects of Herbst appliance: a 3D analysis

O objetivo deste estudo clínico prospectivo foi avaliar os deslocamentos dentoesqueléticos e a remodelação óssea em crianças tratadas com o aparelho de Herbst. A análise das alterações ocorreu através de modelos 3D, e os resultados foram comparados a um grupo-controle não tratado. Foram avaliadas 13 crianças não tratadas (idade média inicial de nove anos) e 13 tratadas com o aparelho de Herbst durante um ano (idade média inicial de 10,6 anos). Os pacientes realizaram tomografias de feixe cônico inicial (T0); após seis meses (T1, apenas para os indivíduos tratados); e no final do período de observação (T2). Modelos 3D foram construídos a partir das tomografias e sobrepostos em relação à superfície da base do crânio. Os deslocamentos das regiões anatômicas de interesse foram visualizados e quantificados (em mm) utilizando mapas coloridos tridimensionais. Os dados foram submetidos à análise estatística de Ancova (p < 0,05). Os mapas coloridos demonstraram que os incisivos superiores em pacientes tratados com o aparelho de Herbst tiveram um menor deslocamento anterior (1,44 mm; +/- 2,36) em relação ao grupo-controle, onde os incisivos superiores foram mais protruídos (3,33 mm; +/- 1,25). A remodelação na região articular foi inexpressiva, menor do que 1 mm. As variáveis da região anterior da maxila e da mandíbula foram estatisticamente insignificantes. Concluiu-se que o aparelho de Herbst não restringiu o crescimento anterior da maxila. Houve maior restrição do deslocamento dos incisivos superiores no grupo tratado do que no grupo-controle. O deslocamento da mandíbula no grupo tratado não foi maior do que no grupo-controle.

The aim of this prospective study was to evaluate the dento-skeletal displacement and bone turnover in children treated with the Herbst appliance. The analysis of the changes was through 3D models and the results were compared to an untreated control group. 13 untreated children (initial age of 9 years) and 13 treated with the Herbst appliance for 1 year (initial mean age 10.6 years) were evaluated. Patients underwent initial cone beam CT (T0), after six months (T1, only for treated individuals) and at the end of the observation period (T2). 3D models were constructed from the scans and superimposed on the surface of the skull base. The displacements of the anatomic regions of interest were visualized and quantified (in mm) using three-dimensional color maps. The data were submitted to statistical analysis Ancova (p < 0.05). The color maps showed that the upper incisors in patients treated with the Herbst appliance had a smaller anterior displacement (1.44 mm; +/- 2.36) than in the control group, where the upper incisors were more protruded (3.33 mm; +/- 1.25). Remodeling the joint region was negligible, less than 1 mm. The variables of the anterior maxilla and mandible were statistically insignificant. It was concluded that the Herbst appliance not restricted forward growth of the maxilla. There was greater restriction of movement of the upper incisors in the treated than in the control group. The displacement of the mandible in the treated group was not higher than in the control group.

Immunoexpression of PPAR-γ and osteocalcin proteins for bone repair of critical-size defects treated with fragmented autogenous abdominal adipose tissue graft.

Immunoexpression of PPAR-γ and osteocalcin proteins was evaluated for bone repair of critical-size defects (CSDs), created in rat calvaria (n=42) and treated with fragmented abdominal autogenous adipose tissue graft. Three groups (n=14) were formed: C (control - blood clot), AB (autogenous bone) and AT (fragmented adipose tissue). The groups were divided into subgroups (n=7) for euthanasia at 30 and 90 days. Histological and immunohistochemical analyses were performed. Data were subjected to descriptive statistics (mode). A complete bone closure was observed in Group AB 90 days after surgery. In Group C, repair was achieved by the formation of collagen fiber bundles oriented parallel to the wound surface at both post-surgery periods. In Group AT the type of healing was characterized by dense connective tissue containing collagen fiber bundles arranged amidst the remaining adipose tissue, with rare heterotopic bone formation associated with fibrosis and different types of tissue necrosis. Immunostaining of PPAR-γ was not observed in any specimen from Groups C and AB. In Group AT, the immunostaining of PPAR-γ was more evident 30 days after surgery. Immunostaining of osteocalcin was present in all groups and at both postoperative periods. The fragmented autogenous abdominal adipose tissue graft did not favor the repair of critical-size bone defects created surgically in rat calvaria as evidenced by the positive immunostaining of PPAR-γ protein and the negative immunostaining of osteocalcin in the osteoblast-like cells and bone matrix.

Immunoexpression of PPAR-? and Osteocalcin Proteins for Bone Repair of Critical-Size Defects Treated with Fragmented Autogenous Abdominal Adipose Tissue Graft

Immunoexpression of PPAR-γ and osteocalcin proteins was evaluated for bone repair of critical-size defects (CSDs), created in rat calvaria (n=42) and treated with fragmented abdominal autogenous adipose tissue graft. Three groups (n=14) were formed: C (control - blood clot), AB (autogenous bone) and AT (fragmented adipose tissue). The groups were divided into subgroups (n=7) for euthanasia at 30 and 90 days. Histological and immunohistochemical analyses were performed. Data were subjected to descriptive statistics (mode). A complete bone closure was observed in Group AB 90 days after surgery. In Group C, repair was achieved by the formation of collagen fiber bundles oriented parallel to the wound surface at both post-surgery periods. In Group AT the type of healing was characterized by dense connective tissue containing collagen fiber bundles arranged amidst the remaining adipose tissue, with rare heterotopic bone formation associated with fibrosis and different types of tissue necrosis. Immunostaining of PPAR-γ was not observed in any specimen from Groups C and AB. In Group AT, the immunostaining of PPAR-γ was more evident 30 days after surgery. Immunostaining of osteocalcin was present in all groups and at both postoperative periods. The fragmented autogenous abdominal adipose tissue graft did not favor the repair of critical-size bone defects created surgically in rat calvaria as evidenced by the positive immunostaining of PPAR-γ protein and the negative immunostaining of osteocalcin in the osteoblast-like cells and bone matrix.

A imunoexpressão das proteínas PPAR-γ e osteocalcina foi avaliada para o reparo ósseo de defeitos de tamanho crítico (DTC) criados em calvária de ratos (n = 42) e tratados com enxerto de tecido adiposo autógeno abdominal macerado. Foram formados três grupos (n=14): C (controlo - coágulo de sangue), AB (osso autógeno) e AT (tecido adiposo fragmentado). Estes grupos foram divididos em subgrupos (n = 7) para a eutanásia em 30 e 90 dias. Foram realizadas análises histológicas e imuno-histoquímico. Os dados foram submetidos à análise estatística descritiva (moda). Um fechamento ósseo completo foi observada no grupo AB 90 dias após a cirurgia. No grupo C a reparação foi alcançada através da formação de feixes de fibras de colágeno orientadas paralelamente à superfície da ferida nos dois períodos pós-operatórios. No Grupo AT, o tipo de cicatrização predominante foi caracterizada pela presença de tecido conjuntivo denso contendo feixes de colágeno de fibras dispostas em meio ao tecido adiposo restante, com raras formações ósseas heterotópicas associada à fibrose e diferentes tipos de necrose tecidual. A imunomarcação do PPAR- γ não foi observada em nenhum espécime dos grupos C e AB. No grupo AT a imunomarcação do PPAR-γ foi mais evidente aos 30 dias de pós-operátorio. A imunomarcação da osteocalcina estava presente em todos os grupos e nos dois períodos de pós-operatório O enxerto autógeno abdominal fragmentado tecido adiposo não favoreceu a reparação de defeitos ósseos de tamanho crítico criados cirurgicamente em calvária de ratos como evidenciado pela imunomarcação positiva da proteína PPAR-γ e a imunomarcação negativa de osteocalcina nos osteoblastos e matriz óssea.

Resistência adesiva de bráquetes ortodônticos sobre resina composta empregando diferentes tratamentos de superfície / Adhesive resistance of orthodontic brackets on composite resin using different surface treatments

O objetivo do presente estudo foi avaliar a resistência de união de bráquetes ortodônticos sobre resina composta após diferentes tratamentos de superfície. Foram confeccionados 60 discos de resina composta (Z100), fixados em cilindros de PVC com resina acrílica e distribuídos aleatoriamente em 6 grupo (n=10) de acordo com o tipo de tratamento de superfície: sem tratamento, sistema Transbond XT (adesivo e resina) (Grupo 1- controle); ácido fosfórico 37% + sistema Transbond XT (Grupo 2); jateamento com óxido de alumínio + sistema Transbond XT (Grupo 3); adesivo Assure (Grupo 4); ácido fosfórico 37% + adesivo Assure e resina Transbond XT (Grupo 5) e jateamento com óxido de alumínio + adesivo Assure e resina Transbond XT (Grupo 6). Todos foram submetidos ao ensaio de resistência ao cisalhamento em uma máquina de ensaio mecânico (Emic DL 2000) a uma velocidade de 0,5 mm/min. Os dados obtidos foram submetidos à análise de variância a dois critérios ANOVA. Os dados não apresentaram diferença entre os grupos avaliados. Conclui-se que sobre a resina Z100 os bráquetes metálicos podem ser colados com sistema Transbond XT ou utilizando o adesivo Assure de forma clinicamente aceitável. O tratamento sobre a resina com ácido fosfórico ou jateamento com óxido de alumínio não favoreceram a adesão.

The aim of this study was to evaluate the bond strength of orthodontic brackets on composite resin after different surface treatments. Sixty composite resin discs (Z100) were fabricated and divided into 6 groups (n = 10) according to different surface treatments: no treatment Transbond XT system (adhesive and resin) (Group 1-control); 37% phosphoric acid gel + Transbond XT system (Group 2); sandblasting with aluminum oxide + Transbond XT system (Group 3); Assure + Transbond XT resin (Group 4); 37% phosphoric acid + adhesive Assure + Transbond XT resin (Group 5); sandblasting with aluminum-oxide + Assure + Transbond XT resin (Group 6). Brackets were fixed with Transbond XT and shear bond strength was tested in a universal testing machine (EMIC DL 2000) at 0.5 mm/min speed. Data were submitted to ANOVA and no significant difference was observed among the groups. It was concluded that when applied on Z100 resin surface metallic brackets bonded using Transbond XT system or Assure have clinic acceptable results. Resin surface treatment with phosphoric acid or sandblasting with aluminum oxide did not favor adhesion.

Complicações clínicas durante o uso do aparelho de Herbst com cantilever e com splint de acrílico removível inferior / Clinical complications during Herbst treatment with cantilever and removable mandibular splint

As quebras do aparelho de Herbst que podem surgir durante o tratamento da má oclusão de Classe II são preocupantes. Da mesma forma que as quebras com os aparelhos fixos geram compromissos adicionais para os pacientes, além do desconforto associado, incluindo também perda de horas de trabalho e tempo. Isso tudo gera custos financeiros adicionais para o consultório e/ou para o paciente e seus responsáveis. A literatura tem mostrado que, independente do desenho do aparelho utlizado, as chances de surgirem complicações durante a utilização do aparelho de Herbst são grandes. Entretanto, isso não deveria desestimular o clínico a utilizar esse tipo de aparelho, pois ele é o aparelho mais eficiente para a correção da Classe com retrognatismo mandibular. O objetivo deste artigo é descrever as principais complicações clínicas observadas com dois tipos de aparelho de Herbst, com cantilever e com splint removível inferior, e sugerir as possíveis soluções para cada situação. As complicações foram classificadas de acordo com o grau de complexidade, em simples e complexas. Após a descrição das complicações e das suas soluções, concluiu-se que é comum a ocorrência de alguma complicação durante o tratamento com o aparelho de Herbst. Sendo assim, o clínico deve estar apto a resolvê-la. Para diminuir as complicações, o aparelho deve ser construído com coroas de aço usando um sistema telescópico sem parafusos. Do ponto de vista clínico, o aparelho de Herbst com cantilever apresenta mais vantagens do que com o splint removível inferior durante a correção da Classe II

The breakages of the Herbst appliance that may arise during the treatment of Class II malocclusion are worrying. Like it happens with breakages of fixed appliances it generates additional appointments; on the loss of work hours and time. Such consequences generate higher costs for the office and/or for the family of the patient. The literature has shown that there are great chances of complications during the use of the Herbst appliance. However, this should not discourage the clinician to use this type of appliance since it is the most efficient on the correction of Class II with mandibular retrognathia. The purpose of this article was to describe the main clinical complications observed on two types of Herbst appliance, with cantilever and with lower removable splint, and suggest possible solutions for each situation. Complications were classified according to the degree of complexity in simple and complex. After a description of the complications and their solutions, it was concluded that it is common the occurrence of complications during the treatment with Herbst appliance. Thus, the clinician should be able to solve them. To minimize these complications, the appliance should be constructed with steel crowns and with a telescopic system without screws. From a clinical standpoint, the Herbst appliance with cantilever presents more advantages than the lower removable splint for the correction of Class II.