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1.
Rev. Odontol. Araçatuba (Impr.) ; 43(supl): 39-45, 2022. ilus, tab, graf
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1399269

RESUMO

O sucesso do tratamento precoce da classe III depende de um bom diagnóstico e da cooperação do paciente na utilização do aparelho extrabucal. Neste trabalho, por meio de um chip (Theramon) instalado na Máscara Facial de Petit da paciente, foi possível monitorar a quantidade de horas que a paciente utilizou o aparelho por dia, durante um período de quatro meses. Paciente do sexo feminino, 7 anos e 11 meses de idade portadora da má oclusão de classe III, utilizou o aparelho de disjunção da maxila (Hyrax) modificado, seguido da Máscara Facial de Petit com chip (Theramon) instalado. A média de uso foi maior do que 11 horas de uso diário. O uso deste dispositivo auxilia no monitoramento do tempo de uso do aparelho, cujo sucesso do tratamento depende da utilização deste pelo paciente(AU)


The success of early treatment of class III depends on a good diagnosis and the cooperation of the patient in the use of the extra oral appliance. In this study, the patient was able to monitor the number of hours the patient used the device per day during a period of four months using a Theramon chip installed in the Patient's Facial Mask. A 7-year, 11-month-old male with Class III malocclusion used the modified maxillary disjunction (Hyrax), followed by the Petit Facial Mask with a Theramon chip installed. The average use was greater than 11 hours of daily use. The use of this device assists in the monitoring of the time of use of the device, whose success of the treatment depends on the use of this by the patient(AU)


Assuntos
Humanos , Feminino , Criança , Prognatismo/terapia , Retrognatismo/terapia , Má Oclusão Classe III de Angle/diagnóstico , Má Oclusão Classe III de Angle/terapia , Prognatismo , Retrognatismo , Técnica de Expansão Palatina , Cooperação do Paciente , Diagnóstico Precoce , Má Oclusão , Má Oclusão Classe III de Angle
2.
J Craniomaxillofac Surg ; 49(10): 898-904, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33994293

RESUMO

The aim of this retrospective study was to compare three-dimensional (3D) soft tissue and hard tissue changes between orthodontics-first approach (OFA) and surgery-first approach (SFA) after mandibular setback surgery. All patients underwent bilateral sagittal split osteotomy, and were examined by lateral cephalograms and 3D optical scanner before surgery (T0) and 1 (T1), 3 (T2), and 12 (T3) months after surgery. Three standard angles (FMA, U1 to FH, IMPA) were measured as hard tissue change and the 2 sets of 3D data were superimposed, and volumetric differences were calculated as soft tissue change. Statistical analyses were performed by using unpaired t-tests. Differences with P < 0.05 were considered significant. A total of 39 patients with mandibular prognathism were included in this study. The OFA group consisted of 24 patients and the SFA group of 15 patients. The SFA group exhibited more labial inclination from T1 to T2 (p = 0.008) and T2 to T3 (p = 0.003) than did the OFA group. There were no significant changes at maxilla and mandible at each term of T0, T1, T2 and T3 (p > 0.05), but compared to before surgery, mandibular volume in SFA group significant increased at 1year (p = 0.049) after surgery. We found that the soft tissue changes after the SFA differed significantly from those after the OFA; thus, soft tissue predictions require more care. An analysis of our data compared with OFA and SFA for the patient with mandibular prognathism confirm that the mandibular soft tissue changes by postoperative orthodontic treatment and occlusal relationship in SFA.


Assuntos
Má Oclusão Classe III de Angle , Ortodontia Corretiva , Prognatismo , Cefalometria , Seguimentos , Humanos , Má Oclusão Classe III de Angle/cirurgia , Má Oclusão Classe III de Angle/terapia , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Maxila , Osteotomia Sagital do Ramo Mandibular , Prognatismo/cirurgia , Prognatismo/terapia , Estudos Retrospectivos , Resultado do Tratamento
3.
J Craniofac Surg ; 30(5): 1556-1559, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31299766

RESUMO

BACKGROUND: To compare the efficacies of botulinum toxin-A injection and dry needling methods in the treatment of patients with myofascial pain syndrome (MPS) in the temporomandibular joint (TMJ). METHODS: In this prospective study, 40 MPS patients (29 women, 11 men) were randomly assigned to abobotulinum toxin-A injection (Group 1, n = 20) or dry needling (Group 2, n = 20) groups. Pain, crepitation, functional limitation, maximum mouth opening, jaw strength were evaluated at baseline and 6 weeks, and the results in both groups were compared. RESULTS: The average age of the authors' patients was 33.8±8.1. There was a remarkable difference between 2 groups regarding visual analog scale for TMJ pain at rest (P = 0.048). The pain at rest was relieved more effectively in Group 2 at the end of 6 weeks. Improvement in jaw protrusion angles on the right (P = 0.009) and left (P = 0.002) sides was more evident in Group 2 after 6 weeks. There were significant pain relief and functional improvement after treatment in both groups. In Group 2, recovery of the TMJ function was more obvious in 6 weeks following dry needling (P = 0.002). CONCLUSION: The authors suggest that abobotulinum toxin-A injection and dry needling yield satisfactory therapeutic outcomes regarding pain relief and restoration of function in patients with MPS involving TMJ. Further multicentric, randomized, controlled trials on larger series are warranted to obtain more accurate and reliable information.


Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Síndromes da Dor Miofascial/tratamento farmacológico , Articulação Temporomandibular/efeitos dos fármacos , Terapia por Acupuntura , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes da Dor Miofascial/terapia , Manejo da Dor , Prognatismo/terapia , Estudos Prospectivos , Resultado do Tratamento , Escala Visual Analógica , Adulto Jovem
4.
J Craniofac Surg ; 30(6): e544-e547, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30939558

RESUMO

This case report introduces a treatment in mandibular prognathism correction by combining the surgery-first (SF) approach and clear aligners. An intraoral scanner (TRIOS 3, 3Shape, Copenhagen, Denmark) and a virtual setup program (OrthoAnalyzer, 3Shape) were used for treatment simulation. All clear aligners were fabricated using a 3-dimensional printer. The total treatment was completed within 3 months after surgery. An immediate improvement of the facial profile was obtained using the SF approach, and rapid and esthetic tooth movement was achieved using clear aligners. This case report demonstrated that the combination of the SF approach and clear aligners could be a patient-oriented surgical-orthodontic treatment method.


Assuntos
Má Oclusão Classe III de Angle/cirurgia , Prognatismo/cirurgia , Humanos , Masculino , Má Oclusão Classe III de Angle/terapia , Aparelhos Ortodônticos Removíveis , Procedimentos Cirúrgicos Ortognáticos , Impressão Tridimensional , Prognatismo/terapia , Técnicas de Movimentação Dentária/métodos , Adulto Jovem
5.
Dent Med Probl ; 55(2): 217-225, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30152628

RESUMO

Saethre-Chotzen syndrome (SCS) belongs to a group of rare congenital disorders connected with craniosynostosis and syndactyly. The purpose of this paper is to provide a review of the literature, to collect all reported symptoms and to describe the case of an 11-year-old female with SCS. The electronic databases PubMed and Scopus were searched to gain all symptoms of SCS described in the literature. The most common features of SCS described in the literature are synostosis of the coronal suture, syndactyly, facial asymmetry, low hairline, prominent ear crus, prominent nasal bridge, eyelid ptosis, and ocular hypertelorism. Less common symptoms include hearing loss, renal abnormalities and cardiac defects. Intraoral manifestations of SCS include maxillary hypoplasia, mandibular prognathism and high arched palate. Moreover, in some patients mental disability is observed, which may be connected with the size of the deletion in the Twist gene. There are no pathognomonic symptoms of SCS, which would indicate a diagnostic problem. Our patient displayed small dysmorphic changes within the skull and limbs and proper intellectual development. On the basis of an intraoral, extraoral examination and X-rays, she was diagnosed with relative mandibular prognathism. Currently, she is treated with a removable appliance. This report emphasizes a considerable variability of symptoms in SCS and highlights the most common features.


Assuntos
Acrocefalossindactilia/complicações , Cefalometria , Criança , Feminino , Humanos , Aparelhos Ortodônticos Removíveis , Fenótipo , Prognatismo/diagnóstico , Prognatismo/etiologia , Prognatismo/terapia , Radiografia Panorâmica
6.
Biomed Res Int ; 2018: 4926528, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29992146

RESUMO

OBJECTIVE: The purpose of the present study was to investigate the improvements of facial profile and postoperative stability by single mandibular setback surgery. MATERIALS AND METHODS: The study included twenty-seven patients who underwent mandibular prognathism correction by sagittal split ramus osteotomy (SSRO). Cephalometric radiograms (lateral and frontal) were collected and analyzed at three intervals: preoperatively (T1), immediately postoperatively (T2), and final follow-up postoperatively (T3). The lateral and frontal cephalometric parameters were measured. The immediate postoperative change (T21), postoperative stability (T32), and final surgical change (T31) were calculated and analyzed. The null hypothesis is that postoperative stability (T32) was not significantly correlated to amount of mandibular setback (T21). RESULTS: The immediate postoperative change (T21) of menton (Me) was significantly backward 8.7 mm. In the final postoperative change (T31), average chin points anterior movements were approximately 0.32 mm. Investigating frontal appearance, inter ramus posterior (InterRp) and intergonion (InterGo) widths were significantly increased with 1.8 and 2.2 mm, respectively. Bilateral ramus angles were not significantly increased, about 1°. The horizontal Me (T32) had significant correlation (p = 0.028) with amount of setback (T21). Therefore, null hypothesis is rejected. CONCLUSION: Postoperative relapse was significantly correlated to the amount of setback. The frontal transverse changes (InterRp and InterGo) were significantly increased.


Assuntos
Bochecha/anatomia & histologia , Prognatismo/terapia , Adulto , Cefalometria , Feminino , Seguimentos , Humanos , Masculino , Má Oclusão Classe III de Angle , Mandíbula , Osteotomia , Osteotomia Sagital do Ramo Mandibular , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
7.
Int J Oral Maxillofac Surg ; 47(8): 1015-1021, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29426739

RESUMO

This study investigated 36 patients at 10-15 years after they had undergone mandibular setback surgery by intraoral vertical ramus osteotomy (IVRO) and subsequent intermaxillary fixation for 6 weeks. The patients completed a 37-item structured questionnaire to evaluate patient satisfaction and possible long-term effects of the treatment. Visual analogue scales were used to measure self-perceived changes in seven items concerning oral function and appearance. Oral health-related quality of life was assessed using the Oral Impacts on Daily Performance (OIDP) index. The main reasons for seeking treatment were to improve chewing function and appearance. The treatment had resulted in significant improvements regarding chewing function, appearance, bullying, and self-confidence in social settings (all P<0.05). All patients were either very satisfied (61%) or reasonably satisfied (39%) with the treatment result. The mean OIDP frequency score was 8.49 on a scale from 8 to 40. Seventy-four percent of the patients reported no oral impacts on quality of life. In conclusion, 10-15 years after combined orthodontic and IVRO surgical treatment of mandibular prognathism, the patients were satisfied, and oral health-related quality of life was reported to be good.


Assuntos
Saúde Bucal , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Satisfação do Paciente , Prognatismo/terapia , Qualidade de Vida , Adolescente , Adulto , Idoso , Terapia Combinada , Feminino , Humanos , Masculino , Osteotomia Mandibular , Pessoa de Meia-Idade , Inquéritos e Questionários , Resultado do Tratamento
8.
J Oral Maxillofac Surg ; 74(12): 2487-2496, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27549608

RESUMO

PURPOSE: To examine and compare the 3-dimensional (3D) postoperative changes of the condylar position after mandibular setback surgery using the orthodontics-first approach (OFA) and surgery-first approach (SFA). MATERIALS AND METHODS: This retrospective cohort study included patients who had undergone bilateral sagittal split ramus osteotomy for mandibular prognathism using OFA or SFA. Computed tomography images were obtained and analyzed preoperatively (T0), postoperatively (T1), and at the 6-month follow-up visit (T2). The bodily shift of the condylar center and rotational movement of the condylar head were measured using the 3D coordinate system between each time point and compared between the OFA and SFA groups. Repeated measures analysis of variance with a Bonferroni post hoc test was used to compare the time course changes of the condylar position for the 2 surgical-orthodontic approaches. RESULTS: A total of 55 patients (mean age 21.9 years; 31 males, 24 females) were evaluated. Of the 55 patients, 29 had undergone OFA and 26, SFA. In both groups, the condyle showed perioperative lateral and inferior displacement with inward rotation, followed by returning to its preoperative position during the 6 months postoperatively. No significant difference was found between the 2 groups in the time course change of the condylar position. CONCLUSIONS: Regardless of the timing of the operation (OFA vs SFA), the perioperative and postoperative changes of the condylar position after mandibular setback surgery are equivalent.


Assuntos
Imageamento Tridimensional , Côndilo Mandibular/diagnóstico por imagem , Ortodontia Corretiva , Osteotomia Sagital do Ramo Mandibular , Prognatismo/terapia , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Período Intraoperatório , Masculino , Côndilo Mandibular/cirurgia , Período Pós-Operatório , Prognatismo/diagnóstico por imagem , Prognatismo/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
9.
Am J Orthod Dentofacial Orthop ; 149(1): 114-26, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26718385

RESUMO

This case report presents the camouflage treatment that successfully improved the facial profile of a patient with a skeletal Class III malocclusion using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy. The patient was an 18-year-old woman with chief complaints of crooked teeth and a protruded jaw. Camouflage treatment was chosen because she rejected orthognathic surgery under general anesthesia. A hybrid type of bone-borne rapid maxillary expander with palatal mini-implants was used to correct the transverse discrepancy, and a mandibular anterior subapical osteotomy was conducted to achieve proper overjet with normal incisal inclination and to improve her lip and chin profile. As a result, a Class I occlusion with a favorable inclination of the anterior teeth and a good esthetic profile was achieved with no adverse effects. Therefore, the hybrid type of bone-borne rapid maxillary expander and a mandibular anterior subapical osteotomy can be considered effective camouflage treatment of a skeletal Class III malocclusion, providing improved inclination of the dentition and lip profile.


Assuntos
Má Oclusão Classe III de Angle/terapia , Osteotomia Mandibular/métodos , Técnica de Expansão Palatina , Prognatismo/terapia , Adolescente , Processo Alveolar/patologia , Dente Pré-Molar/patologia , Cefalometria/métodos , Implantes Dentários , Feminino , Seguimentos , Humanos , Incisivo/patologia , Lábio/patologia , Má Oclusão Classe III de Angle/cirurgia , Maxila/patologia , Miniaturização , Dente Molar/patologia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico , Técnica de Expansão Palatina/instrumentação , Planejamento de Assistência ao Paciente , Prognatismo/cirurgia , Resultado do Tratamento
10.
Int J Orthod Milwaukee ; 26(2): 69-76, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26349294

RESUMO

Nonsurgical orthodontic treatment of a patient with severe skeletal Class III malocclusion, negative overjet, increased overbite and maxillary crowding is described Although the treatment options included an orthodontic-surgical approach, high cost of the surgical procedure was the main reason for extreme dental compensation to have been performed. Four-premolar extraction protocol associated with intermaxillary Class III elastics were used to correct the malocclusion at the expense of increasing the initial dental compensation without producing any noticeable skeletal change. Satisfactory and stable occlusion was achieved with dental and smile esthetics improvement, but the amount of facial changes was limited by the nonsurgical protocol. The clinical results and implications of compensatory treatment as well as its relevance within the patient context are discussed based on scientific evidences.


Assuntos
Má Oclusão Classe III de Angle/terapia , Dente Pré-Molar/cirurgia , Cefalometria/métodos , Estética Dentária , Feminino , Seguimentos , Humanos , Fechamento de Espaço Ortodôntico/instrumentação , Procedimentos Cirúrgicos Ortognáticos , Sobremordida/terapia , Planejamento de Assistência ao Paciente , Preferência do Paciente , Satisfação do Paciente , Prognatismo/terapia , Extração Dentária/métodos , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento , Adulto Jovem
11.
Int J Orthod Milwaukee ; 26(1): 19-24, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25881379

RESUMO

Skeletal Anterior open bite abnormality in adults is probably the most difficult to correct in orthodontics just behind Skeletal Class III abnormality. Literature research shows various techniques to correct this problem, often via orthognathic surgery, but it was difficult to find in the literatures a simplified non-surgical technique. This author propose, a simplified, non-surgical technique to correct skeletal anterior open bite in adults using non-ligating, frictionless brackets and vertical elastics. Some indications and contra-indications will be discussed


Assuntos
Mordida Aberta/terapia , Planejamento de Assistência ao Paciente , Cefalometria/métodos , Feminino , Humanos , Má Oclusão Classe III de Angle/terapia , Mordida Aberta/classificação , Desenho de Aparelho Ortodôntico , Braquetes Ortodônticos , Fios Ortodônticos , Ortodontia Corretiva/métodos , Técnica de Expansão Palatina/instrumentação , Prognatismo/terapia , Retrognatismo/terapia , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento , Adulto Jovem
12.
Aust Orthod J ; 31(2): 226-35, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26999897

RESUMO

OBJECTIVES: To describe a multidisciplinary treatment approach that includes corticotomy, orthodontic force and orthognathic surgery for the management of skeletal Class III surgical cases. The main advantage of the combined techniques is a reduction in treatment time for young adult patients. METHOD: Accelerated Osteogenic Orthodontics (AOO) was delivered to three young adult patients during their pre-surgical orthodontic treatment. After aligning and levelling the dental arches, a piezosurgical corticotomy was performed to the buccal aspect of the alveolar bone. Bone graft materials were used to cover the decorticated area and soft tissue flaps were replaced. RESULTS: The mean time for extraction space closure was 5.4 ± 1.3 months and the mean time for pre-surgical orthodontic treatment was 12.0 ± 0.9 months. The average total treatment time was 20.4 ± 2.4 months. A pre-existing bony fenestration in the buccal cortex adjacent to the right lateral incisor root apex of Case 1 was corrected. CONCLUSION: The facial aesthetics of three patients improved following multidisciplinary treatment. This approach may be an efficient method for the orthognathic patient who desires a reduced treatment time, but further clinical research is required.


Assuntos
Má Oclusão Classe III de Angle/cirurgia , Procedimentos Cirúrgicos Ortognáticos/métodos , Osteogênese/fisiologia , Adolescente , Processo Alveolar/cirurgia , Dente Pré-Molar/cirurgia , Transplante Ósseo/métodos , Cefalometria/métodos , Terapia Combinada , Feminino , Humanos , Masculino , Má Oclusão Classe III de Angle/terapia , Fechamento de Espaço Ortodôntico/métodos , Osteotomia/métodos , Piezocirurgia/métodos , Prognatismo/cirurgia , Prognatismo/terapia , Retrognatismo/cirurgia , Retrognatismo/terapia , Retalhos Cirúrgicos/cirurgia , Extração Dentária/métodos , Resultado do Tratamento , Adulto Jovem
13.
Angle Orthod ; 85(2): 322-34, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25032737

RESUMO

This case report presents the successful use of palatal mini-implants for rapid maxillary expansion and mandibular distalization in a skeletal Class III malocclusion. The patient was a 13-year-old girl with the chief complaint of facial asymmetry and a protruded chin. Camouflage orthodontic treatment was chosen, acknowledging the possibility of need for orthognathic surgery after completion of her growth. A bone-borne rapid expander (BBRME) was used to correct the transverse discrepancy and was then used as indirect anchorage for distalization of the lower dentition with Class III elastics. As a result, a Class I occlusion with favorable inclination of the upper teeth was achieved without any adverse effects. The total treatment period was 25 months. Therefore, BBRME can be considered an alternative treatment in skeletal Class III malocclusion.


Assuntos
Assimetria Facial/terapia , Má Oclusão Classe III de Angle/terapia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico , Técnica de Expansão Palatina/instrumentação , Adolescente , Cefalometria/métodos , Queixo/patologia , Implantes Dentários , Feminino , Humanos , Mandíbula/patologia , Maxila/patologia , Miniaturização , Osso Nasal/patologia , Planejamento de Assistência ao Paciente , Prognatismo/terapia , Fatores de Tempo , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento
14.
Braz. oral res. (Online) ; 29(1): 1-6, 2015. tab, ilus
Artigo em Inglês | LILACS | ID: lil-777208

RESUMO

The objective of this article was to investigate the perception of esthetic changes in the facial profile of bilateral Class II patients treated with the Modified Thurow Appliance for extraoral treatment. Silhouettes were traced of profiles of patients who initially presented a bilateral Class II molar relationship and who, post-treatment, presented molars in a Class I relationship. Three groups were formed: the first composed of patients with maxillary protrusion (SNA >84°), the second with maxillary retrusion (SNA <80°), and the third with a well-positioned maxilla (SNA 80-84°). A panel of 200 lay evaluators judged the profile esthetics by a randomized drawing of the silhouettes. The multiple analysis results showed that the profile esthetic scores for the three positions of the maxilla were greatly influenced by significant interactions with the characteristics (like sex and age) of the evaluators: retrusive maxilla (Score *Age Group, p< 0.001), normal maxilla (Score *Sex, p= 0.024; Score *Age Group,p= 0.050) and protrusive maxilla (Score *Age Group,p< 0.001). It was observed that the profile of Class II patients with protrusion, normal relationship and retrusion of the maxilla, improved in their esthetic post-treatment result; however, the evaluators showed greater satisfaction with the groups of protrusion and normal position of the maxilla. The Modified Thurow Appliance provided significant improvements in the esthetics of the profile of patients who presented protrusion and normal position of the maxilla. However, its use was not the best treatment option for patients with maxillary retrusion.


Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Adulto Jovem , Estética Dentária , Face/anatomia & histologia , Má Oclusão Classe II de Angle/terapia , Aparelhos Ortodônticos , Fatores Etários , Análise de Variância , Cefalometria , Percepção , Prognatismo/terapia , Retrognatismo/terapia , Fatores Sexuais , Resultado do Tratamento
15.
Bull Tokyo Dent Coll ; 55(4): 185-97, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25477036

RESUMO

Change in occlusion and masticatory function after orthodontic treatment was investigated by a follow-up study in a group of 14 patients with malocclusion (3 men, 11 women, aged 12-46 years). All completed a food questionnaire and underwent occlusal force evaluation using a pressure-sensitive sheet at pre-treatment, post-treatment, and during the retention phase. The number of foods identified as difficult to eat decreased at post-treatment in all patients. The mean occlusal force was 646.6±223.5 N at pretreatment, 401.1±109.1 N at post-treatment, and 530.6±183.6 N during the retention phase. The mean occlusal contact area was 14.1±5.9 mm(2) at pre-treatment, 6.5±1.7 mm(2) at post-treatment, and 9.8±3.8 mm(2) during the retention phase. The mean average occlusal pressure was 47.6±6.6 MPa at pre-treatment, 62.2±5.7 MPa at post-treatment, and 55.4±6.7 MPa during the retention phase. A Dental Prescale film evaluation revealed that occlusal force and occlusal contact area increased over the 1-year retention phase. An improvement in level of satisfaction with mastication ability was reported at post-treatment and during the retention phase. Average occlusal pressure at post-treatment increased significantly (p <0.01), which may account for the observed increase in the ability of the patients to bite through food. These results suggest that an increase in average occlusal pressure improves level of satisfaction with mastication ability.


Assuntos
Força de Mordida , Oclusão Dentária , Mastigação/fisiologia , Ortodontia Corretiva , Adolescente , Adulto , Criança , Comportamento Alimentar , Feminino , Seguimentos , Humanos , Masculino , Má Oclusão/terapia , Pessoa de Meia-Idade , Contenções Ortodônticas , Procedimentos Cirúrgicos Ortognáticos/métodos , Sobremordida/terapia , Satisfação do Paciente , Prognatismo/terapia , Extração Dentária/métodos , Adulto Jovem
16.
Am J Orthod Dentofacial Orthop ; 146(2): 249-54, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25085308

RESUMO

Treatment of an impacted maxillary central incisor poses a unique challenge to the orthodontist because of its position within the esthetic zone, requiring careful management of the soft tissues and an effective biomechanical setup for alignment. This article describes a novel method of extending an extrusion wire from cross tubes attached on the base archwire for forced eruption of impacted central incisors. The effectiveness and versatility of this method are demonstrated with 2 patients.


Assuntos
Incisivo/patologia , Extrusão Ortodôntica/métodos , Dente Impactado/terapia , Adolescente , Fenômenos Biomecânicos , Criança , Feminino , Humanos , Incisivo/anormalidades , Má Oclusão Classe III de Angle/terapia , Maxila/patologia , Neoplasias Maxilares/diagnóstico por imagem , Odontoma/diagnóstico por imagem , Desenho de Aparelho Ortodôntico , Extrusão Ortodôntica/instrumentação , Fios Ortodônticos , Técnica de Expansão Palatina/instrumentação , Prognatismo/terapia , Radiografia Interproximal , Raiz Dentária/anormalidades , Dente não Erupcionado/terapia
17.
Dental press j. orthod. (Impr.) ; 19(3): 139-157, May-Jun/2014. graf
Artigo em Inglês | LILACS | ID: lil-723145

RESUMO

INTRODUCTION: Orthodontics, just as any other science, has undergone advances in technology that aim at improving treatment efficacy with a view to reducing treatment time, providing patients with comfort, and achieving the expected, yet hardly attained long-term stability. The current advances in orthodontic technology seem to represent a period of transition between conventional brackets (with elastic ligatures) and self-ligating brackets systems. Scientific evidence does not always confirm the clear clinical advantages of the self-ligating system, particularly with regard to reduced time required for alignment and leveling (a relatively simple protocol), greater comfort for patients, and higher chances of performing treatment without extractions - even though the number of extractions is more closely related to patient's facial morphological pattern, regardless of the technique of choice. Orthodontics has recently and brilliantly used bracket individualization in compensatory treatment with a view to improving treatment efficacy with lower biological costs and reduced treatment time. OBJECTIVE: This paper aims at presenting a well-defined protocol employed to produce a better treatment performance during this period of technological transition. It explores the advantages of each system, particularly with regards to reduced treatment time and increased compensatory tooth movement in adult patients. It particularly addresses compensable Class III malocclusions, comparing the system of self-ligating brackets, with which greater expansive and protrusive tooth movement (maxillary arch) is expected, with conventional brackets Capelozza Prescription III, with which maintaining the original form of the arch (mandibular arch) with as little changes as possible is key to yield the desired results. .


INTRODUÇÃO: a Ortodontia passa, como toda ciência, por constantes evoluções tecnológicas que buscam aumentar a efetividade da abordagem terapêutica, visando a diminuição do tempo de tratamento, o aumento do conforto para os pacientes, bem como a obtenção da tão almejada, e pouco alcançada, estabilidade em longo prazo. O estágio atual de desenvolvimento tecnológico da Ortodontia representa, ao que tudo indica, uma fase de transição entre os sistemas convencionais de ligação (com módulos elásticos) e os chamados autoligáveis. As evidências científicas nem sempre consubstanciam a clara percepção clínica das vantagens desse sistema, no que diz respeito a um menor tempo de alinhamento e nivelamento, uma relativa simplificação técnica, maior conforto para os pacientes, além do aumento da capacidade de tratamento sem extrações - embora essa indicação esteja mais ligada à avaliação do padrão morfológico facial, e menos a qualquer escolha técnica. Desde um passado recente e não menos brilhante, a Ortodontia vem utilizando a individualização de braquetes para tratamentos compensatórios, buscando aumentar a efetividade da abordagem terapêutica, com menores custos biológicos e menor tempo de tratamento. OBJETIVO: o presente artigo tem como objetivo apresentar um protocolo bem definido de melhor aproveitamento dessa fase de transição tecnológica, buscando explorar o que cada sistema tem de melhor, principalmente sob a óptica da redução do tempo de tratamento e aumento da capacidade de movimentação dentária compensatória em pacientes adultos. Especificamente, serão abordadas as más oclusões de Classe III compensáveis, usando o sistema de braquetes ...


Assuntos
Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Desenho de Aparelho Ortodôntico , Braquetes Ortodônticos/classificação , Protocolos Clínicos , Cefalometria/métodos , Tomada de Decisões , Arco Dental/patologia , Má Oclusão Classe III de Angle/diagnóstico , Má Oclusão Classe III de Angle/terapia , Mandíbula/patologia , Maxila/patologia , Sobremordida/diagnóstico , Sobremordida/terapia , Planejamento de Assistência ao Paciente , Prognatismo/diagnóstico , Prognatismo/terapia , Tecnologia Odontológica , Fatores de Tempo , Resultado do Tratamento , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos
18.
Am J Orthod Dentofacial Orthop ; 145(5): 672-84, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24785932

RESUMO

Beckwith-Wiedemann syndrome (BWS) is a congenital growth disorder. Children born with BWS develop enlarged organs, including the tongue, a large body, and other signs. A woman with BWS was treated and followed for 30 years. Treatment consisted of tongue reduction, orthopedic and orthodontic treatment, orthognathic surgery, and retention. The patient was first treated when she was 5 years old. Her original orthodontic problems included macroglossia, anterior open bite, anterior crossbite, and a skeletal Class III jaw relationship caused by significant mandibular protrusion. The jaw-base relationships did not improve in the early preadolescent period after phase 1 of orthodontic treatment with a vertical chincap. With the growth spurt accompanying puberty, she developed a severe skeletal Class III jaw relationship and a constricted maxillary arch. Surgically assisted rapid maxillary expansion was performed at 23 years of age to correct the severe discrepancy between the maxillary and mandibular dental arch widths. Then, at 26 years, a LeFort I osteotomy, a horseshoe osteotomy, a bilateral sagittal split ramus osteotomy, and genioplasty were performed after presurgical orthodontic treatment with extraction of the mandibular first molars. Both the facial profile and the occlusion were stable after 6 years of retention. This case report discusses the result of long-term observation of a patient with BWS who underwent tongue reduction, early orthodontic treatment, and surgical-orthodontic treatment.


Assuntos
Síndrome de Beckwith-Wiedemann/terapia , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Síndrome de Beckwith-Wiedemann/cirurgia , Pré-Escolar , Aparelhos de Tração Extrabucal , Feminino , Seguimentos , Mentoplastia/métodos , Glossectomia/métodos , Humanos , Estudos Longitudinais , Macroglossia/cirurgia , Má Oclusão Classe III de Angle/cirurgia , Má Oclusão Classe III de Angle/terapia , Maxila/anormalidades , Mordida Aberta/cirurgia , Mordida Aberta/terapia , Osteotomia de Le Fort/métodos , Osteotomia Sagital do Ramo Mandibular/métodos , Técnica de Expansão Palatina , Planejamento de Assistência ao Paciente , Prognatismo/cirurgia , Prognatismo/terapia , Resultado do Tratamento
19.
Bull Tokyo Dent Coll ; 55(1): 39-47, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24717929

RESUMO

While osteomas often occur in the orofacial area, it is relatively rare for one to occur in the temporomandibular joint area. Here, we report a patient who underwent multidisciplinary treatment including high condylectomy for peripheral osteoma arising in the left mandibular condyle. The patient was a 46-year-old woman with the chief complaint of facial asymmetry. Cephalometric analysis revealed skeletal anterior crossbite due to anterior deviation of the mandible, with chin deviation of 10 mm to the right. A computed tomography scan revealed bone hyperplasia in the mesiodistal and inner areas of the left mandibular condyle, which exhibited outward anterior displacement. Bone scintigraphy showed a circular area of strong radioisotope accumulation with indistinct boundaries, consistent with the lesion in the left mandibular condyle. The above findings led to a diagnosis of skeletal mandibular prognathism with facial asymmetry due to peripheral osteoma originating in the left mandibular condyle. After orthodontic treatment and surgical resection of the tumor and mandibular condyle, preservation and prosthetic treatment were undertaken. A well-balanced facial appearance and good occlusion were achieved.


Assuntos
Assimetria Facial/diagnóstico , Côndilo Mandibular/patologia , Neoplasias Mandibulares/diagnóstico , Osteoma/diagnóstico , Equipe de Assistência ao Paciente , Cefalometria/métodos , Assimetria Facial/terapia , Feminino , Humanos , Má Oclusão Classe III de Angle/diagnóstico , Má Oclusão Classe III de Angle/terapia , Côndilo Mandibular/cirurgia , Neoplasias Mandibulares/cirurgia , Pessoa de Meia-Idade , Osteoma/cirurgia , Prognatismo/diagnóstico , Prognatismo/terapia , Amplitude de Movimento Articular/fisiologia , Tomografia Computadorizada por Raios X/métodos , Técnicas de Movimentação Dentária/métodos
20.
J Oral Maxillofac Surg ; 72(3): 596-602, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24528564

RESUMO

PURPOSE: To quantitatively evaluate lower incisor decompensation and the surrounding periodontal region after augmented corticotomy-assisted surgical orthodontics in patients with Class III malocclusion. MATERIALS AND METHODS: This prospective study enrolled patients with severe Class III malocclusion who underwent augmented corticotomy in the lower anterior region before orthodontic surgery. Cone-beam computed tomograms and lateral cephalograms were obtained before treatment (T0), after presurgical orthodontic treatment (T1), and at removal of the orthodontic surgical appliances (T2). Repeated measures analysis of variance was used to compare variables at each time point: root length (RL), anterior vertical alveolar bone level at the labial side (AVBL), posterior vertical alveolar bone level at the lingual side (PVBL), labial alveolar bone thickness at the apex (LA), lingual alveolar bone thickness at the apex (LP), and angle of the incisor to the mandibular plane (L1-MP). RESULTS: In the 8 subjects studied, RL was maintained from T0 to T2 (P > .05), whereas AVBL and PVBL increased from T0 to T1 (P < .05) and then decreased from T1 to T2 (P < .05). LA and L1-MP increased from T0 to T1 (P < .001) but remained steady from T1 to T2 (P > .05). LP decreased from T0 to T1 (P < .05) but increased from T1 to T2 (P < .05) with no further change. CONCLUSIONS: Augmented corticotomy-assisted surgical orthodontics can achieve adequate tooth decompensation with minimal periodontal side-effects in the lower anterior region in patients with Class III malocclusion.


Assuntos
Má Oclusão Classe III de Angle/cirurgia , Má Oclusão Classe III de Angle/terapia , Osteotomia Mandibular/métodos , Ortodontia Corretiva/instrumentação , Procedimentos Cirúrgicos Ortognáticos , Adolescente , Análise de Variância , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Má Oclusão Classe III de Angle/diagnóstico por imagem , Desenvolvimento Maxilofacial , Odontometria , Osteotomia de Le Fort , Osteotomia Sagital do Ramo Mandibular , Prognatismo/cirurgia , Prognatismo/terapia , Estudos Prospectivos , Estatísticas não Paramétricas , Dimensão Vertical
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