Prevalence and extent of Alveolar dehiscence and fenestration in Class I hyperdivergent subjects with different buccolingual inclinations of maxillary molar teeth: a CBCT study

Buccolingual position of teeth could affect the prevalence of alveolar bone defects. Presence of alveolar defects may have a deleterious effect on orthodontic treatment. The aim was to assess the prevalence and extent of dehiscence and fenestration in Class I hyperdivergent subjects and correlate it with buccolingual inclinations(BL) of maxillary first molar teeth. Methods: This retrospective study involved 80 CBCTs of class I hyperdivergent subjects divided into two groups - group A (n=33) buccolingual inclination >9º and group B (n=47) buccolingual inclination <9º. Prevalence and extent of alveolar bone dehiscence and fenestrations were measured in CBCTs using OSIRIX Lite software. Descriptive statistics, Mann Whitney U test and Spearman correlation were done for evaluating intergroup differences and correlation with Buccolingual inclination. Results: Overall prevalence of dehiscence and fenestration in maxillary first molars was 60.95% and 5% respectively. In the buccal alveolar bone, prevalence of dehiscence was highest in group A (84.6%) for 16 and in the lingual alveolar bone prevalence of dehiscence was highest in group B (71.4%) for 26 . On intergroup comparison, the extent of lingual alveolar bone dehiscence (26) in group B was significantly higher (p value <0.05) than in group A. No significant correlation between the extent of dehiscence and fenestration with buccolingual inclination of molar teeth was noted. Conclusion: Molar teeth with BL inclinations of more than 9º had higher prevalence of dehiscence on the buccal side and molar teeth with BL inclinations less than 9 degrees had more dehiscence on the lingual side. But no significant correlation of BL inclination with prevalence and extent of dehiscence and fenestration was noted

Class I and Class II Patients Treated with Damon System: A Study of Transversal, Sagittal and Torque Values Variations

ABSTRACT Objective: To analyze the transversal and anterior-posterior changes obtained in patients treated only with the Damon system. Material and Methods: 51 patients with either class I or class II division 1 sagittal relationship treated with the Damon system and the same archwire sequence were retrospectively selected. Dental casts of each patient before (T0) and after treatment (T1) were scanned and analyzed using NEMOCAST 3D software. Inter-molar, inter first-premolar, inter-second premolar and inter-canine distances were measured in both upper and lower arches. Initial and final lateral cephalograms were traced using the OrisCeph program. Pre and post-treatment measurements were compared using the t-test for repeated measurements. The Pearson Correlation Index and Linear Regression Analysis were used to determine the dependence between continuous variables. The significance level was set at 0.05. Results: Transversal diameters in the upper arch increase statistically significantly, especially in the bicuspid area. Initial intra-arch diameter was the only statistically significant variable correlated with the final expansion obtained. A linear negative correlation between the initial latero-posterior torque and the final expansion was observed in both arches. Conclusion: Using identical arches in patients with very different initial characteristics, the changes in bicuspids' diameters remain the most predominant. Patients with initial more negative torque in the posterior region had a higher expansion amount.

Evaluation of the maximum tongue and lip pressure in individuals with Class I, II, or III Angle malocclusions and different facial types / Avaliação da pressão máxima da língua e dos lábios em indivíduos com má oclusão Classe I, II e III de Angle e diferentes padrões faciais

ABSTRACT Purpose To compare the maximum anterior and posterior tongue pressure, tongue endurance, and lip pressure in Class I, II, and III malocclusions and different facial types. Methods A cross-sectional observational analytical study was carried out in 55 individuals (29 men and 26 women) aged between 18 and 55 years. The participants were divided into groups according to Angle malocclusion (Class I, II, and III) and facial type. The maximum anterior and posterior tongue pressure, tongue endurance, and maximum lip pressure were measured using the IOPI (Iowa Oral Performance Instrument). To determine the facial type, the cephalometric analysis was accomplished using Ricketts VERT analysis as a reference. Results There was no statistically significant difference when comparing the maximum pressure of the anterior and posterior regions of the tongue, the maximum pressure of the lips, or the endurance of the tongue in the different Angle malocclusion types. Maximum posterior tongue pressure was lower in vertical individuals than in mesofacial individuals. Conclusion Tongue and lips pressure, as well as tongue endurance in adults was not associated with the type of malocclusion. However, there is an association between facial type and the posterior pressure of the tongue.

RESUMO Objetivo comparar a pressão máxima anterior e posterior da língua, a resistência da língua e a pressão labial em indivíduos com más oclusões Classe I, II e III e diferentes tipos faciais. Método foi realizado um estudo analítico observacional transversal em 55 indivíduos (29 homens e 26 mulheres) com idades entre 18 e 55 anos. Os participantes foram divididos em grupos de acordo com a classificação de Angle para má oclusão (Classe I, II e III) e tipo facial. A pressão máxima anterior e posterior da língua, a resistência da língua e a pressão máxima dos lábios foram medidas usando o IOPI (Iowa Oral Performance Instrument). Para determinar o tipo facial, a análise cefalométrica foi realizada utilizando como referência a análise Ricketts VERT. Resultados não houve diferença estatisticamente significativa ao comparar a pressão máxima das regiões anterior e posterior da língua, a pressão máxima dos lábios ou a resistência da língua nos diferentes tipos de má oclusão. A pressão máxima posterior da língua foi menor em indivíduos com tipo facial vertical do que nos indivíduos mesofaciais. Conclusão a pressão de língua e lábios, assim como a resistência de língua em adultos não foi associada ao tipo de má oclusão. No entanto, existe uma associação entre o tipo facial e a pressão posterior da língua.

Factors affecting the stability of maxillary extraction site closure

ABSTRACT Introduction: A side effect observed in cases treated with extractions is the instability of orthodontic space closure. Objective: The aim of this study was to investigate the influence of gingival invagination, presence of third molars and facial pattern, on the stability of orthodontic space-closure in the maxillary arch. Methods: Ninety-nine subjects (41 male and 58 female) with Class I malocclusion treated with four premolars extraction were evaluated. Extraction sites reopening and gingival invaginations were evaluated in scanned dental models in the posttreatment and 1-year posttreatment stages (mean age 16.1 years). Third molars presence was evaluated at 1-year posttreatment panoramic radiographs, and the facial pattern (SN.GoGn) was evaluated in the initial lateral headfilms. Multiple logistic regression analysis was used to estimate the influence of the aforementioned independent variables on the frequency of extraction space reopening. Results: Space reopening was observed in 20.20% of the subjects 1-year post-debonding. Gingival invaginations were present in 25.73% of quadrants after debonding and in 22.80% 1-year posttreatment. The mean pre-treatment SN.GoGn was 35.64 degrees (SD=5.26). No significant influence was observed of the three independent variables on the instability of extraction site closure. Conclusions: The presence of gingival invaginations, third molars and facial growth pattern do not seem to influence maxillary extraction sites reopening.

RESUMO Introdução: Um efeito colateral observado nos casos tratados com extrações é a instabilidade do fechamento ortodôntico do espaço. Objetivo: O objetivo do presente estudo foi investigar a influência da invaginação gengival, da presença de terceiros molares e do padrão facial na estabilidade do fechamento ortodôntico dos locais de extração na arcada superior. Métodos: Noventa e nove indivíduos (41 homens e 58 mulheres) com má oclusão de Classe I tratados com extração de quatro pré-molares foram avaliados. A reabertura dos locais de extração e as invaginações gengivais foram avaliadas nos modelos dentários digitalizados nos estágios pós-tratamento e um ano pós-tratamento (idade média de 16,1 anos). A presença dos terceiros molares foi avaliada em radiografias panorâmicas de um ano pós-tratamento, e o padrão facial (SN.GoGn) foi avaliado nas radiografias laterais iniciais. Análise de regressão logística múltipla foi utilizada para estimar a influência das variáveis independentes citadas na frequência de reabertura do espaço de extração. Resultados: A reabertura do espaço foi observada em 20,20% dos sujeitos um ano após a remoção do aparelho. Invaginações gengivais estiveram presentes em 25,73% dos quadrantes após a remoção do aparelho e em 22,80% após um ano pós-tratamento. O SN.GoGn pré-tratamento médio foi de 35,64 graus (DP = 5,26). Não foi observada influência significativa das três variáveis independentes sobre a instabilidade do fechamento do local de extração. Conclusões: A presença de invaginações gengivais, terceiros molares e padrão de crescimento facial não parece influenciar na reabertura dos locais de extração maxilar.

Effect of Conventional Versus Passive Self-Ligating Vestibular Appliances on Torque, Tip and Transverse Dental Changes in Patients Affected by Class I Malocclusion: A Retrospective Study

ABSTRACT Objective: To evaluate the effects of passive self-ligating appliances (PSLAs) and conventional ligating appliances (CLAs) during orthodontic treatment regarding torque, tip, and transversal dental changes. Material and Methods: Dental parameters were digitally acquired from pre- and post-treatment models of each subject belonging to two groups of patients treated with PSLAs (23 patients; 11 females and 12 males with a mean age of 14.2 ± 1.6 years) and CLAs (18 patients; 10 females and 8 males with a mean age of 14.3 ± 1.9 years), respectively. All subjects had Class I or slight Class II malocclusion (= 2mm), permanent dentition and no previous orthodontic treatment. After normality of data was assumed, a paired sample t-test rejected any side differences at T0 and, therefore, the data were grouped by tooth group. Statistical analyses were performed using a linear mixed-effect framework, assuming the appliance, time, and interactions as fixed effects and the tooth type as random effects. Finally, post-hoc effect analysis was used to contrast modeled marginal effects (p<0.05). Results: For both appliances, there is a general increase of both torque and transverse values at T1, especially for PSLAs. Tip shows a general reduction in the lateral sectors for both appliances is registered. The only significant statistical difference referred to appliances' efficacy is located to mandibular intermolar width. Conclusion: Both appliances have an expansive potential for both torque and transverse dental changes. No evident differences are detectable between appliances except for the rate of the mandibular intermolar width increase.

Altering Vertical Dimension: A Literature Review / Alteración de la dimensión vertical: Revisión de la literatur a

The alteration of the vertical dimension it's been a controversial issue for more than 50 years, today is not known an exact protocol to determine what is the right vertical dimension for each person and the appropriate variation to which you can submit a patient without causing any type of joint, muscle, functional or aesthetic alteration. In this review, we show the different concepts and criteria that must be taken into account in order to carry out successful treatments, whether in dentate, partially edentulous or totally edentulous patients to determine a vertical dimension that adapts to each patient through parameters such as facial aesthetics, health of the temporomandibular joint, occlusion and phonetics.

La alteración de la dimensión vertical es un tema controvertido desde hace más de 50 años, al día de hoy no se conoce un protocolo exacto para determinar qué es la dimensión vertical adecuada para cada persona y la variación adecuada de esta a la que se puede alguna vez un paciente sin provocar algún tipo de alteración articular, muscular, funcional o estética. En este artículo de revisión de tema, se muestran los diferentes conceptos y criterios que se deben tener en cuenta para llevar a cabo el éxito los tratamientos que se realizan ya sea en pacientes dentados, editados o totalmente editados para determinar una dimensión vertical que se adaptan a cada paciente mediante parámetros como la estética facial, la salud de la articulación temporomandibular, oclusión y fonética.

Tooth extractions in Orthodontics: first or second premolars?

ABSTRACT Tooth crowding and protrusions demand rigorous attention during orthodontic planning that includes the extraction of first and second premolars. Some characteristics, such as dentoalveolar bone discrepancies, maxillomandibular relations, facial profile, skeletal maturation, dental asymmetries and patient cooperation, are important elements of an orthodontic diagnosis. This study discusses the options of treatments with extractions and describes the correction of a Class I malocclusion, bimaxillary protrusion, severe anterior crowding in both dental arches and tooth-size discrepancy, using first premolar extractions.

RESUMO Apinhamentos e protrusões dentárias têm requerido rigor durante o planejamento ortodôntico envolvendo exodontias de primeiros e segundos pré-molares. Algumas características como discrepância entre dentes e suas respectivas bases ósseas, relacionamento maxilomandibular, perfil facial, maturação esquelética, assimetrias dentárias, patologias e cooperação do paciente têm sido consideradas elementos importantes de diagnóstico ortodôntico. Sendo assim, o presente artigo teve por objetivo discutir as opções de tratamento com extrações dentárias e apresentar a correção de uma má oclusão de Classe I, biprotrusão, com severo apinhamento anterior em ambas as arcadas e discrepância de tamanho dentário, por meio da exodontia de primeiros pré-molares.

Developmental association of palatal dimensions and palatal rugae characteristics in Angle´s classes I, II and III of malocclusion / Asociación de desarrollo de las dimensiones palatinas y las características de las rugas palatinas en las clases I, II y III de maloclusión de Angle

During development, bony changes in the palate are reflected in the palatal rugae. Therefore, we hypothesized that the palatal dimensions (PD) influence the shape and number of palatal rugae (PR). The objectives were to record the palatal rugae characteristics (PRC) and palatal dimensions (intercanine distance (ICD), intermolar distance (IMD), palatal height (PH) and palatal area (PA) in Classes I, II and III malocclusion patients and investigate their interrelationship, and statistically examine the possibility of predicting PRC with the PD. Four hundred eighty-one pre-orthodontic study casts of healthy patients with normal palate anatomy were grouped as Classes I, II and III and scanned using 3D cast scanner. The PRC, ICD, IMD, PH, and PA were recorded digitally using 3D enabled software. The data was statistically analyzed. A strong statistically significant difference was observed between PA and number of straight and wavy rugae. ICD and the number of straight rugae were also related. A weak correlation exists between malocclusion classes and PA. The remaining rugae characteristics did not exhibit any relation with palatal dimensions. PA is positively related to the number of straight rugae and negatively related to the number of wavy rugae. Bigger palates have more straight rugae and less number of wavy rugae. A weak correlation between PA and Angle's class I malocclusion exists. We also propose that PA has a developmental association with the number and shape of PR.

Durante el desarrollo, los cambios óseos en el paladar se reflejan en las rugas palatinas. Por lo tanto, planteamos la hipótesis de que las dimensiones palatinas influyen en la forma y el número de las rugas palatinas. Los objetivos fueron registrar las características de las rugas palatinas y las dimensiones palatales (distancia intercanina, distancia intermolar, altura palatina y área palatina) en pacientes con maloclusión de clases I, II y III e investigar su interrelación, y examinar estadísticamente la posibilidad de predecir las características de las rugas palatinas con las dimensiones palatinas. Cuatrocientos ochenta y un estudios pre-ortodónticos de pacientes sanos con anatomía normal del paladar se agruparon como Clases I, II y III y se escanearon con un escáner de emisión 3D. La distancia intercanina, distancia inter molar, altura palatina y área palatina se registraron digitalmente utilizando el software 3D. Los datos se analizaron estadísticamente. Se observó una diferencia estadísticamente significativa entre la altura palatina y el número de rugas rectas y onduladas. Se registró también la distancia intercanina y el número de rugas rectas. Existe una correlación débil entre las clases de maloclusión y la altura palatina. Las características restantes de las rugas palatinas no mostraron ninguna relación con las dimensiones palatinas. El área palatina está relacionada positivamente con el número de rugas rectas y negativamente relacionada con el número de rugas onduladas. Los paladares más grandes tienen más rugas rectas y menor cantidad de rugas onduladas. Existe una correlación débil entre el área palatina y la clase I de maloclusión de Angle. También proponemos que el área palatina tiene una asociación de desarrollo con el número y la forma de rugas palatinas.

Management of Dento-Maxillary Disharmony in Angle Class I Malocclusion with anterior crowding, midline shifting, and deep bite: A case report

@#Dento-maxillary disharmony is characterized as disproportion between tooth size and dental arch. This case report describes the treatment progress of a patient with dento-maxillary disharmony with Class I malocclusion using fixed orthodontic appliances. The patient is a 19-year-old female who came with chief complaint of crowding and ectopic upper canines. Correction of crowding and deep bite was achieved by fixed appliance with extraction. In Class I malocclusion, severity, etiology, and type of disharmony guide the treatment plan for optimal results.

Deglutition pattern in Angle's Class II malocclusion

ABSTRACT Purpose: to analyze the electromyographic activity of the suprahyoid muscles during deglutition in participants with Angle´s Class II malocclusion. Methods: electromyographic data recordings were performed in the supra-hyoid muscles during swallowing and at rest, in 30 volunteers, 15 Angle´s Class I participants and 15 Angle´s Class II malocclusion, aged 15-27 years old. The Root Means Square values for both tests were analyzed, and for the deglutition test, the Linear Envelope was used to observe the type of muscle activation pattern. Results: during the test at rest, there was no significant difference in Root Means Square values (p=0.22) between Class I and Class II subjects. During deglutition, it was found that Angle´s Class II subjects had significantly higher RMS values (p=0.01) as compared to Class I volunteers. Regarding the type of muscle activation pattern, there was a significant difference between Class I and Class II participants with a predominance of type 1 peak for Class I and type 2 peak for Class II. Conclusion: there was a difference in electromyographic recordings during deglutition in participants with Angle´s Class II as compared to Class I participants with a tendency towards two contraction peaks, showing a greater imbalance during the function. There was no difference between groups in the rest position.

Palatal rugae characteristics and its relationship with Angle class 1, 2 & 3 malocclusions / Características de rugas palatinas y su relación con ángulos de maloclusiónes clase 1, 2 & 3

SUMMARY: The objectives of the study were to, 1. Compare the accuracy of four methods of acquisition of palatal rugae (PR) characteristics (PRC). 2. Study the predominant PRC in Angles Class 1, 2, and 3 malocclusions. 3. To statistically correlate the predominant PRC with Class 1, 2 & 3 malocclusions and thus explore the possibility of utilizing it in predicting malocclusions. Study casts and intraoral 3D scan images (3Shape® Intra-Oral Scanner) of the palate of 104 healthy orthodontic patients were included as Group I and Group II respectively. The casts of Group I were scanned using 3Shape® (Group III) and Sirona inEos X5® (Group IV) cast scanners. PRC for all groups were recorded and PRC of Group I was compared with PRC of Groups II, III and IV for possible matching. 3D images of Group IV were further divided according to Angles classification and predominant PRC analyzed. 97.8 % of PRC match was observed in Group I and Group IV. Wavy and complex rugae were predominant in Class 1 and 3 malocclusions and showed statistically significant difference between Class 1, 2 and 3 malocclusions (p=0.00 and 0.014 respectively) with wavy being higher in Class 1 and complex being higher in Class 3 (LSD Post Hoc analysis). Direct intraoral 3D scanning and 3D scanning of the palatal area of casts are equally reliable methods for PR acquisition for examining PRC. All PRC considered together have a minimal impact on prediction of malocclusions, however, influence of wavy characteristic was maximum.

RESUMEN: Los objetivos del estudio fueron los siguientes: 1. Comparar la precisión de cuatro métodos de adquisición de las características de la rugosidad palatina (CRP). 2. Estudiar las CRP predominantes en maloclusiones clases 1, 2 y 3. 3. Correlacionar estadísticamente las CRP predominantes con maloclusiones clase 1, 2 y 3 e investigar la posibilidad de utilizarlas en la predicción de maloclusiones. Se incluyeron en el Grupo I y en el Grupo II, los moldes de estudio y las imágenes de barrido 3D intraoral (3Shape® Intra-Oral Scanner) del paladar de 104 pacientes ortodónticos sanos. Los escaneos del Grupo I se escanearon utilizando escáner fundidos 3Shape® (Grupo III) y Sirona inEos X5® (Grupo IV). CRP para todos los grupos se registraron y CRP del Grupo I se comparó con las CRP de los Grupos II, III y IV para una posible coincidencia. Las imágenes 3D del Grupo IV se dividieron de acuerdo con la clasificación de ángulos y las CRP predominantes analizadas. Se observó un 97,8 % de concordancia en CRP en los grupos I y IV. Las rugas onduladas y complejas predominaron en las maloclusiones de Clases 1 y 3 y mostraron diferencias estadísticamente significativas entre las maloclusiones de Clases 1, 2 y 3 (p = 0,00 y 0,014 respectivamente), siendo el ondulado más alto en la Clase 1 y el complejo en la Clase 3 (LSD Post Hoc). El escaneo 3D intraoral directo y el escaneado 3D del área palatal son métodos igualmente confiables para la adquisición de CRP para el examen de las CRP. Todas las CRP consideradas en conjunto tienen algún grado de impacto en la predicción de las maloclusiones, sin embargo, fue mayor la influencia de la característica ondulada.

Forma y tamaño del arco dental en poblaciones de tres ascendencias étnicas colombianas / Form and size of the dental arch in populations of three Colombian ethnic ancestries

Introducción: En la actualidad existe poca referencia sobre la configuración de los arcos dentales en poblaciones latinoamericanas y se han descrito múltiples formas y variaciones para dichos arcos que se derivan especialmente de pacientes caucásicos. Objetivo: Describir la forma y tamaño de los arcos dentales de tres poblaciones Colombianas (Mestiza, Indígena, Afrodescendiente) en Condiciones de Normo Oclusión. Materiales y métodos: Estudio descriptivo transversal en 184 modelos distribuidos por la ascendencia étnica identificada a través de sus características morfológicas en 66 indígenas, 70 afrodescendientes y 48 mestizos con edades entre los 11 y 41 años de edad. Las variables estudiadas fueron distancia intercanina, distancia intermolar, longitud anterior del arco, perímetro de arco superior e inferior. Los modelos se fotocopiaron y luego se digitalizaron para posteriormente determinar la forma del arco mediante tres observadores. Resultados: La forma predominante en las 3 etnias es la ovalada. Existe baja concordancia entre la forma de arco maxilar y mandibular en un mismo individuo. Hubo una relación significativa entre la forma de arco superior cuadrada y el grupo étnico indígena. Se encontró diferencia significativa en la distancia intercanina superior en las tres formas de arcos. Conclusión: La forma de arco ovoide es la de mayor prevalencia en todos los grupos étnicos, se encontró una diferencia significativa en el ancho intercanino entre las formas del arco para el arco superior. Hubo una relación significativa entre la etnia indígena y la forma de arco superior cuadrada.

Introduction: At present there is little reference to the configuration of dental arches in Latin American populations and have been described many forms and variations for these arcs are derived especially from Caucasian patients. Objective: Describe the shape and size of the dental arches three Colombian populations (mestizo, indigenous, Afro-descendant) under occlusion Normo. Materials and methods: A cross over 184 models of study according to their racial characteristics and population were divided into 3 groups, 66 Indians, 70 and 48 mestizos African descent aged between 11 and 41 years old. The variables studied were intercanine width, intermolar distance, above the arc length, circumference of upper and lower arch. The photocopies of study models were scanned and subsequently determine the shape of the arc by three observers. Results: The predominant form in the three races is the oval. There is low correlation between maxillary and mandibular arch in the same individual. There was a significant relationship between the arc-shaped square top and Indian ethnicity. There was significant difference in the upper intercanine width between arch forms. Conclusion: The ovoid shaped arched is the most prevalent in all ethnic groups, a significant difference was found in the intercanine width between the arch shapes for the upper arch. There was a significant relationship between indigenous ethnicity and the shape of a square upper arch.

Comparative evaluation of soft tissue changes in Class I borderline patients treated with extraction and nonextraction modalities

Abstract Objective: To compare soft tissue changes in Class I borderline cases treated with extraction and nonextraction modalities. Methods: A parent sample of 150 patients with Class I dental and skeletal malocclusion (89 patients treated with premolar extraction and 61 patients without extraction) was randomly selected and subjected to discriminant analysis which identified the borderline sample of 44 patients (22 extraction and 22 nonextraction patients). Pretreatment and post-treatment cephalograms of the borderline subsample were analyzed using 22 soft tissue parameters. Results: Upper and lower lips were more retracted and thickness of the upper lip increased more in the borderline extraction cases (p < 0.01). The nasolabial angle became more obtuse and the interlabial gap was reduced in the borderline extraction cases (p < 0.01). Lower lip, interlabial gap and nasolabial angle showed no changes in the borderline nonextraction cases. Conclusion: The soft tissue parameters which can be used as guideline in decision making to choose either extraction or nonextraction in Class I borderline cases are upper and lower lip protrusion in relation to the E-plane and Sn-Pg' line, lower lip protrusion in relation to the true vertical line (TVL), upper lip thickness, nasolabial angle and interlabial gap.

RESUMO Objetivo: comparar as alterações sofridas nos tecidos moles em casos limítrofes de Classe I tratados com extrações e sem extrações. Métodos: uma amostra inicial de 150 pacientes com má oclusão esquelética e dentária de Classe I (89 pacientes tratados com extrações de pré-molares e 61 pacientes tratados sem extrações) foi aleatoriamente selecionada e submetida a uma análise discriminante, a qual permitiu selecionar uma amostra de 44 pacientes limítrofes (22 tratados com extrações e 22 tratados sem extrações). Telerradiografias obtidas antes e depois do tratamento dessa subamostra de pacientes limítrofes foram analisadas, utilizando-se 22 grandezas em tecidos moles. Resultados: nos casos limítrofes tratados com extrações, houve maior retração dos lábios superior e inferior e um maior aumento na espessura do lábio superior (p < 0,01); bem como o ângulo nasolabial tornou-se mais obtuso e o espaço interlabial sofreu redução (p < 0,01). Já nos casos limítrofes tratados sem extrações, o lábio inferior, o espaço interlabial e o ângulo nasolabial não apresentaram alterações significativas. Conclusão: as grandezas em tecidos moles que podem ajudar na tomada de decisão entre o tratamento com e sem extrações nos casos limítrofes de Classe I são: protrusão dos lábios superior e inferior em relação ao plano E e em relação à linha Sn-Pg', protrusão do lábio inferior em relação à linha vertical verdadeira (LVV), a espessura do lábio superior, o ângulo nasolabial e o espaço interlabial.

Angle Class I malocclusion with anterior negative overjet

ABSTRACT This clinical case report describes the orthodontic treatment of an 8-year and 9-month old female patient with Angle Class I malocclusion, anterior crossbite and canine Class III relationship. Orthodontic treatment was carried out in two stages. The first one was orthopedic, while the second one included the use of a fixed appliance and the need for space gain for reshaping of maxillary lateral incisors. The two-stage treatment combined with multidisciplinary Restorative Cosmetic Dentistry allowed excellent esthetic and functional outcomes to be achieved. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as a requirement for the title of certified by the BBO.

RESUMO O presente caso clínico relata o tratamento ortodôntico de uma paciente com oito anos e nove meses de idade, portadora de má oclusão de Classe I de Angle, com mordida cruzada anterior e relação de classe III entre os caninos. O tratamento ortodôntico foi realizado em duas etapas, sendo a primeira ortopédica e a segunda constando de aparatologia fixa, havendo necessidade de ganho de espaço para reanatomização dos incisivos laterais superiores. O tratamento em duas etapas, aliado à multidisciplinariedade com a Dentística Restauradora, permitiu a obtenção de excelente resultado final estético e funcional. O presente caso clínico foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO) como parte dos requisitos para obtenção do título de Diplomado pelo BBO.

Treating dental crowding with mandibular incisor extraction in an Angle Class I patient

Mandibular dental crowding often encourages patients to seek orthodontic treatment. The orthodontist should decide between protrusion of incisors or decrease in dental volume so as to achieve proper alignment and leveling. The present study reports the treatment of an Angle Class I malocclusion adolescent female brachyfacial patient with severe mandibular dental crowding, increased curve of Spee and deep overbite. The patient was treated with extraction of a mandibular incisor. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as a requirement for the title of certified by the BBO.

O apinhamento dentário inferior, com frequência, motiva os pacientes a buscarem tratamento ortodôntico. Ao ortodontista cabe a decisão entre protruir os incisivos ou diminuir o volume dentário, a fim de obter o adequado alinhamento e nivelamento. O presente relato aborda o tratamento de uma má oclusão Classe I de Angle, em paciente adolescente, sexo feminino, braquifacial, com severo apinhamento na arcada inferior, curva de Spee e sobremordida aumentadas, e tratada com exodontia de um incisivo inferior. Esse caso clínico foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO) como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

Interproximal wear versus incisors extraction to solve anterior lower crowding: A systematic review

OBJECTIVE: To determine by means of a systematic review the best treatment, whether interproximal wear or incisor extraction, to correct anterior lower crowding in Class I patients in permanent dentition. METHODS: A literature review was conducted using MEDLINE, Scopus and Web of Science to retrieve studies published between January 1950 and October 2013. In selecting the sample, the following inclusion criteria were applied: studies involving interproximal wear and/or extraction of mandibular incisors, as well as Class I cases with anterior lower crowding in permanent dentition. RESULTS: Out of a total of 943 articles found after excluding duplicates, 925 were excluded after abstract analysis. After full articles were read, 13 were excluded by the eligibility criteria and one due to methodological quality; therefore, only fours articles remained: two retrospective and two randomized prospective studies. Data were collected, analyzed and organized in tables. CONCLUSION: Both interproximal wear and mandibular incisor extraction are effective in treating Class I malocclusion in permanent dentition with moderate anterior lower crowding and pleasant facial profile. There is scant evidence to determine the best treatment option for each case. Clinical decision should be made on an individual basis by taking into account dental characteristics, crowding, dental and oral health, patient's expectations and the use of set-up models. .

OBJETIVO: determinar, por meio de uma revisão sistemática, o melhor tratamento entre desgastes interproximais e extração de incisivos para a correção de apinhamento anteroinferior em pacientes Classe I com dentição permanente. MÉTODOS: foram feitas buscas nas bases de dados eletrônicas MEDLINE, Scopus e Web of Science por artigos publicados de janeiro de 1950 até outubro de 2013. Os critérios de inclusão foram estudos que abordassem tratamentos com desgastes interproximais e/ou extração de incisivos inferiores, de casos Classe I com apinhamento anteroinferior na dentição permanente. RESULTADOS: dos 943 artigos encontrados após a remoção dos duplicados, 925 foram excluídos após a leitura dos resumos. Após leitura dos artigos completos, 13 foram excluídos pelos critérios de eligibilidade e um pela qualidade metodológica, restando quatro artigos, sendo dois retrospectivos e dois prospectivos randomizados. Os dados foram coletados, analisados e organizados em tabelas. CONCLUSÕES: tanto o desgaste interproximal quanto a extração de incisivo inferior são tratamentos eficazes em Classe I na dentição permanente, com apinhamento anteroinferior moderado e perfil facial agradável. Há fracas evidências para determinar a escolha do melhor tratamento para cada caso. A decisão clínica deve ser tomada em bases individuais, considerando as características anatômicas dentárias, da severidade do apinhamento, condições de saúde dentária e bucal, expectativas dos pacientes e ensaio em modelos (set-up). .

3M self-locking bracket versus straight wire bracket during orthodontic treatment / 中国组织工程研究

BACKGROUND:Self-locking brackets changed the traditional ligation mode and obviously elevated the sliding mechanism of the teeth and the effect of its spreading during orthodontic treatment, and effectively decreased friction force. OBJECTIVE:To explore the differences of the application of 3M self-locking bracket and traditional straight wire bracket during orthodontic treatment. METHODS:A total of 796 patients receiving orthodontic correction of mild and moderate misaligned teeth, including 398 males and 400 females, at the age of 11-19 years old. 398 patients received 3M SmartClipTM self-ligating bracket braces as observation group. The remaining 398 patients received MBT straight wire appliance. The width of molars, intercanine width, superior anterior tooth convexity and correction were compared between the two groups. RESULTS AND CONCLUSION:The width of premolars and superior anterior tooth convexity were significantly better after correction than that before correction in both groups (P<0.05). Moreover, the correction outcomes were significantly better in the observation group than in the control group (P<0.05). No significant difference in the width of first molar and intercanine width was detected before and after treatment in either group, as wel as between the two groups. Aligned dentition time and the total therapeutic duration were shorter in the observation group than in the control group (P<0.05). These findings indicate that compared with the traditional MBT straight wire bracket braces, expansion arch effect of the 3M SmartClipTM self-ligating bracket braces is obvious;clinical treatment can reduce the rate of extraction cases, and shorten the course of correction.

Tratamento da mordida aberta anterior com a utilização do gancho J / Treatment of open bite using J hook

O presente artigo tem a finalidade de relatar um caso clínico de uma paciente afro-brasileira, dolicofacial, 18 anos de idade, com mordida aberta anterior (MAA) dentoalveolar associada ao hábito de sucção digital. O tratamento ortodôntico consistiu na colocação de um aparelho ortodôntico fixo com bráquetes Edgewise e controle vertical com o uso do Gancho J com puxada alta somente na arcada inferior, com a finalidade de rotação anti-horária da mandíbula e o consequente fechamento da mordida. Simultaneamente, a paciente foi encaminhada para tratamento fonoaudiológico. O tratamento foi finalizado com êxito ao final de 36 meses com a correção da MAA havendo melhora das relações vertical e sagital entre a maxila e a mandíbula, obtenção de estética, equilíbrio e harmonia facial, além das características oclusais e funcionais. Assim, foi possível concluir que após a remoção do hábito de sucção digital é necessário que seja feita uma intervenção multidisciplinar que, neste caso, consistiu numa intervenção ortodôntica associada a um acompanhamento fonoaudiológico. Além disto, o uso de um extrabucal, colocado diretamente no aparelho ortodôntico na arcada inferior (Gancho J) foi primordial no fechamento da mordida, pois houve um controle vertical, o que proporcionou uma rotação mandibular no sentido anti-horário e o consequente fechamento da mordida.

This article aims to report a case of an Afro-Brazilian patient, dolicofacial, 18 years of age, with open bite dentoalveolar associated with digit sucking habit. Orthodontic treatment consisted on a fixed orthodontic appliance with edgewise brackets and vertical control using the J hook with high pull only in the lower jaw for the purpose of anti-clockwise rotation of the mandible and the consequent closing of the bite. Simultaneously, the patient was referred for speech therapy. The treatment was completed successfully at the end of 36 months with the correction of open bite with an improvement of vertical and sagittal relations between the maxilla and the mandible obtaining facial aesthetics and harmony besides the occlusal and functional characteristics. Thus, it was concluded that after breaking digit habit, a multidisciplinary intervention is required.In this case it consisted on an orthodontic intervention associated with a speech therapist. In addition, the use of a headgear placed directly on the archwire, the lower arch in the case was the J hook, was paramount in closing the bite because there was a vertical control which provided a mandibular rotation in a counterclockwise direction and the consequent closing of the bite

Class I malocclusion with severe double rotrusion treated with first premolars extraction

Angle Class I malocclusion with bimaxillary protrusion is characterized by severe buccal tipping of incisors, which causes upper and lower lip protrusion. First premolars extraction is recommended to reduce facial convexity as a result of anterior teeth retraction, which keeps canines and first molars in key to occlusion. In order to yield orthodontic results that are compatible with ideal esthetic and cephalometric outcomes, the space closure phase needs to be carried out with overbite and incisors torque control. The majority of cases also requires maximum anchorage of posterior teeth. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as a requirement for the title of certified by the BBO.

A má oclusão de Classe I de Angle com biprotrusão é caracterizada pela inclinação acentuada dos incisivos para vestibular, o que provoca a protrusão dos lábios superior e inferior. As extrações dos primeiros pré-molares têm sido indicadas para reduzir a convexidade facial com a retração dos dentes anteriores, mantendo a relação de chave de oclusão dos caninos e dos primeiros molares. Para a obtenção de resultados compatíveis com as metas estéticas e cefalométricas idealizadas para o tratamento ortodôntico, é necessário que a fase de fechamento de espaços seja realizada com controle da sobremordida e do torque dos incisivos. Na maioria dos casos, também há necessidade de se proporcionar ancoragem máxima aos dentes posteriores. O presente caso clínico foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO) como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

Bolton ratio in subjects with normal occlusion and malocclusion

AIM: To verify the presence of Bolton anterior and total discrepancy in Brazilian individuals with natural normal occlusion and Angle's Class I and Class II, division 1 malocclusions. METHODS: The sample was divided in three groups (n=35 each): natural normal occlusion; Class I malocclusion; Class II, division 1 malocclusion. Of the 105 Caucasian Brazilian individuals, 24 were boys and 81 were girls aged from 13 to 17 years and 4 months. The mesiodistal width of the maxillary and mandibular teeth, from the left first molar to the right first molar, was measured on each pre-treatment dental plaster cast using a digital caliper accurate to 0.01 mm resolution. Values were tabulated and the Bolton ratio was applied. The Kolmogorov-Smirnov test was used to verify if data were normally distributed (p>0.2). For comparison between the values obtained and those from the Bolton standard, Student's t test was used and one-way ANOVA was used for comparisons among the 3 groups, with a significance level of 5% (p<0.05). RESULTS: For groups 1, 2 and 3, respectively, the total ratio found was 90.36% (SD 1.70), 91.17% (SD±2.58) and 90.76% (SD±2.45); and the anterior ratio was 77.73% (SD 2.39), 78.01% (SD 2.66) and 77.30% (SD 2.65). CONCLUSIONS: There was no significant difference among the groups regarding the values indicated in the Bolton ratio.