Aparatos funcionales preferidos por ortodoncistas en Colombia para tratar maloclusiones clases II y III / Preferred functional appliances among orthodontists in colombia to treat class II and III malocclusions / Aparelhos funcionais preferidos entre ortodontistas na Colômbia para tratar maloclusões de classe II e III

Antecedentes: La preferencia de los ortodoncistas en Colombia en el uso de aparatos funcionales y los factores diagnósticos que pueden influenciar la indicación del clínico de una determinada aparatología no es bien conocidos. Objetivo: Comparar las preferencias en el uso de aparatos funcionales para tratamiento de maloclusiones clases II y III entre un posgrado de ortodoncia y una población de ortodoncistas y evaluar la asociación entre el aparato indicado y las características demográficas y diagnósticas de los pacientes del postgrado de ortodoncia. Métodos: Estudio de corte transversal. Se revisaron 565 historias clínicas, de un programa de posgrado de ortodoncia y 180 encuestas a miembros de la Sociedad Colombiana de Ortodoncia (SCO). Para evaluar asociación se utilizó la prueba Chi2 y prueba t. La significancia estadística fue establecida en P < 0,05. Resultados: En el posgrado de ortodoncia el aparato funcional más utilizado para tratar la maloclusión Clase II fue el Simoes Network (55,42 %) y para Clase III fue el Lázaro (28,95 %). La mayoría de los miembros de la SCO prefiere tratar la maloclusión de Clase II con las Pistas Indirectas Planas (32,78 %) y la Clase III con la Máscara Facial (62,22 %). Se encontraron diferencias estadísticamente significativas (P < 0,05) entre las preferencias de uso de aparatos funcionales por los ortodoncistas de SCO y el postgrado de ortodoncia evaluado. Conclusiones: Los resultados sugieren que la indicación de los aparatos funcionales para el manejo de maloclusiones Clase II y Clase III no solamente está guiada por la maloclusión, sino que también por la formación académica y preferencias individuales de los ortodoncistas.

Background: The preference for the functional appliances to treat Class II and Class III malocclusions by orthodontists in Colombia and their reasons to select them is not well established, yet. Purpose: To compare the preferences in the use of functional appliances to treat Class II and Class III malocclusions between an orthodontic graduate program and the orthodontist members of the Colombian Society of Orthodontists (CSO) and to evaluate the association between the indicated functional appliance and the diagnostic and demographic characteristics of the patients in the orthodontic program. Methods: In this cross-sectional study were reviewed 565 clinical records of the orthodontic graduate program and the survey of 180 members of the CSO. Chi square and t test at a level of significance P < 0.05 were used to compare both groups. Results: the most frequently functional appliance used to treat Class II malocclusion in the orthodontic graduate program was Simoes Network (55, 42 %) and to treat Class III was the Lazaro (28, 95 %). CSO members preferred Planas indirect tracks (32,78 %) to treat Class II and Facial Mask (62,22 %) to treat Class III. Statistically significant differences (P < 0, 05) in the use preference of functional appliances between the orthodontic graduate program and the orthodontist from the CSO were found. Conclusions: The results suggest that the selection of functional appliances to treat Class II and Class III malocclusions is not only guided by the malocclusion but by the orthodontist´s academic background and individual preferences as well.

Antecedentes: A preferência pelos aparelhos funcionais para tratar as más oclusões de Classe II e Classe III por ortodontistas na Colômbia e seus motivos para selecioná-los ainda não está bem estabelecida. Objetivo: Comparar as preferências no uso de aparelhos funcionais para tratamento de más oclusões Classe II e Classe III entre um programa de pós-graduação ortodôntica e os membros ortodontistas da Sociedade Colombiana de Ortodontistas (CSO) e avaliar a associação entre o aparelho funcional indicado e o características diagnósticas e demográficas dos pacientes no programa ortodôntico. Métodos: Neste estudo transversal foram revisados 565 prontuários clínicos do programa de pós-graduação ortodôntica e a pesquisa de 180 membros da OSC. Qui-quadrado e teste t ao nível de significância P <0,05 foram usados para comparar ambos os grupos. Resultados: o aparelho funcional mais frequentemente utilizado para tratar a má oclusão de Classe II no programa de pós-graduação ortodôntica foi a Rede Simões (55, 42%) e para tratar a Classe III foi o Lazaro (28, 95%). Os membros da OSC preferiram as pistas indiretas Planas (32,78%) para tratar a Classe II e a Máscara Facial (62,22%) para tratar a Classe III. Diferenças estatisticamente significantes (P <0,05) na preferência de uso de aparelhos funcionais entre o programa de pós-graduação ortodôntica e o ortodontista da OSC foram encontradas. Conclusões: Os resultados sugerem que a seleção de aparelhos funcionais para tratar as más oclusões de Classe II e Classe III não é guiada apenas pela má oclusão, mas também pela formação acadêmica do ortodontista e preferências individuais.

Comparison Between Nickel and Chromium Levels in Serum and Urine in Patients Treated with Fixed Orthodontic Appliances: A Longitudinal Study

Objective: To compare levels of nickel and chromium in serum and urine in orthodontic patients treated with fixed orthodontic appliances. Material and Methods: Nickel and chromium ion concentration were measured in serum and urine of twenty patients (12 females and 8 males, aged 17-28 years old) who had fixed orthodontic treatment using Coupled Plasma-Atomic Emission Spectroscopy. The samples were taken before treatment (Baseline), two months, and six months later during treatment. Data were analyzed using repeated ANOVA, Bonferroni post-hoc test, and paired t-tests. The level of significance was set at 5%. Results: Average serum nickel level changed from 6.420 ppb to 6.855 ppb. Average serum chromium level changed from 5.305 ppb to 5.505 ppb in 6 months. Average urinary nickel level changed from 5.320 ppb to 5.610 ppb. Average urinary chromium level changed from 5.370 ppb to 5.520 ppb in 6 months. There was a statistically significant difference in serum (p<0.001) and urinary chromium (p=0.007) levels between observation times. Conclusion: Orthodontic treatment might raise both urinary and serum nickel levels, but the differences were not statistically significant; the alterations in chromium levels were not consistent; nickel levels were higher in serum than in urine; chromium levels were higher in urine than in serum.

Satisfacción del uso de brackets metálicos en relación a higiene oral, confort y autopercepción estética / Satisfaction with the use of metal brackets in relation to oral hygiene, comfort and esthetic self-perception

Introducción: aunque el uso de braquets está destinado a mejorar la estética dental, también se asocia a reacciones negativas al requerir de aparatos fijos visibles que alteran la fisonomía, aspectos funcionales y de higiene oral del paciente. Esto podría determinar una baja adherencia al tratamiento ortodóncico. Objetivo: evaluar la satisfacción del paciente con brackets metálicos en relación con la higiene oral, confort y autopercepción estética en la primera y cuarta semana de tratamiento. Métodos: se desarrolló un estudio observacional, longitudinal, prospectivo de base individual. A partir del juicio de tres expertos se construyó un cuestionario de satisfacción para tratamiento ortodóncico basado en 10 preguntas referidas a las dimensiones de higiene oral, confort y autopercepción estética. Del universo de pacientes próximos a comenzar su tratamiento en el Instituto Nacional de Ortodoncia en Santiago de Chile, se estimó una muestra 45 individuos, según los antecedentes descritos por Caniklioglu. Fueron seleccionados por conveniencia, entre mayo y junio de 2012. Los criterios de inclusión consideraron hombres y mujeres mayores de 15 años. Se excluyó a quienes habían mantenido tratamientos ortodóncicos previos o que tuvieran enfermedades invalidantes para responder el cuestionario. Resultados: la confiabilidad final del cuestionario alcanzó un α= 0,769. El cambio en los puntajes entre la primera y segunda medición fue de 8,06 ± 1,65 a 10,82 ± 1,52 puntos en la dimensión de higiene oral; de 10,51 ± 2,2 a 15,42 ± 1,97 puntos en la de confort y de 8,64 ± 1,83 a 11,37 ± 1,64 puntos en la autopercepción estética. El puntaje total fue de 27,2 ± 4,48 puntos en la primera semana de tratamiento y de 37,6 ± 4,02 puntos en la cuarta semana. Conclusiones: el nivel de satisfacción general en pacientes chilenos portadores de braquets metálicos mejora de la primera a la cuarta semana de instalados los aparatos, así como en cada una de sus dimensiones: higiene oral, confort y autopercepción estética(AU)

Introduction: although brackets are intended to improve dental esthetics, they are also associated with negative reactions, due to the need to use visible fixed appliances altering the patient's physiognomy, functional capacity and oral hygiene. This could lead to low adherence to orthodontic treatment. Objective: evaluate patient satisfaction with metal brackets in relation to oral hygiene, comfort and esthetic self-perception in the first and fourth weeks of treatment. Methods: an longitudinal prospective observational study was conducted on an individual basis. Starting from the judgment of three experts, an orthodontic treatment satisfaction questionnaire was developed based on 10 questions about the variables oral hygiene, comfort and esthetic self-perception. From the universe of patients about to start treatment at the National Institute of Orthodontics in Santiago de Chile, a sample of 45 individuals was selected applying the antecedents described by Caniklioglu. Participants were selected by convenience between May and June 2012. All male and female patients aged over 15 years were included, except for those who had undergone previous orthodontic treatment or suffered from conditions preventing them from answering the questionnaire. Results: final reliability of the questionnaire was α= 0.769. Score variation between the first and the second measurement was 8.06 ± 1.65 to 10.82 ± 1.52 points for oral hygiene, 10.51 ± 2.2 to 15.42 ± 1.97 points for comfort and 8.64 ± 1.83 to 11.37 ± 1.64 points for esthetic self-perception. Total score was 27.2 ± 4.48 points for the first week of treatment and 37.6 ± 4.02 points for the fourth week. Conclusions: overall satisfaction among Chilean patients wearing metal brackets improves from the first to the fourth week after installation of the appliance. This applies to all three dimensions: oral hygiene, comfort and esthetic self-perception(AU)

Efeito da amarração em Ortodontia, com ligaduras elastoméricas e de aço inoxidável, na saúde periodontal / Effects of orthodontic ligation-using elastomeric and stainless steel ligatures-on periodontal health

OBJETIVO: o presente estudo avaliou clinicamente as condições periodontais de um grupo teste e um grupo controle utilizando-se os seguintes três sistemas de indexação periodontal: índice de biofilme, índice de sangramento e profundidade de sondagem. MÉTODOS: o grupo teste foi composto por 20 indivíduos com média etária de 13,5 anos, submetido ao tratamento ortodôntico fixo, que recebeu duas formas de ligaduras: a elastomérica e a de aço inoxidável. Os resultados foram comparados entre si e com um grupo controle, sem tratamento ortodôntico, composto de 15 indivíduos com média etária de 15,3 anos. As mensurações foram realizadas previamente ao tratamento ortodôntico (T1) e seis meses após a colocação do aparelho ortodôntico fixo (T2); e, no grupo controle, após seis meses da mensuração inicial (T2). Ambos os grupos foram orientados quanto à higiene bucal, segundo a técnica de Bass, antes do início do tratamento. RESULTADOS E CONCLUSÕES: os resultados das análises das faces dentárias demonstraram um aumento estatisticamente significativo nos índices de biofilme (P=0,000), sangramento gengival (P=0,000) e profundidade de sondagem (P=0,000), quando T1 e T2 e os grupos foram comparados; entretanto, não foram encontradas diferenças estatisticamente significativas entre as ligaduras elastoméricas e de aço inoxidável na avaliação desses índices periodontais.

OBJECTIVE: This study aimed to conduct a clinical evaluation of the periodontal conditions of a test group and a control group using three periodontal indexing systems, namely: dental biofilm index (DBI), bleeding index (BI) and pocket probing depth (PPD). METHODS: The test group consisted of 20 subjects with a mean age of 13.5 years undergoing fixed orthodontic treatment involving the use of two types of ligature: elastomeric ligature (EL) and stainless steel ligature (SSL). The results were compared with a control group without prior orthodontic treatment, comprising 15 subjects with a mean age of 15.3 years. The measurements were performed prior to orthodontic treatment (T1) and six months after placement of a fixed orthodontic appliance (T2); and in the control group, six months after the initial measurement (T2). Both groups were instructed about oral hygiene, according to the Bass technique, before treatment. RESULTS AND CONCLUSIONS: Dental surfaces showed a statistically significant increase in levels of biofilm (P=0.000), gingival bleeding (P=0.000) and probing depth (P=0.000). When the T1 and T2 groups were compared, however, no statistically significant differences were found between EL and SSL in terms of these periodontal indexes.

Bilateral complete cleft lip repair with augmentation of the central vermilion and use of intraoral palatal appliance

Repair of bilateral cleft lip is challenging and many procedures were developed to improve the results and shape of the lip and nose. A presurgical, passive, intraoral orthodontic palatal appliance is used to maintain the arch width to prevent the collapse that occurs with lip repair. The appliance is fitted as soon as possible after the first visit of the patient and removed just before the lip repair. Cheek-to-cheek tape is applied to return back the premaxilla within the palatal arch. Then, the repair reestablishes the skin and muscle continuity after separation of the orbicularis oris muscle from its overlying skin attachment and underlying mucosa. One important feature of the lip is the fullness of the central vermilion which is an important feature in the shape of the upper lip. Augmentation of the central vermilion is done by using a lateral advancement vermilion flap with utilization of the inferior prolabial vermilion for reconstruction of the central part of the vermilion. These studies evaluates the effect of augmentation of the central vermilion by inclusion of the prolabial vermilion in the reconstruction of the central part of the vermilion as regards the final shape of the lip and evaluate the benefit of presurgical intraoral palatal appliance in facilitating lip repair. The study was done on 42 patients. The repair of cleft lip was done at 3-4 months age. Intraoral palatal appliance was applied for all cases from attending the patients up to just prior to lip repair. Cheek to cheek tap for receding back the premaxilla was applied for all patients. Lip repair with orbicularis oris muscle reconstruction and inclusion of the prolabial vermilion in reconstruction of the central part of the vermilion was done 2-4 months following the palatal appliance. The complications as regards appliance application, vermilion thickness or deformity, Cupid's bow feature, dehiscence, incidence of nasolabial fistula, philtrum alignment and palatal expansion or collapse were recorded. Satisfactory results were achieved with this method. The Cupid's bow and the central part of the vermilion appeared more natural with easy lip repair. None of the patients developed dehiscence of the wound or nasolabial fistula. Nine developed noticeable scar and five developed lip discrepancy. Six patients developed contracture of the two lateral philtral scars