Impact of Early Loss of Lower First Permanent Molars on Third Molar Development and Position

ABSTRACT Objective: To evaluate the effects of unilateral loss of the lower first permanent molar (L6) on the position and development of the lower third molar (L8). Material and Methods: Fifty-four panoramic radiographs of subjects with unilateral loss of L6 were examined. The L8 on the side of the L6 loss was compared with the L8 in the hemiarch without L6 loss (contralateral). The effect of L6 loss on the positioning of L8 was examined in all the samples (n=54), whereas the effect on the development of the third molar was examined in 38 patients with L8 with incomplete root formation. The Signs statistical test was used to evaluate the comparison between loss and contralateral hemiarches. Results: In 20 (37%) of 54 subjects, the L8 was better positioned in the hemiarch with loss of the lower first molar (p<0.001) compared with the control side. In the remaining 34 subjects, no difference was found. When only the L8 considered as impacted on the control side was examined (n=30), the cases with better positioning on the side with L6 loss increased to 66.6% (p<0.001). Conclusion: The loss of lower first molars improves the position of the lower third molar during its active eruption, mainly when the lower third molar is impacted. However, L6 loss does not affect the root development of lower third molars.

In Vitro Study of Tooth Surfaces After Interproximal Enamel Reduction: Extraoral Scanner and SEM Analysis

ABSTRACT Objective To perform a morphological evaluation concerning the extent of interproximal enamel reduction (IPR) with different manual instruments in different types of teeth and a qualitative analysis of enamel surface characteristics at the contact point before and after IPR. Material and Methods 40 freshly extracted, caries-free, and intact human teeth were used for the study (20 bicuspids and 20 incisors) and performed IPR just on the mesial surface. The morphological variation of contact point was evaluated by superimposed the stl file, obtained thanks to an extraoral scanner, at T0 and T1 for each tooth. Two types of strip were used, Intensiv Manual Ortho Strips Coarse/Medium and Steelcarbo Horico Strips. Teeth were then cut lengthwise, removed the most apical root portion and the mesial and distal halves were gilded and observed at different magnifications. Results The morphological variation following stripping mainly depends on the extent of the stripping, while the diameter, the type of strip and the shape of the tooth itself do not appear to be relevant. The 500X and 1500X magnifications allowed to appreciate better the characteristics of the surface of the stripped enamel and the differences with the intact enamel. All teeth treated, independently from the kind of strip used, shows deep marks and grooves in the direction of stripping. In both cases, the enamel appears significantly damaged at great magnifications. Conclusion Stripping always and inevitably leads to a change in the shape of the contact point and is directly correlated to the amount of stripping performed. The use of polishing after the removal of enamel interproximal is necessary in all cases.

Evaluation of the prototype of a new bracket-positioning gauge

ABSTRACT Objective: The purposes of this study were to present a prototype of a bracket-positioning gauge, which makes vertical inclination of the instrument difficult, allowing a reduction of vertical bracket positioning error, and to test its accuracy in bracket positioning by groups of individuals with different clinical experience and in specific groups of teeth. Methods: For the testing of the prototype, four groups of six participants each were used: Group 1 was composed of undergraduate students in the dental school, who had no previous experience in bonding orthodontic attachments; Group 2 was composed of orthodontic graduate students in the dental school; Group 3 consisted of orthodontists with a maximum of 5 years of clinical experience; Group 4 comprised orthodontists with more than 5 years of clinical experience. A typodont was simulated with a Class I crowded malocclusion, which reproduced the same occlusal characteristics for all groups to be bonded. All participants were instructed to bond 0.022×0.028-in Edgewise brackets on the labial surfaces of the upper and lower incisors, canines, and premolars at a height of 4 mm from the incisal edge or the labial cusp tip. Results: Only the mean value of Group 1 showed statistically significant difference in the comparison with the standard measurement. In the groups of teeth, the difference was significant for the premolar and incisor groups. Conclusion: Clinical experience interfered with the accuracy of vertical positioning of orthodontic attachments. As for the groups of teeth, premolars, followed by canines and incisors had the closest mean values to the standard measurement.

RESUMO Objetivos: os objetivos deste estudo foram apresentar um protótipo de posicionador de braquetes ortodônticos que dificulte a inclinação no sentido vertical, possibilitando a redução dos erros de altura no posicionamento desses acessórios; além de testar sua precisão na colagem, realizada por grupos de indivíduos com diferentes tempos de experiência clínica em Ortodontia e em grupos específicos de dentes. Métodos: para os testes do protótipo desenvolvido, quatro grupos de seis participantes foram formados. O Grupo 1 foi composto por alunos do curso de Odontologia sem qualquer prática com colagem em Ortodontia; o Grupo 2, por estudantes em Ortodontia; o Grupo 3, por ortodontistas com menos de cinco anos de experiência clínica; e o Grupo 4, por ortodontistas com mais de cinco anos de experiência clínica em Ortodontia. Em um typodont, foi simulada uma má oclusão Classe I com apinhamento, com as mesmas características para todas as colagens realizadas. Todos os participantes foram instruídos a colar braquetes Edgewise 0,022" x 0,028" na superfície vestibular dos incisivos, caninos e pré-molares superiores e inferiores, na altura de 4mm da borda incisal ou cúspide vestibular. Resultados: somente a média do Grupo 1 apresentou diferença estatisticamente significativa na comparação com a medida padrão. Nos grupos de dentes, a diferença foi significativa para o grupo dos pré-molares e incisivos. Conclusão: o tempo de experiência clínica interferiu na precisão do posicionamento vertical do acessório ortodôntico e, quanto aos grupos de dentes, as médias mais próximas à medida padrão foram dos pré-molares, seguidas pelos caninos e incisivos.

Digital models: How can dental arch form be verified chairside?

ABSTRACT Introduction: Plaster dental casts are routinely used during clinical practice to access maxillary dental arch form and assist on fabrication of individualized orthodontic archwires. Recently introduced, digital model technology may offer a limitation for the obtainment of a dental physical record. In this context, a tool for dental arch form assessment for chairside use is necessary when employing digital models. In this regard, paper print of the dental arch seems thus to be useful. Methods: In the present study, 37 lower arch models were used. Intercanine and intermolar widths and dental arch length measurements were performed and compared using plaster dental casts, digital models and paper print image of the models. Ortho Insight 3D scanner was employed for model digitalization. Results: No statistically significant differences were noted regarding the measurements performed on the plaster or digital models (p> 0.05). Paper print images, however, showed subestimated values for intercanine and intermolar widths and overestimated values for dental arch length. Despite being statistically significant (p< 0.001), the differences were considered clinically negligible. Conclusion: The present study suggests that paper print images obtained from digital models are clinically accurate and can be used as a tool for dental arch form assessment for fabrication of individualized orthodontic archwires.

RESUMO Introdução: os modelos de gesso são usados rotineiramente, durante a prática clínica, para avaliação da forma da arcada inferior e para auxiliar na confecção de arcos ortodônticos individualizados. A tecnologia dos modelos digitais, introduzida recentemente, pode oferecer uma limitação na obtenção de um registro físico da arcada dentária. Assim, quando se utilizam modelos digitais, faz-se necessária uma ferramenta clínica para obtenção da forma da arcada. Com essa finalidade, poderia-se imprimir, em papel, uma imagem da arcada dentária obtida a partir do modelo de gesso. Métodos: nesse estudo, 37 modelos da arcada inferior foram utilizados, nos quais foram realizadas medições das distâncias intercaninos, intermolares e comprimento da arcada; sendo, então, comparadas entre modelos de gesso, modelos digitalizados com um scanner Ortho Insight 3D e imagens impressas em folha de papel A4. Resultados: não foram encontradas diferenças estatisticamente significativas nas medidas realizadas nos modelos de gesso e modelos digitais (p > 0,05). As imagens impressas, contudo, mostraram valores subestimados para as distâncias intercaninos e intermolares, e superestimados para o comprimento da arcada. Apesar de serem estatisticamente significativas (p< 0,001), as diferenças foram consideradas clinicamente insignificantes. Conclusão: o presente estudo sugere que as imagens obtidas por meio dos modelos digitais e impressas em papel são clinicamente acuradas e podem ser utilizadas como uma ferramenta auxiliar na confecção dos arcos ortodônticos individualizados.

High-intensity laser application in Orthodontics

ABSTRACT Introduction: In dental practice, low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are mainly used for dental surgery and biostimulation therapy. Within the Orthodontic specialty, while LLLT has been widely used to treat pain associated with orthodontic movement, accelerate bone regeneration after rapid maxillary expansion, and enhance orthodontic tooth movement, HILT, in turn, has been seen as an alternative for addressing soft tissue complications associated to orthodontic treatment. Objective: The aim of this study is to discuss HILT applications in orthodontic treatment. Methods: This study describes the use of HILT in surgical treatments such as gingivectomy, ulotomy, ulectomy, fiberotomy, labial and lingual frenectomies, as well as hard tissue and other dental restorative materials applications. Conclusion: Despite the many applications for lasers in Orthodontics, they are still underused by Brazilian practitioners. However, it is quite likely that this demand will increase over the next years - following the trend in the USA, where laser therapies are more widely used.

Hacia dónde va la Ortodoncia / Where Orthodontics Goes

Desde el año 400 a.C. que Hipócrates se refería a la integración del organismo como un todo relacionando la forma alargada del cráneo de algunas personas y las arcadas dentales, así como la disposición irregular de los dientes señalando que pudieran ser causantes de dolores de cabeza y sangramiento de las encías; han transcurrido más de 2400 años, a pesar de ello hoy en día muchos especialistas de Ortodoncia no comprenden la importancia de la ortopedia dentofacial y la ortodoncia miofuncional en el tratamiento temprano de las deformaciones dentoalveolares y las malposiciones dentales

Slot 0, 018" ou 0,022": por que existem duas opções ? Um guia para a escolha / The 0.018" or 0.022" slot systems: why two options are available? A guide for indications

The first Edgewise brackets were utilized with gold wire and the slot designed with 0.022" high to present sufficient rigidity. When gold was replaced by stainless steel, cheaper and stiffer, it was proposed to reduce the slot size to 0.018". The two different sizes of brackets are used in contemporary orthodontics and many clinical orthodontists are unaware of the advantages they may have. The aim of this paper is to present, based on the orthodontic literature, the main characteristics influenced by the brackets slot size and compile data to drive orthodontists in choosing the bracket that best meets their clinical needs.

Os primeiros braquetes Edgewise eram utilizados com fios de ouro e concebidos com o slot de 0,022" de altura, para que apresentassem rigidez suficiente. Com a substituição do ouro pelo aço inoxidável, mais barato e mais rígido, foi proposta a redução do slot para 0,018". As duas diferentes dimensões de braquetes são utilizadas na Ortodontia contemporânea e muitos ortodontistas clínicos desconhecem suas vantagens. O objetivo deste artigo foi apresentar, baseando-se na literatura ortodôntica, as principais características influenciadas pelo tamanho do slot dos braquetes e compilar os dados para direcionar o ortodontista na escolha do braquete que melhor atenda às suas necessidades clínicas.

Avaliação da qualidade dos relatos de revisões sistemáticas publicadas em periódicos nacionais ortodônticos / Evaluation of the quality of report of systematic reviews published in Brazilian orthodontic periodicals

As revisões sistemáticas e meta-análises provêm o maior nível de evidência científica e, por este motivo, é necessário que estes estudos sejam reportados com extremo rigor metodológico. Objetivo: Avaliar a qualidade dos relatos de revisões sistemáticas publicadas em periódicos nacionais da área de Ortodontia. Material e métodos: Por meio do uso da palavra-chave “revisão”, e utilização de filtros apropriados, realizaram-se buscas manual e eletrônica por revisões sistemáticas publicadas entre 2000 e 2015 em periódicos ortodônticos brasileiros. Os resultados da busca foram examinados e selecionados, conforme critérios de elegibilidade pré--estabelecidos. A qualidade do relato das revisões selecionadas foi avaliada segundo instrumentos AMSTAR (Assessment of Multiple Systematic Reviews) e PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Resultados: A busca deu origem a 267 estudos, dos quais 39 foram incluídos para análise.Foi observado que as falhas mais comuns se relacionaram à ausência de buscas abrangentes, falha no relato da listagem de artigos excluídos e de variáveis de interesse, relato incompleto ou extração inadequada de dados e a não utilização de instrumentos de avaliação de qualidade. A qualidade no relato não esteve associada ao periódico, mas revisões publicadas em inglês parecem demonstrar maior qualidade. Apesar de a qualidade de relato ter melhorado desde 2000, não se nota tendência de evolução ao longo dos últimos anos.Conclusões: A qualidade dos relatos de revisões sistemáticas publicadas em periódicos ortodônticos nacionais pôde ser considerada de baixa a moderada. Por este motivo, estas ainda são passíveis de melhora significativa.

Systematic reviews and meta-analyses provide the best scientific evidence. Therefore, it is necessary that these studies be accurately reported. Objective: The aim of this study was to evaluate the quality ofthe report of systematic reviews published in Brazilian periodicals on Orthodontics. Material and methods: With the use of the key word “review”, and appropriate search filters, electronic and manual searches were performed in order to locate systematic reviews that were published between 2000 and 2015 in Brazilian periodicals in Orthodontics. Resultant records were examined and selected, according to pre-defined eligibility criteria. The quality of the reports was evaluated after the application of AMSTAR (Assessment of Multiple Systematic Reviews) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta--analyses) assessment tools. Results: Initial search resulted in 267 studies, out of which 39 were includedfor the analysis. It was observed that the most frequent flaws were: non-comprehensive searches, failure tocite excluded studies and the outcomes of interest, incomplete report or inappropriate data extraction, andfailure to use quality assessment tools. The overall quality of the report was not associated to the journal ofpublication, but reviews published in English language seemed to present higher quality. Even though the quality of report improved since 2000, such trend appeared to weaken over the last years. Conclusions: The quality of the report of systematic reviews published in Brazilian periodicals on Orthodontics was consideredas sub-optimal. The refore, these studies are still likely to be significantly improved.

O desafio do tratamento ortodôntico do paciente com fenótipo facial hiperdivergente / The challenge of the orthodontic treatment of the hyperdivergent facial phenotype patient

Objetivo: o artigo visa informar aos profissionais da área de Ortodontia os desafios de se diagnosticare tratar pacientes que apresentem fenótipo facial hiperdivergente. Materiais e métodos: através de revisão sistemática da literatura, via PubMed e Google Acadêmico, identificou-se os melhores artigos, descritivos e experimentais, nas áreas relacionadas. Dessa seleção, 30 artigos foram revisados e discutidos. Resultados: embora a prevalência de fenótipos faciais hiperdivergentes na população dos EUA (por falta de dados referentes à população brasileira) seja bastante pequena, seu diagnóstico e tratamento são desafiadores. Os principais fatores causais envolvidos em seu desenvolvimento são:a) genéticos; b) epigenéticos e; c) ambientais. A postura mandibular tem um papel fundamental no estabelecimento deste tipo facial, e algumas características morfológicas são patognomônicas: a)excessiva altura facial anterior inferior; b) falta de altura facial posterior; c) ângulo goníaco aberto;d) rotação mandibular desfavorável; e) plano oclusal inclinado anteriormente para baixo; f) sínfisementoniana aumentada e fina e; g) ossos corticais mais delgados, tanto na maxila como na mandíbula.Além disso, esses indivíduos apresentam funções respiratória e mastigatória deficientes. Em geral, apresentam mordida aberta anterior e possivelmente mordida cruzada posterior. Conclusão: o estabelecimento do fenótipo facial hiperdivergente é complexo e multifatorial. A ocorrência de fenômenos morfofuncionais severos sequenciais é difícil de ser controlada ou revertida e as possibilidades terapêuticas são, na melhor das hipóteses, limitadas e ainda experimentais.

Goal: the goal of the paper is to inform orthodontic professionals about the challenges to diagnose and to treat patients presenting hyperdivergent facial phenotype. Materials and methods: a systematic review of the literature was conducted using PubMed and Google Academics, and the best descriptive and experimental studies in the related areas were identified. From the initial selection, 30 papers were revised and discussed. Results: although the prevalence of individuals presenting hyperdivergent facial phenotype in the USA population (since no Brazilian epidemiologic is available) is considerably low, diagnosis and treatment are challenging. The major causal factors involved in its development are: a)genetic; b) epigenetic and; c) environmental. The mandibular posture has a fundamental role in the establishment of such facial type, and some morphological features are pathognomonic: a) excessive inferior anterior facial height; b) lack of posterior facial height; c) increased goniac angle; d) un favorable mandibular rotation; e) occlusal plane anterior ly tilted down; f) higher and thinner mandibular symphysisand; g) thinner maxillary and mandibular cortical bones. Furthermore, these individuals present respiratory and masticatory functions deficiences. In general, they present anterior open bite and possibly posterior cross bite. Conclusion: settling of the hyperdivergent facial phenotype is complex and multifactorial. The occurrence of sequential severe morphofunctional phenomena is hardly controlledor reverted, while therapeutic options are limited and still experimental.

Evaluation of fracture torque resistance of orthodontic mini-implants / Resistência de fratura ao torque de mini-implantes ortodônticos

This study sought to assess the fracture torque resistance of miniimplants used for orthodontic anchorage. Five commercially available brands of miniimplants were used (SIN®, CONEXÃO®, NEODENT®, MORELLI®, and FORESTADENT®). Ten miniimplants of each diameter of each brand were tested, for a total 100 specimens. The miniimplants were subject to a static torsion test as described in ASTM standard F543. Analysis of variance (ANOVA) with the Tukey multiple comparisons procedure was used to assess results. Overall, mean fracture strength ranged from 15.7 to 70.4 N·cm. Miniimplants with larger diameter exhibited higher peak torque values at fracture and higher yield strength, regardless of brand. In addition, significant differences across brands were observed when implants were stratified by diameter. In conclusion, larger miniimplant diameter is associated with increased fracture torque resistance. Additional information on peak torque values at fracture of different commercial brands of miniimplants may increase the success rate of this orthodontic anchorage modality.

O objetivo do presente estudo foi avaliar a resistência de fratura ao torque de miniimplantes ortodônticos. Foram utiliza das cinco marcas comerciais (SIN®, CONEXÃO®, NEODENT®, MORELLI® e FORESTADENT®). Para cada diâmetro, de cada marca comercial, foram testados 10 miniimplantes, totalizando 100 amostras. Os miniimplantes foram submetidos a um Ensaio Estático de Torção, conforme a norma técnica ASTM F543. Os resultados foram submetidos à Análise de Variância (ANOVA) complementado pelo teste de compa rações múltiplas de Tukey. Os valores médios de resistência de fratura ao torque variaram de 15,7 a 70,4 N·cm e miniimplantes de maior diâmetro apresentaram maiores valores de torque máximo de fratura e de limite de escoamento, independente da marca comercial. Além disso, foram obser vadas diferenças significativas entre as marcas comerciais quando agrupadas de acordo com o diâmetro. Concluise que miniimplantes de maior diâmetro apresentaram maiores valores de resistência de fratura ao torque. Informações sobre o torque máximo de fratura das diferentes marcas comerciais podem aumentar o índice de sucesso deste método de ancoragem ortodôntica.

Avances en la planificación de casos tratados con ortodoncia y cirugía ortognática. Parte 2 / Advances in planning the cases treated with orthodontics and orthognathic surgery. Part 2

En estos artículos los autores presentan una nueva línea de instrumentos de precisión usados en el procedimiento de laboratorio para la preparación de modelos set-up, corrección de modelos set-up y cirugía de modelos de acuerdo con el plan de tratamiento ortodóncico y quirúrgico. Se describen en este artículo el Set-Up Model Maker (SUM), el Occlusal Plane Reference (OPR) y el Surgical Model Accuracy Device (SMAD), y se explica su utilización a través del tratamiento de un caso clínico con clase III esquelética y mordida abierta...

In these articles the authors introduce a new line of precision instruments used in the laboratory procedure for set-up models preparation, set-up models correction and model surgery according to the orthodontic and surgery treatment plan. The Set-Up Model Maker (SUM), the Occlusal Plane Reference (OPR) and the Surgical Model Accuracy Device (SMAD) are described in this article, and its use is explained through the case report of a treatment of a skeletal class III case with open bite...

La enseñanza-aprendizaje de la asignatura Ortodoncia en la carrera de estomatología en Cuba / The teaching and learning of the subject Orthodontics in the dentistry career in Cuba

Fundamento: La didáctica de las ciencias estomatológicas cubanas acumula experiencias que justifican las características actuales del proceso de enseñanza-aprendizaje en la asignatura Ortodoncia de la carrera de estomatología. Objetivo: Identificar los aspectos históricos que distinguen el proceso de enseñanza-aprendizaje en la asignatura Ortodoncia, en la educación estomatológica cubana. Metodología: Se empleó el método analítico-sintético, el histórico-lógico y el análisis documental con la revisión de bases de datos médicas de reconocido prestigio. Desarrollo: Se logró establecer una secuencia lógica de hechos trascendentes en la enseñanza-aprendizaje de la asignatura Ortodoncia desde sus inicios, cuatro décadas posteriores al comienzo de la estomatología, su evolución con variaciones en la denominación, inclusión de temáticas, ubicación en el plan de estudios e identificación de insuficiencias, presentes en la actualidad Conclusiones: A pesar del perfeccionamiento ascendente aún existen deficiencias en la enseñanza-aprendizaje de la asignatura Ortodoncia que se pueden superar al asumir lo más actual de la didáctica contemporánea.

Background: The didactics of Cuban stomatological sciences accumulates experiences that justify the current characteristics of the teaching-learning process in the subject of Orthodontics in the dentistry career. Objective: To identify the historical aspects that distinguish the process of teaching and learning in the subject of Orthodontics in Cuban stomatological education. Methodology: the analytic-synthetic method, logical and historical method and document analysis with review of medical databases of well-recognized prestige were used. Development: It was possible to establish a logical sequence of significant events in the teaching and learning of the subject of Orthodontics since its inception, four decades after the start of stomatology, its evolution with variations on the name, including themes, location in the study plan and identifying shortcomings, currently present. Conclusions: Despite the ascending improvement there are still shortcomings in the teaching and learning of the subject of Orthodontics that can be overcome by taking the most contemporary of didactic teaching today.

Comparison of two types of biomecanics for deep overbite correction

To compare two types of treatment for Class II deep overbite malocclusion assessing maxillary and mandibular arches behavior in subjects submitted to full orthodontic treatment with standard edgewise appliance and those who used straight wire appliance. METHODS: The sample consisted of 50 patients treated with full fixed appliances either with edgewise appliance n=25, Group 1, or with straight wire appliance n=25, Group 2. In both groups lateral cephalometric radiographs were compared with those done at the beginning of treatment and at its end, in order to quantify the cephalometric measures 8 linear and 6 angular presenting the maxillary and mandibular arches behavior in the anteroposterior and vertical directions. All patients were treated without extraction or use of Class II intermaxillary elastics during the full orthodontic treatment. RESULTS: In both groups the treatment of malocclusion contributed for mandibular forward displacement, reduction of deep overbite and overjet, reduction of mandibular plane with anti-clockwise rotation and labial projection of maxillary incisors. CONCLUSIONS: In both groups the sample showed favorable mandibular displacement, reduction of facial convexity, and profile improvement with anti-clockwise rotation. The correction of deep overbite was due to labial projection and intrusion of maxillary incisors...

Calidad de los servicios de ortodoncia / Quality of orthodontic services

Fundamento: La evaluación de la calidad de los servicios de ortodoncia permite la orientación hacia la mejora. Objetivo: Argumentar los criterios para la evaluación de la calidad de los servicios de ortodoncia. Conclusiones: A pesar de la importancia de la evaluación de la calidad de los servicios de ortodoncia, los reportes de su realización en Cuba son escasos. En esta evaluación es necesario determinar el nivel de satisfacción, mediante encuestas al que recibe el servicio y al que lo brinda. Se describen cuatro dimensiones a considerar: humana, técnica, del entorno físico y los resultados del tratamiento de ortodoncia.

Background: the evaluation of the quality of orthodontic services allows orientation toward improvement Objective: to argue the criteria for assessing the quality of orthodontic services Conclusions: despite the importance of assessing the quality of orthodontic services, reports of its performance in Cuba are scarce. In this evaluation it is necessary to determine the level of satisfaction for those who get the service and those who provide it. Four dimensions to consider are described: human, technical, physical environment and the results of orthodontic treatment.

Braquetes ortodônticos se fixam com resina composta sem o uso de sistemas adesivos? / Orthodontic brackets bond with composite resin without the use of adhesive systems?

Introdução e objetivo: esta revisão de literatura foi realizada utilizando-se das bases de dados Medline, LILACS, BBO e Scielono período de 2004 a 2013, sobre a fixação de braquetes ortodônticos com resina composta, com e sem o uso de sistemas adesivos. Conclusões: Concluiu-se que a fixação dos braquetes ortodônticos com o emprego do sistema adesivo é efetiva em campo operatório limpo e seco, bem como na ausência do sistema adesivo, que além de não causar danos à superfície do esmalte diminui os passos clínicos do atendimento ortodôntico. E na presença de umidade, a melhor opção é a resina composta hidrofílica.

Introduction and objective: this literature review was performed using the databases Medline, LILACS, BBO and Scielo in the period from 2004 to 2013, about the fixation of orthodontic brackets with composite resin, with and without the use of adhesive systems. Conclusions: It was concluded that the fixation of orthodontic brackets with the use of the adhesive system is effective in clean and dry operative field, as well as in the absence of the adhesive system, that besides not causing damages to the surface of the enamel reduces the clinical steps of the orthodontic care. And in the humidity presence, the best option is thehydrophilic composite resin.

Satisfacción de especialistas, pacientes y familiares con el servicio de ortodoncia / Satisfacción de especialistas, pacientes y familiares con el servicio de ortodoncia

Fundamento: la satisfacción del especialista, el paciente y sus familiares determinan la calidad de los servicios de ortodoncia. Objetivo: identificar el nivel de satis facción de especialistas, pacientes y familiares con los servicios de ortodoncia en cuanto a las dimensiones humana, técnica, entorno físico y resultados del tratamiento de ortodoncia. Metodología: se realizó un estudio transversal en la Clínica Estomatológica Docente Provincial de Sancti Spíritus, en el período comprendido entre marzo de 2012 y 2013. La población estuvo constituida por 5 especialistas de ortodoncia, 141 pacientes en etapa de contención y 98 familiares. Se aplicaron métodos empíricos y de la estadística descriptiva con procedimientos matemáticos . Resultados: el 60,0 % de los especialistas, el 89,4 % de los pacientes y el 80,6 % de sus familiares estuvieron satisfechos con el servicio de ortodoncia. Las insatisfacciones de los especialistas fueron la insuficiente realización de cursos de actualización, la inestabilidad de materiales, carencia de instrumentales y equipos, así como el resultado del tratamiento y en pa cientes y familiares fue la inestabilidad en el suministro de recursos y las insuficientes condiciones de trabajo. Conclusiones: la mayoría de los especialistas se manifestó medianamente satisfechos, mientras que los pacientes y familiares se manifestaron satisfechos con el servicio de ortodoncia en todas las dimensiones evaluadas.

Background: the satisfaction of the specialist, patient and family to determine the quality of orthodontic services. Objective: to identify the level of satisfaction of specialists, patients and families with orthodontic services regarding the human, technical dimensions, physical environment, and orthodontic treatment outcomes. Methodology: a cross-sectional study was made at the Provincial Teaching Dental Clinic of Sancti Spíritus, in the period between March 2012 and 2013, the population consisted of 5 specialists in orthodontics, 141 patients with containment stage and 98 families. Empirical methods and descriptive statistics with mathematical procedures were applied. Results: 60.0 % of specialists, 89.4 % of patients and 80.6 % of families were satisfied with the service of orthodontics. Dissatisfaction of the specialists were the insufficient conducting of refresher courses, unstable materials, lack of instrumental and equipment as well as the treatment outcome; and in patients and families the instability in the supply of resources and inadequate working conditions. Conclusions: most specialists expressed themselves moderately satisfied, while patients and relatives were satisfied with the orthodontic service in all the evaluated dimensions.

Soportes de autoligado en ortodoncia / Orthodontic brackets

Fundamento: el sistema de ligado del arco al soporte debe ser seguro, fuerte, rápido, confortable para el paciente, fácil de usar y producir poca fricción. Objetivo: argumentar el manejo de las técnicas fijas con el uso de los soportes de autoligado. Conclusiones: los soportes de autoligado constituyen una opción novedosa en ortodoncia, pero en Cuba se han utilizado poco. Se clasifican en pasivos y activos. El sistema Damon, Vision LP y Time son los más utilizados entre los pasivos y el Speed e In Ovation entre los activos. Se describen cuatro fases de tratamiento para usar la técnica con este tipo de soportes y a pesar de su alto costo, es más ventajosa que las técnicas precedentes.

Background: the system bound to the orthodontic bracket arch must be safe, strong, rapid and comfortable for the patient, easy to use and must provoke little friction. Objective: to argue about the management of fixed techniques with the use of brackets. Conclusions: brackets constitute a newfangled option in orthodontics, but in Cuba it has been rarely used. They are classified into passive and active. Damon system, Vision LP and Time are the mostly used among the passive ones and the Speed and In Ovation among the active ones. Four phases of treatment are described to use the technique of these orthodontic brackets and in spite of its high cost; it is more advantageous than the previous techniques.

Effect of elastomeric ligatures on frictional forces between the archwire and orthodontic bracket

Aim: To evaluate the frictional force between the archwire and orthodontic bracket generated by elastomeric ligatures with polymer coating (Super slick, TP Orthodontics) and conventional ligatures (Morelli) using two types of insertion techniques. Methods: Forty elastomeric ligatures, 20 with polymer coating and 20 conventional, were evaluated. Each type of ligature was separated into two groups (n=10), according to the insertion mode: conventional or crossed (from mesial to distal region crossed in front). To analyze friction, 40 5-cm-long segments of stainless steel orthodontic archwire 0.019" x 0.025" (Morelli) and Edgewise brackets (slot 0.022" x 0.028"; Morelli) were used. Each set (bracket, wire and elastic) was submitted to frictional testing in a universal test machine (Instron 4411) at a crosshead speed of 5 mm/min. Each bracket was moved 5 mm on the wire, with maximum friction and mean friction being recorded by software. Three readouts were taken for each bracket. Data were submitted to two-way ANOVA and Tukey’s test (p<0.05). Results: It was shown that for maximum and mean friction, the polymer-coated ligature did not differ statistically from the conventional type in a dry environment condition. Ligatures placed incrossed mode promoted significantly greater friction than those placed in conventional mode, irrespective of the type of elastomeric ligature. Conclusions: Friction depended on the insertion mode, but not on the type of elastomeric ligature.

Profile of the orthodontist practicing in the State of São Paulo - Part 2

INTRODUCTION: The choice of brackets, bands and wires is a very important aspect of orthodontic treatment. Stainless steel prevailed for a long time, but new alloys and resources have emerged to diversify the orthodontic wire mechanics. OBJECTIVE: This study aimed to investigate the profile and materials used by orthodontists practicing in the State of São Paulo, Brazil. METHODS: A questionnaire was sent to 2,414 specialists in Orthodontics and Dentofacial Orthopedics registered with the Regional Board of Dentistry of São Paulo State (CRO-SP). To assess the association between qualitative variables, the Chi-square association test was employed at 5% significance level. RESULTS: Five hundred and ninety-three (24.65%) questionnaires were completed and sent back. Efficiency was the key reason given by the professionals for choosing a particular material. The majority showed a preference for metal brackets (98%), followed by ceramics (32%) and polycarbonate (7.8%). The most widely used brackets had 0.022 x 0.028-in slots (73.2%). Regarding orthodontic wires, 88.2% employed round steel wires and conventional round NiTi wires, while 52.6% used round heat-activated NiTi and 46.5% rectangular TMA wires. Elastics (92.9%) were the most widely used method to tie the orthodontic archwire to the bracket. CONCLUSIONS: In this survey, the orthodontists claimed that efficiency was the major motivator for choosing orthodontic materials. Conventional brackets tied with conventional elastic ligatures are still the most used by the professionals. Among steel and conventional Nitinol wires, round wires ranked first. The use of resources recently available to Brazilian orthodontists, such as self-ligating brackets and mini-implants, was not significant.

INTRODUÇÃO: a escolha do tipo de braquetes, ligaduras e fios são fatores importantes no tratamento ortodôntico. O aço inoxidável predominou por muito tempo, mas novas ligas metálicas diversificaram o universo de fios disponíveis, assim como surgiram outros recursos. OBJETIVO: analisar o perfil do ortodontista do estado de São Paulo em relação aos materiais que utiliza. MÉTODOS: foi enviado um questionário a 2414 especialistas em Ortodontia e Ortopedia Facial inscritos no Conselho Regional de Odontologia do estado de São Paulo. Para avaliar a associação entre as variáveis qualitativas, foi utilizado o teste qui-quadrado, ao nível de significância de 5%. RESULTADOS: houve o retorno de 593 (24,65%) questionários preenchidos. A eficácia do material ortodôntico foi o principal motivo alegado para sua escolha. A maioria demonstrou preferência por braquetes metálicos (98%), cerâmicos (32%) e de policarbonato (7,8%). O slot mais citado foi o de 0,022" x 0,028" (73,2%). Sobre os fios ortodônticos, 88,2% empregam fio de aço redondo e o NiTi convencional redondo; 52,6% o NiTi termoativado redondo e 46,5% o TMA retangular. A ligadura elástica foi a forma mais empregada (92,9%) para fixar o arco ortodôntico ao braquete. CONCLUSÕES: os ortodontistas analisados alegaram ser a eficácia o principal motivo de escolha do material; os braquetes convencionais unidos com ligaduras elásticas ainda são os mais utilizados. Entre os fios ortodônticos, os de secção redonda apareceram em primeiro lugar, tanto os de aço como os de nitinol convencional. Recursos recentes na Ortodontia brasileira, como os braquetes autoligáveis e os mini-implantes, não apresentaram uso significativo.