RESUMEN
OBJECTIVES: To evaluate the effectiveness of the low-level laser therapy (LLLT) in accelerating the early treatment of the skeletal anterior open bite (AOB) and to evaluate the associated skeletal and dentoalveolar changes. MATERIALS AND METHODS: A three-arm, parallel-group, randomized controlled trial was conducted on 42 patients aged 8-10 years with skeletal AOB. Patients were randomly allocated to three groups: the fixed posterior bite block+low-level laser therapy (FPBB+LLLT) group; the fixed posterior bite block (FPBB) group; and the untreated control group (UCG) in a 1:1:1 allocation ratio. The LLLT dose in the FPBB+LLLT group was applied using 808-nm wavelength Ga-Al-As semiconductor laser device with the energy of 4-joules/point and irradiation time of 16 seconds/point. LLLT was applied in the first visit; then, it was applied on day 3, 7 and 14 of the first month. Afterwards, it was applied every 15 days until the end of the treatment. Lateral cephalometric images were taken at the beginning of the treatment (T0) and at the end of the active phase (T1). The primary outcome measures were the overall time needed to correct the AOB and the skeletal and dentoalveolar changes. RESULTS: The correction of the AOB required significantly less mean time in the FPBB+LLLT group compared to the FPBB group (xÌ =7.07, xÌ =9.42 months, respectively; P=0.001). The mean upper first molar intrusion in the FPBB+LLLT group was 1.21mm and significantly greater than that of the FPBB group (0.82mm; P=0.018). However, there was a slight mean extrusion of the upper first molar in the UCG (0.32mm). CONCLUSIONS: The overall time needed to correct the AOB was shorter in the FPBB+LLLT group. The LLLT appeared to be effective in accelerating orthodontic tooth movement. FPBB alone or LLLT were effective in the early treatment of anterior open bite (AOB). The two interventional groups produced similar dentoalveolar and skeletal changes; most of which were dentoalveolar in the correction of the anterior open bite.
Asunto(s)
Terapia por Luz de Baja Intensidad , Mordida Abierta , Aceleración , Cefalometría/métodos , Niño , Humanos , Mordida Abierta/terapia , Técnicas de Movimiento Dental/métodosRESUMEN
El objetivo de esta segunda parte es relacionar el protocolo utilizado en el Ateneo Argentino de Odontología (A.A.O.) expuesto en la Parte I, con los cefalogramas laterales diseñados por los Dres. Arne Björk, Joseph Jarabak, James McNamara y Robert Ricketts y proponer las visiones complementarias en la búsqueda de un diagnóstico y un plan de tratamiento de mayor precisión. La aplicación de una secuencia lógica en el diagnóstico de una maloclusión permite establecer una categoría de análisis jerarquizada en función de los condicionantes y de las posibilidades de intervención terapéutica (AU)
The objective of this second part is to relate the protocol used in the Ateneo Argentino de Odontología (A.A.O.) exposed in Part I, with the lateral cephalograms designed by the Drs. Arne Bjork, Joseph Jarabak, James McNamara and Robert Ricketts and propose complementary visions in the search for a more accurate diagnosis and treatment plan. The application of a logical sequence in the diagnosis of malocclusion, allows to establish a category of hierarchical analysis according to the conditions and the possibilities of therapeutic intervention (AU)
Asunto(s)
Humanos , Masculino , Femenino , Protocolos Clínicos , Cefalometría/métodos , Maloclusión/diagnóstico por imagen , Planificación de Atención al Paciente , Argentina , Sociedades Odontológicas/organización & administración , Diagnóstico ClínicoRESUMEN
Background: Increased awareness on the role of oral functions in the aetiology of Class II deformities has led to the wide spread of myofunctional training appliances as easy and possibly effective treatment for children with Class II malocclusion but their efficacy is yet to be proven. Objectives: To evaluate soft- and hard-tissue changes following 12 months of Class II division 1 treatment in growing patients with a conventional functional appliance (a modified Activator) versus a myofunctional Trainer system (T4K®). Setting and sample population: Department of Orthodontics, Dental School. Participants, study design, and methods: Sixty Class II division 1 children (8-12 years old) were recruited from primary schools and were distributed randomly into two equal groups. Randomization was based on a computer-generated sequence of random numbers. Data analysis included: the Activator group (28 patients, mean age = 10.6 ± 1.3 years); the T4K® group (26 patients, mean age = 10.3 ± 1.4 years). Skeletal, dentoalveolar, and soft tissues changes were assessed using standardized lateral cephalograms collected before and after 12 months of treatment. No blinding was applied in this trial. Results: Improvement in the Class II skeletal and dentofacial characteristics were significantly greater in the Activator group when compared with the T4K® group. The improvement was evident in a significant decrease in the skeletal angle ANB with Activator (x¯ = -1.89 ± 1.12) compared to T4K® (x¯ = -0.9 ± 1.01) (P = 0.01), a significant greater increase in the facial convexity angle with Activator (x¯ = 2.61 ± 3.71) more than T4K® (x¯ = 0.2 ± 2.51) (P = 0.04), and a significant reduction in the overjet (x¯ = -3.0 ± 2.3 mm) compared to (x¯ = -1.5 ± 1.9 mm; P = 0.01) with Activator versus T4k®, respectively (P = 0.001). Limitations: This study was a short-term study (12-month follow-up). Conclusions: The results of the current study indicated that the Activator was more effective than the T4K® in treating Class II division 1 growing patients. Registration: The trial was not registered in any major database of clinical trials. Protocol: The protocol was not published before the commencement of the trial but can be given upon request.
Asunto(s)
Aparatos Activadores , Maloclusión Clase II de Angle/terapia , Terapia Miofuncional/métodos , Ortodoncia Correctiva/instrumentación , Cefalometría/métodos , Niño , Cara/patología , Femenino , Humanos , Masculino , Maloclusión Clase II de Angle/patología , Ortodoncia Correctiva/métodos , Sobremordida/terapia , Resultado del TratamientoRESUMEN
AIM: This study evaluated if oral supplementation with the probiotic bacterium Lactobacillus reuteri DSM 17938 improved enteral feeding tolerance and growth rates in extremely low birthweight (ELBW) infants. METHOD: A randomised, double-blind, placebo-controlled trial comprising 134 ELBW (<1000 g) infants born before gestational week 28 + 0. Daily supplementation of L. reuteri (1.25 × 108 bacteria/day) or placebo started within 3 days and continued until gestational week 36 + 0. Primary outcome was feeding tolerance and secondary outcome growth rate calculated as z-score development. RESULTS: Feeding tolerance was similar in the probiotic and placebo group. Time to full enteral feeds was 15 days in both groups. The z-score of the head circumference decreased in both groups from birth to day 28 of life, but it decreased less in the L. reuteri group compared to the placebo group: -1.2 SD (95% CI: -1.4 to -1.0) versus -1.7 SD (95% CI: -2.0 to -1.5; p = 0.001). Other growth parameters were similar in the study groups. CONCLUSION: Lactobacillus reuteri did not reduce time to reach full enteral feeds in ELBW infants. The L. reuteri supplemented infants, however, had a better growth rate of the head during the first month of life.
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Desarrollo Infantil/fisiología , Suplementos Dietéticos , Nutrición Enteral/métodos , Cabeza/crecimiento & desarrollo , Recien Nacido con Peso al Nacer Extremadamente Bajo , Probióticos/uso terapéutico , Cefalometría/métodos , Método Doble Ciego , Femenino , Edad Gestacional , Hospitales Universitarios , Humanos , Lactante , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Limosilactobacillus reuteri , Masculino , Valores de Referencia , Medición de Riesgo , Estadísticas no Paramétricas , Suecia , Resultado del TratamientoRESUMEN
OBJECTIVES: The goal of this study was to analyze skeletal, dental, and soft tissue changes of patients treated with customized lingual systems and to evaluate the clinical effectiveness of miniscrew anchorage. METHODS: Nine upper first premolar extraction patients who were treated with customized lingual appliances were included in this study. Miniscrews were used for reinforcement of molar anchorage. Cephalometric films and study models were obtained before treatment (T1), after alignment (T2), and after treatment (T3). Treatment effects were analyzed by cephalometric radiographs and study models. RESULTS: The upper anterior teeth were retracted significantly at T2 and T3 (4.41 ± 4.14 mm and 5.51 ± 2.48 mm, respectively). During space closure, the upper first molars showed slight mesial movement (1.50 ± 1.97 mm). The intercanine width of the upper arch increased at T2 (1.59 ± 1.81 mm), but decreased at T3 (0.11 ± 1.00 mm). The sella-nasion-A, A-nasion-B, and mandibular plane angles were not significantly changed at T3. The upper lip showed continuous retraction at both T2 and T3 (1.40 ± 1.46 mm and 2.32 ± 2.48 mm, respectively). CONCLUSIONS: By using miniscrew anchorage for lingual orthodontics, patients' dental and soft tissue changes considerably improved and molar anchorage was reinforced.
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Tornillos Óseos , Maloclusión/cirugía , Aparatos Ortodóncicos , Ortodoncia/métodos , Tratamiento de Tejidos Blandos/instrumentación , Adolescente , Adulto , Diente Premolar/cirugía , Cefalometría/métodos , Niño , Femenino , Humanos , Masculino , Maloclusión/patología , Mandíbula/anatomía & histología , Mandíbula/cirugía , Maxilar/anatomía & histología , Maxilar/cirugía , Modelos Dentales , Ortodoncia/instrumentación , Tratamiento de Tejidos Blandos/métodos , Extracción DentalRESUMEN
Rigid external distraction is currently performed to correct cases of severe maxillary hypoplasia. As an improvement of this technique, we propose the use of an intranasal bone-borne traction hook. This study is a retrospective chart review of the intranasal bone-borne traction hooks used in the treatment of severe maxillary hypoplasia. There were 110 patients treated with the hooks from 2005 to 2017. The maximum traction force was 7.75 kg, and there were few complications encountered during distraction. There were 76 patients who had the hooks removed under local anaesthesia. A cephalometric analysis was conducted in 56 patients. The average advancement of A-point was 9.9 ± 4.2 mm, 8.4 ± 2.5 mm, 11.0 ± 3.7 mm, 17.9 ± 4.4 mm for the trans-sutural distraction osteogenesis (DO), maxillary anterior segment DO, Le Fort I osteotomy DO and Le Fort III/II osteotomy DO, respectively. The average changes of sella-nasion-point A (SNA) were 8.89 ± 4.30 degrees, 8.21 ± 3.17 degrees, 10.49 ± 3.26 degrees, and 15.10 ± 4.00 degrees, respectively. The A point-nasion-B point (ANB) also showed increases in all procedures with P < 0.001. In conclusion, this technique sufficiently advances the midface and ensures the scars are concealed in the nasal base. The traction hook can bear a large traction force, causes minimal complications and is easily removed.
Asunto(s)
Anomalías Maxilofaciales/cirugía , Osteogénesis por Distracción/métodos , Osteotomía Le Fort/métodos , Instrumentos Quirúrgicos , Tracción/instrumentación , Adolescente , Adulto , Anestesia Local/métodos , Huesos , Cefalometría/métodos , Niño , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Femenino , Humanos , Masculino , Anomalías Maxilofaciales/diagnóstico , Nariz , Osteogénesis por Distracción/instrumentación , Osteotomía Le Fort/efectos adversos , Osteotomía Le Fort/instrumentación , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Adulto JovenRESUMEN
La técnica ortodóncica de baja fricción utiliza brackets pasivos de autoligado con una serie de arcos superelásticos que mantienen las fuerzas aplicadas sobre las piezas dentarias a nivel de la "biozona o zona fuerza óptima". La utilización de gomas intermaxilares ligeras (2 onzas o 56,68 g) en estos tratamientos, desde etapas iniciales, sobre todo en pacientes en crecimiento, permite obtener resultados muy favorables en cuanto a la resolución de la maloclusión de Clase II. Objetivo: evaluar el tratamiento de Ortodoncia de un paciente Clase II esqueletal con sobremordida, sin realizar exodoncias de premolares y utilizando elásticos intermaxilares en fases iniciales de tratamiento. Materiales y método: se presenta el caso clínico de un paciente de sexo masculino de 11 años, de Clase II esqueletal con sobremordida y apiñamiento dentario anterior superior e inferior moderado, con su diagnóstico y evaluación completos pre y post tratamiento y control y seguimiento al año. El tratamiento se realiza con brackets autoligantes (técnica de Damon). Resultados: se obtiene la corrección completa de la Clase II y la sobremordida, alcanzando los objetivos deseados de estética facial y función, en oclusión y desoclusiones, con buen desarrollo de las basales y conservación de la altura de las corticales alveolares a nivel de los caninos. Conclusión: Mediante los recursos terapéuticos disponibles en la actualidad y evaluando al niño en etapas tempranas, podremos combinar diferentes tratamientos para alcanzar los objetivos propuestos en menor tiempo y con óptimos resultados en una maloclusión de Clase II con sobremordida con biotipo mesofacial (AU)
The low friction orthodontic technique uses passive self-ligating brackets with a series of superelastic arches that maintain the forces applied to the dental pieces at the "Biozone or Optimal Force Zone". The use of inter maxillary light elastics (2 ounces or 56.68 yr.) from the initial stages in growing patients, yields very favorable results in terms of correction of Class II malocclusion. Objective: To assess the orthodontic treatment of a skeletal Class II patient with overbite, without extraction of premolars and using elastic in the early stages of treatment. Materials and methods: an 11 year old male skeletal Class II patient with overbite and moderate crowding in upper and lower anterior teeth, with complete diagnostic and evaluation before and after treatment and with annual control. For the treatment, self-ligating brackets (Damon technique) were employed. The results: Total correction of Class II condition and overbite was obtained. The desired goals of facial aesthetics and correct function were attained in occlusion and desocclusion, as well as development of the osseous basis and conservation of the canine alveolar cortical height. Conclusion: Through the employment of therapeutic resources available at present and following up the child through his developmental stages, it is possible to combine different treatments to achieve the proposed objectives in a shorter time with excellent results in mesofacial type patients with Class II malocclusion and deep overbite (AU)
Asunto(s)
Humanos , Masculino , Niño , Soportes Ortodóncicos/tendencias , Sobremordida/terapia , Maloclusión Clase II de Angle/terapia , Planificación de Atención al Paciente , Goma , Biotipología , Cefalometría/métodos , Resultado del Tratamiento , Diagnóstico Precoz , Fricción Ortodóntica , Desarrollo MaxilofacialRESUMEN
OBJECTIVES: Archaeological and genetic research has demonstrated that the Pacific Coast was a key route in the early colonization of South America. Research examining South American skeletons >8000 cal BP has revealed differences in cranial morphology between early and late Holocene populations, which may reflect distinct migration events and/or populations. However, genetic, cultural, and some skeletal data contradict this model. Given these discrepancies, this study examines â¼9000 years of prehistory to test the hypothesis that Early skeletons have a distinct cranial morphology from later skeletons. MATERIALS AND METHODS: Using 3D digital models, craniofacial landmarks, and geometric morphometric analyses, we compared Early Holocene crania (n = 4) to later Chilean samples (n = 90) frequently absent in continental assessments of craniofacial variation. PCA, Mahalanobis distances, posterior and typicality probabilities were used to examine variation. RESULTS: Two of the earliest skeletons from northern Chile show clear affinities to individuals from later sites in the same region. However, the hypothesis cannot be rejected as one Early individual from northern Chile and one individual from inland Patagonia did not always show clear affinities to coastal populations. DISCUSSION: Biological affinities among northern populations and other regions of Chile align with genetic and archaeological data, supporting cultural and biological continuity along the Pacific Coast. In Patagonia, archaeological data are in accordance with skeletal differences between the Early inland steppe individual and coastal populations. This study incorporates 3D methods and skeletal datasets not widely used in assessments of biological affinity, thus contributing to a critical body of research examining the ancient population history of western South America.
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Cefalometría/métodos , Imagenología Tridimensional/métodos , Cráneo/anatomía & histología , Adulto , Antropología Física , Chile , Femenino , Historia Antigua , Migración Humana , Humanos , Indígenas Sudamericanos/historia , Masculino , Modelos AnatómicosRESUMEN
BACKGROUNDS: This article presents an alternate surgical treatment method to correct a severe anterior protrusion in an adult patient with an extremely thin alveolus. To accomplish an effective and efficient anterior segmental retraction without periodontal complications, the authors performed, under local anesthesia, a wide linear corticotomy and corticision in the maxilla and an anterior segmental osteotomy in mandible. METHODS: In the maxilla, a wide linear corticotomy was performed under local anesthesia. In the maxillary first premolar area, a wide section of cortical bone was removed. Retraction forces were applied buccolingually with the aid of temporary skeletal anchorage devices. Corticision was later performed to close residual extraction space. In the mandible, an anterior segmental osteotomy was performed and the first premolars were extracted under local anesthesia. RESULTS: In the maxilla, a wide linear corticotomy facilitated a bony block movement with temporary skeletal anchorage devices, without complications. The remaining extraction space after the bony block movement was closed effectively, accelerated by corticision. In the mandible, anterior segmental retraction was facilitated by an anterior segmental osteotomy performed under local anesthesia. Corticision was later employed to accelerate individual tooth movements. CONCLUSIONS: A wide linear corticotomy and an anterior segmental osteotomy combined with corticision can be an effective and efficient alternative to conventional orthodontic treatment in the bialveolar protrusion patient with an extremely thin alveolar housing.
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Maloclusión Clase II de Angle , Métodos de Anclaje en Ortodoncia/métodos , Osteotomía/métodos , Técnicas de Movimiento Dental/métodos , Adulto , Anestesia Local/métodos , Diente Premolar/patología , Diente Premolar/cirugía , Cefalometría/métodos , Femenino , Humanos , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase II de Angle/cirugía , Mandíbula/cirugía , Maxilar/cirugía , Radiografía/métodos , Resultado del TratamientoRESUMEN
Objetivo: determinar la ubicación vertical y anteroposterior del huesohioides en pacientes entre los 12 y 20 años de edad, que inician tratamientoortodóncico en el Departamento de Ortodoncia y Ortopedia dentomaxilofacial de la Universidad Autónoma de Yucatán. Materialy métodos: La muestra fue de 17 radiografías laterales de cráneo. Serealizó trazado del triángulo hioideo para determinar la ubicación vertical(clasificación de Rocabado) y el plano de referencia Ptv (propuesto por Ricketts) para la ubicación anteroposterior del hueso hioides. Enla descripción de los resultados según su biotipo facial; se empleó el promedio, desviación estándar y el coeficiente de variación (CV = DE/Prom) como medida de variabilidad relativa. Se utilizaron intervalos de confi anza Bootstrap (ICB) del 95 por ciento para la media y la determinación del rango de posibles valores de la ubicación hioidea. Resultados: El 58.82 por ciento de la muestra presentó la ubicación inferior del hioides. En los braquifaciales se encontró una posición adelantada del hioides, al igual que la mayoría de los pacientes mesofaciales (66.66 por ciento). Conclusión: La posición del hueso hioides en relación con el biotipo facial juega un papel importante durante los tratamientos ortodóncicos, ya que nos podría orientar en la posición lingual.
Objective: to determine the vertical and anteroposterior position of thehyoid bones in patients between the ages of 12 and 20 years with diff erentfacial growth patterns upon their commencing orthodontic treatmentat the Autonomous University of Yucatáns Department of Orthodontics.Material and methods. Our sample consisted of 17 lateral cephalometricradiographs traced manually, with the hyoid triangle being measured todetermine the vertical position of the hyoid bone (as per the cephalometricanalysis of Rocabado). The position of the anteroposterior hyoid bones wasdetermined using Rickettss PTV reference plane (linear measurements weretaken as described by Ricketts). For the purposes of comparison betweendiff erent skeletal patterns, the mean, standard deviation, and coeffi cientof variation (CV=SD/m) were used as a measure of relative variability.Bootstrap Confi dence Intervals (BCI) of 95% were used for the mean andfor determining the range of possible values for the location of the hyoid.Results: In 58.82% of the sample, the position of the hyoids was found tobe lower. In brachyfacial subjects, the hyoids were found to be positionedfurther forward, as was the case with most of the mesofacial subjects(66.66%). Conclusion: The relative position of the hyoid bones in specifi cfacial biotypes plays an important role during orthodontic treatment, giventhat it could help in the positioning of the tongue.
Asunto(s)
Humanos , Masculino , Adolescente , Femenino , Adulto Joven , Biotipología , Cefalometría/métodos , Hueso Hioides/anatomía & histología , Ortodoncia Correctiva , México , Estándares de Referencia , Interpretación Estadística de DatosRESUMEN
OBJECTIVES: There is controversy regarding the relationship between mandibular position and alterations of the cranial base that provoke a more anterior location of the glenoid fossa. Artificially deformed skulls display marked alterations of the cranial base. This study evaluates mandibular changes as function of the morphology of the cranial base in these skulls. MATERIAL AND METHODS: A geometric morphometric study was performed on lateral cephalometric X-rays of three groups of skulls: 32 with anteroposterior deformity, 17 with circumferential deformity and 39 with no apparent deformity. RESULTS: In artificially deformed skulls, the cranial base was deformed causing the mandibular condyle to be in a more anterior position. There was a complete remodelling of the mandible involving narrowing and elongation of the mandibular ramus, rotation of the corpus of the mandible and increased vertical height of the symphysis. Forward displacement did not occur. Integration between mandible and cranial base is not altered by deformation of the skull. CONCLUSIONS: Deformity of the cranial vault exerts an influence on the mandible, supporting the theory of modular units in complete integration. This also supports the theory that mandibular prognathism is a multifactorial result and not a direct effect of displacement of the cranial base.
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Cefalometría/métodos , Anomalías Craneofaciales/diagnóstico por imagen , Procesamiento de Imagen Asistido por Computador/métodos , Mandíbula/patología , Base del Cráneo/patología , Cráneo/diagnóstico por imagen , Cráneo/patología , Arqueología , Anomalías Craneofaciales/etnología , Anomalías Craneofaciales/etiología , Historia Antigua , Humanos , Indígenas Sudamericanos/etnología , Masculino , Mandíbula/crecimiento & desarrollo , Cóndilo Mandibular/patología , Perú/etnología , Análisis de Componente Principal , Prognatismo/etiología , Radiografía/métodos , Cráneo/crecimiento & desarrollo , Base del Cráneo/crecimiento & desarrolloRESUMEN
AIMS: The aim of the present study was to evaluate if cranial dysfunctions felt by osteopaths could correlate with sagittal dysmorphologies diagnosed by orthodontists, using cephalometric traces in the sagittal plane. Metholology: One hundred and six children between 6 and 12 years old (42 boys and 64 girls) were tested by an osteopath to determine if the cranial movement felt was considered to be eased in flexion or extension. To test reproducibility intra-operator, 27 randomly selected subjects were tested twice, at a one-month interval by the same osteopath before the start of their orthodontic treatment. These tests were then correlated with a cephalometric analysis of the sagittal plane to determine what type of dysmorphology existed, if any, as well as the angle of the spheno-occipital synchondrosis (SOS). RESULTS: Practitioners systematically found more cranial movement in extension for all the bones in patients in skeletal class II than in the others. Similarly, they systematically found more cranial movement in flexion in patients in skeletal class III than in the other skeletal classes. However, there was no significant difference found in SOS angulation between skeletal classes I, II, and III. DISCUSSION: This study tends to confirm the correlation, described previously by orthodontists, between the mobility of the bones of the cranial vault and dysmorphic dentofacial characteristics in the sagittal plane. Anomalies during development could lead to the typical cranial characteristics of flexion or extension. As such, these situations could be related to skeletal classes III and II respectively.
Asunto(s)
Cefalometría/métodos , Suturas Craneales/patología , Maloclusión/terapia , Ortodoncia , Médicos Osteopáticos , Base del Cráneo/patología , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Maloclusión Clase I de Angle/terapia , Maloclusión Clase II de Angle/terapia , Maloclusión de Angle Clase III/terapia , Mandíbula/patología , Maxilar/patología , Hueso Nasal/patología , Hueso Occipital/patología , Reproducibilidad de los Resultados , Base del Cráneo/diagnóstico por imagen , Dimensión VerticalAsunto(s)
Humanos , Masculino , Niño , Maloclusión/diagnóstico , Maloclusión/terapia , Ortodoncia Correctiva/métodos , Planificación de Atención al Paciente , Postura/fisiología , Aparatos Activadores , Cefalometría/métodos , Modalidades de Fisioterapia/métodos , Hábitos , Terapia Miofuncional , Aparatos OrtodóncicosRESUMEN
Several studies have demonstrated the beneficial role of functional tongue therapy in stabilizing treatments for dental malocclusion and treating sleep-disordered breathing (SDB). The aim of this retrospective study was to evaluate the effect on the upper airways of the Tongue Right Positioner device (TRP) used for the correction of atypical swallowing. We analyzed lateral headfilms of 94 orthodontic patients aged between 11 and 17, before the start of treatment and after establishment of mature swallowing, treated with the TRP (TRP group) or by reeducation exercises (control group). In the TRP group, the establishment of mature swallowing occurs twice as fast as in the control group. This led to thinning of the floor of the mouth (-8.38%, P<0.001) linked to anteroposterior enlargement of the pharynx (+10.48%, P<0.01), both probably due to an increase in genioglossal and styloglossal muscle tone and correction of cranio-cervical posture (+2.52%, P<0.01). These results are not dependent on the type of orthodontic treatment. They suggest that the TRP could be used in the treatment of SDB.
Asunto(s)
Terapia Miofuncional/instrumentación , Diseño de Aparato Ortodóncico , Ortodoncia Correctiva/instrumentación , Hábitos Linguales/terapia , Adolescente , Cefalometría/métodos , Niño , Mentón/anatomía & histología , Trastornos de Deglución/terapia , Femenino , Estudios de Seguimiento , Cabeza/anatomía & histología , Humanos , Hueso Hioides/anatomía & histología , Masculino , Maloclusión/terapia , Tono Muscular/fisiología , Terapia Miofuncional/métodos , Cuello/anatomía & histología , Músculos del Cuello/fisiología , Faringe/anatomía & histología , Estudios Retrospectivos , Síndromes de la Apnea del Sueño/terapia , Resultado del TratamientoRESUMEN
OBJECTIVES: Craniosynostosis, the premature fusion of cranial bones, has traditionally been described as a disease of increased bone mineralization. However, multiple mouse models of craniosynostosis display craniosynostosis simultaneously with diminished cranial bone volume and/or density. We propose an alternative hypothesis that craniosynostosis results from abnormal tissue mineralization through the downregulation of tissue-non-specific alkaline phosphatase (TNAP) enzyme downstream of activating mutations in FGFRs. MATERIAL AND METHODS: Neonatal Crouzon (FGFRC342Y/+) and wild-type (FGFR+/+) mice were injected with lentivirus to deliver a recombinant form of TNAP. Mice were sacrificed at 4 weeks postnatal. Serum was collected to test for alkaline phosphatase (AP), phosphorus, and calcium levels. Craniofacial bone fusion and morphology were assessed by micro-computed tomography. RESULTS: Injection with the TNAP lentivirus significantly increased serum AP levels (increased serum AP levels are indicative of efficient transduction and production of the recombinant protein), but results were variable and dependent upon viral lot and the litter of mice injected. Morphological analysis revealed craniofacial form differences for inferior surface (p=0.023) and cranial height (p=0.014) regions between TNAP lentivirus-injected and vehicle-injected Crouzon mice. With each unit increase in AP level, the odds of lambdoid suture fusion decreased by 84.2% and these results came close to statistical significance (p=0.068). CONCLUSION: These results suggest that TNAP deficiency may mediate FGFR2-associated craniosynostosis. Future studies should incorporate injection of recombinant TNAP protein, to avoid potential side effects and variable efficacy of lentiviral gene delivery.
Asunto(s)
Fosfatasa Alcalina/genética , Craneosinostosis/terapia , Terapia Genética , Receptor Tipo 2 de Factor de Crecimiento de Fibroblastos/genética , Cráneo/patología , Fosfatasa Alcalina/sangre , Animales , Calcificación Fisiológica/genética , Calcio/sangre , Cefalometría/métodos , Suturas Craneales/crecimiento & desarrollo , Suturas Craneales/patología , Craneosinostosis/fisiopatología , Cisteína/genética , Modelos Animales de Enfermedad , Femenino , Vectores Genéticos/genética , Lentivirus/genética , Masculino , Ratones , Ratones Endogámicos BALB C , Hueso Occipital/crecimiento & desarrollo , Hueso Occipital/patología , Hueso Parietal/crecimiento & desarrollo , Hueso Parietal/patología , Fósforo/sangre , Transducción de Señal/genética , Cráneo/crecimiento & desarrollo , Tirosina/genética , Microtomografía por Rayos X/métodosRESUMEN
Class II division 1 malocclusion is the most common malocclusion. It shows specific clinical characteristics such as large overiet and deep overbite resulting in a soft tissue profile imbalance. Majority of the patients with class II division 1 malocclusions have an underlying skeletal discrepancy between the maxilla and mandible. The treatment of skeletal class II division 1 malocclusion is done taking into consideration the age, growth potential, severity of malocclusion, and compliance of patient with treatment. Myofunctional appliances can be successfully used to treat growing patients with class II division 1 malocclusion. This article presents a discussion on successful treatment of class II division 1 malocclusion with growth modification approach using twin block appliances.
Asunto(s)
Maloclusión Clase II de Angle/terapia , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos Funcionales , Sobremordida/terapia , Cefalometría/métodos , Niño , Humanos , Masculino , Mandíbula/crecimiento & desarrollo , Avance Mandibular/instrumentación , Terapia Miofuncional/instrumentación , Técnica de Expansión Palatina/instrumentación , Planificación de Atención al PacienteRESUMEN
INTRODUCTION: Juvenile idiopathic arthritis in temporomandibular joints (TMJs) is often treated with intra-articular steroid injections, which can inhibit condylar growth. The purpose of this study was to compare simvastatin (a cholesterol-lowering drug that reduces TMJ inflammation) with the steroid triamcinolone hexacetonide in experimental TMJ arthritis. METHODS: Joint inflammation was induced by injecting complete Freund's adjuvant (CFA) into the TMJs of 40 growing Sprague Dawley rats; 4 other rats were left untreated. In the same intra-articular injection, one of the following was applied: (1) 0.5 mg of simvastatin in ethanol carrier, (2) ethanol carrier alone, (3) 0.15 mg of triamcinolone hexacetonide, (4) 0.5 mg of simvastatin and 0.15 mg of triamcinolone hexacetonide, or (5) nothing additional to the CFA. The animals were killed 28 days later, and their mandibles were evaluated morphometrically and with microcomputed tomography. RESULTS: The analysis showed that the TMJs subjected to CFA alone had decreased ramus height compared with those with no treatment (P <0.05). Groups that had injections containing the steroid overall had decreases in weight, ramus height, and bone surface density when compared with the CFA-alone group (P <0.0001). Groups that had injections containing simvastatin, however, had overall increases in weight (P <0.0001), ramus height (P <0.0001), condylar width (P <0.05), condylar bone surface density (P <0.05), and bone volume (P <0.0001) compared with the groups receiving the steroid injections, and they were not different from the healthy (no treatment) group. CONCLUSIONS: Treatment of experimentally induced arthritis in TMJs with intra-articular simvastatin preserved normal condylar bone growth.
Asunto(s)
Antiinflamatorios/uso terapéutico , Artritis Experimental/tratamiento farmacológico , Artritis Juvenil/tratamiento farmacológico , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Mandíbula/efectos de los fármacos , Simvastatina/uso terapéutico , Trastornos de la Articulación Temporomandibular/tratamiento farmacológico , Triamcinolona Acetonida/análogos & derivados , Animales , Densidad Ósea/efectos de los fármacos , Cefalometría/métodos , Modelos Animales de Enfermedad , Portadores de Fármacos , Combinación de Medicamentos , Etanol , Imagenología Tridimensional/métodos , Inyecciones Intraarticulares , Masculino , Mandíbula/crecimiento & desarrollo , Cóndilo Mandibular/efectos de los fármacos , Cóndilo Mandibular/crecimiento & desarrollo , Tamaño de los Órganos/efectos de los fármacos , Ratas , Ratas Sprague-Dawley , Triamcinolona Acetonida/uso terapéutico , Microtomografía por Rayos X/métodosRESUMEN
The lack of the left first molar maxillary and the left second molar maxillary, caused respectively by impaction and agenesis is a very rare case, which determines an important occlusal imbalance and asymmetrical mandible movement. A gnatologic and functional orthodontic approach were planned to improve the retrognathic mandible and the muscular activity using kinesiograph and electromyography.
Asunto(s)
Anodoncia/terapia , Maloclusión Clase II de Angle/terapia , Diente Molar/patología , Diente Impactado/terapia , Cefalometría/métodos , Niño , Electromiografía/métodos , Femenino , Estudios de Seguimiento , Humanos , Avance Mandibular/métodos , Músculo Masetero/fisiopatología , Maxilar/patología , Diente Molar/anomalías , Contracción Muscular/fisiología , Terapia Miofuncional/métodos , Músculos del Cuello/fisiopatología , Aparatos Ortodóncicos Funcionales , Planificación de Atención al Paciente , Retrognatismo/terapia , Músculo Temporal/fisiopatologíaRESUMEN
INTRODUCTION: Becker muscular dystrophy is an X-chromosomal linked anomaly characterized by progressive muscle wear and weakness. This case report shows the orthodontic treatment of a Becker muscular dystrophy patient with unilateral open bite. METHODS: To correct patient's malocclusion, general anesthesia and orthognathic surgery were not considered as an option. Conventional orthodontic treatment with intermaxillary elastics and muscular functional therapy were employed instead. RESULTS: After 36 months, open bite was corrected. The case remains stable after a 5-year post-treatment retention period. .
INTRODUÇÃO: a distrofia muscular de Becker é uma anomalia ligada ao cromossomo X, caracterizada por desgaste muscular progressivo e fraqueza. Este relato de caso mostra o tratamento ortodôntico de um paciente com distrofia muscular de Becker e mordida aberta unilateral. MÉTODOS: na correção de sua má oclusão, anestesia geral e cirurgia ortognática não foram consideradas como uma opção. Tratamento ortodôntico convencional com elásticos intermaxilares e terapia miofuncional foram empregados. RESULTADOS: após 36 meses, a mordida aberta foi corregida. O processo manteve-se estável após um período de cinco anos de retenção de pós-tratamento. .
Asunto(s)
Adolescente , Humanos , Masculino , Distrofia Muscular de Duchenne/complicaciones , Terapia Miofuncional/métodos , Mordida Abierta/terapia , Técnicas de Movimiento Dental/métodos , Cefalometría/métodos , Estudios de Seguimiento , Maloclusión Clase I de Angle/terapia , Sobremordida/terapia , Planificación de Atención al Paciente , Hábitos Linguales/terapia , Técnicas de Movimiento Dental/instrumentaciónRESUMEN
INTRODUCTION: Currently, positive airway pressure is the gold standard treatment of obstructive sleep apnea (OSA). Unfortunely, adherence rates are poor. Alternative therapies are mandibular advancement device (MAD) and maxillomandibular advancement (MMA). PATIENTS: This retrospective study compared both treatment effectiveness on patients with moderate and severe OSA from January 2005 to September 2012, and carried out predictive factor of effectiveness. We defined therapeutic success as an apnea hypopnea index (AHI) less than 15 per hour and at least a 50% reduction of the initial index. The difference in effectiveness has been studied using regression logistic adjusted on MAD versus MMA propensity score. RESULTS: This study included 198 patients. 37 were treated by MMA, and 161 with MAD. MMA treatment was significantly more efficient than MAD treatment with an odds ratio of 3.22; CI95% 1.31Γ7.82 (p = 0.011). Younger age and lower initial AHI were predictive of increased success. There was no significant interaction between the treatment and morphologic patient factors. CONCLUSION: In our sample of patients, MMA surgery was significantly more efficient than MAD treatment for the patients with moderate or severe OSA. No morphologic characteristic was identified to determine which patients would benefit most from MAD versus MMA surgery.