Automated artificial intelligence-based three-dimensional comparison of orthodontic treatment outcomes with and without piezocision surgery.

OBJECTIVE(S): This study aims to evaluate the influence of the piezocision surgery in the orthodontic biomechanics, as well as in the magnitude and direction of tooth movement in the mandibular arch using novel artificial intelligence (AI)-automated tools. MATERIALS AND METHODS: Nineteen patients, who had piezocision performed in the lower arch at the beginning of treatment with the goal of accelerating tooth movement, were compared to 19 patients who did not receive piezocision. Cone beam computed tomography (CBCT) and intraoral scans (IOS) were acquired before and after orthodontic treatment. AI-automated dental tools were used to segment and locate landmarks in dental crowns from IOS and root canals from CBCT scans to quantify 3D tooth movement. Differences in mesial-distal, buccolingual, intrusion and extrusion linear movements, as well as tooth long axis angulation and rotation were compared. RESULTS: The treatment time for the control and experimental groups were 13.2 ± 5.06 and 13 ± 5.52 months respectively (P = .176). Overall, anterior and posterior tooth movement presented similar 3D linear and angular changes in the groups. The piezocision group demonstrated greater (P = .01) mesial long axis angulation of lower right first premolar (4.4 ± 6°) compared with control group (0.02 ± 4.9°), while the mesial rotation was significantly smaller (P = .008) in the experimental group (0.5 ± 7.8°) than in the control (8.5 ± 9.8°) considering the same tooth. CONCLUSION: The open source-automated dental tools facilitated the clinicians' assessment of piezocision treatment outcomes. The piezocision surgery prior to the orthodontic treatment did not decrease the treatment time and did not influence in the orthodontic biomechanics, leading to similar tooth movements compared to conventional treatment.

Dental long axes using digital dental models compared to cone-beam computed tomography.

OBJECTIVE: Standard methods of evaluating tooth long axes are not comparable (digital dental models [DDMs], panoramic and cephalometric radiographs) or expose patients to more radiation (cone-beam computed tomography [CBCT]). This study aimed to compare angular changes in tooth long axes using DDMs vs using CBCTs. SETTINGS AND SAMPLE POPULATION: Secondary data analysis of DDMs and CBCTs, taken before and after orthodontic treatment with piezocision of 24 patients. METHODS: Angular changes in tooth long axes were evaluated using landmarks on first molars (centre of the occlusal surface and centre of the furcation), canines and incisors (cusp tip and centre of the root at the cementoenamel junction). Wilcoxon test, intraclass correlation coefficient (ICC) and Bland-Altman plots were used to test intra- and inter-rater agreement and compare DDM and CBCT measurements. RESULTS: The mesiodistal angulation and buccolingual inclination DDM measurements were reproducible. Overall mean differences between DDM and CBCT measurements of mesiodistal angulation, 1.9°±1.5°, and buccolingual inclination, 2.2 ± 2.2°, were not significant for all teeth. ICC between DDM and CBCT measurements ranged from good (0.85 molars) to excellent (0.94 canines; 0.96 incisors). The percentages of measurements outside the range of ±5 were 17.4% for molars, 13.8% for canines and 4.5% for incisors. CONCLUSIONS: DDM assessment of changes in tooth long axes has good reproducibility and yields comparable measurements to those obtained from CBCT within a 5° range. These findings lay the groundwork for machine learning approaches that synthesize crown and root canal information towards planning tooth movement without the need for ionizing radiation scans.

Buccal bone defects and transversal tooth movement of mandibular lateral segments in patients after orthodontic treatment with and without piezocision: A case-control retrospective study.

INTRODUCTION: This study aimed to compare the extent of buccal bone defects (dehiscences and fenestrations) and transversal tooth movement of mandibular lateral segments in patients after orthodontic treatment with and without piezocision in cone-beam computed tomography and digital dental models. METHODS: The study sample of this study consisted of cone-beam computed tomography scans and digital dental models taken before (T0) and after (T1) orthodontic treatment of 36 patients with moderate mandibular anterior crowding. The experimental group consisted of 17 patients that had piezocision performed at the beginning of treatment with the goal of accelerating tooth movement, which was compared with 19 patients who did not receive piezocision. The measurement of bone defects, buccolingual inclination, and transversal distances of the tooth in the mandibular lateral segments (mandibular canines, premolars, and first molars) were evaluated at baseline and at the end of the orthodontic treatment. RESULTS: Overall, an increase in dehiscences, buccal inclination, and arch width from T0 to T1 was observed in both groups, but no statistically significant difference was found between groups. A significant increase in fenestrations from T0 to T1 was observed only for the canines in the experimental group. No statistically significant association was found between the increase of dehiscences and the amount of buccolingual inclination or transversal width changes. However, the changes in transversal width were statistically significantly associated with the increase in buccal inclination at the canines, first and second premolars. CONCLUSIONS: No significant differences were found in buccal dehiscences and transversal tooth movement (buccolingual inclination and arch width) of mandibular lateral segments between patients after orthodontic treatment with and without piezocision. Dehiscences, buccal inclination, and arch width significantly increased from T0 to T1 in both groups.

Comparison of linear and angular changes assessed in digital dental models and cone-beam computed tomography.

OBJECTIVE: To compare the three-dimensional (3D) linear displacements and the mesiodistal and buccolingual angulation changes after orthodontic treatment in digital dental models (DDMs) and 3D models derived from cone-beam computed tomography (CBCT). SETTINGS AND SAMPLE POPULATION: Digital dental model and CBCT scans were selected from 24 adults who had undergone orthodontic treatment for mandibular anterior crowding. MATERIAL AND METHODS: 3D linear displacements and changes in angular measurements (mesiodistal and buccolingual angulation) were assessed in pre- and post-treatment DDM and CBCT images using the software ITK-snap and 3D SlicerCMF. Intra- and inter-rater agreement of measurements in DDM and CBCT were tested using the intraclass correlation coefficient (ICC). DDM and CBCT measurements were compared using the Wilcoxon test (P < .05), ICC and Bland-Altman plots. RESULTS: Intra- and inter-rater agreement varied from good (ICC > 0.75) to excellent (ICC > 0.90) for both DDM and CBCT measurements. Although no significant difference between DDM and CBCT methods was observed for linear measurements of tooth movement, the angular assessments were different for most measurements. The agreement between measurements from both assessments varied from poor to excellent. CONCLUSIONS: Longitudinal assessments of tooth movements including 3D linear displacements and mesiodistal and buccolingual angulation are reproducible when using both DDM and CBCT. Changes in angular measurements due to orthodontic treatment are discordant when measured in the digital models (clinical crown) and in the CBCT images (whole tooth).

Two-phase orthodontic treatment in a patient with turner syndrome: an unusual case of deep bite.

Turner syndrome is caused by complete or partial absence of one X chromosome. These patients usually have a delay in growth and altered body proportions, causing sexual infantilism, short stature, delayed bone maturation, and variations in craniofacial morphology, among other systemic complications. The skeletal features associated with this syndrome include maxillary growth reduction with midface hypoplasia; mandibular micrognathia; high, narrow palate; V-shaped maxillary arch; and open bite. This case report shows a two-phase orthodontic treatment in a patient with Turner syndrome with a Class II malocclusion and severe deep bite, which is an unusual feature in patients with this disease. A conventional orthodontic treatment was performed, and after 20 months in retention the patient remains stable.

Sagittal cranial projections dataset extracted from CBCT volumes corrected to natural head position in a mixed ethnicity population.

This dataset features 200 sagittal projection images derived from Cone Beam Computed Tomography (CBCT) scans, corrected according to the Natural Head Position (NHP) guidelines proposed by Fredrik Lundström and Anders Lundström. The images originate from orthodontic patients in Cali, Valle del Cauca, Colombia, encompassing both initial phases and ongoing treatments. The dataset is divided into two groups: 100 images from female subjects (CoF) and 100 from male subjects (CoM), facilitating gender-specific studies. The dataset is accompanied by an Excel file ``Data info.xlsx'' that details the rotation angles in the axial (Yaw), coronal (Roll), and sagittal (Pitch) planes, along with the pixel size and image dimensions. This detailed documentation supports the replication of studies and aids in the interpretation of cephalometric analyses. Corrections made to align the images with NHP standards involve adjustments in the three main anatomical planes using points from the frontozygomatic suture (Fz) in the axial and coronal planes, and sella (S) and nasion (N) for the sagittal plane.

Root resorption in relation to a modified piezocision technique.

OBJECTIVES: To evaluate root resorption of lower incisors and canines quantitatively in a group of patients who underwent orthodontic treatment with piezocision and/or a collagen reinforcement technique with a fully resorbable three-dimensional (3D) collagen xenograft matrix compared with a control group. MATERIALS AND METHODS: The study sample of this secondary analysis consisted of 32 periodontally healthy patients with angle Class I malocclusion or mild Class II or III malocclusion and moderate irregularity index scores who underwent orthodontic treatment and had before (T0) and after treatment (T1) cone-beam computed tomography scans. Root resorption of lower incisors and canines was assessed quantitatively in the following four groups: the control group received orthodontic treatment without piezocision, experimental group 1 received orthodontic treatment with piezocision, experimental group 2 received orthodontic treatment with piezocision and a 3D collagen matrix, and experimental group 3 received orthodontic treatment with a 3D collagen matrix. RESULTS: An overall statistically significant decrease in root length from T0 to T1 for all groups was observed (P < .05). However, there was no significant difference among the groups in the amount of root length decrease from T0 to T1. CONCLUSIONS: Orthodontic treatment combined with piezocision does not increase the risk of root resorption of lower incisors and canines when compared with orthodontic treatment without acceleration techniques. More studies with larger samples should be undertaken to confirm these results.

Improving shear bond strength of metallic brackets after whitening.

OBJECTIVE: To evaluate a protocol for bonding metallic brackets after bleaching with hydrogen peroxide (HP). METHODS: 60 extracted maxillary premolar were randomly divided into an unbleached control group and two groups bleached with a solution of 35% hydrogen peroxide prior to bonding. The teeth in one of the treated groups were bonded immediately after bleaching; while the other group was treated with 10% sodium ascorbate immediately after bleaching and before bonding. The teeth in all groups were stored in an artificial saliva solution for 7 days after bonding. The shear bond strength data was measured in megapascals (MPa) and the fail attempts were verified. The significance level was established at p< 0.05. RESULTS: The unbleached group, in which brackets were bonded to untreated enamel, had the highest bond strength values (11.0 ± 5.7MPa) in comparison to the bleached group (7.14 ± 40MPa), in which brackets were bonded to recently bleached enamel. Slightly improved bond strength was observed in the antioxidant group (8.13 ± 5.4MPa), in which the teeth were bleached and then the antioxidant was applied to the teeth before bonding. Unbleached and bleached groups showed statistically significant difference for shear bond strength (p=0.03) and load strength (p=0.03); no significant differences were noted between unbleached and antioxidant groups (p=0.52). CONCLUSION: The antioxidant treatment applied immediately after bleaching was effective in reversing the reduction in shear bond strength of brackets after tooth bleaching.

Relationship between the polymorphism in the interleukin 1-ß and the treatment time of patients subjected to a modified piezocision technique.

AIM: We aimed to evaluate the correlation between the polymorphism of the interleukin 1-Beta (IL1-ß, +3954 C>T) and tooth movement, in a group of Colombian patients undergoing surgically accelerated orthodontic tooth movement. METHODS: The study was nested to a controlled clinical trial. Blood samples were taken from 11 women and 29 healthy Colombian male volunteers between 18 and 40 years old, after 1 year of starting orthodontic treatment. The patients presented malocclusion class I, with grade II or III. To detect the genetic polymorphism of the nucleotide +3954 C to T in the IL-1ß gene, we used a real-time PCR assay. RESULTS: Eleven individuals presented the allele 2 (T) heterozygous with the allele 1 (T/C) and 19 individuals were homozygous for the allele 1 (C/C). When analyzing the presence of the SNP, no significant differences were found in any of the variables. The best treatment was reflected in Group 3 (selective upper and lower alveolar decortication and 3D collagen matrix) and Group 4 (only selective alveolar decortication in the upper arch, with 3D collagen matrix), with 27% and 35% more speed respectively than in the control group. CONCLUSIONS: Our analyses indicated that a reduction in the total treatment time can be mostly potentiated by using decortication and collagen matrices and not for the presence of the allele 2 in the IL-1ß. Nevertheless, it is important that further studies investigate if the polymorphism could be associated with the speed of tooth movement and analyze the baseline protein levels.

OBJETIVO: Evaluar la correlación entre el polimorfismo de la interleucina 1-Beta (IL1-ß, +3954 C> T) y el movimiento de los dientes, en un grupo de pacientes colombianos sometidos a un movimiento dental ortodóncico acelerado quirúrgicamente. MÉTODOS: Este fue un estudio secundario derivado de un ensayo clínico aleatorio controlado. Se tomaron muestras de sangre de 11 mujeres y 29 voluntarios varones colombianos sanos entre 18 y 40 años, después de 1 año de comenzar el tratamiento de ortodoncia. Los pacientes presentaron maloclusión clase I, con grado II o III. Para detectar el polimorfismo genético del nucleótido +3954 C a T en el gen IL-1ß, se usó un ensayo de PCR en tiempo real. RESULTADOS: 11 individuos presentaron el alelo 2 (T) heterocigoto con el alelo 1 (T / C) y 19 individuos fueron homocigotos para el alelo 1 (C / C). Al analizar la presencia del SNP, no se encontraron diferencias significativas en ninguna de las variables. El mejor tratamiento se reflejó en el Grupo 3 (decorticación alveolar superior e inferior selectiva y matriz de colágeno 3D) y el Grupo 4 (solo decorticación alveolar selectiva en el arco superior, con matriz de colágeno 3D), con un 27% y un 35% más de velocidad, respectivamente, que en el grupo de control. CONCLUSIONES: Los análisis indicaron que una reducción en el tiempo total de tratamiento puede potenciarse principalmente mediante el uso de decorticación y matrices de colágeno y no por la presencia del alelo 2 en la IL-1ß. Sin embargo, es importante que otros estudios investiguen si el polimorfismo podría estar asociado con la velocidad del movimiento de los dientes y analizar los niveles de proteína de referencia.

3D Analysis of Facial Morphology of a Colombian Population Compared to Adult Caucasians.

OBJECTIVE: The purpose of this study involves describing the facial morphology of a Colombian population with three-dimensional (3D) imaging, and comparing their facial morphology with the Caucasian to create a database for this ethnicity. MATERIALS AND METHODS: The study, which included 135 subjects selected from the Valle University in Cali, Colombia, and 535 Caucasian subjects selected from the FaceBase-Data (1U01DE024449-01), was funded by the National Institute of Dental and Craniofacial Research. All images were taken in the natural head position (NHP) and captured using a stereo-photogrammetric camera system (3dMDface) to obtain a 3D image of each patient. The subjects were between 19 to 31 years of age, with a normal body mass index (BMI), and no craniofacial deformities. All images were plotted and analyzed using the 3dMDVultus software to calculate linear and angular measurements. Standard deviation (SD) and means were calculated for each measurement and analyzed using t-test for different samples. RESULTS: The Hispanic population had wider eyes, more protruded upper and lower lips, wider face, and greater mandibular width. Caucasian females had a more acute full profile, larger middle third, and less protrusive lips. Understanding the facial morphology of different populations would help to establish a better diagnosis and treatment planning for each ethnicity. CONCLUSIONS: From this study, the following conclusions may be drawn:1. The mean values of Colombian males showed greater measurements than females in the majority of measurements.2. Caucasian females had a more acute full profile, larger middle and lower third, and less protrusive lips.3. This study showed significant ethnic differences in the linear and angular measurements, showing us the importance of considering these findings in the diagnosis and treatment planning when a Hispanic population is involved. Soft tissue values should reflect the norms according to each ethnic population in order to achieve treatment goals.

Patient Specific Classification of Dental Root Canal and Crown Shape.

This paper proposes machine learning approaches to support dentistry researchers in the context of integrating imaging modalities to analyze the morphology of tooth crowns and roots. One of the challenges to jointly analyze crowns and roots with precision is that two different image modalities are needed. Precision in dentistry is mainly driven by dental crown surfaces characteristics, but information on tooth root shape and position is of great value for successful root canal preparation, pulp regeneration, planning of orthodontic movement, restorative and implant dentistry. An innovative approach is to use image processing and machine learning to combine crown surfaces, obtained by intraoral scanners, with three dimensional volumetric images of the jaws and teeth root canals, obtained by cone beam computed tomography. In this paper, we propose a patient specific classification of dental root canal and crown shape analysis workflow that is widely applicable.

Correction of Class III malocclusion with alternate rapid maxillary expansions and constrictions using a hybrid hyrax-mandibular miniplate combination and simultaneous orthodontic treatment: A case report.

In this report, we describe the successful use of alternate rapid maxillary expansions and constrictions with a hybrid hyrax-mandibular miniplate combination and simultaneous orthodontic treatment for the management of severe Class III malocclusion due to maxillary hypoplasia in an 11-year-old girl. The devices were removed after 20 months of treatment, and the family was instructed about a careful control and retention program that should be followed in accordance with the patient's growth. The final result included the correction of Class III malocclusion with adequate function and excellent facial esthetics, which restored the patient's self-esteem and provided personal motivation. The outcomes showed good stability after 24 months of retention. The decrease in the duration of active treatment is the most important finding from the present case. Considering that facial esthetics in adolescence is a determining factor for the development of a personality and interpersonal relationships, we recommend the use of this protocol for growing patients, who will exhibit not only an improved physical appearance but also a better quality of life.

Accuracy and reliability of mandibular digital model registration with use of the mucogingival junction as the reference.

OBJECTIVE: The aim of the study was to validate a method of mandibular digital model (DM) registration, acquired from an intraoral scanner, compared with high-resolution voxel-based cone beam computed tomography (CBCT) registration with use of the mucogingival junction as the reference. STUDY DESIGN: Pre- and post-treatment CBCT and DM images from 12 adults were randomly selected from an initial sample of 40 patients who had undergone orthodontic treatment. The DM registration was performed in 6 steps: (1) construction of 3-dimensional (3-D) volumetric label maps of CBCT scans, (2) voxel-based registration of CBCT scans, (3) prelabeling of CBCT images, (4) approximation and registration of DM models to the corresponding CBCT models, (5) mucogingival-junction registration of pretreatment and post-treatment DM images, and (6) measurements. The Mann-Whitney U test was used to calculate the significance of differences between the CBCT and DM registrations. The intraclass correlation coefficient (ICC) was performed to assess reproducibility of the registration method. RESULTS: When registered CBCT models and registered DM models were compared, no statistically significant differences in the measurements were found (right-left P = .267; anterior-posterior P = .238; superior-inferior P = .384; and 3-D P = .076). ICC showed excellent intra- and inter-rater correlation (ICC > 0.90). CONCLUSIONS: The method of DM registration of the mandible with use of the mucogingival junction as the reference is accurate, reliable, and reproducible.

Surgery-first approach with 3D customized passive self-ligating brackets and 3D surgical planning: Case report.

It is possible to unify three-dimensional customized orthodontic techniques and three-dimensional surgical technology. In this case report, it is introduced a treatment scheme consisting of passive self-ligation customized brackets and virtual surgical planning combined with the orthognathic surgery-first approach in a Class III malocclusion patient. Excellent facial and occlusal outcomes were obtained in a reduced treatment time of five months.

Condylectomy and "surgery first" approach: An expedited treatment for condylar hyperplasia in a patient with facial asymmetry.

Condylar Hyperplasia (CH) is a self-limiting pathology condition that produces severe facial deformity at the expense of mandibular asymmetry. In this case report a 15-year-old female patient was diagnosed with Unilateral Condylar Hiperplasia (UCH) by mean of single-photon emission computed tomography (SPECT) and histological study. A high condylectomy in the right condyle was performed to stop the active status of the hyperplasia. A month after condylectomy, orthognathic jaw impaction and asymmetric mandibular setback surgery was performed with the Surgery First Approach (SFA). After 10 days, orthodontic appointments were made every two weeks during 4 months. The active phase of treatment lasted 14 months. Excellent facial and occlusal outcomes were obtained and after 24 months in retention the results remained stable.

Mandibular cervical headgear in orthopedic and orthodontic treatment of Class III cases.

AIM: To show craniofacial and dental changes to the mandibular dentition with the use of cervical headgear as well as the mechanics used in the early management of Class III malocclusions. METHODS: Clinical photos and cephalometric radiographs of 5 patients with different types of Class III malocclusion treated with mandibular cervical headgear are shown in this article. RESULTS: The use of the mandibular cervical headgear showed to be clinically effective in the treatment of different types of Class III malocclusions. The main effects of the appliance were posterior and anterior rotation of the mandible and distalization of the mandibular molars. CONCLUSION: The mandibular cervical headgear is a good alternative for the treatment of these cases and is well-accepted and tolerated by the patients.

Efecto óseo y craneofacial de la obesidad / Bone and craniofacial effect of obesity

RESUMEN Desde que se inició su reporte a nivel mundial en 1975 por la Organización Mundial de la Salud, la obesidad se ha comportado como una pandemia. Datos de 2016 muestran que un 13 % del total de la población mundial adulta es obesa. Esta pandemia tiene efectos a nivel sistémico muy conocidos, como hipertensión arterial, diabetes, accidentes cerebrovasculares, enfermedades digestivas, distintos tipos de cáncer, osteoporosis y osteoartritis. También tiene efectos menos investigados y poco conocidos, como el crecimiento de los maxilares, caries y enfermedades periodontales. Existen reportes de los efectos a nivel del tejido óseo que tiene la obesidad, tanto en la osteoblastogénesis como en la osteoclastogénesis; en donde los adipocitos generan alteraciones de los niveles de la hormona leptina, adiponectina y algunas citoquinas, teniendo como resultado la disminución de la masa ósea. Es por todo lo anterior que mediante una revisión bibliográfica en las bases de datos Embase, PubMed, ScienceDirect y SCIELO, utilizando los términos normalizados skull, bone, obesity, growth y las palabras clave en inglés obese, craniofacial, development, morphometry; se encontró que la literatura científica reporta diferentes estudios en personas obesas, en los que se ha demostrado que los individuos en etapa de adolescencia presentan cambios morfológicos específicos, como el aumento de la base anterior de cráneo, longitud de uno o ambos maxilares y aumento en la longitud del cuerpo mandibular.

ABSTRACT Obesity, since its worldwide report in 1975 by the World Health Organization; has behaved like a pandemic. Data from 2016 show that 13 % of the adult world population is obese. This pandemic has well-known systemic effects such as high blood pressure, diabetes, stroke, digestive diseases, various types of cancers, osteoporosis and osteoarthritis. It also has less investigated and little-known effects, such as maxillary growth, caries and periodontal diseases. There are reports of the effects on bone tissue of obesity, both in osteoblastogenesis and in osteoclastogenesis; in which the adipocytes generate alterations in the levels of the hormone leptin, adiponectin and some cytokines, resulting in a decrease in bone mass. It is for all of the above, that through a systematic review in the databases: Embase, PubMed, ScienceDirect and SCIELO; using the normalized terms: skull, bone, obesity, growth; and the key words in English: obese, craniofacial, development, morphometry. It was found that the scientific literature shelters different studies in obese individuals, where it has been shown that individuals in the adolescence stage present specific morphological changes such as increased anterior skull base, length of one or both maxillary and increase on the length of the mandibular body.

Improving shear bond strength of metallic brackets after whitening

ABSTRACT Objective: To evaluate a protocol for bonding metallic brackets after bleaching with hydrogen peroxide (HP). Methods: 60 extracted maxillary premolar were randomly divided into an unbleached control group and two groups bleached with a solution of 35% hydrogen peroxide prior to bonding. The teeth in one of the treated groups were bonded immediately after bleaching; while the other group was treated with 10% sodium ascorbate immediately after bleaching and before bonding. The teeth in all groups were stored in an artificial saliva solution for 7 days after bonding. The shear bond strength data was measured in megapascals (MPa) and the fail attempts were verified. The significance level was established at p< 0.05. Results: The unbleached group, in which brackets were bonded to untreated enamel, had the highest bond strength values (11.0 ± 5.7MPa) in comparison to the bleached group (7.14 ± 40MPa), in which brackets were bonded to recently bleached enamel. Slightly improved bond strength was observed in the antioxidant group (8.13 ± 5.4MPa), in which the teeth were bleached and then the antioxidant was applied to the teeth before bonding. Unbleached and bleached groups showed statistically significant difference for shear bond strength (p=0.03) and load strength (p=0.03); no significant differences were noted between unbleached and antioxidant groups (p=0.52). Conclusion: The antioxidant treatment applied immediately after bleaching was effective in reversing the reduction in shear bond strength of brackets after tooth bleaching.

RESUMO Objetivo: Avaliar um protocolo para colagem de braquetes metálicos após clareamento com peróxido de hidrogênio (PH). Método: Sessenta pré-molares superiores extraídos foram aleatoriamente divididos em um Grupo Controle (sem clareamento) e dois grupos que receberam clareamento, antes da colagem, com solução de peróxido de hidrogênio a 35%. Em um dos grupos tratados (Grupo Clareamento), os braquetes foram colados imediatamente após o clareamento, enquanto o outro (Grupo Antioxidante) foi tratado com ascorbato de sódio a 10%, imediatamente após o clareamento e antes da colagem. Os dentes, em todos os grupos, foram armazenados em saliva artificial por 7 dias após a colagem. As informações relativas à resistência da colagem foram registradas em megapascals (MPa) e as tentativas fracassadas foram verificadas. O nível de significância foi estabelecido em p < 0,05. Resultados: O Grupo Controle, no qual os braquetes foram colados ao esmalte não clareado, apresentou os valores mais altos de força de adesão (11,0 ± 5,7 MPa), em comparação ao Grupo Clareamento (7,14 ± 40 MPa), no qual os braquetes foram colados ao esmalte recém-clareado. Uma suave melhora na força de adesão foi observada no Grupo Antioxidante (8,13 ± 5,4 MPa), no qual, após os dentes serem clareados, foi aplicado antioxidante aos dentes, antes da colagem. Os Grupos Controle e Clareamento apresentaram uma diferença estatisticamente significativa para a resistência da colagem (p =0,03) e a resistência à carga (p= 0,03); porém, nenhuma diferença significativa foi notada entre os Grupos Controle e Antioxidante (p =0,52). Conclusão: O tratamento antioxidante aplicado imediatamente após o clareamento foi efetivo em reverter a diminuição da resistência da colagem dos braquetes após o clareamento dentário.