Effect of oral exposure on chemical, physical, mechanical, and morphologic properties of clear orthodontic aligners.

INTRODUCTION: The dental industry is heavily committed to developing more esthetic solutions for orthodontic treatments. Invisalign is a system of transparent orthodontic aligners introduced as an alternative to conventional orthodontic fittings with brackets and metal wires. This study aimed to assess the chemical, physical, mechanical and morphologic changes in these polymeric aligners after exposure to the oral environment. METHODS: Twenty-four Invisalign orthodontic aligners were equally divided into 2 groups: an in vivo aged group in which patients used aligners for 14 days and the reference group, unexposed to the oral environment. Different experimental techniques were used to study the chemical structure, the color changes and translucency, the density and subsequent volume of the aligners, mechanical properties, surface roughness, morphology and elemental composition. The data were subjected to several statistical analyses. RESULTS: Clear orthodontic aligners exhibit chemical stability but undergo a statistically significant optical change in color and translucency. There was a gradual increase in the water absorption rate and the dimensional variation of the polymer, indicating a strong correlation among these factors. The mechanical properties of the polymer showed a statistically significant decrease in its elastic modulus and hardness. There was a slight tendency toward increased surface roughness of the material, but no statistical differences were found between reference and aged groups. The surface morphology of the used aligners demonstrates microcracks, distortions and biofilm formation. CONCLUSION: Intraoral aging adversely affected the physical, mechanical, and morphologic properties of the Invisalign appliance.

Is there a correlation between dental and cervical vertebrae maturation stages in growing subjects? A systematic review with meta-analysis.

OBJECTIVE: To assess the evidence on the relationship between dental and cervical vertebrae maturation. MATERIALS AND METHODS: Searches were performed (up to December 2021) in seven databases, as well as in gray literature. Studies that included growing subjects, which evaluated the correlation between the stages of tooth formation and the maturation of cervical vertebrae, were eligible. The methodological quality of the selected reports was assessed using the JBI checklist for cross-sectional studies. Random-effects meta-analyses were implemented to calculate the pooled correlation coefficients between the maturation stages of cervical vertebrae and each tooth type. The GRADE approach was followed to assess the certainty of evidence. RESULTS: Seventy-seven studies were selected. Most of them had limitations related to sampling and reliability of the methods to evaluate maturation. The syntheses evidenced positive correlations between the maturation of cervical vertebrae and the formation/calcification stages of the following lower teeth: canine (n = 7318; r = 0.692; 95% CI: 0.656-0.724), first premolar (n = 6194; r = 0.689; 95% CI: 0.649-0.725), second premolar (n = 6194; r = 0.695; 95% CI: 0.659-0.729), and second molar (n = 7905; r = 0.698; 95% CI: 0.652-0.739). All estimates were affected by the risk of bias and the presence of unexplained statistical heterogeneity. CONCLUSIONS: The evidence points to an apparent positive correlation between dental and cervical vertebrae maturation. These results need to be carefully evaluated as the body of evidence is of very low quality. CLINICAL RELEVANCE: Dental maturation might be a potential indicator of skeletal craniofacial growth status. A routine dental x-ray could be sufficient, reducing radiation exposure by requesting additional radiographs.

Development of a calcified odontogenic hamartoma following avulsion of a permanent central incisor.

The avulsion of a permanent immature tooth is a serious condition and a real emergency in dentistry. The management of a traumatized avulsed tooth is always a challenge to the clinician. This case report concerns the development of a calcified odontogenic hamartoma after the avulsion of an immature central incisor in an eight-year-old female. The patient presented for the treatment four months after the avulsion. Her intraoral examination showed complete healing of the area but an atypical appearance of the alveolar area of the missing tooth was observed in the periapical radiograph. A new radiographic scan performed six months later revealed the formation of a radiopaque irregular structure at the cervical level of the alveolar ridge at the site of the missing tooth. Surgical removal was performed, and the histopathological examination revealed a hamartomatous proliferation of odontogenic tissue with calcification. After healing, the lateral incisor was orthodontically moved mesially and restored to resemble the central incisor. An orthodontic device was installed to improve function and aesthetics of the patient.

Escobar Syndrome-An Multidisciplinary Approach for an Excellent Outcome With 3 Years of Follow-Up.

This case report intends to provide the facial characteristics of Escobar syndrome and to describe the orthodontic treatment of a 12-year-old female patient diagnosed with it. Escobar syndrome, a variant of the multiple pterygium syndrome, is a rare disorder with many systemic, facial, and oral manifestations.The patient presented with mixed dentition, severe dolichofacial pattern, increased lower facial height, convex profile, severe anterior open bite, maxillary hypoplasia, and mandibular retrognatism. The multidisciplinary approach included soft cleft palate repair, orthodontic treatment, orthognathic surgery, restorative cosmetic dentistry, speech therapy, and physiotherapy. Despite the limitations imposed by the syndrome, this report illustrates how the multidisciplinary treatment approach aided in the correction of occlusal function and facial esthetics and improvement in the quality of life of the patient with Escobar syndrome.

Does mandibular advancement ortho-surgical procedure cause condyle changes? A case-series analysis.

INTRODUCTION: Mandibular advancement surgery corrects bone bases while establishing patients' functional and aesthetic rehabilitation. However, little is known about the results of this procedure in the structures that make up the stomatognathic system, as the condyles. OBJECTIVE: This study aimed to evaluate the structural and positional changes of mandibular condyles in ortho-surgical patients who underwent mandibular advancement surgery. MATERIAL AND METHODS: A prospective investigation was conducted with cone-beam computed tomography images. Using Dolphin Imaging® software, seven ortho-surgical patients with Angle Class II malocclusion and mandibular deficiency were evaluated. The images assessed were obtained at pre-surgical phase and after, at least, 1 year of the procedure. To study the structural and positional changes of condyles, linear and angular measurements were obtained, and the right and left sides of patients were compared. Descriptive statistical analysis was performed and, in order to verify possible significant differences, normality tests (Kolmogorov-Smirnov) were applied, followed by a paired t-test to define significance. RESULTS: For all measures evaluated in this study, no statistically significant differences were found. CONCLUSION: The ortho-surgical procedure performed did not change the structure and position of the condyles of patients who underwent surgical mandibular advancement. Right and left mandibular condyles behaved similarly, suggesting stability and condylar adaptation after surgery.

Changes of pulp-chamber dimensions 1 year after rapid maxillary expansion.

INTRODUCTION: The purpose of this study was to examine the effect of orthopedic forces on maxillary first molars' and maxillary central incisors' pulp chambers in children having rapid maxillary expansion as the only intervention compared with children having no orthodontic intervention by using cone-beam computed tomography images. METHODS: In this prospective controlled clinical study, we evaluated 60 maxillary first molars and 60 maxillary central incisors from 30 children (18 boys, 12 girls) in the mixed dentition and during the pubertal growth period. The treated group had rapid maxillary expansion with the Haas expander, followed by 6 months of retention and 6 months of follow-up out of retention; the control group had no intervention during the study. Cone-beam computed tomography scans were taken initially and 1 year after the rapid maxillary expansion active phase. Initially, a 3-dimensional scrolling in all pulp chambers of the evaluated teeth was performed with Dolphin Imaging software (version 11.0; Dolphin Imaging & Management Solutions, Chatsworth, Calif) to describe the incidence of pulp-chamber calcifications. The dimensions of the pulp chambers of the molars and incisors were also investigated. Cross-sectional and longitudinal slices were used for each molar (coronal and axial slices) and incisor (sagittal and axial slices). The area (mm(2)) was obtained from 3 slices of each kind (6 measurements for each tooth). RESULTS: The results suggest that rapid maxillary expansion did not induce new pulp-chamber calcification. Also, it did not interfere in normal pulp-chamber dimension changes of the anchorage molars. CONCLUSIONS: The pulp chamber of the central incisors can be expected to be minimally wider 1 year after the therapy.

Does bone mineral density influence the primary stability of dental implants? A systematic review.

OBJECTIVE: The aim of this systematic review was to investigate the influence of bone mineral density on the primary stability of dental implants. MATERIAL AND METHODS: A search of health science databases (Cochrane Library, MEDLINE-PubMed, ISI Web of Knowledge, EMBASE, LILACS) and grey literature was performed, including papers published until January 2011. The main key words used were "bone density" (MeSH/DeCS), "dental implant" (MeSH/DeCS), "implant stability", "implant stability quotient", "ISQ", "resonance frequency analysis", "RFA", "Osstell", "Periotest value", "PTV", "Periostest", "insertion torque", "placement torque", "cutting torque". The inclusion criteria comprised observational clinical studies performed in patients who received dental implants for rehabilitation; studies that evaluated the association between bone mineral density and implant primary stability; bone density assessment performed by measurement of Hounsfield units using cone beam computed tomography; and dental implant primary stability evaluated by ISQ value, PTV value or insertion torque measurement. The articles selected were carefully read and classified as low, moderate and high methodological quality, and data of interest were tabulated. RESULTS: Ten articles met the inclusion criteria, but only seven were included because of overlapping patients. They were classified as low or moderate methodological quality and control of bias, and presented positive association between primary stability and bone density. CONCLUSIONS: There is a positive association between implant primary stability and bone mineral density of the receptor site. However, the methodological quality and control of bias of the studies should be improved to produce stronger evidences.

Effect of cigarette smoke on aesthetic brackets: an in vitro study.

OBJECTIVE: The objective of this study was to evaluate the effect of cigarette smoke (CS) on physical and mechanical properties of ceramic, polycarbonate and alumina ceramic brackets. The null hypothesis tested was that aesthetic brackets would not be influenced by CS. METHODS: Ninety aesthetic brackets were allocated to three groups (n = 30): ceramic (GCE), polycarbonate (GCO) and alumina ceramic (GPS). Ten samples of each group were assigned to color and surface roughness analysis, performed before (T0) and after (T1) exposure to CS; and twenty samples were allocated into control and experimental groups (n = 10) (not exposed and exposed to CS, respectively) for shear bond strength test (SBS). Exposure to CS followed an adaptation of the method described by Le Mesurier. Colorimetric reading, surface morphology and roughness, SBS and adhesive remnant index (ARI) were assessed. Statistical analysis comprised independent and paired t-tests, ANOVA/Tukey and Fisher's exact tests (α = 0.05). RESULTS: Changes were observed in brackets' color (NBS: GCE = 2.4; GCO = 1.9; GPS = 2.1), surface roughness (ΔRa: GCE = 1.1 ± 0.8 µm; GCO = 1.9 ± 1.5µm; GPS = -0.3 ± 0.1 µm / ΔRz: GCE = 1.4 ± 1.0 nm; GPS = -0.5 ± 0.1 nm); and SBS (GPS - experimental = 221.8 ± 48.6 N) after exposure to CS (p< 0.05). CONCLUSIONS: Exposure, in vitro, of aesthetic brackets to CS resulted in changes of color to darker and more opaque shades, surface roughness alterations, and higher SBS values. ARI scores were not associated with exposure to CS.

Does rapid maxillary expansion have long-term effects on airway dimensions and breathing?

INTRODUCTION: In this systematic review, we identified and qualified the evidence of long-term reports on the effects of rapid maxillary expansion (RME) on airway dimensions and functions. METHODS: Electronic databases (Ovid, Scirus, Scopus, Virtual Health Library, and Cochrane Library) were searched from 1900 to September 2010. Clinical trials that assessed airway changes at least 6 months after RME in growing children with rhinomanometry, acoustic rhinometry, computed tomography, or posteroanterior and lateral radiographs were selected. Studies that used surgically assisted RME and evaluated other simultaneous treatments during expansion, systemically compromised subjects, or cleft patients were excluded. A methodologic-quality scoring process was used to identify which studies would be most valuable. RESULTS: Fifteen articles fulfilled the inclusion criteria, and full texts were assessed. Three were excluded, and 12 were assessed for eligibility. Four articles with low methodologic quality were not considered. The remaining 8 were qualified as moderate. The posteroanterior radiographs showed that nasal cavity width increases; in the lateral radiographs, decreased craniocervical angulation was associated with increases of posterior nasal space. Cone-beam computed tomography did not show significant increases of nasal cavity volume. Rhinomanometry showed reduction of nasal airway resistance and increase of total nasal flow, and acoustic rhinometry detected increases of minimal cross-sectional area and nasal cavity volume. CONCLUSIONS: There is moderate evidence that changes after RME in growing children improve the conditions for nasal breathing and the results can be expected to be stable for at least 11 months after therapy.

Reasons influencing the preferences of prospective patients and orthodontists for different orthodontic appliances.

OBJECTIVE: To evaluate the reasons influencing the preferences for a certain type of orthodontic appliance over another among prospective patients (PP) and orthodontists. METHODS: A total of 49 PP and 51 orthodontists were asked about their preferences for the following appliances: clear aligners (CA), lingual metallic brackets (LMB), polycrystalline and monocrystalline ceramic brackets, and buccal metallic brackets (BMB). The participants rated the importance of 17 potential reasons that would explain their choices. The reasons that contributed most to these preferences were identified. Non-parametric tests (Fisher's exact, χ2 and Mann-Whitney tests) and multivariate analyses (regression and discriminant analysis) were used to assess the data (α = 0.05). RESULTS: CA and BMB were the most chosen appliances by PP and orthodontists, respectively. LMB was the most rejected option among both groups of participants (p < 0.001). Rates of the importance of pain/discomfort, smile esthetics, finishing details, and feeding/speech impairment showed the highest differences between PP and orthodontists (p < 0.0005). Discriminant analyses showed that individuals who considered treatment time and smile esthetics as more important were more likely to prefer CA, while those who prioritized finishing details and cost were more likely to choose BMB (p < 0.05). CONCLUSIONS: Reasons related to comfort and quality of life during use were considered as more important by PP, while those related to the results and clinical performance of the appliances were considered as more relevant by orthodontists.

Display of the incisors as functions of age and gender.

BACKGROUND: Older subjects usually show less of their upper incisors and more of their lower incisors than younger subjects. OBJECTIVES: To determine how much of the upper and lower central incisor crowns are visible in Brazilian subjects with their lips at rest. METHODS: The subjects were 240 white Brazilian subjects divided into four age groups: Group 1, 12 to 15 years of age; Group 2, 20 to 30 years of age; Group 3, 31 to 50 years of age and Group 4, 51 years of age and older. Each group contained 30 males and 30 females. The vertical display of the incisors was measured in millimetres from the midpoints of the incisal edges of the upper and lower central incisors to the borders of the upper and lower lips. RESULTS: In females, the mean upper central incisor display reduced from 4.45 mm in Group 1 to 1.32 mm in Group 4, and in males it reduced from 3.35 mm in Group 1 to 0.57 mm in Group 4. Less of the lower central incisor crowns were displayed in Group 1 females (Mean: 0.47 mm) than in Group 4 females (Mean: 2.22 mm), and in Group 1 males (Mean: 0.61 mm) than in Group 4 males (Mean: 3.05 mm). Brazilian women showed significantly more of their upper incisor crowns than Brazilian men in Groups 1, 2 and 4, whereas Brazilian men showed significantly more of their lower central incisors than Brazilian women in Group 4. CONCLUSIONS: With the lips at rest, older Brazilians display less of their upper central incisors and more of their lower central incisors than young Brazilians. Women show more of their upper incisors than men, while men display more of their lower central incisors than women.

Rates of tooth movement and bone remodeling activity: Self-ligating versus conventional brackets.

BACKGROUND: Bracket systems have been developed with the purpose of reducing frictional resistance between the archwire and accessories. The aim of this research was to compare rates of tooth movement and regions of cellular bone modeling activity along tooth root surfaces of teeth moved with conventional vs. self-ligating brackets. MATERIAL AND METHODS: The experiments were conducted in 20 male dogs. Bands were cemented in all intermediate incisors, with conventional brackets (Morelli) on the right side and hybrid self-ligating ones (T3-American Orthodontics) on the left side. A 0.019" x 0.025" stainless steel wire was inserted passively in the slot of these brackets with chain elastics (250 gf) to perform sliding mechanics. Clinical records of the orthodontic mechanics were made before and after 15 days of the tooth movement. The dental segments of the animals were prepared for light microscopy. Statistical analysis of variance and the Tukey correction with a P value at 5% were used. RESULTS: There were no significant differences in tooth movement rates between the two types of brackets but differences, in the bone modeling activity, suggested that tooth movement with the self-ligating brackets resulted in more tipping and less translational movement than tooth movement with the conventional brackets. CONCLUSIONS: The rates of tooth movement were similar between the two systems. The histological evaluation of cellular bone modeling activity along tooth root surfaces showed more translation movement of teeth with the conventional brackets, and more tipping movement of teeth with self-ligating brackets. Key words:Edgewise, histological reactions, orthodontic movement, self-ligating, brackets.

Impaction of mandibular third molars after orthodontic treatment by the edgewise method: a retrospective study.

This study aimed to determine the incidence of mandibular third molar (M3) impaction after orthodontic treatment by edgewise appliances, and identify possible determinant factors of M3 impaction. A retrospective cohort study was conducted with 1154 patients. Complete orthodontic records were analyzed pretreatment and posttreatment, considering the following variables: type of Angle malocclusion, treatment with or without extraction of first premolars, overbite, stage of dentition, M3 prior angulation and duration of orthodontic treatment. Impaction was determined after radiographic evidence of total closure of the root apex. The chi-square test and Poisson regression (p < 0.05) were used for statistical analysis with a hierarchical approach. Rate ratios (RR) and 95% confidence intervals (CI) were calculated. Mandibular M3 impaction incidence was 17%. Overbite equal to or greater than 4 mm (RR = 1.23, 95%CI: 1.11-1.26, p < 0.001), prior mesial angulation of M3 (RR = 0.59, 95%CI: 0.52-0.68, p < 0.001), non-extraction of first premolars (RR=1.06, 95%CI: 1.01-1.12, P=0.019) and orthodontic treatment time equal to or less than three years (RR = 0.94. 95%CI: 0.90-0.99, p < 0.014) were significantly associated with impacted M3. There was no correlation between the type of Angle malocclusion and the risk of impaction. In conclusion, the incidence of mandibular M3 impaction was considered low. The main pretreatment factors directly involved in impaction were mesioangulation of M3 and overbite equal to or greater than 4 mm. Orthodontic treatment with extraction of first premolars and treatment time greater than 3 years reduce the risk of impaction.

The influence of cigarette smoke on colour stability and friction property of aesthetic orthodontic wires-In vitro study.

OBJECTIVE: To evaluate the colour stability and friction property of aesthetic orthodontic wires when exposed to cigarette smoke. MATERIALS AND METHODS: Forty-eight samples of aesthetic orthodontic wires (0.019″×0.025″) were allocated to three experimental groups according to their brand (n=8): GAD (Aditek™); GTP (TP Orthodontics™); GRM (Rocky Mountain™) and their respective control groups (GC) (n=8). Samples were exposed to 2 cycles of smoke in a hermetic chamber while GCs were stored in artificial saliva at 37°C. Colour analysis (CIEL*a*b* colour space and NBS units) was performed on 5mm wire segments with the Vita Easyshade Compact spectrophotometer. The friction analysis was performed in a universal test machine, in segments of 5cm wires tied to ceramic brackets with maximum values recorded in N/cm. The comparison between groups was performed with the ANOVA/Tukey test (a=0.05) and the effect of the time evaluated with ANOVA-MR with Bonferroni correction (a=0.016). RESULTS: GTP and GRM did not show significant colour and friction property variations and did not differ from GC during the study (P>0.05). However, GAD was significantly sensitive to colour changes (T1-T0-L*: -4.09±1.06; a*: 2.25±0.39; b*: 1.70±0, (T2-T0-L* 0.66±0.92; a*: 2.76±0.35) and friction (T2-T0: 2.07±1.00N/cm) (P<0.016). CONCLUSION: Exposure to cigarette smoke may alter the mechanical and optical properties of aesthetic orthodontic wires.

The use of lidocaine as an anti-inflammatory substance: a systematic review.

OBJECTIVE: To investigate existence of evidence that supports the therapeutical use of lidocaine as an anti-inflammatory substance. METHODS: A search on health sciences databases was performed, including only papers published in English until May 2007 which reported in vivo experimental studies that tested lidocaine as an anti-inflammatory substance and used morphological and/or biochemical analysis. The keywords used were: "lidocaine & inflammation", "lidocaine & neutrophils" and "lidocaine & prostaglandin". The search results were previous selected by title and abstract, and then articles were read and those that met inclusion criteria were carefully analyzed and classified. RESULTS: Only 10 articles met the inclusion criteria, and were carefully read. They were ranked (A, B, and C) according to the level of evidence produced. Seven articles were classified as C, two classified as B, and one classified as A. Despite methodological differences, all of them, except for one, reported that lidocaine showed anti-inflammatory effects. CONCLUSIONS: According to the reviewed literature, lidocaine has a potential as an anti-inflammatory agent. However, there is still a lack of well-designed studies to support its clinical use, and none of them evaluated its effects on a mucous epithelium.

Fatores que influenciam insucesso no uso de mini-implante: uma revisão de literatura

Os dispositivos de ancoragem temporária ou mini-implantes adquirem cada vez mais relevância no manejo clínico dos tratamentos ortodônticos. Entretanto, apesar dos resultados clínicos expressivos obtidos, algumas intercorrências podem acometer a ancoragem no decorrer do tratamento. Os insucessos podem estar associados a fatores relacionados ao profissional, ao paciente ou ao próprio parafuso. Outrossim, existem fatores que podem contribuir para o sucesso clínico na utilização destes dispositivos, como a seleção apropriada do comprimento do mini-implante, a escolha de áreas adequadas para inserção do dispositivo, além de conhecimentos acerca da densidade óssea, de forma a contribuir para a estabilidade primária, a prática de bons hábitos de higiene bucal ou ainda a utilização de dispositivos autoperfurantes. Assim, o presente estudo propôs-se a revisar a literatura científica disponível acerca de mini-implantes com artigos científicos selecionados utilizando as bases de dados PubMed, Scopus, Web of Science, Cochrane Library, Embase, BVS, Opengrey, Google Scholar e Catálogo de teses e dissertações. Após aplicados os critérios de seleção, 32 artigos foram selecionados para compor este trabalho. Conclui-se que a utilização dos mini-implantes mantém o controle ideal da ancoragem, de modo a evitar movimentações dentárias indesejáveis, sendo inegável o sucesso clínico dos dispositivos de ancoragem temporária na Ortodontia. Entretanto, é comprovado que complicações cuja etiologia pode variar entre profissional, paciente ou o próprio parafuso são capazes de acometer a ancoragem no decorrer do tratamento ortodôntico, de modo a implicar falhas e insucesso dos miniparafusos.

Does mandibular advancement ortho-surgical procedure cause condyle changes? A case-series analysis

ABSTRACT Introduction: Mandibular advancement surgery corrects bone bases while establishing patients' functional and aesthetic rehabilitation. However, little is known about the results of this procedure in the structures that make up the stomatognathic system, as the condyles. Objective: This study aimed to evaluate the structural and positional changes of mandibular condyles in ortho-surgical patients who underwent mandibular advancement surgery. Material and Methods: A prospective investigation was conducted with cone-beam computed tomography images. Using Dolphin Imaging® software, seven ortho-surgical patients with Angle Class II malocclusion and mandibular deficiency were evaluated. The images assessed were obtained at pre-surgical phase and after, at least, 1 year of the procedure. To study the structural and positional changes of condyles, linear and angular measurements were obtained, and the right and left sides of patients were compared. Descriptive statistical analysis was performed and, in order to verify possible significant differences, normality tests (Kolmogorov-Smirnov) were applied, followed by a paired t-test to define significance. Results: For all measures evaluated in this study, no statistically significant differences were found. Conclusion: The ortho-surgical procedure performed did not change the structure and position of the condyles of patients who underwent surgical mandibular advancement. Right and left mandibular condyles behaved similarly, suggesting stability and condylar adaptation after surgery.

RESUMO Introdução: A cirurgia de avanço mandibular corrige as bases ósseas e estabelece a reabilitação funcional e estética dos pacientes. Entretanto, pouco se sabe sobre os resultados desse procedimento nas estruturas que compõem o sistema estomatognático, como os côndilos. Objetivo: Este estudo teve como objetivo avaliar as alterações estruturais e posicionais dos côndilos mandibulares em pacientes ortodôntico-cirúrgicos submetidos à cirurgia de avanço mandibular. Material e Métodos: Foi realizada investigação prospectiva com imagens de tomografia computadorizada de feixe cônico. Utilizando o software Dolphin Imaging®, foram avaliados sete pacientes ortodôntico-cirúrgicos com má oclusão Classe II de Angle e deficiência mandibular. Foram avaliadas imagens da fase pré-cirúrgica e de, no mínimo, um ano após o procedimento. Para estudar as alterações estruturais e posicionais dos côndilos, foram obtidas medidas lineares e angulares e comparados os lados direito e esquerdo dos pacientes. Foi realizada análise estatística descritiva e, para verificar possíveis diferenças significativas, foram aplicados testes de normalidade (Kolmogorov-Smirnov), seguido de teste t pareado, para definição de significância. Resultados: Para nenhuma das medidas avaliadas nesse estudo foram encontradas diferenças estatisticamente significativas. Conclusão: O procedimento ortodôntico-cirúrgico realizado não alterou a estrutura e a posição dos côndilos dos pacientes submetidos à cirurgia de avanço mandibular. Os côndilos mandibulares direito e esquerdo comportaram-se de forma semelhante, sugerindo estabilidade e adaptação condilar após a cirurgia.

Nasal bone length in human fetuses by X-ray.

BACKGROUND: To construct a normal range for the prenatal nasal bone length (NBL) in Brazilians irrespective to the knowledge of the ethnic genetic background. STUDY DESIGN: We studied 35 human fetuses (20 males, 15 females) ranging from 14 to 22 weeks of gestation. Gestational age (GA), crown-rump length (CRL), foot length (FL) and body mass (BM) were measured. The X-ray of the head lateral view was made with the specimens placed directly on the film and the NBL was measured. The NBL was correlated with the GA, the CRL, the FL, and the BM using log-transformed data and the allometric model log y=log a+b log x. RESULTS: Correlations of the NBL growth with GA, CRL, FL, and BM were positive and significant (P<0.05), but NBL vs. BM showed the smallest R indicating this correlation as of little practical use. No sexual dimorphism in the NBL growth in the second trimester fetuses was observed. The NBL grew with positive allometry relative to GA, CRL and BM, but it was allometrically slightly negative relative to the FL in both genders. The NBL be allometrically positive against GA, CRL and BM means the bone grew with growth rates higher than those indices in the period analyzed, but not against FL. CONCLUSION: NBL could be considered an auxiliary measurement in the assessment of the 2nd trimester fetal development because its strong correlation with GA, CRL and FL, even when nothing is known about the ethnicity of the population.

Selective alveolar corticotomy to intrude overerupted molars.

Orthodontic intrusion of overerupted molars in adults is challenging for most clinicians. Efficient intrusion can be achieved by combining selective alveolar corticotomies with a modified full-coverage maxillary splint to reduce surgical risks, treatment time, and costs for both orthodontists and patients.

Relação entre desmame precoce, desenvolvimento de hábitos bucais deletérios e maloclusões na infância / Relationship between early weaning, development of harmful oral habits and malocclusions in childhood

Objetivo: o objetivo desta pesquisa foi analisar a associação do tempo de aleitamento materno com a prática de hábitos deletérios e o desenvolvimento de maloclusões na primeira infância. Materiais e Métodos: foram aplicados 171 formulários às mães com 18 anos ou mais que acompanharam o processo de amamentação de seu(s) filho(s) de 4 a 10 anos de idade. O questionário foi composto por 22 perguntas, sendo 15 específicas e relacionadas ao aleitamento, hábitos deletérios da criança (uso de chupeta, sucção de dedo e sucção do próprio lábio) e maloclusões específicas (mordida cruzada posterior, mordida cruzada anterior e mordida aberta). Resultados: a prevalência da amamentação exclusiva por 6 meses ou mais foi de 52%, enquanto 29,8% das crianças foram amamentadas de 0 a 5 meses e 18,2% nunca foram amamentadas no seio exclusivamente. Quanto a alimentação complementar, grande parcela (37,4%) encontrada evidenciou início após os 6 meses; 57,9% das mães relataram algum tipo de dificuldade para amamentar e 34,5% das crianças fizeram uso de chupeta. Em relação aos hábitos deletérios, 10% desenvolveram sucção de dedo. O relato de desenvolvimento de maloclusões foi de 9,4% das crianças com mordida cruzada posterior; 7,6% mordida cruzada anterior e 18,7% mordida aberta anterior. Conclusão: sendo assim, é possível inferir que o tempo preconizado pela Organização Mundial da Saúde para aleitamento materno exclusivo foi fundamental para o não desenvolvimento de hábitos deletérios e maloclusões. Em contrapartida, quanto mais cedo a introdução de alimentos complementares, e a interrupção do aleitamento exclusivo nos seis primeiros meses, maior o risco do desenvolvimento de hábitos e consequentemente maloclusões.

Objective: the objective of this research was to analyze the association of breastfeeding duration with the practice of deleterious habits and the development of malocclusions in early childhood. Materials and Methods: a total of 171 forms were applied to mothers aged 18 years or older who followed the breastfeeding process of their child(ren) between 4 and 10 years of age. The questionnaire consisted of 22 questions, 15 of which were specific and related to breastfeeding, the child's deleterious habits (use of a pacifier, finger sucking and lip sucking) and specific malocclusions (posterior crossbite, anterior crossbite and open bite). Results: the prevalence of exclusive breastfeeding for 6 months or more was 52%, while 29.8% of children were breastfed from 0 to 5 months and 18.2% were never exclusively breastfed. As for complementary feeding, a large portion (37.4%) found to start after 6 months; 57.9% of the mothers reported some type of difficulty in breastfeeding and 34.5% of the children used a pacifier. Regarding deleterious habits, 10% developed finger sucking. The report of development of malocclusions was 9.4% of children with posterior crossbite; 7.6% anterior crossbite and 18.7% anterior open bite. Conclusion: therefore, it is possible to infer that the time recommended by the World Health Organization for exclusive breastfeeding was fundamental for the non-development of deleterious habits and malocclusions. On the other hand, the earlier the introduction of complementary foods and the interruption of exclusive breastfeeding in the first six months, the greater the risk of developing habits and, consequently, malocclusions.