The effects of corticotomy and piezocision in orthodontic canine retraction: a randomized controlled clinical trial.

BACKGROUND: The aims of this study were to evaluate the efficacy of alveolar corticotomy (AC) and piezocision (PZ) in accelerating maxillary canine retraction, and their effects on multiple bone remodeling expression in gingival crevicular fluid (GCF). A split-mouth, randomized controlled clinical trial was performed at the Department of Orthodontics of Pontifical Catholic University of Minas Gerais, Brazil. Eligibility criteria included orthodontic need for first maxillary premolars extractions, followed by canine retraction. Fifty-one adult patients were recruited and randomly assigned to 3 groups (allocation ratio 1:1:1). Random allocation of surgical or control interventions to each side of the maxillary arch was also conducted: G1 - AC × Control, G2 - PZ × Control, and G3 - AC × PZ. Both the definition of the group and the decision of the experimental or control sides were randomized by the software. Intraoral digital scans were performed before, 7 and 14 days after the beginning of canine retraction, and subsequently, at every 14 days until a maximum period of 6 months. GCF samples were collected before, and 1, 2, 4, 8, and 12 weeks. The primary outcome consisted in the cumulative distal movement of the canines and was measured by digital model superimposition. The secondary outcome consisted in GCF bone remodeling samples that were quantified in a multiplex immunoassay. The measurements examinator was properly blinded. RESULTS: Forty-seven patients, 19 males and 28 females, were analyzed (mean age 20.72, SD = 6.66, range 15 to 38). Statistically significant differences in canine distal movement between AC and control in G1 were not observed (p > 0.05). In G2, PZ showed lower cumulative incisal and cervical measurements than control from the 2nd to the 24th week (p < 0.05). In G3, PZ showed a lower cumulative incisal and cervical measurements than AC from the16th to the 24th week (p < 0.05). In all groups, differences on biomarkers expression occurred at specific timepoints (p < 0.05), but a distinct pattern was not observed. CONCLUSIONS: AC and PZ were not effective to accelerate maxillary canine retraction and did not induce a distinct pattern of biomarker expression. TRIAL REGISTRATION: NCT03089996 . Registered 24 March 2017 - Registered.

Effects of piezocision in orthodontic tooth movement: A systematic review of comparative studies.

BACKGROUND: The aim of this systematic review was to evaluate the effects of piezocision in accelerating orthodontic tooth movement (OTM) and its possible adverse effects. MATERIAL AND METHODS: The Databases Medline, Embase, CENTRAL and LILACS were searched until March 2019, for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that used piezocision associated with orthodontic treatment. A manual search was also performed. The search, studies selection, assessment of risk of bias and data collection were carried out by two independent reviewers. RESULTS: Eleven publications were included in this review (4 CCTs and 7 RCTs). No study presented low risk of bias. Different types of tooth movement were evaluated: lower anterior alignment, en-masse retraction, overall orthodontic treatment and canine distalization. A total of 240 participants were analyzed in the included studies. Seven studies found significant acceleration in the piezocision group, while two studies found no differences. Adverse effects regarding patient's satisfaction, pain perception, or worsening of periodontal parameters were not observed. There was no consensus concerning anchorage loss and root resorption. CONCLUSIONS: The literature does not provide high-quality evidence to confirm that Piezocision results in significant OTM acceleration. Therefore, high-quality RCTs should be conducted to allow reliable conclusions about the effects of piezocision in orthodontics. Key words:Piezosurgery, tooth movement techniques, orthodontics.

Avaliação da superfície de fios ortodônticos de NiTi após utilização de produtos contendo fluoretos / Evaluation of NiTi orthodontic wires surfaces after use of fluoride products

A resistência à abrasão e à corrosão de três fios ortodônticos de níquel titânio (Superelastic, 3M; Turbo Wire, Ormco e Copper NiTi, Ormco) frente ao uso de flúor e escovação foram avaliados através de simulação in vitro. Foram utilizadas a microscopia eletrônica de varredura (MEV) para avaliação da morfologia superficial e espectroscopia por dispersão em energia (EDS) para avaliação da composição química elementar dos fios antes e após os experimentos. Vinte segmentos de cada fio foram obtidos e divididos em dois grupos, contendo dez amostras de cada tipo, sendo que, em um grupo, as amostras foram imersas em solução de fluoreto de sódio 0,05% por tempo equivalente a 1 mês de bochechos diários de 1 minuto. No outro grupo, foram feitas escovações dos fios por período de tempo referente a um mês de 3 escovações diárias com creme dental contendo fluoreto de sódio a 0,24%. As imagens obtidas das superfícies dos fios foram analisadas por comparação observacional descritiva. Todas as amostras usadas no experimento se mostraram susceptíveis a modificações diante da escovação com pasta contendo fluoreto de sódio. Já frente à imersão em solução, os fios que mais apresentaram alterações foram o Superelastic e o Copper NiTi, mostrando aumento de pites de corrosão e aprofundamento de sulcos preexistentes. A composição química elementar dos fios manteve-se inalterada frente aos experimentos. Concluiu-se que a escovação e os fluoretos afetam as superfícies dos fios, podendo aumentar o atrito e o acúmulo de biofilme na superfície durante o tratamento ortodôntico.(AU)

Abrasion and corrosion resistance of three nickel-titanium orthodontic wires (Superelastic, 3M; Turbo Wire, Ormco and Copper NiTi, Ormco) under sodium fluoride usage and tooth brushing were evaluated through in vitro simulation. Scanning electron microscopy (SEM) for morphological surface analysis and energy dispersive spectroscopy (EDS) for elementary chemical composition were used for evaluation of the wires before and after assays. Twenty segments of each wire were obtained and divided in two groups containing ten samples of each type. One group of samples was immersed in sodium fluoride solution 0.05% during equivalent time of one month of daily 1 minute mouthwashes. In the other group the wires were brushed three times daily using a dental cream with sodium fluoride 0.24% during one month. Wire surfaces images obtained were analyzed by means of comparative observational description. All samples exhibited superficial changes under tooth brushing with fluoride dental cream. Considering fluoride solution immersion, Superplastic and Copper NiTi showed increasing in pitches of corrosion and deepening of existing grooves. Elementary chemical composition of wires remained unaltered. Concluding, tooth brushing and fluorides affect the surfaces of NiTi orthodontic wires, which may increase the friction and accumulation of biofilm in the surface during orthodontic treatment. (AU)

Uso do cad-cam no tratamento cirúrgico e protético de ameloblastoma mandibular: relato de caso / Cad-cam use in the surgical and prosthetic treatment of mandibular ameloblastoma: case report

A introdução da tecnologia CAD-CAM no dia-a-dia das especialidades Odontológicas, em particular da Cirurgia Bucomaxilofacial e da Prótese Dentária, abriram um novo horizonte de possibilidades terapêuticas para o tratamento de diversas patologias bucais que culminam com perda de estrutura óssea e edentulismo parcial. Este trabalho faz um relato de caso clínico, no qual um paciente acometido de ameloblastoma mandibular recebeu tratamento cirúrgico e protético auxiliado pelo CAD-CAM (AU)

The introduction of CAD-CAM technology in a daily basis into Dental specialities, particularly in Oral Surgery and Prosthodontics, has opened a new horizon of therapeutic possibilities for the treatment of many oral pathologies that lead to loss of bone structure and partial edentulism. This paper brings a case report of a patient with mandibular ameloblastoma which received surgical and prosthetic treatment with the use of CAD-CAM technology (AU)