Effects of eruption guidance appliance in the early treatment of Class III malocclusion.

OBJECTIVES: To evaluate the dentoskeletal effects and effectiveness of the eruption guidance appliance in Class III patients in the mixed dentition. MATERIALS AND METHODS: The experimental group comprised 22 patients with Class III malocclusion and anterior cross-bite (12 males, 10 females, mean age 7.63 ± 0.96 years) treated with the eruption guidance appliance over a mean period of 1.72 ± 0.48 years. The control group comprised 22 untreated subjects (12 males, 10 females, mean age 7.21 ± 0.60 years) with Class III malocclusion. Lateral cephalometric radiographs were obtained at pretreatment (T1) and posttreatment (T2). Intergroup comparisons were performed with Mann-Whitney and t-tests (P < .05). RESULTS: In the experimental and control groups, the anteroposterior relationship between the maxilla and mandible (ANB angle) remained stable during the treatment period (T1 to T2). The mandibular plane angle decreased in the experimental group and increased in the control group. In the experimental group, the lower anterior face height increase and maxillary molar vertical development were significantly smaller compared to controls. Positive overjet was achieved in 54% of the experimental group. CONCLUSIONS: The eruption guidance appliance produced no change in the skeletal anteroposterior relationship. The anterior cross-bite/edge-to-edge relationship was corrected in only about half of the treated subjects.

Efeito do armazenamento em longo prazo sobre as características mecânicas dos elásticos de látex e sintéticos / Effect of long-term storage on the mechanical characteristics of latex and synthetic elastics

Este estudo objetivou determinar o efeito do armazenamento em longo prazo nas características mecânicas dos elásticos intermaxilares e o período apropriado para substituição no uso clínico. 270 elásticos (135 látex e 135 sintéticos), 3/16" médio, foram submetidos a testes de tração uniaxial com estiramento de 200% até 600% dos seus diâmetros internos. Os elásticos foram divididos nos grupos "Como Recebidos" (CR, n = 15); armazenados em refrigerador por 3 anos (n = 60), e armazenados à temperatura ambiente por 3 anos (n = 60). Os grupos de elásticos armazenados foram subdivididos em 4 subgrupos (n = 15 cada): sem estiramento prévio (SEP); estiramento prévio simulando o ambiente intraoral por 24 horas (EP24h), 48 horas (EP48h) e 72 horas (EP72h). Quanto aos elásticos de látex, as forças expressadas pelo grupo SEP, independente da temperatura de armazenamento, permaneceram similares às forças do grupo CR. Elásticos armazenados em temperatura ambiente de SEP até EP72h perderam aproximadamente 25 gF (p = 0.001), enquanto os refrigerados perderam em média 10 gF (p = 0.05). Sobre os elásticos sintéticos, o grupo SEP, independente da temperatura de armazenamento, ganhou, em média, 50 gF (p = 0.001) em comparação ao grupo CR. Os armazenados em temperatura ambiente, desde SEP até EP72h, perderam em média 30 gF (p = 0.001), enquanto os refrigerados perderam aproximadamente 50 gF (p = 0.001). Concluiu-se que os elásticos ortodônticos armazenados em longo prazo em suas embalagens originais expressam forças maiores do que os elásticos novos, e ao usar clinicamente elásticos armazenados a longo prazo, as substituições podem ser feitas a cada 72 horas sem perda da eficiência mecânica (AU)

This paper aimed to determine the effect of long-term storage on latex and non-latex intermaxillary elastics, and the proper time between substitutions. 270 elastics (135 latex and 135 non-latex elastics), medium force and standard size of 3/16", underwent uniaxial tensile tests with increase from 200% to 600% of their inner diameter. Each type was divided into groups of as received elastics (AR - n = 15), 3 years stored under refrigeration (n=60), and e years stored at room temperature (n=60). The stored groups were divided into 4 subgroups (n = 15): no previous stretching (NPS), pre-stretched si mulating the intraoral environment during 24 hours (PS24h), 48 hours (PS48h), and 72 hours (PS72h). About the elastics of latex, the forces expressed by the NPS at room temperature remained equal to the AR, while the forces of the refrigerated NPS had increased ±70 gF on average (p = 0.001). PS24h to PS72h at room temperature showed loss of ±20 gF (p = 0.001) when compared to the NPS or to AR. Non-latex - NPS, regardless of the temperature of storage, increased forces ± 70gF (p = 0.001) when compared to the AR. Starting at PS24h to PS72h, it was seen an average loss of ± 40gF (p = 0.001) when compared to the NPS. All 3 years stored non-latex elastics forces increased ± 30gF (p = 0.01) when compared to the AR. It was concluded that orthodontic elastics long-term stored in their original packages shows higher average forces than new elastics, and the replacement, when using long-term stored could be every 72 hours (AU)

Root resorption in Class II malocclusion treatment with and without maxillary premolar extractions.

INTRODUCTION: Class II malocclusion treatment efficiency with maxillary premolar extractions has been reported. However, no study evaluated the root resorption associated with this protocol. Therefore, this study aimed to compare the degree of root resorption of the maxillary incisors in Class II malocclusion treatment with and without maxillary premolar extractions. METHODS: The sample consisted of 56 patients with complete Class II malocclusion, divided into 2 groups. Group 1 comprised 28 patients (10 female, 18 male) treated with maxillary first premolar extractions, and group 2 was composed of 28 patients (16 female, 12 male) treated without extractions. The groups were matched regarding initial age, treatment time, crowding, initial malocclusion severity, finishing quality, initial overjet, and overbite. Periapical radiographs of the maxillary incisors were used to assess the degree of root resorption using a scoring system. In addition, treatment changes involving maxillary incisors were evaluated in lateral headfilms. Intergroup comparisons were performed with t, Mann-Whitney U, and chi-square tests (P <0.05). RESULTS: Overjet, overbite, inclination, vertical positional changes, and vertical and horizontal apical displacements of maxillary incisors were similar between groups. There was no statistically significant difference between groups regarding root resorption of maxillary incisors. Root resorption degree ranged from mild to moderate in both groups. CONCLUSIONS: Treating complete Class II malocclusion with 2 maxillary premolar extractions resulted in a similar root resorption as treating without maxillary premolar extractions. An individualized evaluation of root resorption predisposing factors should be performed for each patient.

Transverse stability of Class II malocclusion correction with the pendulum appliance.

INTRODUCTION: This study aimed to evaluate the stability of transverse changes after Class II malocclusion correction with the pendulum fixed distalizer, followed by preadjusted edgewise fixed orthodontic appliances. METHODS: This longitudinal study was conducted in the maxillary dental casts of 20 Class II malocclusion subjects (mean age, 12.5 years; 14 females and 6 males). Eighty 3-dimensional maxillary dental casts were analyzed; 20 at the beginning of treatment, 20 after distalization, 20 after edgewise appliance debonding, and 20 at 5 years posttreatment. Maxillary transverse distances between canines, first premolars, second premolars, first molars, and second molars were analyzed using Geomagic Studio 5 (3D Systems, Rock Hill, SC). RESULTS: There were no significant changes in intercanine distance during and after treatment. There were significant interfirst and intersecond premolar distance increases during treatment. There were significant interfirst and intersecond molar distance increases during the distalization phase. However, there were significant decreases in these distances at the end of treatment. There were no significant long-term posttreatment changes. CONCLUSIONS: The intercanine distance remains stable during and after treatment. The interfirst and intersecond premolar distances significantly increase during treatment and remain stable after treatment. The interfirst and intersecond molar distances increase during the distalization phase, decrease at the end of treatment, and remain stable after treatment.

Estudo de deflexão de carga de fios ortodônticos de níqueltitânio: abordando a pseudoelasticidade e a influência do desvio padrão / Orthodontic Nickel-Titanium wires load deflection study: addressing pseudoelasticity and influence of the standard deviation

Resumo Proposição: O objetivo deste estudo é verificar os fenômenos de pseudoelasticidade em fios ortodônticos de níquel-titânio utilizados no tratamento do apinhamento dentário. Métodos: Onze grupos de fios ortodônticos de níquel-titânio, calibre 0,36mm (0.014") de 6 marcas diferentes (Abzil convencional e termoativado; GAC convencional e termo ativado; Morelli convencional e termoativado; Ormco CuNiTi; Orthometric convencional e termoativado e Orthosource convencional e termoativado) foram testados pelo teste de descarga, em deflexões de 0,5mm, 1mm, 2mm e 3mm. Foi utilizada uma máquina de teste universal INSTRON 3342 com uma célula de carga 10N e, para padronizar os testes, seguiu-se o regulamento ISO 15.841. A análise estatística foi realizada usando os testes subsequentes: Kolmogorov-Smirnov para verificar a normalidade e ANOVA, seguido do teste de Tukey para comparações intergrupos. Resultados: Todos os grupos foram classificados como pseudoelásticos, dentro de uma faixa de força de 40cN, no máximo. Conclusões: Dentre esses grupos, os que apresentaram pseudoelasticidade e excelente homogeneidade foram Morelli termoativado e Ormco CuNiTi. (AU)

Abstract Proposition: The purpose of this study is to check the pseudoelasticity phenomena on nickel-titanium orthodontic wires, used to treat dental crowding. Methods: Eleven groups of nickel-titanium orthodontic wires, caliber 0.36mm (0.014") of 6 different brands (Abzil conventional and heat-activated; GAC conventional and heat-activated; Morelli conventional and heat-activated; Ormco CuNiTi; Orthometric conventional and heat-activated and Orthosource conventional and heat-activated) were tested by bend testing, at deflections of 0.5mm, 1mm, 2mm and 3 mm. A universal testing machine INSTRON 3342 with a 10N load cell was used and, in order to standardize the tests, the ISO 15.841 regulation was followed. Statistical analysis was performed using the subsequent tests: Kolmogorov-Smirnov to verify normality and ANOVA followed by Tukey test for intergroup comparisons. Results: All groups were classified as pseudoelastic, within a range of maximum. force of 40cN. Conclusions: Among these groups those that presented pseudoelasticity and excellent homogeneity were Morelli heat-activated and Ormco CuNiTi. (AU)

Expansor maxilar diferencial como uma alternativa clínica para as correções transversais: relato de caso clínico / Differential maxillary expander as a clinical alternative for transverse corrections: a case report

Aproximadamente um terço dos pacientes com atresia maxilar apresenta uma constrição mais acentuada da distância intercaninos, quando comparada à distância intermolares superiores. Nesses casos, uma quantidade de expansão individualizada é requerida nas regiões anterior e posterior do arco dentário a fim de prevenir a sobre-expansão na região dos pré-molares e molares, redundando num risco aumentado de deiscências ou fenestrações ósseas vestibulares. Uma alternativa clínica para a correção transversal, nesses casos, é a utilização do Expansor Maxilar Diferencial (EMD). Esse aparelho ortopédico com dois parafusos permite realizar uma expansão diferencial significantemente maior na região anterior, quando comparada à região posterior do arco dentário superior. O objetivo deste artigo é relatar um caso clínico de uma paciente do sexo feminino, na dentadura permanente jovem, com mordida cruzada posterior, tratada de forma individualizada e eficiente com o EMD. (AU)

Approximately one third of patients with maxillary atresia show greater constriction of intercanine distance compared to the intermolar distance. In these cases, an individualized amount of expansion is required in the anterior and posterior regions of the dental arch, in order to prevent overexpansion in the premolar and molar region, resulting in increased risk of dehiscence or bone fenestration. A clinical alternative for transverse correction in these cases is the Differential Maxillary Expander (DME). This orthopedic expander with two screws allows accomplishing a significantly greater differential expansion in the anterior region compared to the posterior region of the maxillary dental arch. The aim of this article is to report a clinical case of a female patient in the early permanent dentition with posterior crossbite that was individually and efficiently treated using the DME.(AU)

Compensatory Class III malocclusion treatment associated with mandibular canine extractions

ABSTRACT Skeletal Class III malocclusions are ideally treated with orthodontic-surgical approaches. However, if there are no significant soft tissue implications and the patient does not want to undergo orthognatic surgery, other treatment options may be considered. The current case report describes a compensatory alternative for Class III malocclusion treatment, by means of mandibular canine extractions. This treatment alternative provided facial profile and occlusal improvement, which remains stable seven years posttreatment.

RESUMO As más oclusões esqueléticas de Classe III são idealmente tratadas com intervenções ortodôntico-cirúrgicas. Contudo, se não existirem implicações estéticas faciais e se o paciente não desejar se submeter à cirurgia ortognática, outras opções de tratamento podem ser consideradas. O presente caso clínico descreve um tratamento compensatório alternativo para a má oclusão de Classe III, com extrações de caninos inferiores. Esse tratamento alternativo propiciou melhoras no perfil facial e na oclusão, que permaneceu estável após sete anos da sua finalização.

Mandibular dental arch short and long-term spontaneous dentoalveolar changes after slow or rapid maxillary expansion: a systematic review.

OBJECTIVE:: The aim of this systematic review was to analyze the short and long-term spontaneous dentoalveolar changes of the mandibular dental arch after slow (SME) or rapid (RME) maxillary expansion in the mixed and early permanent dentitions. METHODS:: An electronic search was performed in the following databases: PubMed/Medline, Cochrane Library, Scopus, Embase and Web of Science. Eligibility criteria for article selection included randomized controlled trials and prospective studies written in English, with no restriction of year of publication, involving patients who underwent SME or RME during the mixed or early permanent dentitions. A double-blind search of articles was performed by two reviewers. Initially, the title and the abstract of the studies were read, and their references were also hand-searched for possible missing studies. A methodological quality scoring scale was used to analyze the selected articles. RESULTS:: The search retrieved 373 articles, but only 6 were selected for review after application of the eligibility and exclusion criteria. Non-clinically significant spontaneous dentoalveolar changes of approximately 1mm were found in the mandibular dental arch in the short and long-term, after slow or rapid maxillary expansions. Furthermore, no significant differences were found between treated and control groups. CONCLUSIONS:: There is enough evidence to conclude that negligible short and long-term spontaneous dentoalveolar changes tend to occur in the mandibular dental arch after SME or RME in the mixed and early permanent dentitions. More randomized studies with appropriate control group are required to better evaluate this issue.

Mandibular dental arch short and long-term spontaneous dentoalveolar changes after slow or rapid maxillary expansion: a systematic review

ABSTRACT Objective: The aim of this systematic review was to analyze the short and long-term spontaneous dentoalveolar changes of the mandibular dental arch after slow (SME) or rapid (RME) maxillary expansion in the mixed and early permanent dentitions. Methods: An electronic search was performed in the following databases: PubMed/Medline, Cochrane Library, Scopus, Embase and Web of Science. Eligibility criteria for article selection included randomized controlled trials and prospective studies written in English, with no restriction of year of publication, involving patients who underwent SME or RME during the mixed or early permanent dentitions. A double-blind search of articles was performed by two reviewers. Initially, the title and the abstract of the studies were read, and their references were also hand-searched for possible missing studies. A methodological quality scoring scale was used to analyze the selected articles. Results: The search retrieved 373 articles, but only 6 were selected for review after application of the eligibility and exclusion criteria. Non-clinically significant spontaneous dentoalveolar changes of approximately 1mm were found in the mandibular dental arch in the short and long-term, after slow or rapid maxillary expansions. Furthermore, no significant differences were found between treated and control groups. Conclusions: There is enough evidence to conclude that negligible short and long-term spontaneous dentoalveolar changes tend to occur in the mandibular dental arch after SME or RME in the mixed and early permanent dentitions. More randomized studies with appropriate control group are required to better evaluate this issue.

RESUMO Objetivo: o objetivo da presente revisão sistemática foi analisar as alterações dentoalveolares espontâneas, em curto e longo prazos, após a expansão lenta (ELM) ou rápida (ERM) da maxila, durante a dentição mista e permanente jovem. Métodos: uma busca eletrônica foi executada nas seguintes bases de dados: PubMed/Medline, Cochrane Library, Scopus, Embase e Web of Science. Os critérios de elegibilidade para a seleção dos artigos incluíram ensaios clínicos randomizados controlados e estudos prospectivos escritos em língua inglesa, sem restrição do ano de publicação, envolvendo pacientes que foram submetidos a ELM ou ERM durante a dentição mista ou permanente jovem. Dois revisores realizaram, de forma independente, uma busca por artigos. Inicialmente, o título e o resumo dos artigos foram lidos, e uma busca manual foi realizada nas referências dos artigos selecionados, a fim de se avaliar possíveis estudos não encontrados. Resultados: trezentos e setenta e três artigos foram encontrados com a busca, porém apenas seis foram selecionados para a revisão após a aplicação dos critérios de inclusão e de exclusão. Alterações dentoalveolares espontâneas sem significância clínica de aproximadamente 1 mm foram encontradas na arcada dentária inferior em curto e longo prazos, após a expansão lenta ou rápida da maxila. Além disso, não foram observadas diferenças significativas entre os grupos tratados e os controles. Conclusão: existe evidência suficiente para se concluir que alterações dentoalveolares espontâneas sem significância clínica tendem a ocorrer na arcada dentária inferior em curto e longo prazos após a ELM e ERM na dentição mista e permanente jovem. Mais ensaios clínicos randomizados com grupos controles adequados são necessários para melhor avaliar essa questão.

Compensatory Class III malocclusion treatment associated with mandibular canine extractions.

Skeletal Class III malocclusions are ideally treated with orthodontic-surgical approaches. However, if there are no significant soft tissue implications and the patient does not want to undergo orthognatic surgery, other treatment options may be considered. The current case report describes a compensatory alternative for Class III malocclusion treatment, by means of mandibular canine extractions. This treatment alternative provided facial profile and occlusal improvement, which remains stable seven years posttreatment.

Determinantes do tratamento ortodôntico-cirúrgico / Determinants of orthodontic-surgical treatment

Em algumas situações o ortodontista se depara com o dilema entre indicar apenas o tratamento ortodôntico ou o ortodôntico cirúrgico e muitos critérios devem ser considerados antes de uma decisão final ser tomada. O objetivo deste artigo é apresentar o tratamento ortodôntico-cirúrgico de um paciente com má oclusão de Classe I e discutir quais fatores são relevantes durante a escolha do melhor tipo de tratamento para cada caso.(AU)

In some situations, the orthodontist faces the dilemma of indicating only an orthodontic treatment or a surgical-orthodontic treatment and many criteria must be considered before a final decision is taken. The objective of this article is to present the orthodontic-surgical treatment of a Class I malocclusion patient and discuss which factors are relevant when deciding the best treatment approach for each case (AU)

Avaliação da satisfação dos usuários em relação às ações do núcleo de apoio à saúde da família num município brasileiro de médio porte / Evaluation of the satisfaction of users in relation to the shares of the nucleus of support for family health in municipality brasilien mid-sized / Evaluation of the satisfaction of users in relation to the shares of the nucleus of support for family health in municipality brasilien mid-sized

Objetivo: Esta pesquisa avaliou o nível de satisfação dos usuários sobre o Núcleo de Apoio à Saúde da Família(NASF) e sua atuação em relação à contribuição nas Unidades de Saúde da Família da Secretaria Municipal deSaúde de Macaíba. Metodologia: Os dados foram coletados na rede pública de saúde de Macaíba-RN, a partirde questionário semiestruturado e observação sistemática não participante, tendo como sujeitos 200 usuáriosrepresentantes das 20 unidades pesquisadas. Para análise da questão aberta foi utilizado o processo decategorização. Sobre o método observacional, baseou-se na organização do espaço, nas características dos sujeitos participantes e o conjunto específico das atividades realizadas pelas equipes do Núcleo de Apoio à Saúde da Família segundo um roteiro de observação. Resultados: Para os usuários, o NASF trouxe garantia de melhor acesso aos serviços com atendimento especializado, resolutivo e acolhedor. Conclusão: A existência demelhorias trazidas pelo NASF à comunidade foi percebida por todos os participantes desse estudo, o que justifica a manutenção, continuidade e ampliação destas equipes no município de Macaíba trazendo resolutividade eampliação da cobertura na atenção especializada à população assistida

Objective: This study aimed to assess the level of satisfaction of users on the Support Center for Family Health(NASF) and its performance in relation to the contribution in the Family Health Units of the Municipal HealthMacaíba. Methodology: Data were collected in public health Macaíba-RN in 2012, for semi-structuredquestionnaire and nonparticipating systematic observation, as having interviewed 200 representatives of 20surveyed units. To analyze the open question the categorization process was used. About obser vational methodwas based on the organization of space, the characteristics of the participating subjects and the specific set ofactivities performed by teams of NASF according to a script of observation. Results: For users, the NASF broughtensuring better access to specialized services, resolving and welcoming service. Conclusion: The existence ofimprovements brought by NASF community was perceived by all participants of this study, which justifies the maintenance, continuity and expansion of these teams in the county Macaíba bringing resolution and expanding coverage in specialized care to assisted population

Competências gerais e habilidades específicas: a realidade do ciclo básico / General Competencies and Specific Skills: the reality of the basic cycle

A formação em odontologia vem, ao longo dos anos, sofrendo significativas mudanças. A última alteração considerável foi a construção e implementação das Diretrizes Curriculares Nacionais (DCN), em 2002, para os cursos de graduação. Visando formar cirurgiões-dentistas dotados de conhecimento e pensamento crítico, reflexivo e humanístico, as DCN vêm para guiar a formação profissional para qualquer mercado de trabalho. Assim, esse estudo visou avaliar e discutir a estrutura curricular dos primeiros quatro períodos do curso de Odontologia da Universidade Federal do Rio Grande do Norte com base nas competências gerais e habilidades específicas propostas pelas DCN. Foi realizada a categorização das Habilidades Específicas tomando como base as competências gerais. Em seguida, com base nas categorias formadas, foram detectados os momentos nesses dois anos iniciais em que as mesmas eram desenvolvidas. Ao contrário do que se pensava, a primeira metade do curso, tida como "ciclo básico", que abrange as disciplinas comuns a toda a área da saúde, trabalha elementos importantes das DCN e ainda traz a perspectiva de educação permanente, uma das competências gerais para o futuro profissional. Conclui-se que o "ciclo básico" do curso de odontologia da UFRN contempla todas as competências gerais e habilidades específicas propostas pelas DCN para o curso de Odontologia (AU).

Training in Dentistry has, over the years, undergoing significant changes. The last major change was the construction and implementation of the National Curriculum Guidelines (DCN) in 2002 for undergraduate courses. In order to form dental surgeons endowed with knowledge and critical, reflective and humanistic thoughts, DCN is to guide the training for any job market. Thus, this study aimed to evaluate and discuss the curricular structure of the first four periods of the Dental course at Federal University of Rio Grande do Norte regarding general and specific skills proposed by DCN. The categorization of specific skills based on general skills was conducted. Then, on the basis of these categories, the moments in the early years they were developed. Unlike previously thought, the first half of the course, considered "basic cycle" which includes common disciplines to all health courses, works important elements of DCN and also brings the perspective of permanent education, one of the general competencies for the future professional. It was concluded that the "basic cycle" of Dental School at UFRN includes all general and specific skills proposed by DCN for the dental course (AU).