Have orthodontists changed their retention and follow-up protocols due to contemporary orthodontics? An online survey.

Background: With advancements in orthodontic technology, treatment durations have shortened, often concluding at earlier ages. This shift prompts scrutiny of contemporary retention and post-treatment protocols. The study aimed to assess current professional preferences, compare them against patient age and treatment duration, and investigate the potential impacts of reduced treatment times on professional protocols, particularly when treatment concludes before pubertal growth. Methods: A questionnaire comprising 12 multiple-choice questions focused on active treatment and retention phases was developed using an online survey platform. It was distributed to licensed orthodontists engaged in patient treatment. Bivariate analysis was conducted using ANOVA and the Kruskal-Wallis test, with pairwise comparisons facilitated by the Dwass-Steel-Critchlow-Fligner method. Results: Of 743 respondents, representing a 32% response rate, approximately 70% reported initiating treatment with fixed appliances in pre-pubertal patients. The most prevalent treatment combination involved commencing treatment during early permanent dentition and lasting between 12 to 24 months, resulting in treatment completion before full growth maturation. No discernible individualization was observed in retention protocols or post-retention follow-ups. Traditional retainer prescription post-orthodontic therapy was unanimous among respondents. Notably, experienced orthodontists tended to prefer regular patient visits for follow-up, while less experienced counterparts discharged patients after 12 months. Conclusion: Contemporary orthodontic treatments are characterized by shorter durations, yet orthodontists have not adopted retention and post-treatment follow-up practices accordingly. There is a pressing need for evidence-based guidelines to develop protocols tailored to the shorter treatment durations and the increasing prevalence of younger patients completing treatment.

Reconsidering the role of nasolabial angle in premolar extraction decision-making: A case-series study.

OBJECTIVES: To evaluate the impact of changes in upper incisor inclination and position on the alteration of the nasolabial angle (NLA) in a series of cases involving the extraction of four first premolars. MATERIALS AND METHODS: The study included 41 patients who underwent orthodontic treatment with premolar extractions. The patients were divided into two groups based on their pretreatment NLA values: Group 1 (NLA ≤ 100°) and Group 2 (NLA > 100°). Measurements of NLA, U1.NA and U1-NA were obtained before and after treatment and U1-Ls pretreatment measure was registered. Statistical analyses were performed to compare the differences in NLA, U1.NA and U1-NA between the two groups and to evaluate the influence of these variables added to U1-Ls (T1) on NLA changes. RESULTS: The results showed that Group 1 exhibited significant changes in NLA, while Group 2 did not. However, both groups showed significant changes in U1.NA and U1-NA. In Group 1, 80% of the individuals presented an increase in NLA and 20% no changes. In Group 2, 10% presented a decrease, 57% no changes and 33% an increase in NLA values. Multiple linear regression analysis indicated that the group factor had a statistically significant influence on NLA variation. Additionally, in Group 2, a negative correlation was observed between changes in U1.NA and NLA. CONCLUSIONS: The findings suggest that individuals with higher pretreatment NLA values tend to maintain their NLA values even after the correction of upper incisor inclination.

Colagem indireta no tratamento orto-cirúrgico imediato ­ relato de caso / Indirect bonding in immediate ortho-surgical treatment ­ case report

Por conta das irregularidades da superfície vestibular, dificuldade de colagem em algumas regiões, como também mais facilidade na confecção de arco passivo para cirurgia ortognática de benefício antecipado, a técnica da colagem indireta vem ganhando espaço. Assim, o objetivo do trabalho é relatar um caso clínico de um paciente com 27 anos de idade sem comorbidade sistêmica e diagnosticado com ameloblastoma na mandíbula, na qual foi realizada uma colagem indireta para possibilitar a confecção do arco cirúrgico de forma passiva e, com isso, a cirurgia imediata. Por meio da técnica de colagem indireta, foi feita a colagem dos bráquetes no modelo de gesso e, após a colagem, foi confeccionado o arco passivo superior e inferior. Com os guias de colagem indireta e os arcos prontos, realizou-se a colagem na boca do paciente, os arcos cirúrgicos foram instalados e o mesmo foi encaminhado para realização da cirurgia de remoção do ameloblastoma. Erros no posicionamento dos bráquetes irão interferir no resultado final, aumentando, assim, o tempo de trabalho. A técnica da colagem indireta tem se demonstrado um avanço para a Ortodontia, otimizando o tempo de atendimento clínico como também o tempo cirúrgico nos casos de benefício antecipado. (AU)

Due to the irregularities of the vestibular surface, difficulty in gluing in some regions, as well as ease in creating a passive arch for orthognathic surgery with anticipated benefits, the indirect bonding technique has been gaining ground. Thus, the objective of the work is to report a clinical case of a 27-year-old patient without systemic comorbidity and diagnosed with ameloblastoma in the mandible, to whom indirect bonding was performed to enable the creation of the surgical arch in a passive way and, with this, the immediate surgery. Using the indirect bonding technique, the brackets were bonded to the plaster model and, after bonding, the upper and lower passive arch was created. With the indirect bonding guides and the archwires ready, the bonding was done in the patient's mouth, the surgical archwires were installed, and the patient was sent to undergo surgery to remove the ameloblastoma. Errors in the positioning of the brackets will interfere with the final result, thus increasing working time. The indirect bonding technique has proven to be an advance for Orthodontics, optimizing clinical care time as well as surgical time in cases of anticipated benefit (AU)

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)

Qual a minha sequência preferida de fios ortodônticos durante o tratamento ­ uma escolha baseada em critérios / My favorite sequence of orthodontic wires during the treatment ­ a choice based on criteria

O arco ortodôntico representa o elemento ativo do tratamento e é o principal responsável pela movimentação dentária induzida. O objetivo deste trabalho foi apresentar uma sequência de fios ortodônticos a ser utilizada durante a fase inicial, intermediária e final do tratamento com aparelhos fixos e os critérios a serem observados na seleção destes arcos (AU)

The orthodontic archwire represents the active element for treatment, and it is the main responsible for induced tooth movement. This study aims to present a sequence of orthodontic wires to be used in the early, intermediate and final phases of fixed appliance therapy as well as the criteria to be observed in the selection of these archwires (AU)

Tratamento da classe III com disjunção maxilar e tração reversa da maxila: relato de caso clínico / Class III treatment weth maxillary disjunction and reverse maxillary traction: clinical case report

Objetivo: A má oclusão classe III de Angle se caracteriza por protrusão mandibular, retrusão maxilar ou pela combinação de ambas. Além de prejudicar a estética facial do paciente, essa má oclusão pode causar alterações funcionais e respiratórias. Uma das alternativas de tratamento para esses casos é o uso da máscara de Petit e do aparelho disjuntor de Hyrax. Este estudo tem como objetivo avaliar por meio da cefalometria ortodôntica se o tratamento com expansão maxilar em conjunto com a tração reversa da maxila diminuem os agravos estéticos e funcionais do paciente Classe III. Relato de caso: o relato de caso descrito no presente trabalho é sobre uma paciente que foi submetida a esse tratamento, sendo descrito por meio de análises cefalométricas, exames radiográficos, fotos intrabucais e achados clínicos. Considerações finais: A verificação dos resultados obtidos após o término do tratamento mostrou que a paciente teve uma boa adesão ao uso desses aparelhos e obteve resultados satisfatórios na sua função mastigatória, na sua oclusão e na sua estética facial e dentária.(AU)

Objective: Angle class III malocclusion is characterized by mandibular protrusion, maxillary retrusion or a combination of both. In addition to impairing the patient's facial aesthetics, this malocclusion can cause functional and respiratory changes. One of the treatment alternatives for these cases is the use of the Petit mask and the Hyrax breaker device. This study aims to evaluate, through orthodontic cephalometry, whether the treatment with maxillary expansion in conjunction with the reverse traction of the maxilla reduces the aesthetic and functional problems of Class III patients. Case report: the case report described in the present work is about a patient who underwent this treatment, being described through cephalometric analysis, radiographic examinations, intraoral photos and clinical findings. Final considerations: The verification of the results obtained after the end of the treatment showed that the patient had a good adherence to the use of these devices and obtained satisfactory results in her masticatory function, in her occlusion and in her facial and dental aesthetics.(AU)

Effectiveness and predictability of treatment with clear orthodontic aligners: A scoping review.

INTRODUCTION: In an ideal clinical setting, orthodontic therapy with clear aligners (CA) should improve the patients' initial malocclusion and must guarantee equivalence between the results predicted and those obtained clinically to be considered an effective treatment. Therefore, this scoping review aimed to identify the orthodontic literature concerning the effectiveness and predictability of CA treatments. METHODS: A systematic computerized search was performed in 3 databases: PubMed, Scopus, and Embase. Inclusion criteria selected observational and clinical studies performed in at least 10 adult orthodontic patients, whose results of CA treatment's effectiveness and/or predictability were assessed. RESULTS: The 3 database computerized searches resulted in 1,553 articles, and 169 full texts were considered potentially relevant. After applying the eligibility criteria, 33 studies were included. Most studies (76%) were designed as cohort studies and have been published in the last 5 years (79%). The majority included only non-extraction treatments (73%), and 79% reported results achieved with the Invisalign® system. The most predictable movement was the buccolingual tipping, while the least predictable movements were rotation, intrusion, and extrusion. Aligner treatment was effective for mild to moderate crowding resolution, and the success of overbite correction still seems to be limited. CONCLUSIONS: The studies have demonstrated improvement of initial malocclusion through CA treatments. Still, predictability degree is overestimated and does not accurately reflect the occlusion immediately at the end of treatment. In future studies, there should be an effort to broaden the utilization of alternative aligner systems beyond Invisalign® and broadly disseminate their outcomes to strengthen clear aligners evidence base.

Avaliação da padronização da força inicial liberada por elásticos ortodônticos em cadeia / Evaluation of the standardization of the initial released force by chain orthodontic elastics

Resumo Este trabalho avaliou a padronização da força inicial liberada por elásticos ortodônticos em cadeia em diferentes lotes de fabricação de três marcas comerciais. Foram testadas 762 amostras de elásticos em cadeia incolores, tamanho médio, das marcas Morelli®, Uniden® e Eurodonto®. Os elásticos foram distribuídos em 6 diferentes grupos: Grupo M (Morelli), Grupo U (Uniden) e Grupo E (Eurodonto), com 2 lotes para cada grupo. Os elásticos foram mantidos em um "jig" de acrílico de 07 X 07 cm que foi fixado em uma base de madeira de 55 X 15 cm. Os elásticos foram ativados em 50% de seus comprimentos iniciais e as forças iniciais liberadas foram mensuradas através de um dinamômetro digital de precisão. Foram utilizados os testes de Kolmogorov-Smirnov e "t" de Student com 5% de significância para ambos os testes. Os resultados evidenciaram diferença significativa entre a força inicial média liberada de 336,84g e 270,72g dos lotes 1 e 2, respectivamente, da marca U. Não houve diferença significativa entre os lotes da marca M apresentando força inicial média de 310,31g e 312,77g e da marca E com forças iniciais médias de 378,42 e 377,91. Os grupos M,U e E apresentaram os percentuais de 8,7%, 4,3% e 11,4%, respectivamente, de amostras elásticas liberando força inicial considerada padronizada. Pode-se concluir que as marcas Morelli® e Eurodonto® apresentaram força inicial padronizada quando variações entre os lotes foram investigadas. Porém, todas as marcas comerciais apresentaram percentual muito baixo de amostras elásticas com força inicial padronizada, considerando o intervalo de confiança (AU)

Abstract This study evaluated the standardization of the initial strength delivered by elastomeric chains of different lots of fabrication of three commercial brands. 762 colorless middle size samples of elastomeric chains were tested of the brands Morelli®, Uniden® and Eurodonto®. The elastics were distributed in 6 different groups: Group M (Morelli), Group U (Uniden) and Group E (Eurodonto), with 2 lots for each group. The elastics were maintained in a "jig" of 07 x 07 cm acrylic one that was fixed in a 55 X 15 cm wooden base. The elastics were activated in 50% of his initial lengths and the released inicial force was measured through a digital precision dynamometer. Kolmogorov-Smirnov tests were used and Student "t" test with 5% of significantion for both tests. The results showed significant difference between the mean initial released force of 336.84g and 270.72g of lots 1 and 2, respectively, of brand U. There was no significant difference between lots of brand M presenting average initial force of 310.31g and 312.77g and brand E with initial forces of 378.42 and 377.91. Groups M, U and E presented the percentages of 8.7%, 4.3% and 11.4%, respectively, of elastic samples releasing initial strength considered standardized. It can be concluded that the Morelli® and Eurodonto® brands showed standardized initial strength when variations between lots were investigated. However, all commercial brands had a very low percentage of elastic samples with standardized initial strength, considering the confidence interval (AU)

Tratamento multidisciplinar de paciente adulto padrão face curta ­ relato de caso / Interdisciplinary treatment of short-face adult patient ­ case report

Resumo Introdução: As más-oclusões do Padrão Face Curta são responsáveis por prejuízos estéticos e funcionais, entretanto o diagnóstico tardio impede o tratamento ortopédico preventivo e a cirurgia ortognática pode ser uma opção para os pacientes desfuncionados. Objetivo: Descrever por meio de um relato de caso o tratamento ortodôntico descompensatório cirúrgico associado à reabilitação estética de um paciente Padrão Face Curta. Descrição: Paciente Padrão Face Curta, sexo masculino, 26 anos, leucoderma, relação de Classe II total de molar e canino, sobremordida e sobressalência aumentada, protrusão dentária superior, relação de lábio comprimido, terço inferior da face diminuído. O tratamento proposto foi o tratamento ortodôntico descompensatório cirúrgico associado à reabilitação estética, considerando a gravidade dos sinais apresentados e a queixa do paciente. No final do tratamento, houve o resgate do equilíbrio estético e oclusal, com a solução total das queixas do paciente. Conclusão: Neste relato de caso, pôde se verificar a necessidade da participação interdisciplinar para obter um melhor resultado em um paciente Padrão Face Curta. O diagnóstico e planejamento realizado pelo ortodontista e pelo cirurgião bucal foram essenciais para alcançar um bom acabamento estético e funcional. (AU)

Abstract Introduction: Short-face Pattern malocclusions are responsible for aesthetic and functional impairments; however, late diagnosis excludes preventive orthopedic treatment, and orthognathic surgery can be an option for dysfunctional patients. Objective: To describe through a case report the surgical decompensatory orthodontic treatment associated with aesthetic rehabilitation of a Short-faced Pattern patient. Description: Short-face Pattern patient, male, 26 years old, leucoderma, total Class II molar and canine relationship, increased overbite and overjet, maxillary teeth protrusion, compressed lip relationship, decreased lower third of the face. The proposed treatment was a surgical decompensatory orthodontic treatment associated with aesthetic rehabilitation, considering the severity of the signs presented and the patient's complaint. At the end of the treatment there was aesthetic and occlusal balance rescue, with total solution of the patient's complaints. Conclusion: In this case report, we can verify the need for interdisciplinary participation to obtain a better result in a Short-faced Pattern patient. The diagnosis and planning performed by the orthodontist and the oral surgeon were essential to reach a good aesthetic and functional finishing.(AU)

Tratamento compensatório da má oclusão de Classe III esquelética com mini-implante ­ relato de caso / Compensatory treatment of skeletal Class III malocclusion with miniscrews ­ case report

Resumo O tratamento compensatório da má oclusão de Classe III esquelética representa uma opção para pacientes adultos que não desejam se submeter ao tratamento ortodôntico-cirúrgico e desejam melhorias na oclusão e estética facial. O sucesso do tratamento compensatório da má oclusão de Classe III depende de um correto diagnóstico e planejamento de tratamento que considere a gravidade das discrepâncias verticais e anteroposteriores e o padrão de crescimento do paciente. O objetivo deste estudo é apresentar o tratamento de um paciente adulto com má oclusão esquelética moderada de Classe III e protrusão mandibular tratada com ancoragem esquelética e sliding jig ancorado em mini implantes e elásticos intermaxilares de Classe III. Os resultados alcançados levaram a uma melhora significativa no perfil do paciente com a estética do sorriso. Relações de molares e caninos de Classe I foram alcançadas. O sucesso na correção da discrepância oclusal anteroposterior e a correção estética de uma má oclusão de Classe III através do tratamento compensatório com elásticos de Classe III e mini implantes podem ser alcançados se a adesão do paciente for satisfatória. (AU)

Abstract Compensatory treatment of skeletal Class III malocclusion represents an option for adult patients who do not want to undergo orthodontic-surgical treatment and wish occlusion and facial aesthetics improvements. The success of the compensatory treatment of Classe III malocclusion depend on a correct diagnosis and treatment planning that considers the severity of vertical and anteroposterior discrepancies and the patient growth pattern. The aim of this study is to present the treatment of an adult patient with moderate skeletal Class III malocclusion and mandibular protrusion treated with skeletal anchorage whit miniscrew-anchored sliding jig and Class III intermaxillary elastics. The results achieved led to a significant improvement in the patient profile whit smiles esthetics. Class I molar and canine relationships were achieved. Successful on the correction of the anteroposterior occlusal discrepancy and esthetic correction of a Class III malocclusion through compensatory treatment with Class III elastics and miniscrew can be achieved if patient's compliance is satisfactory. (AU)

Tratamento da má oclusão de Classe II com o propulsor mandibular PMW: acompanhamento de 4 anos / Treatment of CL II malocclusion with the PMW-type mandibular propulsion: 4-year follow-up

O presente artigo teve como objetivo descrever, por meio de um caso clínico, o manejo ortopédico com intenção corretiva de um paciente Padrão II por retrusão mandibular, má oclusão de Classe II divisão 1 e face aceitável. Relato do caso: O paciente foi submetido a um tratamento com o propulsor mandibular Westerich (PMW) associado à ortodontia fixa. Resultados: A terapia utilizada proporcionou a correção da relação sagital de Classe II, com considerável ganho estético no perfil facial em razão da suavização da ângulo mentolabial e da compensação com inclinação vestibular dos incisivos inferiores. No acompanhamento de 4 anos pôde-se observar excelente estabilidade do tratamento com manutenção dos efeitos dentoalveolares, boa qualidade da tábua óssea vestibular e da inserção gengival dos incisivos inferiores. Conclusão: o aparelho ortopédico fixo PMW é uma opção eficaz para o tratamento de paciente Padrão II por deficiência mandibular quando os objetivos, principalmente, de ordem dentoalveolares são almejados. O aparelho é de fácil instalação, confortável e depende minimamente da cooperação do paciente, além de proporcionar resultados extremamente satisfatórios com a correção das relações oclusais e estabilidade a longo prazo (AU)

Introduction: The paper describes, through a case report, an orthopedic management of a Pattern II with mandibular retrusion patient, associated with Class II division 1 malocclusion and an acceptable face. Case report: The patient underwent treatment with the Westerich fixed functional device (PMW) associated with fixed orthodontics. Results: The therapy provided correction of the Class II sagittal relationship, with considerable aesthetic improvement due to smoothing of the mentolabial angle and dental compensation by buccal inclination of the lower incisors. 4-year follow-up showed excellent stability and maintenance of dentoalveolar effects. Also, good quality of the buccal bone plate and gingival insertion of the lower incisors were observed. Conclusion: PMW is an effective option for the Pattern II patients with mandibular deficiency treatment when, mostly dentoalveolar effects, are pursued. The device has easy installation, is comfortable and depends minimally on the patient's cooperation. In addition, it provides satisfactory results with the correction of occlusal relationships and long-term stability.(AU)

Versatilidade de ligaduras elastoméricas na correção de rotações unitárias / The versatility of elastomeric ligatures in the correction of single tooth rotations

Resumo Introdução: As ligaduras elastoméricas, também conhecidas popularmente como "elastics", são amplamente utilizadas na ortodontia fixa há bastante tempo. Contudo, além da função de apreender o arco aos slots dos bráquetes, elas também podem ser utilizadas para correção de pequenas giroversões dentárias. Diversas marcas comerciais já desenvolveram um modelo específico de acessório elastomérico para desempenhar essa função, nomeado como "rotator"; porém, por ter um tamanho padronizado, acabam provocando sobrecorreção do movimento em determinadas situações da prática clínica. Descrição da técnica: Desta maneira, o objetivo deste artigo é ilustrar a utilização e versatilidade dos famosos "elastics", posicionados de três formas diferentes nas aletas dos bráquetes, para realizar a correção de pequenas giroversões unitárias na ortodontia fixa. Conclusão: A versatilidade de seu uso permite diferentes magnitudes de correção com praticidade (AU)

Abstract Introduction: Elastomeric ligatures, popularly known as "elastics" have been widely used in orthodontic treatment with fixed appliances for a long time. However, in addition to the function of fixating the archwires to the bracket slots, they may also be used for the correction of minor tooth rotations. Various commercial brands have developed a specific model of elastomeric accessory to perform this function, known as "rotation wedge". However, as they are of a standardized size, they end up causing overcorrection of the movement in certain clinical situations. Technique description: This article aimed to illustrate the use and versatility of the famous "elastics", positioned in 3 different ways on the bracket tie wings to effectuate correction of small single tooth rotations in orthodontic treatment with fixed appliances. Conclusion: The versatility of their use allows different magnitudes of correction with practicality. (AU)

Tratamento de má oclusão de Classe II por meio de distalização sequencial posterior com alinhadores ortodônticos ClearCorrect / Treatment of Class II malocclusion through upper distalization with ClearCorrect aligners

Resumo A segunda mais prevalente má oclusão de Angle na população é a de Classe II. Dentre as abordagens de tratamento consideradas pelos profissionais, está a distalização dos dentes posteriores superiores ou exodontias. A distalização, dependendo do nível de complexidade do caso, pode ser desafiadora e necessitar de mecânicas auxiliares para realizar movimentos translacionais e não somente de inclinação coronária. A escolha da abordagem para esses tratamentos depende diretamente da colaboração do paciente, severidade da má oclusão, caracterização da Classe II, idade do paciente e habilidade técnica do profissional responsável. Com o aumento da procura por tratamentos ortodônticos mais estéticos, os alinhadores ortodônticos têm sido frequentemente uma alternativa aos pacientes. Dependendo da severidade da má oclusão, pode-se associar aos auxiliares comumente utilizados na Ortodontia convencional fixa. Portanto, o objetivo deste trabalho é apresentar a resolução de uma má oclusão de Classe II, divisão 1, com impactação do canino superior direito e desvio de linha média superior para a direita tratada com alinhadores ortodônticos ClearCorrect. (AU)

Abstract The second more prevalent Angle's malocclusion on the population is Class II. Among the continuously considered treatment approaches by clinicians, is the distalization of upper teeth or extractions. The distalizations, depending on the case's complexity, can be challenging and need auxiliary mechanics to perform translation movements and not just crown tipping. The choose of the appliance for these treatments relies directly on the option/collaboration of the patient, malocclusion severeness, patient's age, and technical ability of the main professional taking care of the case. With the crescent search for more aesthetic orthodontic treatments, the clear aligners have been frequently looked for by the patients as an alternative and, regularly related to auxiliaries commonly associated to the conventional fixed appliances. Regarding this context, the objective of this study is to present the case report of a patient with Class II, division 1, upper midline deviation to the right and unerupted upper right canine through the ClearCorrect aligners' system. (AU)

The impact of COVID-19 pandemic on total treatment time of fixed appliances.

BACKGROUND: Several aspects of the orthodontic routine seem to have been affected since the emergence of SARS-CoV-2. We aimed to evaluate the impact of the COVID-19 pandemic on the duration of fixed orthodontic treatment. METHODS: This retrospective study evaluated consecutive cases of patients undergoing fixed orthodontic treatment that completed treatment before (n = 37) or during (n = 26) the COVID-19 pandemic. The impact of the pandemic on treatment time was adjusted for the patient's initial age, sex, number of debonds/breakages, number of missing teeth, initial PAR (Peer Assessment Rating) index (T0) and operator (n = 2), through multiple linear regression. The impact generated by months of treatment conducted during the pandemic period was also examined. Seven poorly finished cases were previously excluded, including five finished during the pandemic. RESULTS: Although the number of absences/missed appointments of patients treated during the pandemic was four months more than those treated in the previous period (p < 0.001), there was no significant effect of the pandemic on total orthodontic treatment time for both operators. There was also an effect of operator (ß = 10.42, p < 0.001) and gender, which was lower in females (ß = 4.77, p = 0.03), on treatment time (R2 = 0.27). The other variables showed no significant association (p > 0.05). CONCLUSION: The COVID-19 pandemic did not have a significant effect on total orthodontic treatment time, although a greater number of absences/missed appointments were observed.

Aesthetic perception of smile in long face pattern patients who underwent maxillary impaction with miniplates or orthognathic surgery.

INTRODUCTION: The gummy smile is perceived in 10% of the population aged 20 to 30 years old, and it causes an aesthetic imbalance in the smile. This study investigated the existence of differences in the aesthetic perception of the smile after correcting the gummy smile using two different techniques: orthognathic surgery for maxillary impaction and miniplate-aided orthodontic impaction. METHODS: Photographs of 16 Long Face Pattern female patients were evaluated by 56 oral and maxillofacial surgeons, 56 orthodontists, and 56 laypeople before and after the treatment with one of the two techniques. These photographs were standardized using the Photoshop program, randomly organized, and then presented to the evaluators via the Google Meeting® application in the PowerPoint® program. To evaluate the attractiveness of the smile, the Visual Analogue Scale (VAS) was used. To analyze the intra and inter-examiner concordances, Spearman's correlation and Kendall's concordance tests were used, respectively. For intergroup comparison, the Friedman test was used, with a 5% significance level. RESULTS: For all three groups of evaluators, the post-treatment evaluation results were superior to the results before the treatment: surgeons and orthodontists assigned higher scores for surgical cases and laypeople for orthodontic cases. CONCLUSION: From a clinical point of view, there was no difference between the results of both techniques with regard to the aesthetic perception of smiles. A gingival exposure ranging from zero to two millimeters was considered the most aesthetic for all evaluators.

The effect of whitening toothpastes on polyurethane and silicone orthodontic clear ligatures: A clinical study.

BACKGROUND: This study aimed to verify the effects of bleaching toothpaste on colour stability, elastic properties, surface topography between aesthetic polyurethane and silicone elastomeric ligatures from different brands. METHODS: Elastomeric ligatures tested were: 1-Mini Single Case Ligature Stick (RMO-polyurethane); 2-Ligature "S" Shaped Dispenser (RMO-Silicone); 3-Sany-tie (GAC-translucent polyurethane); and 4-Sili-tie (GAC-translucent silicone). The ligatures were randomly assigned from the brackets of canines and lower incisors of 40 patients. The study had two phases of 30 days in which a different toothpaste was used, followed by a washout period of 30 days. After each phase, ligatures were submitted to colour checking, tensile strength, and SEM. RESULTS: The average of the ultimate tensile strength (m = 2.59; DP = 0.014) was higher in the control ligatures if compared to the tested ones (m = 2.24; DP = 0.014). There were no statistically significant differences between toothpastes regarding the type of ligature. Also, no interaction was observed between toothpastes in ligature's ultimate tensile strength and strain. The type of toothpaste did not minimize colour changes. CONCLUSION: In conclusion, there was no difference in colour stability and elastic properties between polyurethane or silicone aesthetic elastomeric modules. Whitening toothpastes had no impact on ligatures performance after 30 days in the oral cavity.

Class II treatment effects with fixed functional appliances: Jasper jumper vs. Forsus fatigue resistant device.

OBJECTIVE: This study aimed to compare cephalometric changes of Class II malocclusion patients treated with Jasper Jumper and Forsus, associated with fixed appliances. METHODS: The sample consisted of 62 individuals divided into 3 groups: group 1 included 22 subjects with a mean initial age of 12.39 years, treated with Jasper Jumper associated with fixed appliances for a mean period of 2.43 years; group 2 included 19 subjects with a mean initial age of 12.43 years, treated with Forsus associated with fixed appliances for a mean period of 3.54 years; and group 3 included 22 Class II malocclusion untreated subjects at a mean age of 12.14 years, followed for a mean period of 1.78 years. Intergroup comparison was performed with one-way ANOVA, followed by Tukey test. RESULTS: Both treated groups had similar dentoskeletal changes: restrictive effect on the maxilla; clockwise rotation of the occlusal plane; mild increase in lower anterior facial height; limitation on the vertical development of the maxillary molars; labial tipping and intrusion of the mandibular incisors; extrusion of mandibular molars; improvements of the maxillomandibular relationship, overjet, overbite, molar relationship; and retrusion of the upper lip. The mandibular incisors exhibited greater protrusion in group 1 compared to the other groups. In addition, group 2 presented mild protrusion of the lower lip, and groups 1 and 3 showed mild retrusion. CONCLUSION: The Jasper Jumper and Forsus appliances were effective and showed similar changes in the treatment of Class II malocclusion.

Elásticos intermaxilares no tratamento de má oclusão Classe II divisão 1 ­ um enfoque clínico / Intermaxillary elastics in the treatment of Class II division 1 maloclusion ­ a clinical approach

Resumo As más oclusões têm etiologia multifatorial, são causadas por fatores ambientais e genéticos. Dentre os tipos de más oclusões existentes tem-se a Classe ll, que geralmente se caracteriza pela protrusão de dentes superiores, retrusão de dentes inferiores, prognatismo maxilar ou retrognatismo mandibular. Com o passar dos anos, os elásticos intermaxilares foram sendo desenvolvidos e melhorados, com isso houve um aumento em sua aplicabilidade na Ortodontia. Existem diversas situações clínicas em que se pode utilizar os elásticos, no entanto o profissional precisa entender seus riscos e limitações. Este artigo apresenta um relato de caso sobre o tratamento para Classe II com o uso de elásticos intermaxilares, cuja mecânica é de fácil manuseio e baixo custo.(AU)

Abstract Malocclusions have a multifactorial etiology, they are caused by environmental and genetic factors. Among the existing types of malocclusions there is Class II, which is generally characterized by upper teeth protrusion, lower teeth retrusion, maxillary prognathism or mandibular retrognathism. Over the years, intermaxillary elastics have been developed and improved, thus, there has been an increase in their applicability in Orthodontics. There are several clinical situations in which we can use elastics, however, the professional needs to understand their risks and limitations. This article presents a case report on the treatment of Class II with the use of intermaxillary elastics, whose mechanics are easy to handle and of low cost. (AU)

Atresia maxilar associada à mordida aberta anterior tratada por meio de expansão rápida da maxila assistida cirurgicamente (ERMAC) / Transverse maxillary deficiency associated with open bite treated by surgically assisted rapid maxillary expansion (SARME)

Resumo A expansão rápida da maxila assistida cirurgicamente (ERMAC) é uma opção de tratamento segura e eficaz para a correção da mordida cruzada posterior em adultos. O objetivo deste artigo é relatar um caso clínico de uma paciente de 37 anos de idade com atresia maxilar e mordida aberta aberta anterior, tratada por meio da ERMAC. O plano de tratamento consitiu na expansão cirúrgica da maxila utilizando um aparelho de Hyrax. Foi realizada a cirurgia de Le Fort I associada a Osteotomia vestibular entre as raízes dos incisivos centrais superiores. Ao término do período ativo de expansão, foi instalado aparelho fixo corretivo no arco inferior e após 4 meses após a expansão foi removido o disjuntor e instalado aparelho fixo superior. Os fios de nivelamento foram evoluídos até .019"x.025" aço. Nesta fase, elásticos intermaxilares de Classe II e verticais anteriores foram utilizados para corrigir a Classe II sudbivisão esquerda e a mordida aberta anterior, respectivamente. Após a remoção dos aparelhos fixos corretivos, foram instaladas as contenções; placa Hawley no arco superior e 3×3 no arco inferior. A relação transversal foi corrigida de maneira eficiente por meio da ERMAC, alcançando assim, adequada relação interarcos. A oclusão finalizou estável com conformação do arco e do sorriso satisfatórios.(AU)

Abstract The surgically assisted maxilla expansion (ERMAC) is a safe and effective treatment option for correction of posterior crossbite in adults. The objective of this article is to report a clinical case of a 37-year-old patient with maxillary atresia and anterior open bite, treated by ERMAC. The treatment plan consisted of the surgical expansion of the maxilla using a Hyrax device. Le Fort I surgery was performed in association with vestibular osteotomy between the roots of the upper central incisors. At the end of the active expansion period, a fixed corrective device was installed in the lower arc and after 4 months after the expansion the circuit breaker was removed and a fixed upper apparatus was installed. Leveling wires were evolved up to. 019"x.025" steel. In this phase, intermaxillary elastics of Class II and anterior vertical elastics were used to correct Class II left sudbivision and anterior open bite, respectively. After removing the fixed corrective devices, the containments were installed; Hawley board in the upper arch and 3×3 in the lower arch. The cross-sectional relationship was efficiently corrected by means of the ERMAC, thus achieving an adequate interarcol relationship. The occlusion ended stable with conformation of the arch and the smile satisfactory. (AU)

Avaliação da resistência à torção de mini-implantes após uso clínico e processo de reciclagem / Assessment of mini-implants resistance to torsion after clinical use and recycling process

Resumo Objetivo: O objetivo do presente estudo foi avaliar a influência do uso clínico e do processo de reciclagem nos valores de torção e na resistência mecânica à fratura dos mini-implantes. Material e métodos: Trinta e quatro mini-implantes autoperfurantes de titânio (Ti-6AI-4V) de uma mesma marca comercial com 1,5 mm de diâmetro, 8,0 mm de comprimento e perfil transmucoso de 2,0 mm, que foram selecionados e divididos em dois grupos: Grupo 1 foi composto de 24 mini-implantes inseridos na maxila e mandíbula de 17 pacientes sob tratamento ortodôntico e, que após 4 meses foram removidos e submetidos aos processos de reciclagem, incluindo limpeza e esterilização. O grupo 2 (controle) foi composto por 10 mini-implantes, conforme comercializados pelo fabricante. Os valores de torque de inserção e o torque máximo no momento da fratura dos mini-implantes foram realizados na máquina de teste universal (EMIC). Para comparação dos dados entre os grupos, foi realizado o t independente (p>0,05). Resultados: Não houve diferença estatisticamente significativa no teste de ensaio de resistência à torção entre os grupos analisados. Conclusão: Pode-se concluir que o processo de reciclagem dos mini-implantes não influenciou nos valores de resistência à torção, mantendo-se dentro do limite recomendado pelo fabricante para seu uso clínico.(AU)

Abstract Objective: The objective of the present study was to evaluate the influence of clinical use and the recycling process on torsion values and on the mechanical resistance to fracture of mini-implants. Material and methods: Thirty-four self-drilling titanium (Ti-6AI-4V) mini-implants of the same commercial brand, 1.5 mm in diameter, 8.0 mm in length and 2.0 mm transmucosal profile that were selected and divided into two groups: Group 1 consisted of 24 mini-implants inserted in the maxilla and mandible of 17 patients under orthodontic treatment, and that after 4 months were removed and submitted to recycling processes, including cleaning and sterilization. Group 2 (control) consisted of 10 mini-implants as marketed by the manufacturer. The insertion torque values and the maximum torque at the time of the mini- implant fracture were performed on the universal testing machine (EMIC). To compare data between groups, independent t was performed (p> 0.05). Results: There was no statistically significant difference in the torsion resistance test between the groups analyzed. Conclusion: It can be concluded that the mini-implants recycling process did not influence values of torsion resistance, remaining within the limit recommended by the manufacturer for its clinical use. (AU)