Three-dimensional analysis of posterior tooth inclinations in transverse and sagittal relationships: A cross-sectional study.

OBJECTIVE: To compare tooth inclinations in different sagittal skeletal patterns and transverse maxillary relationships three-dimensionally. METHODS: A cross-sectional study carried out with 132 three-dimensional digital models in the complete permanent dentition divided into six groups (n=22); three groups with maxillary atresia: G1- skeletal class I, G2- skeletal class II and G3-skeletal class III; three groups without maxillary atresia: G4- skeletal class I; G5- skeletal class II and G6- skeletal class III. The comparison between the skeletal pattern was performed by the non-parametric tests of Kruskal Wallis and Dunn and between the groups by the non-parametric test of Mann Whitney. RESULTS: Subjects with skeletal class II and maxillary atresia had a greater lingual inclination of the maxillary teeth than those with class I and III; Subjects with skeletal class II without atresia had a less lingual inclination of the mandibular molars than the other classes (p<0.05). The maxillary premolars showed no variation in dental inclination with atresia, independent of the skeletal class in G1, G2, and G3 (p>0.05). The mandibular premolars showed that the groups without atresia G4, G5, and G6 presented no significant difference (p>0.05). Lower premolars in skeletal class III malocclusion individuals with atresia had a more negative inclination than the others. CONCLUSION: There is a difference in the inclination of posterior teeth between individuals with and without maxillary atresia and skeletal classes I, II, and III.

The Behavior of Probable Sleep Bruxism, Anxiety and Need for Orthodontic Treatment in Adolescents

ABSTRACT Objective: To determine the prevalence of the need for orthodontic treatment, anxiety, and probable sleep bruxism and its association in adolescents. Material and Methods: A cross-sectional study was conducted with 294 adolescents aged between 11 and 16 years. Orthodontic treatment need was determined using the Dental Health Component of the Index of Orthodontic Treatment Needs (IOTN-DHC). Anxiety symptoms were assessed using the Brazilian version of the Multidimensional Anxiety Scale for Children (MASC). The probable sleep bruxism was identified based on the American Academy of Sleep Medicine (AASM) questionnaire. Descriptive data analyses were performed. Simple logistic regression models were applied between each independent variable and the outcome (anxiety score). Variables with p<0.20 in the individual (raw) analyses were studied in a multiple logistic regression model, with p≤0.05 remaining in the final model. Based on the regression models, the prevalence ratios were estimated with the respective 95% confidence intervals. Results: 68.7% of the adolescents had probable sleep bruxism, and 35.4% had a moderate or severe normative need for orthodontic treatment. Adolescents aged up to 12 years (OR=1.82; CI: 1.10-3.02), females (OR=2.67; CI: 1.64-4.34), and with a moderate or severe need for orthodontic treatment according to the IOTN-DHC (OR=1.76; CI: 1.06-2.90), are more likely to have a higher anxiety score. The prevalence of adolescents with a moderate or severe need for normative orthodontic treatment by the IOTN-DHC is 35.4% (95%CI: 29.9-40.8%), while the perceived need for treatment by the IOTN-AC is 14.0% (95%CI: 10.0-17.9%). Adolescents with a high degree of anxiety were more likely to have probable sleep bruxism (OR=3.64; CI: 1.06-12.50). Conclusion: Female adolescents up to 12 years of age and with a moderate or severe need for orthodontic treatment are more likely to have higher levels of anxiety; adolescents with a high degree of anxiety are more likely to have probable sleep bruxism.

Does the initial surface roughness of different CuNiTi wires affect the frictional resistance?

This study aimed to assess and correlate initial surface roughness and frictional resistance of rectangular CuNiTi wires inserted in different self-ligating brackets. The sample consisted of 40 bracket-wire sets (rectangular CuNiTi wires of 0.017" x 0.025" and passive self-ligating brackets) divided into four groups (n=10): metallic self-ligating bracket and metallic CuNiTi wire (G1); metallic self-ligating bracket and rhodium-coated CuNiTi wire (G2); esthetic self-ligating bracket and metallic wire (G3); esthetic self-ligating bracket and rhodium-coated CuNiTi wire (G4). The initial surface roughness of the wires was examined with a Surfcorder roughness meter, model SE1700. Later, frictional resistance was assessed in an Instron 4411 universal testing machine at a speed of 5 mm/min, in an aqueous medium at 35°C. Microscopic analyses of surface morphology were performed with scanning electron microscopy, using an LEO 1430, with magnifications of 1000X. Generalized linear models were applied, considering the 2 x 2 factorial (bracket type x wire type), at a 5% significance level. Regardless of bracket type, the groups with esthetic wires presented higher initial surface roughness than the groups with metallic wires (p<0.05). There was no significant difference between the different bracket-wire sets for frictional resistance and no significant correlation between frictional resistance and initial surface roughness in the environment studied. It is concluded that esthetic wires presented higher initial surface roughness but did not interfere with the frictional resistance between brackets and wires.

Does the initial surface roughness of different CuNiTi wires affect the frictional resistance?

Abstract This study aimed to assess and correlate initial surface roughness and frictional resistance of rectangular CuNiTi wires inserted in different self-ligating brackets. The sample consisted of 40 bracket-wire sets (rectangular CuNiTi wires of 0.017" x 0.025" and passive self-ligating brackets) divided into four groups (n=10): metallic self-ligating bracket and metallic CuNiTi wire (G1); metallic self-ligating bracket and rhodium-coated CuNiTi wire (G2); esthetic self-ligating bracket and metallic wire (G3); esthetic self-ligating bracket and rhodium-coated CuNiTi wire (G4). The initial surface roughness of the wires was examined with a Surfcorder roughness meter, model SE1700. Later, frictional resistance was assessed in an Instron 4411 universal testing machine at a speed of 5 mm/min, in an aqueous medium at 35°C. Microscopic analyses of surface morphology were performed with scanning electron microscopy, using an LEO 1430, with magnifications of 1000X. Generalized linear models were applied, considering the 2 x 2 factorial (bracket type x wire type), at a 5% significance level. Regardless of bracket type, the groups with esthetic wires presented higher initial surface roughness than the groups with metallic wires (p<0.05). There was no significant difference between the different bracket-wire sets for frictional resistance and no significant correlation between frictional resistance and initial surface roughness in the environment studied. It is concluded that esthetic wires presented higher initial surface roughness but did not interfere with the frictional resistance between brackets and wires.

Resumo O objetivo deste estudo foi avaliar e correlacionar a rugosidade superficial inicial e a resistência a fricção dos fios CuNiTi retangulares inseridos em diferentes bráquetes autoligados. A amostra foi composta por 40 conjuntos bráquetes-fios (fios retangulares CuNiTi de 0.017" x 0.025" e braquetes autoligados passivos), divididos em 4 grupos (n=10): bráquete autoligado metálico e fio CuNiti metálico (G1); braquete autoligado metálico e fio CuNiti com revestimento de rhodium (G2); bráquete autoligado estético e fio metálico (G3); bráquete autoligado estético e fio CuNiti com revestimento de rhodium (G4). A rugosidade superficial inicial do fio foi examinada com um rugosímetro Surfcorder modelo SE1700. Posteriormente, a resistência a fricção foi avaliada em uma máquina de ensaios universal Instron 4411, a uma velocidade de 5mm/min em meio aquoso à 35oC. Análises microscópicas da morfologia de superfície foram realizadas por microscopia eletrônica de varredura, utilizando um LEO 1430, com ampliações de 1000X. Foram aplicados modelos lineares generalizados, considerando o fatorial 2 x 2 (tipo de bráquete x tipo de fio), com o nível de significância de 5%. Independentemente do tipo de bráquete, os grupos com fios estéticos apresentaram maior rugosidade superficial inicial que os grupos com fios metálicos (p<0,05). Não houve diferença significativa entre os diferentes conjuntos bráquetes-fios quanto a resistência à fricção e não houve correlação significativa entre a resistência a fricção e a rugosidade superficial inicial no ambiente estudado. Conclui-se que os fios estéticos apresentaram maior rugosidade superficial inicial porém não interferiram na resistência a fricção entre os braquetes e os fios.

Relationship between aesthetic concern and self-esteem in adolescents with severe malocclusion.

OBJECTIVE: This study aimed to evaluate the relationship between aesthetic concern and self-esteem in adolescents with severe malocclusion. METHODS: A cross-sectional study developed with 543 adolescents from 11 to 13 years of age and severe malocclusion was selected. Dental aesthetic index (DAI) diagnosed the malocclusion and selected the groups with greater severity (DAI 3 and 4). Aesthetic concern was assessed using the oral aesthetic subjective impact scale (OASIS) and considered an outcome variable. The global negative self-evaluation (GSE) evaluated self-esteem. The variables were analysed using Poisson multiple regression and the model adjustment determined by the Akaike information criterion (AICC). The effect of each variable on OASIS was expressed as a prevalence ratio (PR) with 95% confidence intervals. The analyses were performed using the R program with a significance level of 5%. RESULTS: A significant association was observed between aesthetic concern scores and self-esteem (p<.05). Individuals with low self-esteem had OASIS scores 14% higher (PR: 1.14; 95% CI: 1.08-1.21). There was no significant association between OASIS and gender and age (p>.05). CONCLUSIONS: Self-esteem modulates how the individual perceives malocclusion. Adolescents with severe and very malocclusion and low self-esteem have greater aesthetic concerns.

What Factors are Associated with Health-Related Quality of Life in Mixed Dentition Children?

Abstract Objective: To associate the OHRQoL and HRQoL in mixed dentition children with the influence on age range, socioeconomic and clinical variables. Material and Methods: A cross-sectional study was carried out with 1,240 children between 6 and 12 years of age. HRQoL was assessed by the Quality of Life Assessment Scale, considered an outcome variable. OHRQoL was determined using specific questionnaires related to the age group: Oral Health Impact Scale in Early Childhood, Child Perceptions Questionnaire for 8 to 10 years, and 11 to 12 years. Dental caries and malocclusion were diagnosed. The socioeconomic class was evaluated. A multiple negative binomial regression analysis was used to test the relationship between HRQoL, OHRQoL scores and socioeconomic and clinical variables. Correlation analyses were performed between the total HRQoL and OHRQoL, with a significance level of 5%. Results: The HRQoL is inversely related to the impact of OHRQoL (p<0.05), modulated by the age group. There was a significant weak negative correlation between the HRQoL scores and the impact of OHRQoL (p<0.05). Conclusion: The OHRQoL impacts the HRQoL, modulated by the age group and with minor influence from socioeconomic and clinical variables (AU).

A Multivariate Analysis of the Psychosocial Impact of Malocclusion and Self-Esteem in Adolescents

Abstract Objective: To evaluate the psychosocial impact of malocclusion and self-esteem in adolescents in the Amazon region. Material and Methods: A cross-sectional study was carried out with 212 adolescents with 12-year-old enrolled in all public schools in the Boca do Acre (Amazonas, Brazil). Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) assessed the psychosocial impact of malocclusion. The self-perception of the need for orthodontic treatment was evaluated by the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and Global Negative Self-evaluation (GSE), the adolescent's self-esteem. The malocclusion was clinically evaluated by the Dental Aesthetic Index (DAI). The variables with p<0.20 in the individual analyses were tested in multiple logistic regression models, and those with p<0.10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI). Results: Adolescents with low self-esteem were 2.20 (95% CI: 1.23-3.93) times more likely to have a more significant impact on dental aesthetics (p<0.05). When verified by domains, the adolescents with low self-esteem had 2.33 (95% CI: 1.31-4.17) and 1.93 (95% CI: 1.09-3.42) times more likely to impact the psychological and social domains of the PIDAQ, respectively. Conclusion: Self-esteem influenced adolescents' perception of dental aesthetics in the domains related to psychological and social impact (AU).

A double-blinded randomized clinical trial of pain perception during orthodontic treatment / Ensaio clínico randomizado duplo cego de percepção da dor durante tratamento ortodôntico

Introduction: Orthodontic movement can cause painful symptoms, especially in the early stages of treatment. Objective: This study aimed to compare the performance of chewing gum and ibuprofen in pain control during the initial period of orthodontic treatment. Material and method: A randomized blind clinical trial, with an allocation ratio of 1:1, was developed with patients aged ≥18 years old. The sample size was established considering a significance level of 5% and test power of 80%, resulting in a minimum of 30 volunteers per group (n=90). Participants were paired regarding sex, age, the severity of malocclusion, defined by the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN), and crowding, determined by Little's irregularity index. The sample was randomly allocated to three groups: Group I (control) placebo; Group II chewing gum; and Group III Ibuprofen. Pain perception was evaluated by the Visual Analog Scale (VAS) in the first 24, 36, and 48 hours after activation of the orthodontic appliance. The data were analyzed by generalized linear models for repeated measures in time. Result: No statistically significant difference (p>0.05) was observed among the groups for the methods of pain therapy evaluated in 24, 36, and 48 hours post-activation. Conclusion: There was no difference among the method used for pain control during the orthodontic treatment.

Introdução: A movimentação ortodôntica pode causar sintomatologia dolorosa, principalmente nas fases iniciais do tratamento. Objetivo: Este estudo teve como objetivo comparar o desempenho da goma de mascar e do ibuprofeno no controle da dor durante o período inicial do tratamento ortodôntico. Material e método: Foi desenvolvido um ensaio clínico randomizado cego, com razão de alocação de 1:1, com pacientes com idade ≥ 18 anos. O tamanho da amostra foi estabelecido considerando um nível de significância de 5% e poder do teste de 80%, resultando em um mínimo de 30 voluntários por grupo (n=90). Os participantes foram pareados quanto ao sexo, idade, gravidade da má oclusão, definida pelo Componente de Saúde Bucal (DHC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN), e apinhamento, determinado pelo índice de irregularidade de Little. A amostra foi distribuída aleatoriamente em três grupos: Grupo I (controle) placebo; Goma de mascar Grupo II; e Grupo III Ibuprofeno. A percepção da dor foi avaliada pela Escala Visual Analógica (EVA) nas primeiras 24, 36 e 48 horas após a ativação do aparelho ortodôntico. Os dados foram analisados por modelos lineares generalizados para medidas repetidas no tempo. Resultado Não foi observada diferença estatisticamente significativa (p>0.05) entre os grupos para os métodos de terapia da dor avaliados em 24, 36 e 48 horas pós-ativação. Conclusão: Não houve diferença entre o método utilizado para controle da dor durante o tratamento ortodôntico.

Impact of facial profile on young adults' oral health-related quality-of-life item levels: A hierarchical analysis.

OBJECTIVE: To assess the impact of facial profile on young adults' oral health-related quality of life (OHRQoL) item levels. METHODS: A cross-sectional study was carried out with a population-based sample of 205 young adults, with a mean age of 23.1 years. The individuals answered questions about OHRQoL (OHIP-14) and self-esteem (Global Negative Self-Evaluation). The Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) was used to evaluate normative orthodontic treatment needs and define dental malocclusion clinically. Facial profile was analyzed using photographs and dichotomized into two levels: normal (straight) and altered facial profile (convex or concave). A calibrated researcher performed the clinical examination. Association between the independent variables and the outcome (OHRQoL) was established by hierarchical multiple linear regression analysis for each item level. Considering the variable of interest (facial profile), the psychological incapacity domain was the most affected item. RESULTS: Individuals with changed facial profile had 2.47 (1.04-5.85) times higher chances of reporting impacts on psychological incapacity than those with a normal profile (p> 0.05). The association was modulated by dental malocclusion and self-esteem. CONCLUSIONS: The convex and concave facial profile showed a negative impact on the psychological aspects of young adults' quality of life.

Orthodontists' preferences regarding the difference of bracket bonding height between the maxillary incisors.

INTRODUCTION: The vertical position of orthodontic brackets in maxillary incisors may influence the incisal step between the anterior teeth and thereby interfere with the smile esthetics. Even so, esthetic standards have been modified over time and consistently required technical adjustments. OBJECTIVE: This study analyzed orthodontists' preferences regarding the difference of bracket bonding height between the maxillary central incisors (MCI) and maxillary lateral incisors (MLI), and further determined whether the orthodontist sex, age and time of specialization have association to their choices. METHODS: This study collected data through an electronic form. Study participants analyzed a clinical case in which they indicated their preference for bracket bonding height. The placement height options ranged from 3.0 mm to 5.5 mm from the incisal edge, with 0.5-mm intervals, or at the clinical crown center (CCC). The difference in the bonding height between the MCI and MLI was analyzed, considering the formation of incisal steps between these teeth. RESULTS: Participants indicated that the difference in bracket bonding height between the MCI and MLI should be as follows: 0 mm (3.9%); 0.5 mm (78.3%); 1 mm (7.6%); 1.5 mm (0.2%); and CCC (9.9%). There was no statistically significant correlation between the choice for bracket bonding height and sex, age and time since specialization. CONCLUSION: Most participating orthodontists choose the 0.5-mm difference in bracket placement height between the MCI and MLI. The variables sex, age and time since specialization did not influence this choice.