Comparison of Gingival Recession of Mandibular Incisors of Class III Patients Immediately after Compensatory or Surgical Orthodontic Treatment.

OBJECTIVE: This study aimed to compare gingival recession in mandibular anterior teeth in patients with Class III malocclusion, immediately after compensatory or surgical orthodontic treatment. MATERIALS AND METHODS: The sample consisted of 40 patients with Class III malocclusion, divided into two groups: Group 1 (compensatory), 20 patients treated with compensatory orthodontics, with a mean initial age of 20.26 years (standard deviation [SD] . = 7.44), mean final age of 23.07 years (SD = 7.32), and mean treatment time of 2.81 years (SD =0.84). Group 2 (surgical), who undergone orthodontic-surgical treatment, with a mean initial age of 23.08 years (SD =5.48), mean final age of 25.43 years (SD =5.12), and mean treatment time of 2.35 years (SD =1.56). Intraoral photographs taken before and after removal of the fixed orthodontic appliance were used to measure the gingival recession, from the cervical of the mandibular incisors from the most cervical point of the gingival margin to the cementoenamel junction. In the initial and final cephalograms, the position of the mandibular incisors was measured. The intergroup comparison was performed using the independent t-test. RESULTS: The results showed that there was no statistically significant difference in the gingival recession at the beginning, at the end, and of changes with treatment between the compensatory and surgical groups. CONCLUSION: It was concluded that the compensatory and surgical orthodontic treatments for Class III malocclusion showed similar results regarding the gingival recession of the mandibular incisors.

Smile attractiveness in class III patients after orthodontic camouflage or orthognathic surgery.

OBJECTIVE: The study's objective was to compare the smile attractiveness in patients with class III malocclusion treated with orthodontic camouflage or orthognathic surgery. MATERIAL AND METHODS: The sample consisted of 30 patients with class III malocclusion treated without extractions divided into two groups, according to the treatment performed: G1, orthodontic camouflage, consisting of 15 patients (9 female; 6 male) with mean initial age of 21.26 years (SD = 7.39) and mean final age of 24.52 years (SD = 7.10). The mean treatment time was 3.26 years (SD = 1.50). G2, ortho-surgical, consisting of 15 patients (8 females; 7 males), with mean initial age of 23.12 years (SD=7.37), mean final age of 25.82 years (SD = 7.14) and mean treatment time of 2.71 years (SD = 0.90). The smile attractiveness was evaluated in black and white photographs of posed smiles taken before and after treatment, with a numerical rating scale from 1 to 10, with 1 being the least attractive and 10 the greatest smile attractiveness. The smiles were evaluated in a questionnaire by 111 participants, 67 orthodontists (mean age 41.31 years, SD = 9.44) and 44 laypeople (mean age 41.41 years, SD = 14.38). Intergroup comparison was performed with independent t test. RESULTS: There was a significant improvement in the smile attractiveness with both camouflage and ortho-surgical treatments. The smile attractiveness was similar between the camouflage and surgical groups at the beginning. There was a significantly greater improvement in smile attractiveness with treatment in the surgical group than in the camouflage group, and at the end of treatment, the surgical group showed greater smile attractiveness than the camouflage group. Orthodontists considered the smiles more attractive both at the beginning and the end of treatment when compared to the assessment made by laypeople. CONCLUSION: The ortho-surgical treatment promoted a greater improvement in the smile attractiveness, and at the final stage, a greater smile attractiveness than the orthodontic camouflage. CLINICAL RELEVANCE: Smile attractiveness is an important characteristic of the final result of orthodontic treatment. Knowing which treatment protocol will provide a better improvement and outcome regarding smile esthetics is essential.

Comparison of Profile Attractiveness between Class III Orthodontic Camouflage and Predictive Tracing of Orthognathic Surgery.

OBJECTIVE: The aim of this study was to compare the profile attractiveness between orthodontic camouflage of the Class III malocclusion and the predictive tracing simulating orthognathic surgery evaluated by dentists and laypeople. Settings and sample population. The sample consisted of 21 patients (9 male; 12 female) with Class III malocclusion treated with orthodontic camouflage and Class III intermaxillary elastics. Material and Methods. The mean initial age of the patients was 24.38 years (SD 3.32), and the mean ANB angle was -1.91° (SD 0.83°). Patients presented skeletal Class III and normal growth patterns. Initial and final lateral cephalograms of each patient were used. The initial cephalogram was used to perform the treatment simulation of orthognathic surgery, and its silhouette was compared to the silhouette obtained from the final cephalogram after Class III orthodontic camouflage. A subjective analysis of profile attractiveness was performed by 47 laypeople and 60 dentists, with scores from 1 (less attractive) to 10 (most attractive). Mann-Whitney tests were used to compare profile attractiveness between the orthodontic treatment and the predictive tracing groups and between dentists and laypeople. RESULTS: The predictive tracing of orthognathic surgery showed to be statistically significantly more attractive (mean score 4.57, SD 2.47) than that of the Class III camouflage orthodontic treatment (mean score 4.22, SD 2.40), with a mean numerical but significant difference of 0.35 (SD 2.01) (P < 0.001). Laypeople were more critical than dentists in evaluating profile attractiveness, but numerical difference between the groups was also small. CONCLUSION: The profile silhouette of predictive tracing simulating orthognathic surgery showed to be more attractive than that of Class III camouflage orthodontic treatment; however, differences were small but statistically significant. Laypeople showed to be more critical than dentists.

Comparison of the facial profile attractiveness in Class III borderline patients after surgical or compensatory orthodontic treatment.

BACKGROUND: This study aimed to compare the facial profile attractiveness of Class III borderline patients after surgical or compensatory orthodontic treatment. MATERIAL AND METHODS: The sample consisted of 60 borderline Class III malocclusion patients, divided into two groups: Group 1 (Surgical): 30 patients (16 male; 14 female) treated with orthodontic fixed appliances and bimaxillary orthognathic surgery. Mean initial age was 20.05 years (s.d.=2.40) and mean treatment time was 2.23 years (s.d.=0.82). Group 2 (Compensatory): 30 patients (13 male; 17 female) treated compensatorily with fixed appliances and Class III elastics. Mean initial age was 18.53 years (s.d.=4.35) and mean treatment time was 2.08 years (s.d.=0.67). Silhouettes of the facial profile were constructed obtained from the pretreatment and posttreatment lateral cephalograms and evaluated by orthodontists (N=41, 22 females and 19 males, mean age of 35.65 years), assigning scores from 1 (least attractive) to 10 (most attractive). Intergroup comparison of profile attractiveness was performed by Mann-Whitney test. For intragroup comparison of initial and final stages, the Wilcoxon test was used. RESULTS: At initial stage, the compensatory group presented a statistically significant greater attractiveness of the profile than the surgical group. With treatment, the surgical group presented significantly more improvement in facial profile than the compensatory group. At the final stage, profile attractiveness of surgical and compensatory groups was similar. CONCLUSIONS: The facial profile attractiveness is similar in Class III patients after orthognathic surgery or compensatory orthodontic treatment. However, surgery provided more improvement in profile attractiveness than the compensatory treatment in Class III patients. Key words:Malocclusion, angle Class III, orthognathic surgery, corrective orthodontics.

Tratamento ortodôntico cirúrgico de mordida aberta anterior ­ relato de caso / Surgical-orthodontic treatment of anterior open bite ­ case report

Resumo A mordida aberta anterior faz parte das más oclusões verticais e é definida como a presença de um trespasse vertical negativo entre as bordas incisais dos dentes anteriores superiores e inferiores, resultando em um maior comprometimento estético e funcional. É uma má oclusão difícil de ser tratada e de estabilidade duvidosa. Sua etiologia é multifatorial e ocorre por dois principais motivos que são a hereditariedade ou causas ambientais. A mordida aberta anterior é classificada em duas categorias: dentária e esquelética. Em casos em que há um maior envolvimento de componentes esqueléticos é necessário associar a cirurgia ortognática ao tratamento ortodôntico. Este artigo tem como objetivo detalhar o tratamento de mordida aberta anterior esquelética de uma paciente tratada com ortodontia associada à cirurgia ortognática envolvendo apenas a mandíbula, com rotação anti-horária da mesma. Os resultados demonstraram que após o preparo ortodôntico e a realização da cirurgia ortognática, a paciente apresentou uma relação molar e de caninos de Classe I, melhora do perfil, diminuição do padrão vertical e obtenção de selamento labial passivo. O correto diagnóstico é fundamental para que se possa optar pelo tratamento que gere bons resultados e satisfação do paciente, sempre levando em consideração o grau de severidade da má oclusão. (AU)

Abstract Anterior open bite is part of vertical malocclusions and is defined as the presence of a negative overbite between the incisal edges of the maxillary and mandibular anterior teeth, resulting in greater aesthetic and functional impairment. It is a malocclusion that is difficult to treat and of doubtful stability. Its etiology is multifactorial and occurs for two main reasons which are heredity or environmental causes. Anterior open bite is classified into two categories: dental and skeletal. In cases in which there is greater involvement of skeletal components, it is necessary to associate orthognathic surgery with orthodontic treatment. This article aims to detail the treatment of skeletal anterior open bite of a patient treated with orthodontics associated with orthognathic surgery involving only the mandible, with its counterclockwise rotation. The results showed that after orthodontic preparation and orthognathic surgery, the patient presented a Class I molar and canine relationship, improved profile, decreased vertical pattern and passive lip sealing. The correct diagnosis is essential to choose the treatment that generates good results and patient satisfaction, always considering malocclusion severity. (AU)

Alternativa de tratamento para intrusão de molares superiores / Alternative treatment for maxillary molar intrusion

A ancoragem em Ortodontia é muito discutida, pois é de fundamental importância no tratamento ortodôntico. Atualmente, a ancoragem esquelética temporária facilita os tratamentos ortodônticos e a obtenção de uma boa finalização, em que antes, na maioria das vezes, só era conseguida com a realização de cirurgia ortognática. Dentre esses recursos, encontram-se os mini-implantes e as miniplacas. O objetivo no relato deste caso clínico foi abordar a utilização de um novo dispositivo de ancoragem esquelética temporária, ou apoio ósseo, em que os mini-implantes são contraindicados, como em casos onde há maior extensão do seio maxilar; e quando as miniplacas tornam-se inviáveis pelo alto custo de instalação. Consiste na utilização de parafusos de enxerto ósseo associada com fio de amarrilho ortodôntico 0,030” para a intrusão dos primeiros molares superiores permanentes, apresentam como vantagens a facilidade de instalação e desconforto mínimo para o paciente, mantendo a estabilidade durante todo o tratamento ortodôntico.

Anchorage in orthodontics is widely discussed because it is of fundamental in orthodontic treatment. Temporary skeletal anchorage facilitates orthodontic treatments with a good finishing which usually could be obtained through orthognathic surgery. This case report aimed at addressing the use of a new temporary skeletal anchorage device or bone support, when mini-implants are contraindicated such as in cases of greater extension of the maxillary sinus; and when mini-plates become unviable due to high cost. It consists on using bone graft associated with 0.030” orthodontic ligature wire, for the intrusion of the first permanent molars. Among the advantages of this approach are its easy installation and minimal discomfort to the patient, while maintaining stability during orthodontic treatment.

Class III Malocclusion Surgical-Orthodontic Treatment.

The aim of the present case report is to describe the orthodontic-surgical treatment of a 17-year-and-9-month-old female patient with a Class III malocclusion, poor facial esthetics, and mandibular and chin protrusion. She had significant anteroposterior and transverse discrepancies, a concave profile, and strained lip closure. Intraorally, she had a negative overjet of 5 mm and an overbite of 5 mm. The treatment objectives were to correct the malocclusion, and facial esthetic and also return the correct function. The surgical procedures included a Le Fort I osteotomy for expansion, advancement, impaction, and rotation of the maxilla to correct the occlusal plane inclination. There was 2 mm of impaction of the anterior portion of the maxilla and 5 mm of extrusion in the posterior region. A bilateral sagittal split osteotomy was performed in order to allow counterclockwise rotation of the mandible and anterior projection of the chin, accompanying the maxillary occlusal plane. Rigid internal fixation was used without any intermaxillary fixation. It was concluded that these procedures were very effective in producing a pleasing facial esthetic result, showing stability 7 years posttreatment.

Nasolabial angle at rest and upon smiling.

PURPOSE: The objectives of this study were 1) to determine the mean and SD of the nasolabial angle (NLA) and the linear measure pronasale (Prn)-A' at rest and upon smiling and 2) to determine the difference between smile and rest in participants with normal occlusion and facial harmony. MATERIALS AND METHODS: The sample consisted of 40 white Brazilian participants (20 of each gender) aged 20 to 30 years and with normal occlusion, a pleasant profile, and facial harmony. The measures NLA and Prn-A' were analyzed in profile photographs at rest and during smile, with a millimeter ruler in front of the profile during use of the Dolphin software. The statistical analysis included dependent t tests to compare the rest and smiling variables. RESULTS: The mean of the NLA at rest was 104.93°; it was 110.67° during smile; and the difference between them was statistically significant, with a mean of 5.74°. The mean of the linear variable Prn-A' at rest was 23.25 mm, whereas during smile it was 24.04 mm, and the difference between them was statistically significant, with a mean of 0.79 mm. CONCLUSIONS: The variability in the NLA and Prn-A' at rest and upon smiling was found to be significant in a normal sample, and it should be considered as a diagnostic tool in the treatment planning for sagittal dentoskeletal deformities.

Estabilidade das relações oclusais e da correção ortodôntica do apinhamento dentário anteroinferior: um estudo em curto e longo prazo / Stability of occlusal relationships and orthodontic correction of the mandibular anterior crowding: a short and long-term study

Proposição: O objetivo deste estudo foi avaliar a estabilidade das relações oclusais e da correção do apinhamento anteroinferior em curto e longo prazo, 5 e 35 anos póstratamento. Material e métodos: A amostra constituiu-se de 28 pacientes, sendo 15 Classe I e 13 Classe II, tratados com extrações de 4 pré-molares, com idade inicial média de 12,72 anos (d.p.= 0,99), idade final de 14,74 anos (d.p.=1,26), e um tempo de tratamento médio de 2,02 anos (d.p.=0,66). A idade média em curto prazo póstratamento foi de 20,15 anos (d.p.=1,34), e em longo prazo foi de 49,40 anos (d.p.=4,54). A média do tempo de avaliação em curto prazo pós-tratamento foi de 5,40 anos (d.p.=0,43) e em longo prazo foi de 34,65 anos (d.p.=4,25). Foram avaliados, nos modelos de estudo das fases inicial, final e em curto e longo prazo pós-tratamento, os índices PAR e de irregularidade de Little. Após a realização da estatística descritiva da amostra total, os índices avaliados foram comparados na amostra total entre os 4 tempos avaliados pelo teste ANOVA dependente e de Tukey. Resultados: Houve diferença significante do índice PAR entre as fases inicial, final e em curto e longo prazo pós-tratamento, sem diferença entre as fases em curto e longo prazo pós-tratamento. Houve diferença significante do índice de irregularidade de Little entre todas as fases estudadas, inicial, final, em curto prazo e em longo prazo pós-tratamento. Conclusões: As relações oclusais, avaliadas pelo índice PAR, foram significantemente corrigidas com o tratamento ortodôntico, apresentaram uma recidiva significante em curto prazo e demonstraram permanecer estáveis em longo prazo pós-tratamento. O apinhamento anteroinferior, medido pelo índice de irregularidade de Little, foi significantemente corrigido com o tratamento, apresentou uma recidiva significante em curto prazo, e continuou a sofrer recidiva significante em longo prazo pós-tratamento.

Proposition: The aim of this study was to evaluate the stability of occlusal relationships and correction of mandibular anterior crowding in short and long-term, 5 and 35 years posttreatment. Material and methods: The sample comprised 28 patients, 15 Class I and 13 Class II, treated with 4 premolars extraction, with mean initial age of 12.72 years (s.d.=0.99), final age of 14.74 years (s.d.=1.26) and mean treatment time of 2.02 years (s.d.=0.66). The mean short-term posttreatment age was 20.15 years (s.d.=1.34), and long-term was 49.40 years (s.d.=4.54). The mean time of short-term posttreatment evaluation was 5.40 years (s.d.=0.43) and long-term was 34.65 years (s.d.=4.25). It was assessed, in the dental casts of initial, final and short-term and long-term posttreatment stages, the PAR index and the Little irregularity index. Upon completion of the descriptive statistics of the total sample, these indices were compared for the whole sample among the 4 stages by dependent ANOVA and Tukey tests. Results: There was significant difference among the PAR index in initial, final and short and long-term posttreatment stages, with no difference between the short and long-term posttreatment stages. There was a significant difference in the Little irregularity index among all the stages studied: initial, final, short-term and long-term posttreatment. Conclusions: The occlusal relationships, assessed by PAR index were significantly corrected with orthodontic treatment, showed a significant relapse in the short-term and demonstrated to remain stable in the long-term posttreatment. The mandibular anterior crowding, measured by the Little irregularity index, was significantly corrected with treatment, showed a significant relapse in the short-term, and continued to suffer significant relapse in the long-term posttreatment.

Estabilidade das relações oclusais e da correção ortodôntica do apinhamento dentário anteroinferior: um estudo em curto e longo prazo / Stability of occlusal relationships and orthodontic correction of the mandibular anterior crowding: a short and long-term study

Proposição: O objetivo deste estudo foi avaliar a estabilidade das relações oclusais e da correção do apinhamento anteroinferior em curto e longo prazo, 5 e 35 anos póstratamento. Material e métodos: A amostra constituiu-se de 28 pacientes, sendo 15 Classe I e 13 Classe II, tratados com extrações de 4 pré-molares, com idade inicial média de 12,72 anos (d.p.= 0,99), idade final de 14,74 anos (d.p.=1,26), e um tempo de tratamento médio de 2,02 anos (d.p.=0,66). A idade média em curto prazo póstratamento foi de 20,15 anos (d.p.=1,34), e em longo prazo foi de 49,40 anos (d.p.=4,54). A média do tempo de avaliação em curto prazo pós-tratamento foi de 5,40 anos (d.p.=0,43) e em longo prazo foi de 34,65 anos (d.p.=4,25). Foram avaliados, nos modelos de estudo das fases inicial, final e em curto e longo prazo pós-tratamento, os índices PAR e de irregularidade de Little. Após a realização da estatística descritiva da amostra total, os índices avaliados foram comparados na amostra total entre os 4 tempos avaliados pelo teste ANOVA dependente e de Tukey. Resultados: Houve diferença significante do índice PAR entre as fases inicial, final e em curto e longo prazo pós-tratamento, sem diferença entre as fases em curto e longo prazo pós-tratamento. Houve diferença significante do índice de irregularidade de Little entre todas as fases estudadas, inicial, final, em curto prazo e em longo prazo pós-tratamento. Conclusões: As relações oclusais, avaliadas pelo índice PAR, foram significantemente corrigidas com o tratamento ortodôntico, apresentaram uma recidiva significante em curto prazo e demonstraram permanecer estáveis em longo prazo pós-tratamento. O apinhamento anteroinferior, medido pelo índice de irregularidade de Little, foi significantemente corrigido com o tratamento, apresentou uma recidiva significante em curto prazo, e continuou a sofrer recidiva significante em longo prazo pós-tratamento...

Proposition: The aim of this study was to evaluate the stability of occlusal relationships and correction of mandibular anterior crowding in short and long-term, 5 and 35 years posttreatment. Material and methods: The sample comprised 28 patients, 15 Class I and 13 Class II, treated with 4 premolars extraction, with mean initial age of 12.72 years (s.d.=0.99), final age of 14.74 years (s.d.=1.26) and mean treatment time of 2.02 years (s.d.=0.66). The mean short-term posttreatment age was 20.15 years (s.d.=1.34), and long-term was 49.40 years (s.d.=4.54). The mean time of short-term posttreatment evaluation was 5.40 years (s.d.=0.43) and long-term was 34.65 years (s.d.=4.25). It was assessed, in the dental casts of initial, final and short-term and long-term posttreatment stages, the PAR index and the Little irregularity index. Upon completion of the descriptive statistics of the total sample, these indices were compared for the whole sample among the 4 stages by dependent ANOVA and Tukey tests. Results: There was significant difference among the PAR index in initial, final and short and long-term posttreatment stages, with no difference between the short and long-term posttreatment stages. There was a significant difference in the Little irregularity index among all the stages studied: initial, final, short-term and long-term posttreatment. Conclusions: The occlusal relationships, assessed by PAR index were significantly corrected with orthodontic treatment, showed a significant relapse in the short-term and demonstrated to remain stable in the long-term posttreatment. The mandibular anterior crowding, measured by the Little irregularity index, was significantly corrected with treatment, showed a significant relapse in the short-term, and continued to suffer significant relapse in the long-term posttreatment...

Avaliação da variabilidade do ângulo nasolabial em repouso e sorrindo em pacientes com oclusão normal e harmonia facial / Evaluation of the variability of the nasolabial Angle in rest and smiling in patients with normal occlusion and facial harmony

Devido à incompatibilidade entre as medidas cefalométricas e a análise facial de alguns casos de retrusão de maxila, e a ausência de estudos que indiquem essa variação e sua implicação no diagnóstico e tratamento dos pacientes, o objetivo desta pesquisa foi determinar: a média e o desvio padrão do ângulo nasolabial (ANL) e da medida linear Prn-A em repouso e sorrindo e a diferença entre sorriso e repouso, em indivíduos com oclusão normal e harmonia facial, além de avaliar a presença de dimorfismo sexual. A amostra constituiu-se de 40 participantes brasileiros, sendo 20 de cada sexo, leucodermas, de faixa etária de 20 a 30 anos de idade, com oclusão normal, perfil facial agradável e harmonia facial. Foram analisadas, nas fotografias de perfil em repouso e sorrindo, com uma régua milimetrada à frente do perfil, e com a utilização do programa Dolphin, as medidas ANL e Prn-A. A análise estatística incluiu a estatística descritiva, testes t dependentes para comparar as variáveis em repouso e sorrindo, e testes t independentes para avaliar o dimorfismo sexual. Como resultados, observou-se que: a média do ANL em repouso foi de 104,93º, com desvio padrão de 8,04, e sorrindo, foi de 110,67º, com desvio padrão de 9,01, sendo que a diferença entre eles foi estatisticamente significante, com média 5,74º e desvio de padrão de 4,11. A média da variável linear Prn-A em repouso foi de 23,25mm, com desvio padrão de 1,95, e sorrindo, foi de 24,04mm, com desvio padrão de 2,07, sendo que a diferença entre eles foi estatisticamente significante, com média 0,79mm e desvio de padrão de 0,65. Não houve dimorfismo sexual para o ANL. A medida Prn-A em repouso e sorrindo se mostrou maior para o sexo masculino quando comparado ao sexo feminino.

Due to the incompatibility of the cephalometric measurements and the facial analysis in some cases of maxillary retrusion, and the absence of studies that indicate this variation and implication in diagnosis and treatment of the patients, the objective of this study was to determine: the mean and standard deviation of the nasolabial angle (NLA) and the linear measure Prn-A during rest and smile and the difference between smile and rest, in subjects with normal occlusion and facial harmony, besides of evaluating the presence of sexual dimorphism. The sample comprised 40 Brazilian subjects, 20 of each sex, leucoderms, aging from 20 to 30 years, with normal occlusion, pleasant facial profile and facial harmony. It was analyzed, in profile photographs in rest and during smile, with a millimeter ruler in front of the profile, and using the Dolphin software, the measures NLA and Prn-A. The statistical analysis included descriptive statistics and dependent t tests to compare the rest and smiling variables and independent t tests to evaluate sexual dimorphism. As results, it was observed that: the mean of the NLA in rest was 104,93º, with a standard deviation of 8,04, and during smile, it was of 110,67º, with standard deviation of 9,01, and the difference between them was statistically significant, with mean of 5,74º and standard deviation of 4,11. The mean of the linear variable Prn-A in rest was of 23,25mm, with standard deviation of 1,95, and during smile, it was of 24,04mm, with standard deviation of 2,07, and the difference between them was statistically significant, with mean of 0,79mm and standard deviation of 0,65. There was no sexual dimorphism for the NLA. The measure Prn-A in rest and during smile showed greater for the males, when compared to females.

Abscesso tardio após exodontia de terceiros molares inferiores: relato de dois casos / Late abscess after extraction of lower third molars: report of two cases

Complicações associadas à exodontia de terceiros molares, embora incomuns, podem ocorrer em alguns casos. As infecções são tratadas local e sistemicamente e nem sempre se disseminam para os espaços fasciais primários e secundários. O presente artigo relata dois casos com evoluções atípicas após exodontia de terceiro molar de dois pacientes jovens, leucodermas e saudáveis que apresentaram quadro de abscesso três semanas após a cirurgia. No caso 1, foi diagnosticada a presença de um fragmento ósseo expelido, correspondente à tábua óssea lingual e teve sua drenagem intra-oral. Porém, no caso 2, o abscesso se disseminou envolvendo os espaços fasciais e foi necessária drenagem por via extra-oral. Além disso, não foi definida a causa específica, e algumas hipóteses foram levantadas e discutidas neste artigo.

Complications associated with the extraction of third molars, although infrequent, can occur in some cases. Infections are treated locally and systemically and do not always spread to the primary and secondary fascial spaces. The present paper reports two cases with an atypical evolution following extraction of a lower third molar in two young healthyl white patients that presented an abscess 3 weeks after surgery. In case 1, the presence of an expelled bone fragment was diagnosed , corresponding to the lingual cortical bone, drained intra-orally. In case 2, however, the abscess had spread to the surrounding fascial space and extra-oral draining was required. Moreover, the specific cause was not established and a number of hypothesis are raised and discussed in this article.

PAR evaluation of treated Class I extraction patients.

OBJECTIVE: To evaluate treatment changes and quality of finishing occlusion in Class I patients treated with four premolar extractions. MATERIAL AND METHODS: Dental casts of 94 subjects (50 males and 44 females) were evaluated. Mean pretreatment age was 13.46 years, and mean treatment time was 2.09 years. The peer assessment rating (PAR) index was obtained from pretreatment and posttreatment dental casts. RESULTS: The mean pretreatment PAR index of 29.46 was reduced to 6.32 at posttreatment stage, achieving a reduction of 78.54% with treatment. There was correlation between the initial PAR and correction during treatment, that is, the more severe the malocclusion the greater the treatment changes. CONCLUSION: The cases evaluated showed a high-standard orthodontic finishing.

Importância clínica do diagnóstico de fratura da crista alveolar nos procedimentos de expansão rápida de maxila assistida cirurgicamente / Clinical importance of alveolar crest fracture diagnosis on the surgically assisted rapid maxillary expansion

A expansão rápida da maxila assistida cirurgicamente (ERMAC) tem sido cada vez mais utilizada no tratamento de pacientes portadores de deficiências transversais de maxila, após a fase de crescimento. Durante o trans-operatório, podem ocorrer dos tipos de fraturas na crista óssea alveolar entre os incisivos centrais superiores: a fratura simétrica e a assimétrica. A utilização de um protocolo de ativação do parafuso expansor, após a cirurgia, sem levar em consideração as particularidades da fratura da crista alveolar pode resultar em complicações tardias como: mobilidade dentária, criação de defeitos ósseos permanentes e prejuízo estético do sorriso. Sendo assim, é importante reconhecer o tipo de fratura, por meio de diagnósticos acessíveis como as técnicas de radiografia periapical e oclusal, para estabelecer uma melhor conduta em relação ao período, tipo ou quantidade de ativação pós-operatória do parafuso expansor.

Cephalometric characterization of skeletal Class II, division 1 malocclusion in white Brazilian subjects

Um dos principais temas em Ortodontia é o estudo do crescimento e desenvolvimento craniofacial. Neste estudo, a caracterização cefalométrica da Classe II, 1ª divisão, esquelética, foi estudada em telerradiografias em norma lateral. O grupo experimental foi composto por 55 indivíduos brasileiros leucodermas, de ambos os gêneros, apresentando um ângulo ANB maior ou igual a 4.5 graus. A idade média foi 13.5 anos. Foram utilizadas grandezas cefalométricas da análise de Steiner e McNamara Jr. para avaliar a relação entre as posições angulares e lineares das bases apicais, estruturas dentárias e destas com as estruturas cranianas, comparando com os valores obtidos de um grupo controle (disponível na Faculdade de Odontologia de Bauru-USP). Os resultados mostraram que, no grupo experimental, a maxila apresentou-se bem posicionada em relação à base craniana. A relação maxilomandibular apresentou uma sobressaliência acentuada, o que já era previsível dado o critério de seleção da amostra experimental. A proporção geométrica entre as bases apicais apresentou a mandíbula de tamanho pequeno e a maxila normal. O padrão de crescimento craniofacial apresentou uma tendência vertical. Os incisivos superiores apresentaram-se inclinados para vestibular e bem posicionados pela avaliação linear. Os incisivos inferiores mostraram-se acentuadamente inclinados para vestibular e protruídos. Não houve diferença estatisticamente significante entre os gêneros.

Cephalometric characterization of skeletal Class II, division 1 malocclusion in white Brazilian subjects.

One of the main points in Orthodontic studies is the growth and development of the craniofacial structures. In this study, skeletal cephalometric characteristics of Class II, division 1 malocclusion were assessed in lateral cephalograms. The experimental sample comprised 55 white Brazilian individuals of both genders, with an ANB angle of 4.5 degrees or higher. The mean age of the subjects was 13.5 years. Steiner and McNamara Jr cephalometric analyses were used in order to evaluate the relation between angular and linear positions of the apical bases, the dental and cranial structures, comparing with the values obtained in the control group (available at Bauru Dental School-USP). The results showed that, for the experimental group, the maxilla was well positioned in relation to the cranial base. The maxillomandibular relation showed an increased overjet, which was predictable based on criteria for sample selection. The geometrical proportion of the apical bases presented a small mandible and a normal sized maxilla. The craniofacial growth pattern presented a vertical tendency. The maxillary incisors were buccally inclined and well positioned by the linear evaluation. The mandibular incisors showed marked buccal inclination and protrusion. No statistically significant difference between genders was found.

Prevalência das más oclusöes em pacientes inscritos para tratamento ortodôntico na Faculdade de Odontologia de Bauru-USP / Prevalence of malocclusions in patients enrolled for orthodontic treatment in Bauru Dental School-USP

Os estudos epidemiológicos säo importantes ferramentas para o conhecimento das necessidades de tratamento e para a avaliaçäo das medidas instituídas. No intuito de estudar a prevalência das principais más oclusöes e irregularidades dentolaveolares, na populaçäo que costuma procurar tratamento ortodôntico na Faculdade de Odontologia de Bauru - USP, examinaram-se os modelos de estudo de 520 pacientes no final da dentadura mista e início da dentadura permanente. A estatística descritiva em porcentagens e a construçäo de gráficos ilustraram a presença do apinhamento primário nos arcos superior (67 por cento) e inferior (71 por cento), bem como a participaçäo das alteraçöes nos sentidos ântero-posterior (Classe II div.1, 50 por cento; Cl. I, 44 por cento para o gênero masculino e 40 por cento para o feminino; Cl. II div.2, 4 por cento masculino e 8 por cento feminino; e Cl. III, 2 por cento), transversal (mordida cruzada anterior 18 por cento e posterior 27 por cento) e vertical (mordida aberta anterior 9 por cento). Ademais, verificou-se a distribuiçäo entre os gêneros, comparando-a aos relatos anteriores da literatura