Long term dental transversal stability of Class II division 1 treated with cervical headgear.

INTRODUCTION: In several conditions, outcome stability is a great challenge for Orthodontics. Previous studies have reported that relapse commonly occurs along the years after orthodontic treatment finishing. OBJECTIVE: The aim of the present study was to evaluate in the long-term transversal dental arch changes of Class II division 1 patients treated with cervical headgear and fixed appliance. METHODS: Plaster study casts of 20 patients treated with cervical headgear without dental extractions were 3D-scanned and evaluated in three distinct times: initial (T1), immediate post-treatment (T2) and long-term retention (T3 - minimum 20 years). Transversal teeth distance of maxillary and mandibular canines, premolars and first molars were measured. RESULTS: A statistically significant increase during treatment was observed for all maxillary teeth transversal distances (p< 0.05). In turn, a significant reduction was observed in the long term (p< 0.05). For the mandibular teeth, canine transversal distance presented statistically significant constriction in the retention period (p< 0.05). Mandibular first molars distance was significantly expanded by treatment (p< 0.05) and remained stable in the long term. The changes observed for the other teeth or other times were considered not statistically relevant. CONCLUSIONS: For the accessed sample, transversal changes occurred during treatment and retention phases in Class II division 1 patients treated with cervical headgear and fixed appliance. Relapse was considered statistically relevant, even with the institution of a retention protocol.

Long term dental transversal stability of Class II division 1 treated with cervical headgear

ABSTRACT Introduction: In several conditions, outcome stability is a great challenge for Orthodontics. Previous studies have reported that relapse commonly occurs along the years after orthodontic treatment finishing. Objective: The aim of the present study was to evaluate in the long-term transversal dental arch changes of Class II division 1 patients treated with cervical headgear and fixed appliance. Methods: Plaster study casts of 20 patients treated with cervical headgear without dental extractions were 3D-scanned and evaluated in three distinct times: initial (T1), immediate post-treatment (T2) and long-term retention (T3 - minimum 20 years). Transversal teeth distance of maxillary and mandibular canines, premolars and first molars were measured. Results: A statistically significant increase during treatment was observed for all maxillary teeth transversal distances (p< 0.05). In turn, a significant reduction was observed in the long term (p<0.05). For the mandibular teeth, canine transversal distance presented statistically significant constriction in the retention period (p<0.05). Mandibular first molars distance was significantly expanded by treatment (p<0.05) and remained stable in the long term. The changes observed for the other teeth or other times were considered not statistically relevant. Conclusions: For the accessed sample, transversal changes occurred during treatment and retention phases in Class II division 1 patients treated with cervical headgear and fixed appliance. Relapse was considered statistically relevant, even with the institution of a retention protocol.

RESUMO Introdução: Em várias condições, a estabilidade dos resultados é um grande desafio para a Ortodontia. Estudos prévios relataram que a recidiva ocorre, comumente, ao longo dos anos, após o término do tratamento ortodôntico. Objetivo: O objetivo da presente pesquisa foi avaliar as alterações transversais da arcada dentária em longo prazo de pacientes Classe II, divisão 1, tratados com aparelho extrabucal cervical e aparelho fixo. Métodos: Modelos de gesso de 20 pacientes tratados com AEB cervical, sem extrações dentárias, foram escaneados e avaliados em três momentos distintos: inicial (T1), pós-tratamento imediato (T2) e acompanhamento de longo prazo (T3, mínimo de 20 anos). A distância transversal entre os caninos superiores e inferiores, pré-molares e primeiros molares foi medida. Resultados: Foi observado aumento estatisticamente significativo durante o tratamento para todas as distâncias transversais dos dentes superiores (p < 0,05). Por sua vez, foi observada redução significativa em longo prazo (p < 0,05). Para os dentes inferiores, a distância transversal intercaninos apresentou constrição estatisticamente significativa no período de contenção (p < 0,05). A distância dos primeiros molares inferiores aumentou significativamente com o tratamento (p < 0,05) e permaneceu estável em longo prazo. As alterações observadas para os outros dentes ou outros tempos foram consideradas sem significância estatística. Conclusões: Para a amostra estudada, as alterações transversais ocorreram durante as fases de tratamento e contenção em pacientes Classe II, divisão 1, tratados com aparelho extrabucal de tração cervical e aparelho fixo. A recidiva foi considerada estatisticamente significativa, mesmo com a instituição de um protocolo de contenção.

Evaluation of anteroposterior and vertical stability 25 years after Angle class II division 1 treatment with cervical headgear.

PURPOSE: The goal was to investigate long-term (minimum 20 years) skeletal and dental changes in Angle class II division 1 patients treated with full-fixed orthodontic appliances and cervical pull headgear. METHODS: A longitudinal retrospective study was performed with 20 orthodontic patients, who were treated exclusively by one experienced clinician and whose treatment had been completed a minimum of 20 years ago. Former patients who had been treated from the mid-1970s to the early 1990s were actively sought. After the recall, 20 patients agreed to participate in the study. Lateral cephalometric radiographs at pretreatment (T1), posttreatment (T2), and long-term follow-up (T3) were digitized and measurements were performed. Angular variables used were SNA, SNB, ANB, OcclPl-FH, PalPl-FH, GoMe-FH, 1­NA, and Y axis. Linear measures were A­NPerp, Pg-NPerp, 1­NAmm, Wits, and LAFH. RESULTS: From T1 to T2, a significant reduction (p < 0.01) in ANB angle from 4.70 to 2.48° and in Wits value from 3.42 to 0.98 mm were observed. It was also noticed a significant increase (p < 0.01) in LAFH from 62.02 to 67.39 mm, probably due to normal facial growth. From T2 to T3, these variables remained stable. No significant changes were observed for any other measure in any of the periods studied. CONCLUSIONS: In the assessed sample, Angle class II division 1 patients treated with cervical pull headgear presented cephalometric outcome stability of treatment, even after a long-term follow-up of a mean of 25 years postretention.

Digital platform for planning facial asymmetry orthodontic-surgical treatment preparation.

Dentofacial deformities usually are surgically treated, and 3D virtual planning has been used to favor accurate outcomes. Cases reported in the present article show that orthognathic surgery carried out to correct facial asymmetries does not comprise only one treatment protocol. 3D virtual planning might be used for surgical planning, but it should also be used to diagnose the deformity, thus allowing for an analysis of the best-recommended possibilities for the orthodontic preparation that suits each individual case.

Digital platform for planning facial asymmetry orthodontic-surgical treatment preparation

ABSTRACT Dentofacial deformities usually are surgically treated, and 3D virtual planning has been used to favor accurate outcomes. Cases reported in the present article show that orthognathic surgery carried out to correct facial asymmetries does not comprise only one treatment protocol. 3D virtual planning might be used for surgical planning, but it should also be used to diagnose the deformity, thus allowing for an analysis of the best-recommended possibilities for the orthodontic preparation that suits each individual case.

RESUMO As deformidades dentofaciais são, geralmente, tratadas de forma cirúrgica, e o planejamento virtual 3D tem sido utilizado para aumentar a precisão dos resultados. Os casos exemplificados no presente artigo mostram que a cirurgia ortognática para correção das assimetrias faciais não apresenta um único protocolo de tratamento. O planejamento virtual 3D pode ser adotado para planejar a cirurgia, mas também deve ser utilizado na fase de diagnóstico da deformidade, assim permitindo uma análise das possibilidades mais indicadas para o preparo ortodôntico mais adequado em cada caso.

Reliability of Bolton analysis evaluation in tridimensional virtual models.

OBJECTIVE: The present study aimed at evaluating the reliability of Bolton analysis in tridimensional virtual models, comparing it with the manual method carried out with dental casts. METHODS: The present investigation was performed using 56 pairs of dental casts produced from the dental arches of patients in perfect conditions and randomly selected from Universidade Federal da Bahia, School of Dentistry, Orthodontics Postgraduate Program. Manual measurements were obtained with the aid of a digital Cen-Tech 4"(r) caliper (Harpor Freight Tools, Calabasas, CA, USA). Subsequently, samples were digitized on 3Shape(r)R-700T scanner (Copenhagen, Denmark) and digital measures were obtained by Ortho Analyzer software. RESULTS: Data were subject to statistical analysis and results revealed that there were no statistically significant differences between measurements with p-values equal to p = 0.173 and p= 0.239 for total and anterior proportions, respectively. CONCLUSION: Based on these findings, it is possible to deduce that Bolton analysis performed on tridimensional virtual models is as reliable as measurements obtained from dental casts with satisfactory agreement.

Reliability of Bolton analysis evaluation in tridimensional virtual models

Objective: The present study aimed at evaluating the reliability of Bolton analysis in tridimensional virtual models, comparing it with the manual method carried out with dental casts.Methods:The present investigation was performed using 56 pairs of dental casts produced from the dental arches of patients in perfect conditions and randomly selected from Universidade Federal da Bahia, School of Dentistry, Orthodontics Postgraduate Program. Manual measurements were obtained with the aid of a digital Cen-Tech 4"(r) caliper (Harpor Freight Tools, Calabasas, CA, USA). Subsequently, samples were digitized on 3Shape(r)R-700T scanner (Copenhagen, Denmark) and digital measures were obtained by Ortho Analyzer software.Results:Data were subject to statistical analysis and results revealed that there were no statistically significant differences between measurements with p-values equal to p = 0.173 and p= 0.239 for total and anterior proportions, respectively.Conclusion:Based on these findings, it is possible to deduce that Bolton analysis performed on tridimensional virtual models is as reliable as measurements obtained from dental casts with satisfactory agreement.

Objetivo: o presente estudo teve como objetivo avaliar a confiabilidade da análise de Bolton em modelos virtuais tridimensionais, comparando-a com a realizada em modelos de gesso.Métodos:foram utilizados 56 pares de modelos de gesso das arcadas dentárias de pacientes oriundos do Curso de Especialização em Ortodontia da Faculdade de Odontologia da Universidade Federal da Bahia, escolhidos aleatoriamente e em perfeito estado. Medidas manuais foram obtidas utilizando-se o paquímetro digital Cen-Tech(r) 4" (Harpor Freight Tools, Calabasas, CA, EUA). Em seguida, os mesmos foram digitalizados pelo scanner R-700TM(3Shape(r), Copenhagen, Dinamarca) e, por meio do programa Ortho AnalyzerTM, da mesma marca, foram obtidas as medidas digitais.Resultados:os dados foram submetidos a testes estatísticos e os resultados demonstraram que não houve diferença estatisticamente significativa nos dois tipos de medições com valores de p = 0,173 e p = 0,239, respectivamente, para as proporções total e anterior.Conclusão:com base nesses achados, pode-se inferir que a análise de Bolton realizada em modelos virtuais tridimensionais é tão confiável quanto a obtida em modelos de gesso, apresentando uma concordância satisfatória.

Tooth-size discrepancy: a comparison between manual and digital methods.

INTRODUCTION: Technological advances in Dentistry have emerged primarily in the area of diagnostic tools. One example is the 3D scanner, which can transform plaster models into three-dimensional digital models. OBJECTIVE: This study aimed to assess the reliability of tooth size-arch length discrepancy analysis measurements performed on three-dimensional digital models, and compare these measurements with those obtained from plaster models. MATERIAL AND METHODS: To this end, plaster models of lower dental arches and their corresponding three-dimensional digital models acquired with a 3Shape R700T scanner were used. All of them had lower permanent dentition. Four different tooth size-arch length discrepancy calculations were performed on each model, two of which by manual methods using calipers and brass wire, and two by digital methods using linear measurements and parabolas. RESULTS: Data were statistically assessed using Friedman test and no statistically significant differences were found between the two methods (P > 0.05), except for values found by the linear digital method which revealed a slight, non-significant statistical difference. CONCLUSIONS: Based on the results, it is reasonable to assert that any of these resources used by orthodontists to clinically assess tooth size-arch length discrepancy can be considered reliable.

Tooth-size discrepancy: A comparison between manual and digital methods

INTRODUCTION: Technological advances in Dentistry have emerged primarily in the area of diagnostic tools. One example is the 3D scanner, which can transform plaster models into three-dimensional digital models. OBJECTIVE: This study aimed to assess the reliability of tooth size-arch length discrepancy analysis measurements performed on three-dimensional digital models, and compare these measurements with those obtained from plaster models. MATERIAL AND METHODS: To this end, plaster models of lower dental arches and their corresponding three-dimensional digital models acquired with a 3Shape R700T scanner were used. All of them had lower permanent dentition. Four different tooth size-arch length discrepancy calculations were performed on each model, two of which by manual methods using calipers and brass wire, and two by digital methods using linear measurements and parabolas. RESULTS: Data were statistically assessed using Friedman test and no statistically significant differences were found between the two methods (P > 0.05), except for values found by the linear digital method which revealed a slight, non-significant statistical difference. CONCLUSIONS: Based on the results, it is reasonable to assert that any of these resources used by orthodontists to clinically assess tooth size-arch length discrepancy can be considered reliable. .

INTRODUÇÃO: na Odontologia, os avanços tecnológicos vêm se manifestando, principalmente, em instrumentos de diagnóstico, como o desenvolvimento dos scanners 3D, capazes de transformar modelos de gesso em modelos digitais tridimensionais. OBJETIVO: o objetivo da presente pesquisa foi avaliar a confiabilidade da análise da Discrepância de Modelo realizada em modelos digitais tridimensionais, comparando-a com a obtida em modelos de gesso. MÉTODOS: utilizou-se modelos de gesso das arcadas dentárias inferiores e seus correspondentes modelos digitais tridimensionais, adquiridos por meio do scanner 3Shape R700T. Foram realizados quatro diferentes cálculos da Discrepância de Modelo para cada modelo selecionado, dois desses por meio de métodos manuais, utilizando paquímetro e fio de latão, e dois por meio de métodos digitais, utilizando medições lineares e por meio da confecção de uma parábola. RESULTADOS: os dados obtidos foram avaliados estatisticamente por meio do teste de Friedman, e observou-se não haver diferença estatisticamente significativa entre os métodos utilizados (p > 0,05), exceto os valores obtidos pelo método digital linear, onde observou-se uma pequena diferença estatística, porém, não são valores considerados clinicamente significativos. CONCLUSÃO: com base nos resultados, é possível afirmar que, quaisquer desses recursos que o ortodontista venha a utilizar em sua vida clínica para obtenção da Discrepância de Modelo, esses são considerados métodos confiáveis. .

Evaluation of buccal bone coverage in the anterior region by cone-beam computed tomography.

INTRODUCTION: The purpose of this study was to compare the sensitivity of diagnoses of buccal bone coverage in anterior teeth between axial and sagittal reconstructions using cone-beam computed tomography. METHODS: Five dry skulls were clinically evaluated to detect bone defects in the anterior maxilla and mandible to establish a gold standard. The skulls were prepared and placed on a Kodak 9000 3-dimensional scanner (Trophy, Marne La Vallée, France) for image acquisition. The images were processed and reconstructed using Kodak Dental Imaging software 3-dimensional module (version 2.4; Kodak Dental Systems, Atlanta, Ga). All bone defects were identified and recorded. RESULTS: In the sagittal and axial reconstructions, regions without bone coverage were diagnosed in 91.03% of cases as "cortex not seen" or "minimum thickness, fine, without marrow bone." CONCLUSIONS: Cone-beam computed tomography can help in the diagnosis of lack of bone coverage on the buccal surfaces of anterior teeth. There was no difference in the performance of the axial and sagittal reconstructions.

Brachycephalic, dolichocephalic and mesocephalic: Is it appropriate to describe the face using skull patterns?

The use of a standardized terminology in the medical sciences is essential for both clinical practice and scientific research. In addition to facilitating communication between professionals, it enhances the reliability of comparisons made between studies from different areas, thereby contributing to a higher level of scientific evidence. Examples of attempts made to standardize the terminology in other areas dedicated to the study of craniofacial morphology can be found in the literature. On the other hand, one can find in the orthodontic literature a variety of terms that render the consensus and communication between orthodontists and other researchers even more problematic. As an example, one could cite the use of the terms brachyfacial, mesofacial and dolichofacial, which form part of a cranial index terminology used to describe facial types. Thus, a reflection on the origin and differences of the terms used to describe the human facial phenotype may pave the way toward a consensus regarding the meaning that best represents the craniofacial patterns.

Brachycephalic, dolichocephalic and mesocephalic: is it appropriate to describe the face using skull patterns?

The use of a standardized terminology in the medical sciences is essential for both clinical practice and scientific research. In addition to facilitating communication between professionals, it enhances the reliability of comparisons made between studies from different areas, thereby contributing to a higher level of scientific evidence. Examples of attempts made to standardize the terminology in other areas dedicated to the study of craniofacial morphology can be found in the literature. On the other hand, one can find in the orthodontic literature a variety of terms that render the consensus and communication between orthodontists and other researchers even more problematic. As an example, one could cite the use of the terms brachyfacial, mesofacial and dolichofacial, which form part of a cranial index terminology used to describe facial types. Thus, a reflection on the origin and differences of the terms used to describe the human facial phenotype may pave the way toward a consensus regarding the meaning that best represents the craniofacial patterns.

A padronização da nomenclatura utilizada nas ciências médicas é fundamental tanto para a prática clínica quanto para a pesquisa científica. Além de facilitar a comunicação entre os profissionais, aumenta a confiabilidade da comparação entre trabalhos de diferentes áreas, favorecendo um melhor nível de evidência científica. Exemplos de esforços, em áreas também voltadas ao estudo da morfologia craniofacial, no sentido de uniformização da terminologia podem ser encontrados na literatura médica. Por outro lado, observa-se na literatura ortodôntica uma diversidade de termos que torna mais difícil o consenso e a comunicação entre ortodontistas e demais pesquisadores. Como exemplo, pode-se citar o uso dos termos braquifacial, mesofacial e dolicofacial, terminologia relativa ao índice craniano utilizada para descrever o tipo facial. Sendo assim, a reflexão sobre a origem e diferenças dos termos utilizados para descrever o fenótipo facial humano pode ser útil ao consenso do significado que melhor representa o padrão craniofacial.

Board Brasileiro de Ortodontia e Ortopedia Facial: certificando excelência / Brazilian Board of Orthodontics and Facial Orthopedics: certifying excellence

O Board Brasileiro de Ortodontia e Ortopedia Facial (BBO) é uma entidade de Certificação Nacional de padrão de excelência clínica no exercício da especialidade. O artigo, ora apresentado, traz o histórico da criação do BBO, sua estrutura e as fases que compõem a avaliação para obtenção da Certificação. Apresenta, ainda, o relato do primeiro exame aplicado no Brasil. O objetivo é multiplicar o conhecimento, entre os profissionais da área, sobre a importância da Certificação BBO como garantia do mais alto grau de qualidade no tratamento ortodôntico.

The Brazilian Board of Orthodontics and Facial Orthopedics (BBO) is the institution that certifies the standards of clinical excellence in the practice of this specialty. This article describes the history of BBO's creation and the examination structure and phases to obtain the BBO Certification. It also presents a detailed report of the first exam applied in Brazil. Its purpose is to expand the knowledge, among professionals in the area, about the importance of BBO Certification as assurance of the highest level of quality in orthodontic treatments.

Estudo comparativo entre traçados cefalométricos manual e digital, através do programa Dolphin Imaging em telerradiografias laterais / Comparative study between manual and digital cephalometric tracing using Dolphin Imaging software with lateral radiographs

OBJETIVO: comparar medidas cefalométricas angulares e lineares obtidas por meio de traçados cefalométricos manual e digital utilizando o programa Dolphin® Imaging 11.0, em telerradiografias laterais. MÉTODOS: a amostra foi composta de 50 telerradiografias laterais. Uma operadora, devidamente calibrada, realizou 50 traçados cefalométricos manuais e 50 digitais, utilizando 8 medidas angulares (FMA, IMPA, SNA, SNB, ANB, 1.NA, 1.NB e Eixo Y) e 6 medidas lineares (1-NA, 1-NB, Co-Gn, Co-A, Linha E-lábio inferior e AFAI). Para análise dos resultados obtidos, foi aplicado o teste t de Student. RESULTADOS: os resultados encontrados não mostraram diferenças estatisticamente significativas em nenhuma das medidas avaliadas (p>0,05). CONCLUSÃO: o método convencional e o computadorizado foram concordantes em todas as medidas angulares e lineares. O programa de traçado cefalométrico Dolphin® Imaging 11.0 pode ser utilizado, de forma confiável, como recurso auxiliar no diagnóstico, planejamento, acompanhamento e avaliação de tratamentos ortodônticos no âmbito clínico e no de pesquisa.

OBJECTIVE: The purpose of this study was to compare angular and linear cephalometric measurements obtained through manual and digital cephalometric tracings using Dolphin Imaging® 11.0 software with lateral cephalometric radiographs. METHODS: The sample consisted of 50 lateral cephalometric radiographs. One properly calibrated examiner performed 50 manual and 50 digital cephalometric tracings using eight angular measurements (FMA, IMPA, SNA, SNB, ANB, 1.NA, 1.NB, Y-Axis) and six linear measurements (1-NA, 1-NB, Co-Gn, Co-A, E Line-Lower lip and LAFH). Results were assessed using Student's t-test. RESULTS: The results showed no statistically significant differences in any of the assessed measurements (p> 0.05). CONCLUSIONS: Conventional and computerized methods showed consistency in all angular and linear measurements. The computer program Dolphin Imaging® 11.0 can be used reliably as an aid in diagnosing, planning, monitoring and evaluating orthodontic treatment both in clinical and research settings.