Optimal management of orthodontic pain.

Pain is an undesirable side effect of orthodontic tooth movement, which causes many patients to give up orthodontic treatment or avoid it altogether. The aim of this study was to investigate, through an analysis of the scientific literature, the best method for managing orthodontic pain. The methodological aspects involved careful definition of keywords and diligent search in databases of scientific articles published in the English language, without any restriction of publication date. We recovered 1281 articles. After the filtering and classification of these articles, 56 randomized clinical trials were selected. Of these, 19 evaluated the effects of different types of drugs for the control of orthodontic pain, 16 evaluated the effects of low-level laser therapy on orthodontic pain, and 21 evaluated other methods of pain control. Drugs reported as effective in orthodontic pain control included ibuprofen, paracetamol, naproxen sodium, aspirin, etoricoxib, meloxicam, piroxicam, and tenoxicam. Most studies report favorable outcomes in terms of alleviation of orthodontic pain with the use of low-level laser therapy. Nevertheless, we noticed that there is no consensus, both for the drug and for laser therapy, on the doses and clinical protocols most appropriate for orthodontic pain management. Alternative methods for orthodontic pain control can also broaden the clinician's range of options in the search for better patient care.

Ortodontia lingual x alinhadores removíveis: quando utilizar / Lingual orthodontics x removable aligners: when to use

A Ortodontia está passando por uma nova fase. Muitos pacientes adultos estão buscando o tratamento atualmente e não querem usar um aparelho convencional. Isso tem feito com que a Ortodontia desenvolva novos métodos de tratamento mais estéticos e também aprimore os já existentes. Duas modalidades de tratamento têm ganhado muito destaque nos últimos anos: a Ortodontia Lingual e os Alinhadores Removíveis. O objetivo deste artigo é descrever a técnica lingual Harmony e os alinhadores removíveis Essix e Clear Aligner, comparando-os e mostrando o tratamento de dois casos clínicos. Para o caso tratado com a técnica Lingual foi escolhido o aparelho Harmony devido à necessidade de grande controle de torque nos incisivos superiores. O caso tratado com alinhadores era um caso simples de recidiva pós-tratamento ortodôntico. Os casos clínicos descritos evidenciaram o papel importante que as novas modalidades de tratamento estético podem ter na Ortodontia contemporânea. Cabe ao ortodontista clínico conhecer essas ferramentas e as utilizar nos casos apropriados.(AU)

Orthodontics is going through a new phase. Many adult patients are currently seeking treatment and do not want to use a conventional device. This has led Orthodontics to develop new aesthetic treatment methods, as well as to improve existing ones. Two treatment modalities have gained much prominence in recent years: Lingual Orthodontics and Removable Aligners. The purpose of this article isx to describe the Harmony lingual technique and the Essix and Clear Aligner removable aligners, comparing them and showing the treatment of two clinical cases. For the case treated with the lingual technique, the Harmony device was chosen due to the need for great torque control in the upper incisors. The case treated with aligners was a simple case of orthodontic posttreatment relapse. The clinical cases described evidenced the important role that the new modalities of aesthetic treatment can have in contemporary Orthodontics. It is up to the clinical orthodontist to know these tools and use them in appropriate clinical cases.(AU)

Avaliação microbiológica da efetividade de uma escova antibacteriana: um estudo in vivo / Microbiological evaluation of the effectiveness of an antibacterial toothbrush: in vivo study

Objetivo: Este trabalho consistiu em um estudo in vivo para avaliar microbiologicamente a efetividade de uma escova antibacteriana comparada à de uma escova convencional. Metodologia: Trinta crianças de dez a 12 anos utilizaram escovas dentais convencionais e antibacterianas por dois períodos experimentais de cinco dias, com duas escovações diárias supervisionadas, sem dentifrício. O desenho do estudo foi cruzado com wash-out de nove dias entre as diferentes escovas. Ao término de cada período, as escovas foram imediatamente imersas em solução salina estéril e agitadas; o caldo produzido foi semeado em ágar BHI, nas concentrações de 10-2 e 10-3. Após um período de incubação de 24 horas a 37 ºC em aerobiose, foi realizada a contagem das unidades formadoras de colônias (UFC/mL) por meio de um software específico. Resultado: No grupo de escovas convencionais, a mediana e intervalos interquartis foi de 105 (27-564,5); já para o grupo de escovas antibacterianas, foi de 53 (4,5-333,5). Após análise dos dados, observou-se ausência de diferenças estatísticas entre os grupos (p = 0,145). Conclusão: Concluiu-se que as escovas de dentes antibacterianas exibiram contaminação bacteriana semelhante à das escovas de dentes convencionais.

Objective: This in vivo study aimed to evaluate the effectiveness of antibacterial toothbrushes compared to conventional toothbrushes in reducing microorganisms contamination. Methodology: Thirty children, 10 to 12 years-old, brushed their teeth with conventional and antibacterial toothbrushes two times a day without toothpaste, during two experimental periods of 5 days. The research was designed as a cross-over study with a wash-out period of nine days between the different toothbrushes. After each trial period, the brushes were immediately immersed in individual flasks containing sterile saline solution. After agitation, the solution was seeded on plates containing the culture medium of Brain Heart Infusion, at concentrations of 10-2 e 10-3, to obtain total viable microorganisms. The plates were incubated for 24 hours at 37 ºC under aerobiosis and colony-forming units were counted by means of a specific software. Result: In conventional toothbrushes group, median and interquartile values were 105 (27-564.5), while for the group of antibacterial toothbrushes were 53 (4.5-333.5). After analyzing the data, we observed no statistical differences between groups (p = 0.145). Conclusion: It was concluded that the antibacterial toothbrushes exhibited bacterial contamination similar to conventional toothbrushes.