Three-dimensional evaluation of dental decompensation and mandibular symphysis remodeling on orthodontic-surgical treatment of Class III malocclusion.

INTRODUCTION: The purposes of this research were to identify the buccolingual inclinations of the mandibular teeth and the mandibular symphysis remodeling that result from the orthodontic decompensation movement. METHODS: The sample consisted of 30 adults with Class III dentofacial deformity, who had presurgical orthodontic treatment. Three-dimensional images were generated by cone-beam computed tomography scans at 2 different times (initial and before orthognathic surgery). Three-dimensional virtual models were obtained and superimposed using automated voxel-based registration at the mandible to evaluate B-point displacement, mandibular molar and incisor decompensation movement, and symphysis inclination and thickness. The 3-dimensional displacements of landmarks at the symphysis were quantified and visualized with color-coded maps using 3D Slicer (version 4.0; www.slicer.org) software. RESULTS: The measurements showed high reproducibility. The patients presented mandibular incisor proclination, which was consistent with the movement of tooth decompensation caused by the presurgical orthodontic treatment. Statistically significant correlations were found between the inclination of the mandibular incisors, symphysis inclination, and B-point displacement. Regarding the thickness of the symphysis and the inclination of the incisors, no statistically significant correlation was found. CONCLUSIONS: The buccolingual orthodontic movement of the mandibular incisors with presurgical leveling is correlated with the inclination of the mandibular symphysis and repositioning of the B-point but not correlated to the thickness of the symphysis.

Micro-osteoperforation effectiveness on tooth movement rate and impact on oral health related quality of life.

OBJECTIVES: To investigate the effect of micro-osteoperforation (MOP) on the rate of tooth movement (RTM), space closure duration, and oral health-related quality of life (OHRQoL) during completion of anterior retraction in patients undergoing combined orthodontic-surgical treatment after premolar extraction and decompensation with sliding mechanics. MATERIALS AND METHODS: Twenty-four participants with indications for premolar extractions were randomly allocated to treatment with conventional sliding mechanics (control group; CG) or with to treatment in which three MOPs were performed every activation (experimental group; EG). Dental impressions were taken monthly until space closure was completed and dental casts were converted to three-dimensional models. After the anterior retraction procedure, Oral Health Impact Profile (OHIP-14) questionnaires were filled out at 4 and 72 hours. RESULTS: Eighteen patients (7 men and 11 women) remained in the trial until space closure was completed (mean follow-up period = 247 days). For full space closure RTM, no significant difference (P = .492) was found between groups (0.614 mm/month for the CG; 0.672 mm/month for the EG). The RTM for different time points, groups, time frames and their interaction were statistically different (P < .05). In multiple correlation analysis, the RTM significantly decreased over time for both groups (P < .05). The OHRQoL scores were significantly higher (worse) for the EG. The psychological, physical and social disabilities, and handicap domains displayed significant differences between the two groups. CONCLUSION: Use of MOPs did not change the full space closure RTM, while it had a negative impact on OHRQoL.

Federating Heterogeneous Datasets to Enhance Data Sharing and Experiment Reproducibility.

Recent studies have demonstrated the difficulties to replicate scientific findings and/or experiments published in past.1 The effects seen in the replicated experiments were smaller than previously reported. Some of the explanations for these findings include the complexity of the experimental design and the pressure on researches to report positive findings. The International Committee of Medical Journal Editors (ICMJE) suggests that every study considered for publication must submit a plan to share the de-identified patient data no later than 6 months after publication. There is a growing demand to enhance the management of clinical data, facilitate data sharing across institutions and also to keep track of the data from previous experiments. The ultimate goal is to assure the reproducibility of experiments in the future. This paper describes Shiny-tooth, a web based application created to improve clinical data acquisition during the clinical trial; data federation of such data as well as morphological data derived from medical images; Currently, this application is being used to store clinical data from an osteoarthritis (OA) study. This work is submitted to the SPIE Biomedical Applications in Molecular, Structural, and Functional Imaging conference.

Mordida aberta anterior – desafio constante? / Anterior open bite – a constant challenge?

A mordida aberta anterior mostra-se um desafio constante. Frequentemente associada a hábitos viciosos bucais e discrepâncias esqueléticas verticais é de difícil tratamento e de fácil recidiva. Este artigo aborda este tipo de má oclusão com considerações etiológicas e de diagnóstico, demonstrando as alternativas de tratamento conservador, a mecânica empregada, os resultados obtidos e o protocolo de contenção.

Anterior open bite represents a constant challenge. Quite often it is associated to oral habits and vertical skeletal dysplasia, being hard to treat and with frequent relapse. This paper approaches this malocclusion type describing etiological and diagnostic factors, presenting conservative treatment alternatives, the selected mechanics as well as the achieved results and retention protocol.

Transversal changes in dental arches from non-extraction treatment with self ligating brackets.

OBJECTIVE: The present study aimed at analyzing, with the use of dental casts, the transverse changes of the upper and lower dental arches, after non-extraction orthodontic treatment, with self-ligating brackets. METHODS: The sample comprised 29 patients, all presenting Class I malocclusion with upper and lower crowding of at least 4 mm and treated only with a fixed appliance, without stripping, extraction or distalization. The dental casts were obtained before and after leveling with 0.019 x 0.025-in stainless steel archwires. CONCLUSIONS: The results indicated that the majority of transverse changes occurred at the premolar areas, both the first and the second, as well as on the upper and lower dental arches. The intercanine distance increased 0.75 mm, on average, in the upper arch and 1.96 mm in the lower arch. The molars also demonstrated a tendency towards an increase in their transverse dimension, however, at a lower intensity comparing to premolars. All measurements presented statistically significant differences with the exception of the maxillary second molars.

Transversal changes in dental arches from non-extraction treatment with self ligating brackets

OBJECTIVE: The present study aimed at analyzing, with the use of dental casts, the transverse changes of the upper and lower dental arches, after non-extraction orthodontic treatment, with self-ligating brackets. METHODS: The sample comprised 29 patients, all presenting Class I malocclusion with upper and lower crowding of at least 4 mm and treated only with a fixed appliance, without stripping, extraction or distalization. The dental casts were obtained before and after leveling with 0.019 x 0.025-in stainless steel archwires. CONCLUSION: The results indicated that the majority of transverse changes occurred at the premolar areas, both the first and the second, as well as on the upper and lower dental arches. The intercanine distance increased 0.75 mm, on average, in the upper arch and 1.96 mm in the lower arch. The molars also demonstrated a tendency towards an increase in their transverse dimension, however, at a lower intensity comparing to premolars. All measurements presented statistically significant differences with the exception of the maxillary second molars.

OBJETIVO: o presente estudo teve por objetivo avaliar, em modelos de gesso, as alterações dimensionais transversais das arcadas dentárias, decorrentes do tratamento ortodôntico sem extração, com braquetes autoligáveis. MÉTODOS: a amostra constou de 29 pacientes que apresentavam má oclusão de Classe I, com apinhamento superior e inferior mínimo de 4mm, que foram tratados unicamente com aparelho fixo, sem desgastes, extração ou distalização dentária. Os modelos de gesso foram obtidos antes e ao final do tratamento. CONCLUSÃO: os resultados indicaram que as maiores alterações transversais ocorreram na região dos pré-molares, tanto dos primeiros como dos segundos, e tanto na maxila como na mandíbula. A distância intercaninos teve aumento, em média, de 0,75mm na arcada superior, e de 1,96mm na inferior. Os molares também demonstraram tendência de aumento das dimensões transversais, porém em menor intensidade que os pré-molares. Todas as medidas denotaram diferença estatisticamente significativa, com exceção dos segundos molares superiores.

Avaliação da inclinação dentária no tratamento compensatório do padrão II com tomografia computadorizada / Assessment of tooth inclination in the compensatory treatment of pattern II using computed tomography

OBJETIVO: avaliar as alterações nas inclinações dos dentes anteriores causadas pelo tratamento ortodôntico, utilizando-se aparelho Straight-Wire, prescrição II Capelozza, antes e após a fase de nivelamento com fios ortodônticos de aço de secção retangular. MÉTODOS: foram selecionados 17 indivíduos adultos de padrão facial II, má oclusão Classe II, indicados para tratamento ortodôntico compensatório. As inclinações dos dentes anteriores foram avaliadas em três tempos clínicos, após o uso dos fios ortodônticos de diâmetros 0,020" (T1); 0,019" x 0,025" (T2) e 0,021" x 0,025" (T3), através de exames de tomografia computadorizada. Empregou-se a análise de variância de Friedman, com nível de significância de 5 por cento, na comparação entre os tempos. RESULTADOS: observou-se que o fios retangulares empregados não foram capazes de produzir uma mudança significativa na mediana da inclinação dentária, exceto por uma discreta alteração nos incisivos laterais inferiores (p<0,05). Por outro lado, constatou-se que a variação das inclinações observadas era menor no fio retangular 0,021" x 0,025", principalmente para os incisivos superiores (p<0,001). CONCLUSÃO: fios retangulares 0,021" x 0,025" produzem uma maior homogeneidade no grau de variação na inclinação dos incisivos superiores, embora sem mudança significativa na sua mediana.

OBJECTIVE: To evaluate changes in the inclination of anterior teeth caused by orthodontic treatment using a Straight-Wire appliance (Capelozza's prescription II), before and after the leveling phase with rectangular stainless steel archwires. METHODS: Seventeen adult subjects were selected who presented with facial pattern II, Class II malocclusion, referred for compensatory orthodontic treatment. Inclinations of anterior teeth were clinically assessed using CT scans at three different times, i.e., after the use of 0.020-in (T1), 0.019 X 0.025-in (T2) and 0.021 X 0.025-in (T3) archwires. Friedman's analysis of variance was applied with 5 percent significance level to compare the three assessments (T1, T2 and T3). RESULTS: It was noted that the rectangular wires were unable to produce any significant changes in inclination medians, except for a slight change in mandibular lateral incisors (p<0.05). On the other hand, variations in inclination were smaller when 0.021 X 0.025-in archwires were employed, particularly in maxillary incisors (P<0.001). CONCLUSION: The use of rectangular 0.021 X 0.025-in archwires produces more homogeneous variations in the inclination of maxillary incisors, but no significant median changes.

Avaliação da inclinação do incisivo inferior através da tomografia computadorizada / Computed tomographic evaluation of inferior incisor position

INTRODUÇÃO: durante muito tempo, a Ortodontia baseou-se em valores normativos obtidos através das análises cefalométricas existentes, utilizando a telerradiografia em norma lateral como exame principal no diagnóstico ortodôntico, ditando o plano de tratamento. O incisivo inferior, em particular, recebeu normas cefalométricas propostas por diversos autores, dentre eles Tweed. Entretanto, os exames radiográficos possuem limitações, pois, em uma imagem bidimensional de uma estrutura tridimensional, a superposição de determinadas estruturas ósseas e dentárias é constante. O advento da tomografia computadorizada disponibilizou meios diagnósticos mais precisos e confiáveis, principalmente pela possibilidade de obtenção da imagem das estruturas em três dimensões. Nesse contexto, parece razoável questionar os dados oriundos da análise clássica da radiografia lateral da face, com intuito de criar fatores de comparação com dados que passarão a ser gerados a partir da mesma imagem obtida pela tomografia. OBJETIVOS: para isso, propusemo-nos a avaliar o ângulo formado entre o longo eixo do incisivo inferior e o plano mandibular, a grandeza IMPA da cefalometria, na telerradiografia convencional e na tomografia computadorizada. MÉTODOS: dezenove pacientes selecionados para tratamento ortodôntico constituíram a amostra deste estudo, 12 do gênero feminino e 7 do masculino, com idades entre 16 anos e 4 meses e 28 anos e 2 meses. Após a coleta de dados, feita por dois examinadores, análises estatísticas para a obtenção dos erros intra e inter-examinadores foram feitas, utilizando nível de significância de 5 por cento. RESULTADOS E CONCLUSÕES: concluiu-se que a obtenção dos valores para o ângulo formado entre o longo eixo do incisivo inferior e o plano mandibular (IMPA) na telerradiografia lateral é um método confiável para uso clínico, porque embora apresente, como regra, valores menores que os encontrados em tomografia computadorizada, as diferenças não...

INTRODUCTION: Orthodontics has always used lateral cephalometric radiographs (LC) as the main examination in the orthodontic diagnosis and treatment plan. The determination of incisor position is part of most cephalometric analysis, including Tweed analysis. However, all radiographic images have limitations, since it is a bidimensional image of a tridimensional structure and overlapping of bone and dental structures often occurs. Computed tomography (CT) allows a trustworthy diagnostic, mainly for its tridimensional images possibility. In this situation it seems reasonable to question the classic cephalometric analysis, creating factors of comparison with computed tomography data. AIM: For this, it was considered the evaluation of the angle between the long axis of the inferior incisor and the mandibular plane (IMPA) in the lateral cephalograph and in the computed tomography. METHODS: Nineteen patients, selected for orthodontic treatment, had constituted the sample of this study, 12 female and 7 male, with ages between 16 years and 4 months and 28 years and 2 months. After the collection of data made by two examiners, statistical analyses for the attainment of the errors intra and inter-examiners had been made, using level of significance of 5 percent. RESULTS AND CONCLUSION: It was concluded that IMPA can be measured in the lateral cephalometric radiographs with trustworthiness, even that its values were smaller when compared with the computed tomography.

Um novo método para avaliar as inclinações dentárias utilizando a tomografia computadorizada / A new method to evaluate teeth tipping using computerized tomography

O exame de tomografia computadorizada vem sendo amplamente utilizado na Odontologia, principalmente na área de Implantodontia, com o objetivo de mensurar a altura e a espessura ósseas. A possibilidade de realizar cortes tomográficos individualizados nos fez levantar a hipótese de sua aplicabilidade para medir inclinações e angulações dentárias na Ortodontia, com maior precisão e confiabilidade. O objetivo deste trabalho é descrever uma nova metodologia para a mensuração das inclinações e angulações dentárias, utilizando a tomografia computadorizada volumétrica. Para isso, foram realizados cortes tomográficos dos dentes anteriores, de dois indivíduos, com padrões faciais II e III, respectivamente. Após a avaliação, concluímos que a tomografia computadorizada pode ser um meio útil para avaliação de inclinações e angulações dentárias, possibilitando grande contribuição para as pesquisas envolvendo o posicionamento dentário e também para a individualização do tratamento ortodôntico, uma vez que permite a verificação individual do posicionamento dentário.

Incidência de fratura de dentes anteriores superiores em relação à linha RH-P - linha de fratura / Fracture incidence of anterior upper teeth in relation to the RH-P line - fracture line

O propósito deste estudo foi determinar a incidência de fratura de incisivos superiores em relação á linha Rh-P (linha da fratura). Foi utilizada uma amostraDe 40 telerradiografias cefalométricas laterais de pacientes com incisivos fraturados, nos quais se determinou a distância da borda incisal dos incisivos permanentes superiores à linha de fratura. Os resultados mostraram que 100% dos incisivos superiores fraturados encontravam-se à frente desta linha. Ressalta-se assim, a importância do tratamento ortodôntico precoce e uso de protetores bucais em crianças que apresentam incisivos superiores posicionados á frente da linha de fratura, como prevenção à traumas deste elementos dentários

The purpose of this study was determine the incidence of fractures in the permanent upper incisors in relation to the Rh-P line (fracture line).A sample of 40 cephalometric lateral teleradiographies of patients with fracture incisors, in which it was determined the distance between the incisal of the upper permanent incisors and the fracture line, was used. The results showed that 100% of the fracture upper teeth were set ahead of this line, which stressed the importance of an early orthodontic treatment and the use of mouth protectors in children who present upper incisors set ahead of the fracture line, as a preventive measure against the fracture of these dental elements

Diagnóstico, prevençäo e tratamento precoce para hábitos bucais deletérios / Diagnosis, prevention and premature treatment for harmful mouth habits

O presente artigo tem por objetivo descrever os Hábitos Bucais Deletérios e os modos como eles se instalam, a fim de fornecer ao ortodontista melhores meios de diagnosticá-los, previni-los e tratá-los precocemente

Diagnóstico, prevenção e tratamento precoce para hábitos bucais deletérios / Diagnosis, prevention and premature treatment for harmful mouth habits

O presente artigo, tem por objetivo descrever os hábitos deletérios bucais e os modos como eles se instalam, a fim de fornecer ao ortodontista melhores meios de diagnosticá-los, preveni-los e tratá-los precocemente