Does the composite attachment of clear aligners compromise the effectiveness of dental bleaching? An in vitro study.

INTRODUCTION: This study aimed to evaluate the effectiveness of dental bleaching with hydrogen peroxide 35% on the surface below the attachments. METHODS: Twenty-four blocks of bovine incisors were equally divided into 2 groups. The control group comprises the enamel surface free of attachments, whereas the attachment group comprises the enamel surface with attachment. Initial staining of samples was performed with black tea for 7 days; then, an attachment was made in the attachment group with Z250 resin and new staining for another 7 days in all samples. After staining, in-office bleaching was performed in both groups, and the attachments from the attachment group were removed. Color reading was performed with a spectrophotometer at all stages: initial (baseline), after 7 days of staining, after 14 days of staining, after immediate bleaching, and after 24 hours of bleaching. The color difference was calculated, and data analysis was performed using the t test for intergroup analysis. RESULTS: The results showed effective bleaching in both groups; however, there was a statistically significant difference in color change between them 24 hours after bleaching. CONCLUSION: It was concluded that the presence of attachment did not impair the action of the bleaching agent on the tooth surface.

Maxillary alveolar bone evaluation following dentoalveolar expansion with clear aligners in adults: A cone-beam computed tomography study.

Objective: To investigate the effects of maxillary orthodontic expansion on the alveolar bone tissue in adult patients treated with aligners by using cone-beam computed tomography. Methods: Thirty patients (22 females and 8 males; mean age: 36.3 years) were treated with Invisalign® aligners. Cone-beam computed tomography and digital models were obtained before (T0) and after (T1) upper arch expansion. The bone thicknesses in the cervical, middle, and apical areas of the incisors, canines, premolar, and first molars were buccally and palatally measured, totaling 96 areas and 2,880 measurements. The buccolingual inclinations and transverse measurements of the teeth were obtained from digital models to correlate them with the bone changes. The statistical tests used were Student's t-test, analysis of variance, and Pearson's correlation tests (p < 0.05). Results: From the 96 areas evaluated, 84 revealed an increase or stability in the alveolar bone thickness and twelve displayed significant bone loss. Bone changes did not correlate with the tooth inclination and transverse measurements. Conclusions: Within the limitation of the present study, mild levels of upper arch expansion obtained with Invisalign® aligners in adult patients did not result in any clinically significant loss of alveolar bone thickness.

Post-COVID-19 influence in orthodontic care from the patient's perspective / Influência nos cuidados ortodônticos, pós-COVID 19, na perspectiva do paciente

Objective: considering the behavioral and paradigm changes due to the social isolation imposed by the new coronavirus pandemic, patients and orthodontists also have anxieties and insecurities in face of the new reality in dental clinics and educational institutions. This study aimed to evaluate, by means of an online questionnaire, the applicability of tele-orthodontics and tele-assistance, the behavior of patients regarding the initiation of or return to orthodontic treatment, and the new changes in clinical care. Material and Methods: the questionnaire was based on the Google Forms platform and consisted of three parts: the first one involved study presentation and informed consent form; the second one involved demographic data collection and characterization of the respondents, and the third one was the questionnaire itself. The questionnaire was sent by email and instant-messaging apps, with data being submitted for descriptive analyzis. Results: a total of 116 replies were returned, and most of the respondents were aged between 18 and 30 years old, female, and residents of the Southeast region. The results showed that tele- orthodontics is still unknown to a significant number of patients (66.4%) and almost half of them (41.4%) want their treatments to be monitored in person, even those whose devices do not require activation. They also prefer the first consultation and diagnosis to be done in person (55.2%). However, they are receptive to the idea of having their data and images transmitted via the Internet, including some remote consultations interspersed with in-person ones, understanding that costs can be lowered. Conclusion: tele-orthodontics is a reality, but for orthodontic patients, its applicability remains restricted to sending images and records (AU)

Objetivo: considerando as mudanças comportamentais e de paradigmas decorrentes do isolamento social imposto pela pandemia do novo coronavírus, pacientes e ortodontistas também apresentam ansiedades e inseguranças diante da nova realidade nas clínicas odontológicas e instituições de ensino. Este estudo teve como objetivo avaliar, por meio de questionário online, a aplicabilidade da teleortodontia e da teleassistência, o comportamento dos pacientes quanto ao início ou retorno do tratamento ortodôntico e as novas mudanças no atendimento clínico. Material e Métodos: o questionário baseou-se na plataforma 'Google Forms" e foi constituído por três partes: a primeira envolveu a apresentação do estudo e o termo de consentimento livre e esclarecido; a segunda envolveu a coleta de dados demográficos e caracterização dos respondentes, e a terceira foi o próprio questionário. O questionário foi enviado por e-mail e aplicativos de mensagens instantâneas, sendo os dados encaminhados para análise descritiva. Resultados: foram devolvidas 116 respostas, sendo a maioria dos respondentes com idade entre 18 e 30 anos, do sexo feminino e residentes na região Sudeste. Os resultados mostraram que a teleortodontia ainda é desconhecida por um número significativo de pacientes (66,4%) e quase metade deles (41,4%) deseja que seus tratamentos sejam acompanhados presencialmente, mesmo aqueles cujos aparelhos não requerem ativação. Preferem também que a primeira consulta e diagnóstico seja presencial (55,2%). No entanto, eles estão receptivos à idéia de ter seus dados e imagens transmitidos pela Internet, incluindo algumas consultas à distância intercaladas com as presenciais, entendendo que os custos podem ser reduzido. Conclusão: a teleortodontia é uma realidade, mas para os pacientes ortodônticos sua aplicabilidade permanece restrita ao envio de imagens e registros (AU)

Passo a passo do planejamento digital para confecção de alinhadores ortodônticos in office / Step-by-step digital planning for in office orthodontic aligners

Resumo Nos últimos anos, a rotina dos ortodontistas vem sendo impactada com o desenvolvimento da tecnologia de softwares de planejamento ortodôntico digital. Por ser uma excelente ferramenta para diagnóstico e planejamento para qualquer técnica ortodôntica e ser um passo fundamental do tratamento ortodôntico com alinhadores transparentes, é importante a adequação a essa nova realidade e rotina clínica. Esse pode ser um processo lento e pode significar trabalho árduo e um grande sacrifício por parte de profissionais menos adeptos à tecnologia ou com pouca experiência e conhecimento dos processos necessários. Este estudo propôs orientar o ortodontista e conduzi-lo, por meio de um passo a passo, ao conhecimento e aplicação do fluxo de planejamento digital (workflow), tendo em vista que essas dificuldades podem representar uma barreira para o desenvolvimento profissional. Foram descritas as etapas que devem ser seguidas no processo de tratamento ortodôntico com alinhadores, explicando e elucidando as ferramentas de planejamento virtual utilizadas em softwares gratuitos ou pagos, disponíveis no momento de desenvolvimento desse trabalho. Concluiu-se que o workflow exige conhecimento ortodôntico, além de uma abordagem técnica e apresenta 9 estágios que devem ser rigorosamente seguidos e executados de maneira sequencial e com atenção.(AU)

Abstract Over the last years the orthodontist's routine has been impacted by the development of digital orthodontic planning software technology. As an excellent tool for diagnosis and planning for any orthodontic technique and as a fundamental step in orthodontic treatment with clear aligners, it is necessary to adapt to this new reality and clinical routine. However, this can be a slow process and may require demanding work and a great sacrifice on the part of professionals who are less adept at the technology or with little experience and knowledge of the necessary processes. This article aimed to guide orthodontists through a step-by-step approach to the knowledge and application of digital planning flow (workflow) since these difficulties can represent a barrier to professional development. The steps that should be followed in the process of orthodontic treatment with aligners were described, explaining, elucidating the virtual planning tools used in free or paid software, available at the time of developing this work. It was concluded that workflow requires orthodontic knowledge, in addition to a technical approach, and has nine stages which should be strictly followed and executed in a sequential and careful manner. (AU)

Estudo cefalométrico das alterações dos terços médio e inferior da face em pacientes com diferentes padrões respiratórios e faciais / Cephalometric study of the changes of the medium and lower thirds of the face in patients with different breathing and facial patterns

OBJETIVOS: avaliar a possível relação dos padrões respiratórios e dos tipos faciais com as grandezas da análise de Ricketts - CF-N.CF-A, Po-Or.ENA-ENP, CF-Go, CF-Xi.Po-Or, Xi-Pm, N-P.Go-M, A-NP, Po-Or.Na - e as grandezas da Nasofaringe e da Bucofaringe propostas por McNamara; dos tipos faciais com os padrões respiratórios e dos padrões respiratórios com as variáveis do Vert. MÉTODOS: a amostra consistiu de 88 telerradiografias em norma lateral de brasileiros leucodermas, dos gêneros masculino e feminino, entre 7 e 13 anos (média de idade 10,5 anos), sendo 45 respiradores bucais e 43 nasais. O método cefalométrico computadorizado abrangeu a análise das grandezas para determinação do tipo facial, segundo Ricketts (Índice Vert). Aplicou-se a avaliação do erro do método pela fórmula de Dahlberg (média = 0,52), seguida das avaliações estatísticas teste "t" de Student e Pearson product correlative coefficient test (p < 0,05). RESULTADOS E CONCLUSÕES: observou-se ausência de alterações estatisticamente significativas das variáveis quando relacionadas aos padrões respiratórios, e presença de diferenças estatisticamente significativas das variáveis Convexidade do ponto A, Altura posterior da face, Profundidade da maxila, Cone facial, Comprimento do corpo e Nasofaringe quando relacionadas aos tipos braqui e dolicofaciais. As variáveis Cone facial e Comprimento do corpo também apresentaram diferenças significativas entre os tipos braquifacial e mesofacial. A variável Cone facial apresentou diferenças significativas entre todos os tipos faciais; o tipo braquifacial apresentou correlação significativa (p = 0,011) com o padrão de respiração nasal e a variável Profundidade facial apresentou diferença estatisticamente significativa (p = 0,028) quando relacionada aos padrões respiratórios.

AIM: To assess the possible relation of respiratory patterns and facial types with linear and angular variables of the Ricketts analysis - CF-N.CF-A, Po-Or.ENA-ENP, CF-Go, CF-Xi.Po-Or, Xi-Pm, N-P.Go-M, A-NP, Po-Or.Na - and the Nasopharynx and Oropharynx linear variables proposed by McNamara; and of the facial types with the respiratory patterns, and the respiratory patterns with the Vert variables. METHODS: The sample consisted of 88 lateral teleradiographs of Brazilian leucoderm boys and girls, ranging from 7 to 12 years of age (mean age 10.5 years) of whom 45 were mouth-breathers and 43 nasal breathers. The computerized cephalometric method covered analysis of the variables to determine the facial type, according to Ricketts (Vert Index). After the measurements were taken, assessment of the method error by the Dahlberg formula was applied (mean = 0.52), followed by t Student and chi-square tests (p < 0.05) statistical assessments. RESULTS AND CONCLUSIONS: There were no statistically significant alterations in the variables when related to the respiratory patterns; there were statistically significant differences in the following variables: Convexity of point A, Posterior face height, Maxilla depth, Facial cone, Corpus length and Nasopharynx when related to the brachyfacial and dolicofacial types. The variables Facial cone and Corpus length also presented significant differences between the brachyfacial and mesofacial types, and the variable Facial cone presented significant differences among all the facial types; the brachyfacial type presented significant correlation (p = 0.011) with the nasal respiratory pattern; and Facial depth presented statistically significant difference (p = 0.028) when related to the respiratory patterns.

Aparelho de Herbst ancorado no aparelho expansor de McNamara: relato de um caso clínico / Herbst appliance associated to McNamara expander: case report

O presente relato tem como objetivo exemplificar a associação do aparelho de Herbst e do aparelho expansor tipo Howe-McNamara mediante a apresentação de um caso cllínico, no qual um paciente leucoderma do gênero masculino, com 8 anos de idade, apresentava uma má oclusão de Classe II com deficiência mandibular. Um trespasse horizontal de 9,5mm associado a uma mordida aberta anterior de 6mm levou ao planejamento do tratamento com o aparelho de Herbst associado ao aparelho expansor encapsulado, obtendo bons resultados ortodôntico e ortopédico, já esperados, os quais mantiveram-se estáveis em acompanhamento realizado 3 anos e 6 meses após o tratamento.

Vertical interincisal trespass assessment in children with speech disorders.

Through a transversal epidemiological study, conducted with 333 Brazilian children, males (157) and females (176), aged 3 to 6 years old, enrolled in a public preschool, this study aimed to evaluate the prevalence of the different types of vertical interincisal trespass (VIT) and the relationship between these occlusal aspects and anterior lisping and/or anterior tongue thrust in the articulation of the lingua-alveolar phonemes /t/, /d/, /n/ and /l/. All children involved were submitted to a VIT examination and to a speech evaluation. Statistical significance was analyzed through the Qui-square test, at a significance level of 0.05 (95% confidence limit). The quantitative analysis of the data demonstrated the following prevalences: 1 - the different types of VIT: 48.3% for normal overbite (NO), 22.5% for deep overbite (DO), 9.3% for edge to edge (ETE) and 19.8% for open bite (OB); 2 - interdental lisping in relation to the different types of VIT: 42% for NO, 12.5% for DO, 12.5% for ETE, 32.9% for OB; and 3 - children with anterior tongue thrust in the articulation of lingua-alveolar phonemes in relation to the different types of VIT: 42.1% for NO, 14% for DO, 10.5% for ETE, 33.3% for OB. The results demonstrated that there was a significant relationship between open bite and anterior lisping and/or anterior tongue thrust in the articulation of the lingua-alveolar phonemes /t/, /d/, /n/ and /l/; and that there was a significant relationship between deep overbite and the absence of anterior lisping and anterior tongue thrust in the articulation of the lingua-alveolar phonemes.

Estudo cefalométrico da correlação da anatomia da base craniana com o padrão facial e as bases apicais / Cephalometric study of the cranial base anatomy correlation with the facial pattern and apical bases

OBJETIVOS: este estudo transversal foi realizado com o objetivo de avaliar cefalometricamente a correlação da anatomia da base craniana com o padrão facial e as bases apicais. METODOLOGIA: foram utilizadas 88 telerradiografias de norma lateral de jovens leucodermas brasileiros com média de idade de 10,3 anos. Utilizou-se o índice VERT de Ricketts para a determinação do padrão facial, distribuindo a amostra em: 37 para o grupo M (mesofaciais), 34 para o grupo D (dolicofaciais) e 17 para o grupo B (braquifaciais). Realizaram-se, manualmente: o desenho anatômico, a demarcação de pontos, o traçado de linhas e planos e a aferição de medidas lineares e angulares. As medidas da base do crânio utilizadas foram S-N, N.S.Ba e S-N.Po-Or, e as medidas das bases apicais foram S.N.A, S.N.B e A.N.B. RESULTADOS E CONCLUSÕES: concluiu-se que, na correlação entre a base craniana e o padrão facial, houve significância entre a variável N.S.Ba e o índice VERT. Na correlação entre a base craniana e as bases apicais, houve significância entre N.S.Ba e as variáveis S.N.A e S.N.B, e entre S-N.Po-Or e as variáveis S.N.A e S.N.B.

AIM: This cross-sectional study was conducted with the object of making a cephalometric evaluation of the cranial base anatomy correlation with the facial pattern and apical bases. METHODS: 88 lateral teleradiographies of young white Brazilian with mean age of 10.3 years were used. The Ricketts VERT index was used to determine the facial pattern, and the sample was distributed as follows: 37 in group M (mesofacial), 34 in group D (dolicofacial) and 17 in group B (brachyfacial). The anatomic drawing, demarcation of points, line and plane tracings, and linear and angular measurement gauging were done manually. The cranial base measurements used were S-N, N.S.Ba and S-N.Po-Or and the apical base measurements were S.N.A, S.N.B and A.N.B. RESULTS AND CONCLUSION: It was concluded that, in the correlation between the cranial base and the facial pattern, there was significance between the variable N.S.Ba and the VERT Index. In the correlation between the cranial base and the apical bases, there was significance between N.S.Ba and the variables S.N.A and S.N.B, and between S-N.Po-Or and the variables S.N.A and S.N.B.

Estudo cefalométrico das alterações dentoesqueléticas da má oclusão de Classe II, divisão 1 tratada com o aparelho de Herbst com cantiléver / Cephalometric study in patients that displayed Class II, division 1 malocclusion treated with herbst appliance

OBJETIVO: Realizou-se um estudo cefalométrico, em telerradiografias, objetivando-se determinar os efeitos no complexo craniofacial de pacientes com más oclusões de Classe II, divisão 1 submetidos ao tratamento com o aparelho de Herbst com cantiléver. METODOLOGIA: Para tanto, utilizou-se uma amostra composta por dois grupos, sendo um experimental e um controle. O grupo experimental originou-se da Faculdade de Odontologia de Bauru - USP, com 25 pacientes tratados com o aparelho ortopédico funcional e a idade inicial média de 12,01 anos. O grupo de controle, pareado cronologicamente ao grupo experimental, foi composto por pacientes não tratados ortodonticamente e/ou ortopedicamente, oriundos do arquivo de documentações denominado Burlington Growth Centre, localizado na Faculdade de Odontologia da Universidade de Toronto, Canadá. Para cada componente dos dois grupos, obtiveram-se as telerradiografias ao início (T1) e ao final (T2) do período de tratamento ou de observação, sendo traçadas manualmente e digitalizadas para um programa de cefalometria. Foram estabelecidas 33 grandezas cefalométricas. RESULTADOS E CONCLUSÕES: A comparação estatística entre o grupo experimental e o grupo controle (teste t de Student, com nível de significância p<0,05) evidenciou que a terapia corrigiu, em curto prazo, a má oclusão inicial, com grandes alterações dentoalveolares, em decorrência da perda substancial de ancoragem dentária, mesializando os molares inferiores e vestibularizando os incisivos inferiores. A terapia restringiu o desenvolvimento normal no sentido vertical dos dentes póstero-superiores, contribuindo decisivamente para a correção da relação molar de Classe II e manutenção do padrão de crescimento craniofacial dos pacientes.

OBJECTIVE: This study investigated the treatment effects on the craniofacial growth of Class II patients treated with Herbst appliance. METHODOLOGY: The sample was comprised of two groups, one experimental and one control group. The experimental group originated from Bauru Dental School, University of São Paulo. This consisted of 25 patients treated by the Herbst appliance, with an initial mean age of 12,01 years. The control group, matched by age with the experimental group, was originated from the Burlington Growth Centre, located at the Faculty of Dentistry, University of Toronto, Canada. All patients were assessed at the beginning (T1) and at the end of the treatment or observation period (T2) and 33 cephalometric variables were established. RESULTS AND CONCLUSIONS: The statistical comparison between the experimental group and the control group (Student t test) showed in short-term fashion, the correction of the initial malocclusion with pronounced dental changes (loss anchorage). The effect in inhibiting the vertical development of the maxillary first molars, essential characteristic to correct the Class II molar relationship and to maintain the craniofacial growth pattern, was shown with the therapy.

Soft tissue profile in white Brazilian adults with normal occlusions and well-balanced faces.

OBJECTIVE: To analyze anteroposterior soft tissue facial parameters for a sample of white Brazilian adults and to compare these measurements with the values proposed for white North American adults. MATERIALS AND METHODS: Facial profile photographs were taken of 59 white Brazilians (30 men and 29 women) with normal occlusions and balanced faces with ages ranging from 18 to 30 years. The independent Student's t-test (P < .05) was used to compare the soft tissue parameters of the Brazilians with those of the North Americans. RESULTS: White Brazilian women presented a less protruded face compared with white American women except for the glabella region. White Brazilian women showed a smaller nasal projection, less protruded upper and lower lips, a more obtuse nasolabial angle, and a smaller projection of the B' point and chin than white American women. Conversely, the two male groups demonstrated less evident soft tissue profile differences, with the exception of the nose projection, which was smaller in white Brazilian men than in white American men. CONCLUSIONS: A universal standard of facial esthetic is not applicable to diverse white populations. Differences regarding the soft tissue profile features were found between white Brazilians and white Americans. These differences should be considered in the orthodontic/orthognathic surgery diagnosis and treatment plan for white Brazilians together with the patient's individual opinion and perception of beauty.

Vertical interincisal trespass assessment in children with speech disorders

Through a transversal epidemiological study, conducted with 333 Brazilian children, males (157) and females (176), aged 3 to 6 years old, enrolled in a public preschool, this study aimed to evaluate the prevalence of the different types of vertical interincisal trespass (VIT) and the relationship between these occlusal aspects and anterior lisping and/or anterior tongue thrust in the articulation of the lingua-alveolar phonemes /t/, /d/, /n/ and /l/. All children involved were submitted to a VIT examination and to a speech evaluation. Statistical significance was analyzed through the Qui-square test, at a significance level of 0.05 (95 percent confidence limit). The quantitative analysis of the data demonstrated the following prevalences: 1 - the different types of VIT: 48.3 percent for normal overbite (NO), 22.5 percent for deep overbite (DO), 9.3 percent for edge to edge (ETE) and 19.8 percent for open bite (OB); 2 - interdental lisping in relation to the different types of VIT: 42 percent for NO, 12.5 percent for DO, 12.5 percent for ETE, 32.9 percent for OB; and 3 - children with anterior tongue thrust in the articulation of lingua-alveolar phonemes in relation to the different types of VIT: 42.1 percent for NO, 14 percent for DO, 10.5 percent for ETE, 33.3 percent for OB. The results demonstrated that there was a significant relationship between open bite and anterior lisping and/or anterior tongue thrust in the articulation of the lingua-alveolar phonemes /t/, /d/, /n/ and /l/; and that there was a significant relationship between deep overbite and the absence of anterior lisping and anterior tongue thrust in the articulation of the lingua-alveolar phonemes.

Assessment of temporomandibular disorder and occlusion in treated class III malocclusion patients

OBJECTIVE: The aims of this study were to compare the prevalence of temporomandibular disorders (TMD) in individuals submitted to either orthodontic or ortho-surgical Class III malocclusion treatment and to assess the influence of occlusal aspects on TMD severity. MATERIAL AND METHODS: The sample consisted of 50 individuals divided into two groups, according to the type of treatment (orthodontic or orthodontic with orthognathic surgery). The presence of signs and symptoms of TMD was evaluated by an anamnestic questionnaire and a clinical examination, including TMJ and muscle palpation, active mandibular range of motion, joint noises and occlusal examination. RESULTS: Based on the anamnestic questionnaire, 48 percent had no TMD, 42 percent had mild TMD and 10 percent had moderate TMD. The presence and severity of TMD did not show any relationship with the type of orthodontic treatment (p>0.05). The chi-square test showed a positive association (p<0.05) between TMD and non-working side occlusal interferences. CONCLUSION: Based on the methodology used and the results obtained, it may be concluded that Class III orthodontic treatment was not associated with the presence of TMD signs and symptoms and the non-working side contacts can be occlusal factors of risk. There was no significant difference in TMD prevalence between the studied groups (orthodontically treated patients and patients treated with orthodontics followed by orthognathic surgery).

Aparelho Churro Jumper: relato de um caso clínico / Churro Jumper appliance: a clinical report

Embora existam diferentes filosofias de tratamento da má oclusão de Classe II de Angle, o atual artigo propõe-se a apresentar a utilização do aparelho Churro Jumper como auxiliar na correção desta discrepância no sentido ântero-posterior, abordando suas indicações e vantagens. A sua eficácia é ilustrada pela apresentação de um caso clínico, no qual este sistema foi empregado obtendo-se um excelente resultado dentário, esquelético e facial. O aparelho Churro Jumper tem um mecanismo idêntico ao Jasper Jumper.

Assessment of temporomandibular disorder and occlusion in treated class III malocclusion patients.

OBJECTIVE: The aims of this study were to compare the prevalence of temporomandibular disorders (TMD) in individuals submitted to either orthodontic or ortho-surgical Class III malocclusion treatment and to assess the influence of occlusal aspects on TMD severity. MATERIAL AND METHODS: The sample consisted of 50 individuals divided into two groups, according to the type of treatment (orthodontic or orthodontic with orthognathic surgery). The presence of signs and symptoms of TMD was evaluated by an anamnestic questionnaire and a clinical examination, including TMJ and muscle palpation, active mandibular range of motion, joint noises and occlusal examination. RESULTS: Based on the anamnestic questionnaire, 48% had no TMD, 42% had mild TMD and 10% had moderate TMD. The presence and severity of TMD did not show any relationship with the type of orthodontic treatment (p>0.05). The chi-square test showed a positive association (p<0.05) between TMD and non-working side occlusal interferences. CONCLUSION: Based on the methodology used and the results obtained, it may be concluded that Class III orthodontic treatment was not associated with the presence of TMD signs and symptoms and the non-working side contacts can be occlusal factors of risk. There was no significant difference in TMD prevalence between the studied groups (orthodontically treated patients and patients treated with orthodontics followed by orthognathic surgery).

Degradação de força dos elásticos ortodônticos intrabucais / Strength degradation of orthodontics intraoral elastics

O objetivo desta pesquisa consistiu em, por meio de um estudo in vitro, avaliar as características de degradação da força de elásticos ortodônticos intrabucais de algumas marcas comerciais disponíveis no mercado, em relação ao tempo de utilização. Realizou-se a medição de força de sessenta e três elásticos ortodônticos de três marcas comerciais distintas, nos tamanhos de 1/8", 3/16", e 5/16" (sete exemplares em cada grupo), durante o período de cinco dias. Os elásticos foram mantidos em um recipiente com água destilada à 37ºC durante todo o experimento, tendo sido medidos em sua força nos seguintes tempos: O, 1, 4, 12, 24, 36 e 120 horas. Os resultados relativos às forças proporcionadas ao início da pesquisa demonstraram severa diferença entre as marcas comerciais. Durante as primeiras 24 horas, verificou-se acentuada degradação da força para todos os grupos estudados, com perda variando entre 9,3% e 22,1%. Após as primeiras 24 horas, houve continuidade na degradação de força, entretanto em proporções menores em todos os grupos. Concluiu-se que os elásticos intrabucais apresentam degradação de força variável entre as marcas comerciais e os tempos de utilização, sendo esta redução da força mais expressiva nas primeiras 24 horas para todos os grupos avaliados.

The purpose of this study, as an in vilro experiment of stretching elastic rings of various commercial brands, was to test the differences of the intraoral elastics strength degradation, among different times of use. Sixty-three orthodontic elastics of three commercial brands, of the following sizes 1/8",3/16" and 5/16" (seven specimens each group), had their strenght tested during five days. The elastics were mantained in a recipient fillied with 37ºC distilled water. Each elastic had its strength measured with a dynamometer at times O, 1,4, 12, 24, 36 and 120 hours. Initial strengths reflect a great difference in the intensity among the brands evaluated. In the first 24 hours, there was an accentuated decline in strength for ali the specimens studies, with a loss of force that ranged from 9.3% to 22.1%. Aher the first 24 hours, the decline in strength continued, but in smoother proportions for alI the groups and brands studied. The elastic rings underwent a degradation of strength that varied in accordance with the time of exposure and the commercial brando Elastic rings are not perfect elastic materiaIs, since their strength undergoes significant degradation as soon as they are attached to "the dental arches, irrespectiveof the size and commercial brand used.

Radiographic evaluation of the condylar position in symptomatic patients pre and pos deprogrammer splint / Avaliação radiográfica da posição condilar em pacientes pré e pós-placa desprogramadora

The present study evaluated the condylar position, pre and post deprogrammer splint, in 18 subjects who showed pain in their temporomandibular joint (TMJ). Methods: A sample of 72 transcranial radiographs of the TMJ was used, being 4 radiographs for each subject (an initial and another post-splint, on the right and left sides). It was outlined in the marking-out, the external acoustic meatus, the outline of the mandibular fossae and the condyle. Aiming to evaluate the condylar position, it was obtained an initial marking-out, and another one, post-splint, measuring the superior, the anterior, and the posterior joint spaces, with the purpose of determining the condylar concentricity and displacement level. Data were analyzed using the analysis of variance method (ANOVA), with a confidence interval of 95%. Results and Conclusion: According to the results, it was not observed any statistically significant difference between the condylar positions pre and post deprogrammer splint.

O presente estudo avaliou a posição condilar, pré e pós-placa desprogramadora, em 18 indivíduos que apresentavam dor na articulação temporomandibular (ATM). Métodos: Utilizou-se uma amostra de 72 radiografias transcranianas da ATM, sendo 4 radiografias por indivíduo (uma inicial e outra pósplaca, dos lados direito e esquerdo). No traçado, foram delineados o meato acústico externo, o contorno da fossa mandibular e o côndilo. Com a finalidade de avaliar a posição condilar, obteve-se um traçado inicial e outro pós-placa, mensurando os espaços articulares superior, anterior e posterior, para se determinar o grau de concentricidade e de deslocamento condilar. Os dados foram analisados pelo método de análise de variância (ANOVA), com intervalo de confiança de 95%. Resultados e Conclusão: De acordo com os resultados, não se observou diferença estatisticamente significante entre as posições condilares pré e pós-placa desprogramadora.

Redução de diastema central no paciente com doença periodontal / Midline diastema closure in patient with periodontal disease

A presença de diastemas na região ântero-superior representa uma má oclusão comum em pacientes com perda de suporte periodontal e prejudicam a estética do sorriso. O tratamento ortodôntico, nestes casos, deve ser realizado com cuidados como recuperação da saúde periodontal prévia e manutenção da mesma durante e após a movimentação ortodôntica. Além da realização do tratamento ortodôntico em um meio livre de inflamação causada pela doença periodontal outros cuidados são importantes como uma mecânica simples com forças extremamente suaves. Com estes cuidados o movimento ortodôntico pode ser realizado livre dos perigos de agravamento da perda óssea e da reabsorção periapical.

The presence of diastema in maxillary arch is a common malocclusion in patients with periodontal disease and they harm the aesthetic smile. The orthodontic treatment must be carried through with cares as recovery of previous the periodontal health and maintenance of the same during and after the orthodontic movement. Beyond the accomplishment of the treatment orthodontic in a free way of inflammation caused for the periodontal disease others care are important as simple mechanics with forces extremely soft. With these cares the orthodontic movement can be carried through free of aggravation of the periodontal disease and the periapical resorption.

Espessura do esmalte nas faces proximais de caninos permanentes superiores e inferiores humanos / Enamel thickness in the proximal faces of the humans lower and upper permanent canines

Introdução - O procedimento de desgaste do esmalte interproximal em ortodontia tem por finalidade promover as correções das discrepâncias dentárias ou garantir estabilidade no final do tratamento. Por ser rotineiramente empregado na clínica ortodôntica, o conhecimento e a determinação da espessura do esmalte é de fundamental importância. Métodos - Com auxílio de um paquímetro digital foram medidos os diâmetros mésio-distal, dos dentes da amostra, que, em seguída, foram incluídos em resina e seccionados em um recortador. Após a obtenção das lâminas centrais, mediu-se, com um perfilômetro de precisão milesimal à altura do ponto de contato, a espessura do esmalte nas faces mesiais e distais de cada dente. Resultados e conclusões: Pôde-se concluir que a espessura média do esmalte nos caninos superiores, em suas faces mesial e distal, mostrou-se maior que nos inferiores e a espessura média do esmalte na face distal maior que a espessura do esmalte na face mesial para os caninos superiores e inferiores.

Introduction - The purpose of the interproximal enamel abrasion procedure in orthodontics is to promote the correction of dental discrepancies, or to assure the stability after orthodontic treatment. Since it is usually utilized in orthodontic clinic, knowing and determining the enamel thickness is of fundamental importance. Method - A digital caliper rule was used to measure the Mesiodistal, Cervicoincisal and Labial-palatal diameters of the sample teeth, which were then included in resin and cut in a trimmer. After obtaining the central lamina, the enamel thickness in the Mesial and Distal faces of each tooth was measured with a millesimal precision outline machine at contact point. Results and Conclusions - We concluded that the average enamel thickness in the upper canines was higher than in the lower canines, and the average enamel thickness in the Distal face was higher than that in the Mesial face.

A disfunção temporomandibular e o tratamento da má oclusão de classe III / The temporomandibular disorder and the class III treatment

Introdução: O objetivo deste estudo é avaliar a prevalência de Disfunção Temporomandibular (DTM) em indivíduos tratados de más oclusões iniciais de Classe IlI. Método: Os 50 casos avaliados foram divididos em dois grupos, sendo o Grupo I composto de 25 pacientes tratados ortodonticamente e o Grupo Il de 25 pacientes submetidos a tratamento ortodôntico seguido de cirurgia ortognática. Um questionário relativo aos principais sintomas de DTM permitiu a classificação da amostra de acordo com a presença e a severidade de DTM. Com base no questionário anamnésico, encontrou-se a prevalência de 42% de DTM leve, 10% de DTM moderada e 48% de ausência de DTM. O teste estatístico aplicado nesta pesquisa foi o Mann-Witney para avaliar diferença entre os grupos. Resultados: Os resultados indicaram que os grupos estudados não apresentaram diferenças significativas quanto ao índice de DTM. Conclusão: Concluiu-se, com base na amostra estudada, que os tratamentos de más oclusões de Classe III não se relacionam com a presença e severidade de DTM.

Introduction: This study evaluated the prevalence of Temporomandibular Disorders (TMD) in individuals after CIass III orthodontic treatment by an anamnestic questionnaire. Method: Sample was composed of 50 individuals divided into two groups, according to the type of treatment (orthodontic or orthodontic with orthognathic surgery). Based on the anamnestic questionnaire, 42% was considered as having mild TMD, while 10% had moderate TMD. Result: The presence and severity of TMD have not shown any relationship with type of orthodontic treatment. Conclusion: Based on that, it was concluded that CIass III orthodontic treatment is not associated with the presence of symptoms of TMD.

Avaliação das formas dos arcos dentários em jovens brasileiros portadores de más oclusões / Evaluation of arch forms in brazilian young people with malocclusion

Introdução - A determinação da forma de arco, como parte do diagnóstico e plano de tratamento ortodôntico, representa um fator importante para a correta finalização com boa estabilidade. Este trabalho tem como objetivo avaliar a prevalência de diferentes formas de arcos em modelos de gesso, usados na documentação ortodôntica. Métodos - Através de análise visual de 296 arcadas, com ajuda de um template desenvolvido pela empresa 3M-UNITEK, foi avaliada a forma de arco mais comum entre os tipos 1 (cônico), 2 (quadrado) e 3 (ovóide) em 148 pares de modelos, sendo 71 jovens do gênero masculino e 77 do gênero feminino, entre 11 e 20 anos, que se apresentaram para tratamento na Disciplina de Ortodontia da Universidade Cidade de São Paulo - UNICID. Resultados - Entre as arcadas estudadas, 126 apresentaram arco do tipo 1 (42,6 por cento), sendo 65 do gênero masculino e 61 do gênero feminino; 25 tipo 2 (8,4 por cento), sendo 17 do gênero masculino e 8 do gênero feminino; e 145 tipo 3 (49 por cento), sendo 60 do gênero masculino e 85 do feminino. O arco tipo 1 foi o que apresentou maior índice de atresia na região de molares, com maior freqüência no arco superior. Mais de 80 por cento dos indivíduos avaliados (119) apresentaram o mesmo tipo de arco nas arcadas superior e inferior. Conclusões - Os resultados sugerem maior prevalência de arcos cônico e ovóide; no entanto, deve-se observar sempre a individualidade de cada caso.