Proximal retention grooves may increase early fracture strength of ART restorations / Sulcos de retenção proximal podem aumentar a resistência a fratura precoce de restaurações de ART

Objective: To evaluate the fracture resistance (RF) of Class II Glass-ionomer Cement (GIC) ART restorations with and without proximal retentions. Material and Methods: 20 freshly extracted human molars were used. Forty (40) standard Mesial-Occlusal (MO) and DistalOcclusal (DO) preparations (20 for each material) were performed with a 245 bur. The unprepared surfaces of the teeth were protected with nail polish and the specimens submerged in 0.5Mol EDTA solution, pH 7.4 for 8h under stirring. The preparations were finished with dentine spoons and 50% received proximal retention with # 3 excavators. 20 cavities were restored with Chemfil Rock (10 with retention and 10 without retention) and 20 cavities were restored with Equia Fil (10 with retention and 10 with no retention) and were stored in an oven at 37ºC and 100% relative humidity for 24h and submitted to axial compression loading in Test Machine - EMIC at a rate of 0.5 mm / minute, until restoration fracture occurred. The values were analyzed by two-way ANOVA (p<0.05). Results: ChemFil Rock presented 300.84 (69.20) (without retention) and 361.70 (81.08) (with retention) and Equia Fil showed 314.60 (69.97) (without retention) and 366.67 (103.38) (with retention). Data obtained with retention were statistically superior to those obtained with non-retained ART restorations (p=0.014). No statistical differences were detected between materials (p=0.761). Conclusion: Retentive grooves improved fracture resistance of Class II GIC ART restorations. (AU)

Objetivo: avaliar a resistência à fratura (FR) de restaurações de ART de Classe II de Cimento de ionômero de vidro (CIV) com e sem retenções proximais. Material e Métodos: Foram utilizados 20 molares humanos recém-extraídos. 40 cavidades padronizadas no sentido Mesial-Oclusal (MO) e Oclusal-Distal (OD) (20 para cada material) foram realizadas com uma broca 245. Os preparos cavitários foram submersos em solução 0,5 mol Mol EDTA, pH 7,4 por 8h sob agitação e foram finalizados com colheres de dentina, nos quais 50% receberam retenções proximais com escavadores #3. 20 cavidades foram restauradas com Chemfil Rock (10 com e 10 sem retenção) e 20 cavidades foram restauradas com Equia Fil (10 com e 10 sem retenção) e armazenadas em estufa a 37ºC e 100% de umidade relativa por 24h e submetidos a carga axial de compressão na máquina de ensaios EMIC a uma taxa de 0,5mm/min, até que a fratura de restauração ocorresse. Os valores foram analisados por ANOVA twoway (p<0,05). Resultados: ChemFil Rock apresentou 300.84 (69.20) (sem retenção) e 361.70 (81.08) (com retenção) e o Equia Fil apresentou 314.60 (69.97) (sem retenção) e 366.67 (103.38) (com retenção). Os dados obtidos com retenção foram estatisticamente superiores àqueles sem retenção (p=0.014). Não houve diferença estatística entre os materiais (p=0.761). Conclusão: Os sulcos retentivos melhoraram a resistência à fratura de restaurações de ART de Classe II de Cimento de ionômero de vidro (CIV).(AU)

Dentoalveolar effects produced by different appliances on early treatment of anterior open bite: A randomized clinical trial.

OBJECTIVES:: To compare different appliances for early anterior open bite (AOB) correction. MATERIALS AND METHODS:: This was a parallel, randomized clinical trial. A prospective sample of patients with AOB was recruited consecutively. Eligibility criteria included angle class I malocclusion with AOB equal to or greater than 1 mm. Participants were allocated by simple randomization to 4 groups: bonded spurs, chin cup, fixed palatal crib, and removable palatal crib. Dentoalveolar changes among the groups were assessed by blinded observers by comparing lateral cephalograms taken before (T1) and 12 months after treatment (T2; analysis of variance followed by Tukey test). Of the measurements, 30% were reassessed for reliability (intraclass correlation coefficient and Bland-Altman agreement test; α = 5%; 95% confidence interval). RESULTS:: A total of 99 patients with a mean AOB of 3.7 mm (mean age 8.4 ± 0.8 years, both genders) were recruited. Dropouts occurred in all the groups, yielding a final sample size of 81 analyzed individuals. Intergroup comparisons of differences (T2-T1) showed significant differences for the incisor positioning variables (1.1, 1-PP, 6-PP, IMPA, 1.NB and 1-GoMe). However, there was no significant difference in AOB reduction among the groups, with an average correction of 3.1 mm. CONCLUSIONS:: All of the tested devices promoted dental changes, especially in the anterior region, and contributed to AOB reduction during the study period. However, fixed palatal crib demonstrated greater impact on the positioning of the incisors.

Dimensional Stability of Alginates Molds Tridimentionally Scanned / Estabilidade Dimensional de Moldes de Alginatos Escaneados Tridimensionalmente

Alginate is among the most used materials in dentistry to create teeth negative printing and reproduction. The goal of this study was to compare dimensional changes of alginate scanned impression materials. Thirty impressions of a standard typodont were performed using three types of alginate (Hydrogum 5; Jeltrate Plus and Avagel). The impressions were scanned by the scanner 3Shape R700T and scans were performed immediately after molding. The analysis of digital models were performed at OrthoAnalyzer ™ 3D software. Measurements were carried out in relation to the transverse dimension (intercanine, interpremolares and intermolar). Method error was evaluated through the Intraclass Correlation Coefficient (ICC) and Bland-Altman. One-way ANOVA, Dunnet Post-test were used to compare the different groups in relation to Typodont (gold standard) for the different outcome variables. The data were tabulated in Statistical Package for Social Sciences version 20.0 and Minitab 17.0 softwares to compare groups. The significance level was 5%. The posterior transverse variables (D1PM, D2PM and DM) presented a statistically significant difference regarding the gold standard (Typodont) for the plaster models performed after the Avagel molding. In the digital models performed just after molding, only in DM, the Avagel material group presented values statistically higher than the control group. The alginates Hydrogum 5 and Jeltrate Plus presented dimensions closer to the gold standard.(AU).

O alginato está entre os materiais de moldagem mais utilizados na Odontologia para criar impressão e reprodução negativa dos dentes. O objetivo desse trabalho foi comparar alterações transversais de três marcas comerciais de alginato (Hydrogum, Jeltrate e Avagel) em moldes de alginatos. Trinta moldes de um Typodont padrão foram realizados, utilizando três tipos de alginato (Hydrogum 5; Jeltrate Plus e Avagel). Os moldes foram escaneados por meio do scanner 3Shape R700T e os escaneamentos realizados logo após a moldagem e logo após a obtenção dos modelos de gesso. As análises dos modelos digitais foram realizadas no software OrthoAnalyzer™ 3D. Foram realizadas mensurações em relação à discrepância transversal (inter-caninos, inter-primeiro pré-molar, inter-segundo pré-molar e inter-molares). O erro do método foi avaliado por meio do Coeficiente de Correlação Intraclasse (CCI) e Bland-Altman. Utilizou-se Análise de Variância (one-way ANOVA, Pós-teste Dunnet) para comparação dos diferentes grupos em relação ao typodont (padrão-ouro) para as diferentes variáveis de desfecho. A análise estatística foi realizada nos programas Statistical Package for Social Sciences versão 20.0 e no programa Minitab 17.0 para comparação dos grupos. O nível de significância foi de 5%. As variáveis transversais posteriores (D1PM; D2PM e DM) apresentaram diferença estatisticamente significante em relação ao padrão-ouro (manequim) para os modelos de gesso realizados após a moldagem com Avagel. Nos modelos digitais realizados logo após a moldagem, apenas na DM, o grupo do material Avagel apresentou valores estatisticamente maiores do que o grupo controle. Os alginatos Hydrogum 5 e Jeltrate Plus apresentaram dimensões mais próximas do padrão-ouro.(AU).

Reliability of CBCT and Periapical Radiography Methods to Evaluate External Apical Root Resorption during Early Phase of Orthodontic Treatment / Confiabilidade dos Métodos de TCFC e Radiografia Periapical para Avaliar a Reabsorção Radicular Apical Externa Durante os Estágios Iniciais do Tratamento Ortodôntico

A reabsorção radicular apical externa - RRAE é um efeito indesejável associado ao movimento dentário induzido. O objetivo deste estudo foi avaliar a confiabilidade de dois métodos radiográficos, a tomográfica computadorizada de feixe cônico - TCFC e a radiografia periapical (RP), para mensurar a RRAE. A amostra foi composta por 25 pacientes (média de idade de 18,02 ± 6,06 anos) com presença de apinhamento de moderado a severo. A RRAE foi verificada em RP e TCFC de incisivos superiores e inferiores em dois tempos (T1 ­ início do tratamento ortodôntico e T2 ­ seis meses após início do tratamento). As RRAE foi avaliada através de mensurações da diferença no comprimento dentário (T2-T1) de cada incisivo. Foram realizadas por dois examinadores previamente calibrados. Nas imagens obtidas pela TCFC, as medidas foram realizadas por meio do programa Dolphin (Chatsworth, Calif), já nas imagens das radiografias periapicais, no programa CorelDraw X5 (Ottawa, Candá). Os erros de medição intra e interexaminadores foram avaliados pelo Coeficiente de Correlação Intraclasse - CCI. Os valores obtidos foram comparados utilizando o teste t de student com nível de significância de 5%. Os resultados da comparação entre T1 e T2, tanto para a RP (0.92mm) quanto para a TCFC (0.25mm), evidenciaram a presença de RRAE para todos os dentes mensurados, com diferença estatisticamente significante. Ambos os métodos são confiáveis para avaliar a RRAE aos 6 meses após início do tratamento ortodôntico, contudo a diferença de magnitude entre as medidas obtidas entre os métodos não justifica a solicitação de TCFC somente para este fim.(AU).

External apical root resorption (EARR) is an undesirable therapeutic effect associated with induced tooth movement. The aim of this studywas to evaluate the reliability of two methods, cone beam computed tomography (CBCT) and periapical radiography (PR), for measuringEARR during early phases of orthodontic treatment. The study included 25 patients (mean age, 18.02 ± 6.06 years) with moderate to severetooth crowding. Maxillary and mandibular incisors were evaluated in CBCT scans and PR at two different times: T1, at the beginning oforthodontic treatment; T2, 6 months after the treatment initiation. The difference in incisor length T2-T1, as measured by two independentcalibrated examiners, represented EARR. Measurements made on the images obtained by I-cat scanner (Hatfield,PA) were performed using theDolphin program (Chatsworth, Calif.). The PR images were imported to the CorelDraw X5 program (Ottawa, Canada). Intraclass correlationcoefficient (ICC) was used to measure intra- and inter-examiner errors. A Student's t-test was used for comparing the results between CBCTand PR, with a significance level of 5%. All teeth showed EARR, using both periapical radiographs (0.92mm) and CBCT (0.25mm). Althoughthe difference between the results of the two techniques was statistically significant, its value was lower than 1mm for all teeth measured. Bothradiographic methods are suitable and reliable for assessing EARR after 6 months of initial orthodontic treatment. However, the differencein magnitude between the measurements obtained by the two methods does not justify requesting CBCT merely to assess EARR duringorthodontic treatment.(AU).

Associação entre disfunção temporomandibular e zumbido em idosos / Association between temporomandibular disorders and tinnitus in the elderly

RESUMO Objetivo Verificar a associação entre zumbido e disfunção temporomandibular em idosos. Métodos Estudo transversal realizado com a inclusão de idosos com vida independente. A disfunção temporomandibular foi avaliada por exame odontológico e o zumbido foi verificado pela história médica. A análise estatística foi realizada utilizando o teste Qui-quadrado, o risco relativo e a regressão logística. Resultados O zumbido foi observado em 82,9% dos indivíduos com disfunção temporomandibular e, através desta análise, observou-se que a disfunção temporomandibular é um fator de risco para o zumbido. Conclusão Houve associação entre zumbido e disfunção temporomandibular na população idosa. Ressalta-se a importância de identificar fatores de risco para o zumbido, que podem ser modificados por meio de intervenções específicas, uma vez que esta prática é essencial na prevenção de episódios futuros, bem como na gestão do processo de tratamento de pacientes idosos, em geral.

ABSTRACT Purpose To verify the association between tinnitus and temporomandibular dysfunction in the elderly. Methods A cross sectional study was conducted with the inclusion of elderly individuals with independent living. Temporomandibular dysfunction was assessed by odontological evaluation and tinnitus was verified by medical history. Statistical analysis was performed using the chi-square test, relative risk and logistic regression. Results Tinnitus was observed in 82.9% of individuals with temporomandibular dysfunction and through this analysis is shown that temporomandibular dysfunction as a risk factor for tinnitus. Conclusion The results showed that there was association between tinnitus and temporomandibular dysfunction in the elderly population and emphasizes the importance of identifying risk factors for tinnitus that can be modified through specific interventions, since it is essential in the prevention of future episodes, as well as managing the process of treatment of elderly patients in general.

Avaliação do Seio Maxilar: Radiografia Panorâmica Versus Tomografia Computadorizada de Feixe Cônico / Evaluation of the Maxillary Sinus: Panoramic Radiography Versus Cone Beam Computed Tomography

O objetivo deste estudo retrospectivo implica em comparar a presença de velamento, o espessamento de mucosa e a presença de septo no seio maxilar em radiografias panorâmicas e tomografias computadorizadas de feixe cônico (TCFC). A amostra foi composta por 100 pacientes do arquivo, que apresentavam as radiografias panorâmicas e as TCFC antes do início do tratamento ortodôntico, sendo 57 mulheres e 43 homens, com média de idade de 19,08 anos. Foram incluídas nesta pesquisa apenas os exames que apresentavam boa qualidade e bom posicionamento do paciente. A avaliação do velamento, espessamento de mucosa e presença de septo no seio maxilar foi realizada por um único examinador calibrado, de forma independente, nas radiografias e nas TCFC. A concordância entre os exames foi avaliada por meio do teste Kappa. Os resultados demonstraram boa concordância entre as radiografias panorâmicas e TCFC (Kappa entre 0,62 a 0,72), com -90, -88 e 89% de convergência entre os métodos, para velamento do seio maxilar; espessamento de mucosa e presença de septo no seio maxilar, respectivamente. Pode-se concluir que foi encontrada concordância satisfatória na avaliação do velamento, espessamento de mucosa e presença de septo no seio maxilar entre as radiografias panorâmica e TCFC. Dessa forma, as características do seio maxilar foram identificadas, de maneira semelhante, na radiografia panorâmica e na TCFC. (AU).

The objective of this retrospective study was to compare the presence of filled maxillary sinus, mucosal thickening and the presence of septum in the maxillary sinus on panoramic radiographs and concomitant computed tomography (CBCT) scans. The sample consisted of 100 patients from the archive who presented the panoramic radiographs and the CBCT before the beginning of the orthodontic treatment, being 57 women and 43 men, with a mean age of 19.08 years. Only the exams that presented good quality and good positioning of the patient were included in this study. The evaluation of the presence of filled maxillary sinus, mucosal thickening and the presence of septum in the maxillary sinus was performed by a single examiner, regardless of who was calibrated on panoramic radiograph and CBCT. The agreement among the exams was assessed by means of Kappa test. The results showed good agreement between panoramic radiograph and CBCT (Kappa between 0.62 and 0.72), with -90, -88 and 89% convergence between the methods, for the presence of filled maxillary sinus, mucosal thickening and presence of septum in the maxillary sinus, respectively. It can be concluded that satisfactory agreement was found in the evaluation of the the presence of filled maxillary sinus, mucosal thickening and presence of septum in the maxillary sinus between the panoramic and CBCT radiographs. Thus, the characteristics of the maxillary sinus were similarly identified in panoramic radiography and CBCT. (AU).

Influence of the presence of Temporomandibular Disorders on postural balance in the elderly.

PURPOSE: To investigate the influence of the presence of Temporomandibular Disorders (TMD) on postural balance in elderly individuals. METHODS: The study sample consisted of 150 elderly: 103 women (67.7±5.0 years) and 47 men (69.3±5.5 years). Evaluation of the presence and severity of TMD included an anamnesis questionnaire, an evaluation of the temporomandibular joint (TMJ), and a muscular examination, which allowed the division of the elderly into 2 groups: G1 (experimental, n=95), with TMD; G2 (control, n=55), without TMD. Postural balance was assessed by means of the one-leg stance test (OLST) on a force platform (BIOMEC400), thus permitting the following measurements: center of foot pressure (COP); mean sway velocity (MV) and frequency (MF) of COP in both the anteroposterior (VAP and FAP) and medial/lateral (VML and FML) directions. The statistical analysis of data was performed using independent t-test, Variance Analysis, and Chi Square test (α=5%). RESULTS: Presence of TMD was observed in 63.3% of the individuals (Group 2), with different degrees of severity (mild: 42.7%, moderate: 14.7%, severe: 6%). Significantly higher TMD was observed for women (73.8%) compared with men (40.4%) (p=0.0002). No significant difference was found in between the groups for all balance parameters, e.g., presence and severity of TMD, presence of pain to palpation of TMJ and of masticatory and cervical muscles. CONCLUSION: The presence and severity of TMD, in addition to the presence of pain to palpation of TMJ and masticatory and cervical muscles did not alter the variables related to postural balance in this population.

Dimensional changes of dental arches produced by fixed and removable palatal cribs: A prospective, randomized, controlled study.

OBJECTIVE: To evaluate the dimensional changes of dental arches on digital models of open bite treatment with fixed and removable palatal cribs. MATERIALS AND METHODS: The sample comprised 41 patients of both sexes who were white, aged 7-10 years, and who had mixed dentition, Angle Class I molar relationship, and a negative overbite of at least 1 mm. The sample was randomly divided into two groups: G1, fixed palatal crib; and G2, removable palatal crib. Cast models, obtained initially (T1) and after 1 year of treatment (T2), were scanned by a three-dimensional (3D) scanner, 3Shape R700, producing a 3D image. Measurements were performed by a calibrated examiner using OrthoAnalyzer™ 3D software. RESULTS: At T2-T1, differences were observed between the groups regarding vertical dentoalveolar development and overjet. There was more mandibular incisor extrusion for G1 (-1.66 mm) than for G2 (-0.54 mm). An overjet increase was observed in G1 (0.56 mm), in contrast to a reduction in G2 (-0.40 mm). There was a similar overbite increase for both groups (3.51 mm for fixed palatal crib and 3.88 mm for removable palatal crib). CONCLUSIONS: Both the treatment protocols are similarly effective for anterior open bite correction, providing an overbite increase with dentoalveolar arch changes, especially in the anterior region.

Influence of the presence of Temporomandibular Disorders on postural balance in the elderly

ABSTRACT Purpose To investigate the influence of the presence of Temporomandibular Disorders (TMD) on postural balance in elderly individuals. Methods The study sample consisted of 150 elderly: 103 women (67.7±5.0 years) and 47 men (69.3±5.5 years). Evaluation of the presence and severity of TMD included an anamnesis questionnaire, an evaluation of the temporomandibular joint (TMJ), and a muscular examination, which allowed the division of the elderly into 2 groups: G1 (experimental, n=95), with TMD; G2 (control, n=55), without TMD. Postural balance was assessed by means of the one-leg stance test (OLST) on a force platform (BIOMEC400), thus permitting the following measurements: center of foot pressure (COP); mean sway velocity (MV) and frequency (MF) of COP in both the anteroposterior (VAP and FAP) and medial/lateral (VML and FML) directions. The statistical analysis of data was performed using independent t-test, Variance Analysis, and Chi Square test (α=5%). Results Presence of TMD was observed in 63.3% of the individuals (Group 2), with different degrees of severity (mild: 42.7%, moderate: 14.7%, severe: 6%). Significantly higher TMD was observed for women (73.8%) compared with men (40.4%) (p=0.0002). No significant difference was found in between the groups for all balance parameters, e.g., presence and severity of TMD, presence of pain to palpation of TMJ and of masticatory and cervical muscles. Conclusion The presence and severity of TMD, in addition to the presence of pain to palpation of TMJ and masticatory and cervical muscles did not alter the variables related to postural balance in this population.

Evaluation of a preventive educational program for malocclusions: 7-year study.

RESULTS: 506 of the 802 guardians/children referred to the PPM joined. As for the children, the most frequently assessed habits were: bottle (56.1%), bottle and pacifier (18.4%), finger (11.9%), bottle and finger (7.1%), pacifier (5.7%), pacifier and finger (0.6%), and bottle/pacifier/finger (0.2%). After parent participation in the meetings, 335 (66.2%) children abandoned their habits. There was a statistical difference between type of oral habit and time to abandonment (p = 0.0001). However, those with only one habit abandoned it more easily (72.6%) than those with two or more associated habits (48.1%) (p = 0.042). Presence or absence of breastfeeding and parents' level of education had no significant effect on habit abandonment. CONCLUSION: PPM was an important tool for spreading knowledge to guardians, greatly contributing to the abandonment of deleterious oral habits. Bottle sucking warrants special attention - mentioned by 81.8% of parents - either alone or associated with other habits. Thus, educational actions to implement the children's approach to oral health are fundamental to making behavioral changes and promoting education of healthy habits, thereby keeping malocclusions from developing.

Tomographic evaluation of the temporomandibular joint in malocclusion subjects: condylar morphology and position.

The aim of this study was to investigate condyle concentricity and morphology, and their association with Class I and II malocclusions (Angle). The sample consisted of 49 individuals of both genders, between 11 and 35 years old, divided into two groups, G1: 26 patients with Class I malocclusion, and G2: 23 patients with Class II malocclusion, selected for orthodontic treatment. Evaluation of the condyle morphology and position was performed by the same previously calibrated examiner using cone-beam computed tomography (CBCT) images of the subjects. The CBCT scans were analyzed by means of a 3D program (Dolphin 11.5, Dolphin Imaging & Management Solutions, Chatsworth, CA, USA), with a 25% level of sensitivity. The images obtained from the coronal slices were employed for the condyle morphology analysis, which classified the condyle form as rounded, as flat or convex, and as triangular or angled. The sagittal slices were used to classify further the condyles as concentric and displaced anteriorly or posteriorly. A clinical examination was also performed, including TMJ and muscle palpation. The kappa test was used to evaluate investigator calibration; the Chi-square and paired t-tests were used for analysis. The convex and anteriorly positioned condyles were found most frequently, regardless of the type of malocclusion. No association was observed between the groups regarding condylar characteristics.

Evaluation of a preventive educational program for malocclusions: 7-year study

Abstract This study aimed at evaluating the Protocol for the Prevention of Malocclusions (PPM), established in the preventive educational program developed by the Public Infant Oral Health Program of the State University of Londrina (PIOHP-UEL). Guardians of three-year-olds or older, maintaining nutritive (bottle) and/or non-nutritive (pacifier and finger) sucking habits, attended meetings designed to alert and guide them to eliminating these habits from their children. PPM patient records (2006-2013) were assessed and the data were described and evaluated by the Chi-square test, with a 5% significance level. Results 506 of the 802 guardians/children referred to the PPM joined. As for the children, the most frequently assessed habits were: bottle (56.1%), bottle and pacifier (18.4%), finger (11.9%), bottle and finger (7.1%), pacifier (5.7%), pacifier and finger (0.6%), and bottle/pacifier/finger (0.2%). After parent participation in the meetings, 335 (66.2%) children abandoned their habits. There was a statistical difference between type of oral habit and time to abandonment (p = 0.0001). However, those with only one habit abandoned it more easily (72.6%) than those with two or more associated habits (48.1%) (p = 0.042). Presence or absence of breastfeeding and parents' level of education had no significant effect on habit abandonment. Conclusion PPM was an important tool for spreading knowledge to guardians, greatly contributing to the abandonment of deleterious oral habits. Bottle sucking warrants special attention - mentioned by 81.8% of parents - either alone or associated with other habits. Thus, educational actions to implement the children's approach to oral health are fundamental to making behavioral changes and promoting education of healthy habits, thereby keeping malocclusions from developing.

Tomographic evaluation of the temporomandibular joint in malocclusion subjects: condylar morphology and position

Abstract The aim of this study was to investigate condyle concentricity and morphology, and their association with Class I and II malocclusions (Angle). The sample consisted of 49 individuals of both genders, between 11 and 35 years old, divided into two groups, G1: 26 patients with Class I malocclusion, and G2: 23 patients with Class II malocclusion, selected for orthodontic treatment. Evaluation of the condyle morphology and position was performed by the same previously calibrated examiner using cone-beam computed tomography (CBCT) images of the subjects. The CBCT scans were analyzed by means of a 3D program (Dolphin 11.5, Dolphin Imaging & Management Solutions, Chatsworth, CA, USA), with a 25% level of sensitivity. The images obtained from the coronal slices were employed for the condyle morphology analysis, which classified the condyle form as rounded, as flat or convex, and as triangular or angled. The sagittal slices were used to classify further the condyles as concentric and displaced anteriorly or posteriorly. A clinical examination was also performed, including TMJ and muscle palpation. The kappa test was used to evaluate investigator calibration; the Chi-square and paired t-tests were used for analysis. The convex and anteriorly positioned condyles were found most frequently, regardless of the type of malocclusion. No association was observed between the groups regarding condylar characteristics.

Dentoalveolar mandibular changes with self-ligating versus conventional bracket systems: A CBCT and dental cast study.

OBJECTIVE: The aim of the present study was to compare dentoalveolar changes in mandibular arch, regarding transversal measures and buccal bone thickness, in patients undergoing the initial phase of orthodontic treatment with self-ligating or conventional bracket systems. METHODS: A sample of 25 patients requiring orthodontic treatment was assessed based on the bracket type. Group 1 comprised 13 patients bonded with 0.022-in self-ligating brackets (SLB). Group 2 included 12 patients bonded with 0.022-in conventional brackets (CLB). Cone-beam computed tomography (CBCT) scans and a 3D program (Dolphin) assessed changes in transversal width of buccal bone (TWBB) and buccal bone thickness (BBT) before (T1) and 7 months after treatment onset (T2). Measurements on dental casts were performed using a digital caliper. Differences between and within groups were analyzed by Student's t-test; Pearson correlation coefficient was also calculated. RESULTS: Significant mandibular expansion was observed for both groups; however, no significant differences were found between groups. There was significant decrease in mandibular buccal bone thickness and transversal width of buccal bone in both groups. There was no significant correlation between buccal bone thickness and dental arch expansion. CONCLUSIONS: There were no significant differences between self-ligating brackets and conventional brackets systems regarding mandibular arch expansion and changes in buccal bone thickness or transversal width of buccal bone.

Dentoalveolar mandibular changes with self-ligating versus conventional bracket systems: A CBCT and dental cast study

OBJECTIVE: The aim of the present study was to compare dentoalveolar changes in mandibular arch, regarding transversal measures and buccal bone thickness, in patients undergoing the initial phase of orthodontic treatment with self-ligating or conventional bracket systems. METHODS: A sample of 25 patients requiring orthodontic treatment was assessed based on the bracket type. Group 1 comprised 13 patients bonded with 0.022-in self-ligating brackets (SLB). Group 2 included 12 patients bonded with 0.022-in conventional brackets (CLB). Cone-beam computed tomography (CBCT) scans and a 3D program (Dolphin) assessed changes in transversal width of buccal bone (TWBB) and buccal bone thickness (BBT) before (T1) and 7 months after treatment onset (T2). Measurements on dental casts were performed using a digital caliper. Differences between and within groups were analyzed by Student's t-test; Pearson correlation coefficient was also calculated. RESULTS: Significant mandibular expansion was observed for both groups; however, no significant differences were found between groups. There was significant decrease in mandibular buccal bone thickness and transversal width of buccal bone in both groups. There was no significant correlation between buccal bone thickness and dental arch expansion. CONCLUSIONS: There were no significant differences between self-ligating brackets and conventional brackets systems regarding mandibular arch expansion and changes in buccal bone thickness or transversal width of buccal bone. .

OBJETIVO: o objetivo do presente estudo foi comparar as alterações dentoalveolares transversais e a espessura óssea da arcada inferior em pacientes submetidos ao tratamento ortodôntico utilizando sistemas de braquetes autoligáveis ou convencionais. MÉTODOS: uma amostra de 25 pacientes requerendo tratamento ortodôntico foi recrutada com base no tipo de braquete. No Grupo 1, 13 pacientes foram tratados com braquetes autoligáveis (SLB, slot 0,022"); o Grupo 2 incluiu 12 pacientes, nos quais foram colados braquetes convencionais (CLB, slot 0,022"). Utilizou-se tomografia computadorizada de feixe cônico e um programa 3D (Dolphin) para avaliar as alterações pré-tratamento (T1) e 7 meses após o início desse (T2). As medições em modelos de gesso foram realizadas com o auxílio de um paquímetro digital. As diferenças intergrupos, bem como intragrupo, foram analisadas por meio de teste t de Student. Além disso, o coeficiente de correlação de Pearson foi utilizado. RESULTADOS: alterações dentoalveolares significativas foram observadas em ambos os grupos. Entretanto, não houve diferenças significativas entre os grupos. Houve uma diminuição da espessura óssea na região posterior e das medidas transversais em ambos os grupos. Não houve uma correlação significativa entre a espessura óssea posterior e a expansão da arcada dentária, em nenhum dos dois sistemas de braquetes utilizados. CONCLUSÕES: comparando-se o uso dos aparelhos autoligáveis e convencionais, concluiu-se que não houve diferenças dentoalveolares significativas quanto à expansão da arcada inferior e quanto à espessura óssea posterior. .

Assessment of cephalometric characteristics in the elderly.

This cross-sectional study aimed at assessing the cephalometric characteristics in the elderly, taking into account differences between genders, age ranges, ethnic groups and dental aspects. The sample consisted of 250 elderly subjects of both genders (163 female, mean age: 68 yr.; 87 male: 70.4 yr.). Conventional lateral cephalograms for cephalometric analysis were scanned and analyzed by Dolphin Imaging software 11.5. The statistical treatment of the data evaluated the influence of gender and age range variables (independent t test), as well as ethnic group, facial profile, and dental characteristics (one-way ANOVA), on cephalometric measurements. A confidence interval of 95% and level of significance of 5% were considered for all the tests performed. The results revealed: 1) The cephalometric measurements evaluated showed significantly lower values for the female gender; 2) a significant decrease in the cephalometric values was observed in relation to the growth pattern, with the advancement of age; 3) significant cephalometric differences were observed between the ethnic groups and the facial profiles; 3) dentulous patients had greater absolute values for all the components evaluated, followed by the individuals with partial dental losses and by those who were edentulous. It may be concluded that the cephalometric alterations observed in this study are inherent to facial maturity, and that they represent specific characteristics regarding each of the variables evaluated. These modifications must be taken into account when planning the treatment for younger patients, to minimize the modifications arising from the natural aging process.

Can bone thickness and inter-radicular space affect miniscrew placement in posterior mandibular sites?

PURPOSE: The proper angle of miniscrew insertion is important for cortical anchorage, patient safety, and biomechanical control. The purposes of this study are to report the alveolar process thickness and inter-radicular space in the posterior region of the mandible, to assess the impact of different miniscrew insertion angle protocols, and to identify differences between the genders or types of malocclusion. MATERIALS AND METHODS: In this retrospective study, 100 individuals were selected for orthodontic treatment at a radiology clinic. Cone-beam computed tomography data were imported into 3-dimensional software. The predictor variable was the location in the mandible and insertion angle. The demographic variables collected included age, gender, and malocclusion (Angle Classes I and II). The primary outcome variables were bone thickness and inter-radicular space. The inter-radicular spaces were evaluated 5 mm from the cement-enamel junction. The bone thicknesses were taken at 45°, 60°, and 90° in relation to the alveolar ridge, simulating a miniscrew insertion. These factors were evaluated for sexual dimorphism and malocclusion (Angle Classes I and II). Sexual dimorphism and malocclusion were evaluated with t tests. To compare the inter-radicular space and the thickness of bone between areas, an analysis of variance for repeated measures was used. RESULTS: The sample was composed of 100 patients with a mean age of 17.4 ± 6.74 years. There were 61 female and 39 male patients and 60 Class I and 40 Class II molar relationships. The inter-radicular space ranged from 2.46 to 3.31 mm, and alveolar bone thickness ranged from 8.01 to 13.77 mm. The thickness tended to decrease with the increase in insertion angle from 45° to 90°. No significant differences between the genders or types of malocclusion were found. CONCLUSIONS: The results of this study suggest that the safest areas for the placement of miniscrews are between the first and second premolars and between the first and second molars, regardless of the angle of insertion.

Assessment of cephalometric characteristics in the elderly

This cross-sectional study aimed at assessing the cephalometric characteristics in the elderly, taking into account differences between genders, age ranges, ethnic groups and dental aspects. The sample consisted of 250 elderly subjects of both genders (163 female, mean age: 68 yr.; 87 male: 70.4 yr.). Conventional lateral cephalograms for cephalometric analysis were scanned and analyzed by Dolphin Imaging software 11.5. The statistical treatment of the data evaluated the influence of gender and age range variables (independent ttest), as well as ethnic group, facial profile, and dental characteristics (one-way ANOVA), on cephalometric measurements. A confidence interval of 95% and level of significance of 5% were considered for all the tests performed. The results revealed: 1) The cephalometric measurements evaluated showed significantly lower values for the female gender; 2) a significant decrease in the cephalometric values was observed in relation to the growth pattern, with the advancement of age; 3) significant cephalometric differences were observed between the ethnic groups and the facial profiles; 3) dentulous patients had greater absolute values for all the components evaluated, followed by the individuals with partial dental losses and by those who were edentulous. It may be concluded that the cephalometric alterations observed in this study are inherent to facial maturity, and that they represent specific characteristics regarding each of the variables evaluated. These modifications must be taken into account when planning the treatment for younger patients, to minimize the modifications arising from the natural aging process.

Signs and symptoms of temporomandibular disorders in the elderly.

PURPOSE: This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. METHODS: The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a muscular examination. The results were analyzed through descriptive statistics as well as using χ2 and the tendency tests. RESULTS: The presence of TMD was observed in 61% of the sample (mild: 43.5%, moderate: 13%, severe: 4.5%). A significantly greater prevalence of TMD was found for females (72.4%) compared with that for men (41.1%) (p<0.0001). Additionally, a significant association among TMD severity and palpation of the TMJ (p=0.0168), of masticatory muscles (p<0.0001), and of cervical muscles (p<0.0001) was verified. Also, there was a significant association between the frequency of headaches and the presence of TMD (p=0.0001). The association between the presence of joint noises and sensitivity to TMJ palpation was not significant. CONCLUSION: The elderly presented high TMD prevalence, mostly in females, with mild severity and related to TMJ and masticatory/cervical muscles palpation. Thus, the accomplishment of a detailed clinical examination to investigate the presence of such disorders is essential and it must not be neglected during the treatment of elderly patients.

Three-dimensional upper-airway assessment in patients with bronchial asthma.

OBJECTIVE: To assess the upper airway (UAW) total volume (TV), the nasopharyngeal narrowest area (NNA), and the oropharyngeal narrowest area (ONA) in patients with bronchial asthma. MATERIALS AND METHODS: The sample consisted of 52 patients divided into two groups: the control group (n  =  26; mean age  =  14.85 years), which consisted of patients not suffering from bronchial asthma; and the asthmatic group (n  =  26; mean age  =  16.65 years), which consisted of patients with bronchial asthma. To assess UAW-related variables (TV, NNA, and ONA), cone-beam computed tomography scans of the patients were evaluated by means of the Dolphin Imaging software 11.5. All measurements were repeated after 30 days, and the results were submitted to reliability tests by means of the intraclass correlation coefficient and the Bland-Altman agreement test. The values obtained for TV, NNA, and ONA for each group were compared by using Student's t-test for independent samples (5% level of significance). RESULTS: The results showed that the groups were matched concerning gender, cephalometric characteristics, and type of malocclusion. The asthmatic group had significantly lower TV (P  =  .01) and ONA (P  =  .007) than the control group. However, no significant difference was observed for NNA between the groups (P  =  .54). CONCLUSIONS: Bronchial asthma may be a determining factor for the reduction of UAW dimensions, as patients with asthma showed significant reductions in TV and ONA dimensions.