Reconsidering the role of nasolabial angle in premolar extraction decision-making: A case-series study.

OBJECTIVES: To evaluate the impact of changes in upper incisor inclination and position on the alteration of the nasolabial angle (NLA) in a series of cases involving the extraction of four first premolars. MATERIALS AND METHODS: The study included 41 patients who underwent orthodontic treatment with premolar extractions. The patients were divided into two groups based on their pretreatment NLA values: Group 1 (NLA ≤ 100°) and Group 2 (NLA > 100°). Measurements of NLA, U1.NA and U1-NA were obtained before and after treatment and U1-Ls pretreatment measure was registered. Statistical analyses were performed to compare the differences in NLA, U1.NA and U1-NA between the two groups and to evaluate the influence of these variables added to U1-Ls (T1) on NLA changes. RESULTS: The results showed that Group 1 exhibited significant changes in NLA, while Group 2 did not. However, both groups showed significant changes in U1.NA and U1-NA. In Group 1, 80% of the individuals presented an increase in NLA and 20% no changes. In Group 2, 10% presented a decrease, 57% no changes and 33% an increase in NLA values. Multiple linear regression analysis indicated that the group factor had a statistically significant influence on NLA variation. Additionally, in Group 2, a negative correlation was observed between changes in U1.NA and NLA. CONCLUSIONS: The findings suggest that individuals with higher pretreatment NLA values tend to maintain their NLA values even after the correction of upper incisor inclination.

Does surgically assisted maxillary expansion improve obstructive sleep apnoea in adults? A systematic review and meta-analysis.

Introduction The aim of this systematic review and meta-analysis was to evaluate the effects of maxillary expansion on adults with obstructive sleep apnoea (OSA).Methods Electronic searches up to July 2021 in eight electronic databases were conducted. Study selection, data extraction, risk of bias evaluation using ROBINS-I, quality of evidence assessment using GRADE and meta-analyses were performed.Results The electronic searches yielded 1,007 studies. Following the application of the eligibility criteria, 15 articles were fully read and five studies were included. The studies evaluated the effects of surgically assisted rapid maxillary expansion in adults with OSA. The meta-analysis demonstrated an improvement in Apnoea-Hypopnea Index (AHI) (MD = -9.91, CI = -14.57 to -5.25), Oxygen Desaturation Index (ODI) (MD = -7.95, CI = -12.23 to -3.67), and Epworth Sleepiness Scale (ESS) (MD = -4.40, CI = -6.39 to -2.40). ROBINS-I indicated serious, no information and critical risk of bias for the included studies. The quality of the evidence was very low.Conclusion The findings herein suggest that maxillary expansion could improve OSA in adults in the short term.

Mini Hyrax vs Hyrax expanders in the rapid palatal expansion in adolescents with posterior crossbite: a randomized controlled clinical trial.

PURPOSE: The aim of this study was to compare the dental effects, impact on quality of life, and pain perception of adolescents wearing Mini Hyrax and Hyrax expanders in rapid palatal expansion. METHODS: Thirty-four adolescents aged 11 to 16 years, with maxillary transverse deficiency (unilateral or bilateral posterior crossbite), were randomly allocated into two groups, Mini Hyrax group and Hyrax group (1:1 ratio). Dental effects were evaluated by digitally superimposed pretreatment and postretention three-dimensional intraoral scans on the palatal rugaes using the software 3DSlicer. Impact on quality of life was assessed with the OHIP-14 questionnaire applied in the pretreatment, posttreatment and postretention. Visual analog scale was applied 24, 48, and 72 h and 7 days after the first activation of the expander. RESULTS: Thirty of the 34 adolescents recruited completed the study. There were no statistically significant differences in dentoalveolar effects between groups. OHIP-14 scores across time among Mini Hyrax wearers were similar to those of the Hyrax wearers. The inter-group comparisons showed no difference between groups with respect to the OHIP-14 scores in posttreatment and postretention (p > 0.05). There were no differences in pain perception between groups. Considering intra-group comparison, the reduction in pain perception among adolescents in the Mini Hyrax group was gradual. Among adolescents in the Hyrax group, a statistically significant reduction between 48 and 72 h was observed. CONCLUSION: There were no significant differences in dental effects, impact on quality of life and pain perception between adolescents wearing Mini Hyrax and Hyrax expanders in rapid palatal expansion.

Does the external nasal dilator strip help in sports activity? A systematic review and meta-analysis.

BACKGROUND: Numerous studies have shown that the external nasal dilator (END) increases the cross sectional area of the nasal valve, thereby reducing nasal resistance, transnasal inspiratory pressure, stabilizing the lateral nasal vestibule, and preventing its collapse during final inhalation. OBJECTIVES: Our objective was to carry out a systematic review of the literature and meta-analysis on the effects of the END during physical exercise. METHODS: After selecting articles in the PubMed, Cochrane Library and EMBASE databases, 624 studies were identified. However, after applying the inclusion and exclusion criteria, 19 articles were considered eligible for review. RESULTS: Those studies included in the meta-analysis, the maximal oxygen uptake (VO2max.) outcome was assessed in 168 participants in which no statistically significant difference was found, MD (95% CI) = 0.86 [- 0.43, 2.15], p = 0.19, and I2 = 0%. The heart rate (HR) outcome was assessed in 138 participants in which no statistically significant difference was found, MD (95% CI) = 0.02 [- 3.19, 3.22], p = 0.99, and I2 = 0%. The rating of perceived exertion (RPE) outcome was assessed in 92 participants in which no statistically significant difference was found, MD (95% CI) = - 0.12 [- 0.52, 0.28], p = 0.56, and I2 = 27%. CONCLUSIONS: The external nasal dilator strip showed no improvement in VO2max., HR and RPE outcomes in healthy individuals during exercise.

Bond Strength and Failure Pattern of Orthodontic Tubes Adhered to a Zirconia Surface Submitted to Different Modes of Application of a Ceramic Primer.

The aim of this study was to evaluate the shear bond strength of orthodontic tubes adhered to ceramics with the Transbond™ XT bonding resin (3M, Maplewood, MN, USA) while varying the surface treatment. Then, the adhesive remaining index (ARI) was verified, and the representative fracture patterns were evaluated via scanning electron microscopy. Forty-eight zirconia blocks were divided into three groups, varying the number of layers of the 10-methacryloyloxy-decyl dihydrogen phosphate (MDP) primer: one, two, or three applications. In addition, 16 lithium disilicate IPS E.max ceramic disks (Ivoclar Vivadent, Schaan, Liechtenstein) were conditioned with 10% hydrofluoric acid for 20 s and underwent a single-layer primer application regimen. The four groups were further stratified to undergo bond testing after either 24 h (control) or 5000 cycles in a thermocycling machine. A shear bond strength test was performed (0.5 mm/min), and the MPa values obtained were submitted to a two-way analysis of variance and Tukey's test. There was no statistical difference among the control group ceramics that received the varying surface treatments. After thermocycling, it was verified that both the E.max disks and the zirconia ceramics with three primer applications obtained the highest bond strength values. In the 24 h groups, a total displacement of the resin from the orthodontic tubes was observed (ARI of 1). After thermocycling, the highest prevalence of an ARI of 5 (adhesive failure) was observed among the zirconia ceramics with single-coat primer application, followed by those with triple-coat primer application (mixed failure). Three applications of the MDP-containing ceramic primer achieved the best result in the present study. Zirconia surface should be treated with three coats of MDP primer to achieve a level of bond strength similar to silica-rich phase ceramic.

A simple approach to correct ectopic eruption of maxillary canines.

This case report describes the orthodontic treatment of a patient with severe crowding; the maxillary right canines were ectopic, positioned far to the buccal side, and superimposed on the lateral incisors in near-transposition. Treatment included extraction of the 4 first premolars. A transpalatal bar was used as an anchorage device, and beta-titanium T-loop springs (0.019 × 0.025″) were used to better control the ideal force applied to retract the maxillary canines. A segmental T-loop spring was used as if it were a modified system of the segmental archwire technique. After the canines were retracted and space created for the anterior teeth, the latter were included in the treatment and the treatment was finished in the usual manner. Excellent results were achieved, both esthetic and functional. The treatment choices and their straightforward approach were appropriate, yielding predictable and stable results in the long term.

Williams-Beuren Syndrome: What Orthodontists Need to Know / Síndrome de Williams-Beuren: Lo que los Ortodoncistas Deben Saber

ABSTRACT: Williams-Beuren syndrome is a rare disease with manifestations such as cardiovascular changes, distinct facial features, mental retardation, and learning disabilities. Oral manifestations are not commonly described and can often be misdiagnosed. This report describes the case of a male patient diagnosed with Williams-Beuren syndrome presenting classic clinical features that affect the face as a convex profile, with maxillary protrusion and mandibular retrusion, a discreetly acute nasolabial angle, passive labial sealing, and an open mandibular angle characteristic of Class II skeletal pattern. In addition, the patient has oral manifestations such as the absence of some dental elements, a Class II of Angle 1st division, dental cross bite, and atresic arches. The periodontal condition presents with generalized gingivitis. Knowledge about the possible manifestations of Williams-Beuren syndrome is important to improve the ability of orthodontists to better serve these patients.

RESUMEN: El síndrome de Williams-Beuren es una enfermedad rara con manifestaciones tales como cambios cardiovasculares, diversas características faciales, retraso mental y problemas de aprendizaje. Las manifestaciones orales no se describen comúnmente y con frecuencia se pueden diagnosticar erróneamente. Este informe describe el caso de un paciente masculino diagnosticado con síndrome de Williams-Beuren que presentaba características clínicas clásicas que afectaban la cara como un perfil convexo, con protrusión maxilar y retrusión mandibular, un ángulo nasolabial discretamente agudo, sellado labial pasivo y un ángulo mandibular abierto característico del patrón esquelético clase II. Además, el paciente presentaba manifestaciones orales tales como, ausencia de algunos elementos dentales, una clase II de Angle 1ª división, mordida dental cruzada y arcos acrílicos. La condición periodontal se presentaba con gingivitis generalizada. El conocimiento sobre las posibles manifestaciones del síndrome de Williams-Beuren es importante ya que mejora la capacidad de los ortodoncistas para atender mejor a estos pacientes.

A produção tecnológica na odontologia: o registro de patentes / Technological production in Dentistry: the patent registration

A geração de conhecimento obtida por meio da pesquisa científica materializa-se no anúncio dos resultados à sociedade. Este se faz basicamente de 2 formas: com apresentações em congressos e publicação de artigos científicos, ou por meio da solicitação de patentes. Se há intenção em auferir ganhos financeiros e materiais com as descobertas, ideias e inventos resultantes da pesquisa, a solicitação de uma patente se faz necessária. O objetivo deste artigo foi contribuir com a divulgação das informações pertinentes às patentes para o profissional da Odontologia brasileira. Uma descrição sucinta das etapas necessárias para a sua solicitação foi realizada. Deve-se reconhecer o esforço do Instituto Nacional de Propriedade Industrial (INPI) em disponibilizar no seu sítio eletrônico todas as informações necessárias aos interessados em fazer um pedido de patente, de maneira inteligível e didática, possibilitando a estes realizar seus próprios pedidos de patente de maneira autônoma.

The generation of knowledge obtained through scientific research materializes in the announcement of results to society. This is basically done in two ways: with presentations at congresses and publication of scientific articles, or through the application for patents. If there is an intention to make financial and material gains with the discoveries, ideas and inventions resulting from the research, the application for a patent is necessary. The aim of this article was to contribute to the dissemination of information pertinent to patents for the Brazilian Dentistry professional. A brief description of the steps required for its request has been made. It must be recognized the effort of the Instituto Nacional da Propriedade Industrial (INPI) to make available on its website all the information necessary to those interested in making a patent application, in an intelligible and didactic way, enabling them to make their own patent applications.

Influence of Class II Elastics on Centric Relation and Centric Occlusion Discrepancy after Orthodontic Treatment / Influencia de los Elásticos de Clase II sobre la Discrepancia de Relación Céntrica para la Oclusión Céntrica Después del Tratamiento Ortodóncico

ABSTRACT: The objective of this study was to verify the influence of the use of Class II intermaxillary elastics on centric relation (CR) to centric occlusion (CO) occlusal discrepancy. A total of 30 patients had been at the contention stage for at least three months were divided in two groups: G1 - 15 had been submitted to intramaxillary orthodontic mechanics only, and G2 - 15 had used Class II intermaxillary elastics. Distances of horizontal and vertical overlap and the distance or coincidence of the mandibular dental midline in relation to the maxillary midline were measured in CR and CO positions. Intergroup comparisons were performed using the Mann-Whitney test. No statistically significant differences (P>0.05) were found between G1 and G2. Both in the horizontal and vertical directions, these discrepancies were smaller than or equal to 1mm in 96.66 % of the patients. In the transverse plane, there was no discrepancy in 63.33 % of the patients, and in 33.33 % these discrepancies were equal to 0.5 mm. The use of Class II elastic didn't be capable of increasing the occlusal discrepancies between CR and CO.

RESUMEN: El objetivo de este estudio fue verificar la influencia del uso de los elásticos intermaxilares Clase II en la discrepancia oclusal entre la relación céntrica (RC) y la oclusión céntrica (OC). Un total de 30 pacientes que permanecieron en la fase de contención durante al menos tres meses se dividieron en dos grupos: G1 - 15 fueron sometidos solamente a la mecánica ortodóncica intramaxilar, y G2 - 15 habían utilizado elásticos de clase II intermaxilar. Se midieron las distancias de traslapo horizontal y vertical y la distancia o coincidencia de la línea mediana dentaria mandibular con respecto a la línea mediana maxilar en las posiciones RC y OC. Las comparaciones entre grupos se realizaron mediante la prueba de Mann-Whitney. No se encontraron diferencias estadísticamente significativas (P> 0.05) entre G1 y G2. Tanto en las direcciones horizontal como vertical, estas discrepancias fueron menores o iguales a 1 mm en el 96,66 % de los pacientes. En el plano transversal, no hubo discrepancia en el 63,33 % de los pacientes, y en un 33,33 % estas discrepancias fueron iguales a 0,5 mm. El uso de la clase II elástica no logró aumentar las discrepancias entre RC y OC.

Fracture strength of orthodontic mini-implants.

OBJECTIVE:: This study aimed at evaluating the design and dimensions of five different brands of orthodontic mini-implants, as well as their influence on torsional fracture strength. METHODS:: Fifty mini-implants were divided into five groups corresponding to different manufactures (DEN, RMO, CON, NEO, SIN). Twenty-five mini-implants were subjected to fracture test by torsion in the neck and the tip, through arbors attached to a Universal Mechanical Testing Machine. The other 25 mini-implants were subjected to insertion torque test into blocks of pork ribs using a torquimeter and contra-angle handpiece mounted in a surgical motor. The shape of the active tip of the mini-implants was evaluated under microscopy. The non-parametric Friedman test and Snedecor's F in analysis of variance (ANOVA) were used to evaluate the differences between groups. RESULTS:: The fracture torque of the neck ranged from 23.45 N.cm (DEN) to 34.82 N.cm (SIN), and of the tip ranged from 9.35 N.cm (CON) to 24.36 N.cm (NEO). Insertion torque values ranged from 6.6 N.cm (RMO) to 10.2 N.cm (NEO). The characteristics that most influenced the results were outer diameter, inner diameter, the ratio between internal and external diameters, and the existence of milling in the apical region of the mini-implant. CONCLUSIONS:: The fracture torques were different for both the neck and the tip of the five types evaluated. NEO and SIN mini-implants showed the highest resistance to fracture of the neck and tip. The fracture torques of both tip and neck were higher than the torque required to insert mini-implants.

Fracture strength of orthodontic mini-implants

ABSTRACT Objective: This study aimed at evaluating the design and dimensions of five different brands of orthodontic mini-implants, as well as their influence on torsional fracture strength. Methods: Fifty mini-implants were divided into five groups corresponding to different manufactures (DEN, RMO, CON, NEO, SIN). Twenty-five mini-implants were subjected to fracture test by torsion in the neck and the tip, through arbors attached to a Universal Mechanical Testing Machine. The other 25 mini-implants were subjected to insertion torque test into blocks of pork ribs using a torquimeter and contra-angle handpiece mounted in a surgical motor. The shape of the active tip of the mini-implants was evaluated under microscopy. The non-parametric Friedman test and Snedecor's F in analysis of variance (ANOVA) were used to evaluate the differences between groups. Results: The fracture torque of the neck ranged from 23.45 N.cm (DEN) to 34.82 N.cm (SIN), and of the tip ranged from 9.35 N.cm (CON) to 24.36 N.cm (NEO). Insertion torque values ranged from 6.6 N.cm (RMO) to 10.2 N.cm (NEO). The characteristics that most influenced the results were outer diameter, inner diameter, the ratio between internal and external diameters, and the existence of milling in the apical region of the mini-implant. Conclusions: The fracture torques were different for both the neck and the tip of the five types evaluated. NEO and SIN mini-implants showed the highest resistance to fracture of the neck and tip. The fracture torques of both tip and neck were higher than the torque required to insert mini-implants.

RESUMO Objetivo: o objetivo do presente estudo foi avaliar o desenho e as medidas de cinco marcas diferentes de mini-implantes ortodônticos, e sua influência na resistência à fratura em torção. Métodos: cinquenta mini-implantes foram divididos em cinco grupos, correspondentes a diferentes fabricantes (DEN, Dentaurum; RMO, Rocky Mountain Orthodontics; CON, Conexão; NEO, Neodent; SIN, Sistema de Implantes Nacional). Vinte e cinco mini-implantes foram submetidos ao teste de fratura por torção no pescoço e na ponta, com mandris fixados a uma máquina universal de testes mecânicos. Os outros 25 mini-implantes foram submetidos ao teste de torque de inserção em blocos de costelas suínas, utilizando-se um torquímetro e um contra-ângulo montado em motor cirúrgico. O formato da ponta ativa dos mini-implantes foi avaliado por microscopia. O teste não-paramétrico de Friedman e o teste F de Snedecor na análise de variância (ANOVA) foram utilizados para avaliar as diferenças entre os grupos. Resultados: o torque de fratura do pescoço variou de 23,45 N.cm (DEN) a 34,82 N.cm (SIN); e o da ponta, entre 9,35 N.cm (CON) e 24,36 N.cm (NEO). O valor do torque de inserção variou de 6,6 N.cm (RMO) a 10,2 N.cm (NEO). As características que mais influenciaram os resultados foram: diâmetro externo, diâmetro interno, razão entre o diâmetro interno e o externo, e a presença de fresagem na região apical do mini-implante. Conclusões: os torques de fratura foram diferentes entre os cinco tipos avaliados, tanto no pescoço quanto na ponta. Os mini-implantes NEO e SIN foram os mais resistentes à fratura do pescoço e da ponta. Os torques de fratura tanto na ponta quanto no pescoço foram maiores do que o torque necessário para a inserção dos mini-implantes.

Prosthetic replacement vs space closure for maxillary lateral incisor agenesis: A systematic review.

INTRODUCTION: Defining the best treatment for maxillary lateral incisor agenesis is a challenge. Our aim in this study was to determine, with the evidence available in the literature, the best treatment for maxillary lateral incisor agenesis in the permanent dentition, evaluating the esthetic, occlusal (functional), and periodontal results between prosthetic replacement and orthodontic space closure. METHODS: Electronic databases (CENTRAL, PubMed, Web of Science, Scopus, and LILACS) were searched in September 2014 and updated in January 2015, with no restriction on language or initial date. A manual search of the reference lists of the potential studies was performed. Risk of bias was assessed by the Newcastle Ottawa Scale. RESULTS: The search identified 2174 articles, of which 1196 were excluded because they were duplicates. Titles and abstracts of 978 articles were accessed, and 957 were excluded. In total, 21 articles were read in full, and 9 case-control studies were included after applying the inclusion and exclusion criteria. Data were extracted from the articles selected, and a table was compiled for comparison and analysis of the results. There were no randomization and blinding, and the risk of bias evaluation found gaps in compatibility and outcome domains in almost all selected studies. CONCLUSIONS: Tooth-supported dental prostheses of maxillary lateral incisor agenesis had worse scores in the periodontal indexes than did orthodontic space closure. Space closure is evaluated better esthetically than prosthetic replacements, and the presence or absence of a Class I relationship of the canines showed no relationship with occlusal function or with signs and symptoms of temporomandibular disorders.

Agenesis of Maxillary Lateral Incisors: Treatment Involves Much More Than Just Canine Guidance.

OBJECTIVE: In this study, we aimed highlight some clinical features present in patients whose maxillary lateral incisors are missing, and proposed more logical, rational and predictable solutions to inform decision making in rehabilitation procedures. METHODS: Literature review and discussion. CONCLUSION: Choosing the best possible treatment for congenital absence of maxillary lateral incisors depends on the multidisciplinary diagnosis of facial, occlusal, functional and periodontal features. It also depends on the individual long-term stability, and it does not only rely on canine-guided disocclusion.

Hypoplastic Canine: Would Treatment Decision be Different if the Diagnosis Were Made with Computed Tomography?

This article discusses the orthodontic treatment of a girl, 9 years old, who presented with Class II malocclusion, bimaxillary rotrusion, anterior open bite, and congenital absence of the right lower premolar, in which a severe hypoplasia on right maxillary canine was nly noted after the extractions of the first maxillary premolars.

Interproximal wear versus incisors extraction to solve anterior lower crowding: a systematic review.

OBJECTIVE: To determine by means of a systematic review the best treatment, whether interproximal wear or incisor extraction, to correct anterior lower crowding in Class I patients in permanent dentition. METHODS: A literature review was conducted using MEDLINE, Scopus and Web of Science to retrieve studies published between January 1950 and October 2013. In selecting the sample, the following inclusion criteria were applied: studies involving interproximal wear and/or extraction of mandibular incisors, as well as Class I cases with anterior lower crowding in permanent dentition. RESULTS: Out of a total of 943 articles found after excluding duplicates, 925 were excluded after abstract analysis. After full articles were read, 13 were excluded by the eligibility criteria and one due to methodological quality; therefore, only fours articles remained: two retrospective and two randomized prospective studies. Data were collected, analyzed and organized in tables. CONCLUSION: Both interproximal wear and mandibular incisor extraction are effective in treating Class I malocclusion in permanent dentition with moderate anterior lower crowding and pleasant facial profile. There is scant evidence to determine the best treatment option for each case. Clinical decision should be made on an individual basis by taking into account dental characteristics, crowding, dental and oral health, patient's expectations and the use of set-up models.

Interproximal wear versus incisors extraction to solve anterior lower crowding: A systematic review

OBJECTIVE: To determine by means of a systematic review the best treatment, whether interproximal wear or incisor extraction, to correct anterior lower crowding in Class I patients in permanent dentition. METHODS: A literature review was conducted using MEDLINE, Scopus and Web of Science to retrieve studies published between January 1950 and October 2013. In selecting the sample, the following inclusion criteria were applied: studies involving interproximal wear and/or extraction of mandibular incisors, as well as Class I cases with anterior lower crowding in permanent dentition. RESULTS: Out of a total of 943 articles found after excluding duplicates, 925 were excluded after abstract analysis. After full articles were read, 13 were excluded by the eligibility criteria and one due to methodological quality; therefore, only fours articles remained: two retrospective and two randomized prospective studies. Data were collected, analyzed and organized in tables. CONCLUSION: Both interproximal wear and mandibular incisor extraction are effective in treating Class I malocclusion in permanent dentition with moderate anterior lower crowding and pleasant facial profile. There is scant evidence to determine the best treatment option for each case. Clinical decision should be made on an individual basis by taking into account dental characteristics, crowding, dental and oral health, patient's expectations and the use of set-up models. .

OBJETIVO: determinar, por meio de uma revisão sistemática, o melhor tratamento entre desgastes interproximais e extração de incisivos para a correção de apinhamento anteroinferior em pacientes Classe I com dentição permanente. MÉTODOS: foram feitas buscas nas bases de dados eletrônicas MEDLINE, Scopus e Web of Science por artigos publicados de janeiro de 1950 até outubro de 2013. Os critérios de inclusão foram estudos que abordassem tratamentos com desgastes interproximais e/ou extração de incisivos inferiores, de casos Classe I com apinhamento anteroinferior na dentição permanente. RESULTADOS: dos 943 artigos encontrados após a remoção dos duplicados, 925 foram excluídos após a leitura dos resumos. Após leitura dos artigos completos, 13 foram excluídos pelos critérios de eligibilidade e um pela qualidade metodológica, restando quatro artigos, sendo dois retrospectivos e dois prospectivos randomizados. Os dados foram coletados, analisados e organizados em tabelas. CONCLUSÕES: tanto o desgaste interproximal quanto a extração de incisivo inferior são tratamentos eficazes em Classe I na dentição permanente, com apinhamento anteroinferior moderado e perfil facial agradável. Há fracas evidências para determinar a escolha do melhor tratamento para cada caso. A decisão clínica deve ser tomada em bases individuais, considerando as características anatômicas dentárias, da severidade do apinhamento, condições de saúde dentária e bucal, expectativas dos pacientes e ensaio em modelos (set-up). .

Bracket Placement According to Malocclusion.

This article reports the orthodontic treatment ofa 25-year-old female patient whose chief complaint was the inclination of the maxillary occlusal plane in front view. The individualized vertical placement of brackets is described. This placement made possible a symmetrical occlusal plane to be achieved in a rather straightforward manner without the need for further technical resources.

Diagnóstico ortodôntico sem as radiografias periapicais de todos os dentes: cuidado, você pode se surpreender / Orthodontic diagnosis without periapical radiograph of all teeth: be careful, you might be surprised

Objetivo: a proposta do presente artigo foi relatar um caso clínico onde, ao serem analisados os detalhes anatômicos na radiografia panorâmica de um paciente previamente ao início do tratamento ortodôntico, não foi detectada a presença de dente extranumerário na região apical do primeiro molar superior esquerdo. Resultado: apesar da presença desse elemento extra, não houve a necessidade de removê-lo para a realização do tratamento ortodôntico, entretanto, poderia em uma outra situação clínica comprometer o bom andamento e sucesso do tratamento. Conclusão: dessa forma, conclui-se com a descrição desse caso clínico que a radiografia panorâmica não substitui o exame periapical no planejamento ortodôntico pois são complementares. Radiografias periapicais apenas dos dentes anteriores poderiam ser insuficientes para o diagnóstico e prevenção dos riscos da terapia ortodôntica.

Compensatory orthodontic treatment for maxillary deficiency: a 4-year follow-up.

In this article, we report the orthodontic treatment of a boy (age 12 years 9 months) who had a midface deficiency, a concave facial profile with maxillary retrusion, a complete crossbite (anterior and posterior), and the maxillary right canine retained in the alveolus. Rapid maxillary expansion was performed followed by complete orthodontic treatment with fixed appliances combined with Class III elastics and anterior vertical elastics. Time was allowed to elapse until growth was virtually over before removing the fixed appliances (at age 18 years 4 months), and no retainer of any type was used. As a result of treatment, significant improvement was noted in his facial appearance, with a proper maxillomandibular relationship, total correction of the maxillary atresia, and satisfactory overjet and overbite. The results remained stable at the 4-year follow-up. Therefore, it can be argued that the use of Class III elastics combined with rapid maxillary expansion has a beneficial effect in the treatment of transverse and sagittal maxillary deficiency in growing patients. Excellence in how the treatment was finished and discontinuation of treatment and control in the final stages of growth contributed to the stability of the final results.