Evaluation of the force generated by gradual deflection of 0.016-inch NiTi and stainless steel orthodontic wires in self-ligating metallic and esthetic brackets.

BACKGROUND: The purpose of this study was to evaluate the deflection forces of 0.016-inch Nitinol and stainless steel orthodontic wires, in association to different self-ligating brackets. MATERIAL AND METHODS: Specimens were mounted in a clinical simulation model and evaluated in a Universal Testing Machine (INSTRON 3342), using a 10N load cell and ISO 15,841, as a protocol. Eight of these models were prepared, each one for the bonding of each set of self-ligating accessories to be tested: Damon Q, Damon Clear (Ormco), In-Ovation R, In-Ovation C (GAC), BioQuick, QuickClear (Forestadent), SmartClip and Clarity SL (3M). Data were subjected to One-way ANOVA, followed by Tukey tests (P<0.05). RESULTS: Elastic deflection results showed that the deactivation forces increased with increase in wire deflection in the different brackets evaluated. For the different combinations, Clarity SL generated the greatest force and Damon Clear presented the lowest force when compared to the other brackets in all alloys and deflections. BioQuick and QuicKlear were those with the most similar behavior with each other. CONCLUSIONS: Strength values increased with gradual increase in wire deflection in all evaluated brackets. Clarity SL generated the greatest and Damon Clear the lowest force when compared to the other brackets in all alloys and deflections tested. Key words:Brackets, orthodontic wires, deflection.

Comparison of deflection forces of esthetic archwires combined with ceramic brackets.

Coated archwires and ceramic brackets have been developed to improve facial esthetics during orthodontic treatment. However, their mechanical behavior has been shown to be different from metallic archwires and brackets. Therefore, the aim of this study was to compare the deflection forces in coated nickel-titanium (NiTi) and esthetic archwires combined with ceramic brackets. Material and Methods Non-coated NiTi (NC), rhodium coated NiTi (RC), teflon coated NiTi (TC), epoxy coated NiTi (EC), fiber-reinforced polymer (FRP), and the three different conventional brackets metal-insert polycrystalline ceramic (MI-PC), polycrystalline ceramic (PC) and monocrystalline ceramic (MC) were used. The specimens were set up on a clinical simulation device and evaluated in a Universal Testing Machine (Instron). An acrylic device, representative of the right maxillary central incisor was buccolingually activated and the unloading forces generated were recorded at 3, 2, 1 and 0.5 mm. The speed of the testing machine was 2 mm/min. ANOVA and Tukey tests were used to compare the different archwires and brackets. Results The brackets presented the following decreasing force ranking: monocrystalline, polycrystalline and polycrystalline metal-insert. The decreasing force ranking of the archwires was: rhodium coated NiTi (RC), non-coated NiTi (NC), teflon coated NiTi (TC), epoxy coated NiTi (EC) and fiber-reinforced polymer (FRP). At 3 mm of unloading the FRP archwire had a plastic deformation and produced an extremely low force in 2; 1 and 0.5 mm of unloading. Conclusion Combinations of the evaluated archwires and brackets will produce a force ranking proportional to the combination of their individual force rankings.

Comparison of deflection forces of esthetic archwires combined with ceramic brackets

Abstract Coated archwires and ceramic brackets have been developed to improve facial esthetics during orthodontic treatment. However, their mechanical behavior has been shown to be different from metallic archwires and brackets. Therefore, the aim of this study was to compare the deflection forces in coated nickel-titanium (NiTi) and esthetic archwires combined with ceramic brackets. Material and Methods Non-coated NiTi (NC), rhodium coated NiTi (RC), teflon coated NiTi (TC), epoxy coated NiTi (EC), fiber-reinforced polymer (FRP), and the three different conventional brackets metal-insert polycrystalline ceramic (MI-PC), polycrystalline ceramic (PC) and monocrystalline ceramic (MC) were used. The specimens were set up on a clinical simulation device and evaluated in a Universal Testing Machine (Instron). An acrylic device, representative of the right maxillary central incisor was buccolingually activated and the unloading forces generated were recorded at 3, 2, 1 and 0.5 mm. The speed of the testing machine was 2 mm/min. ANOVA and Tukey tests were used to compare the different archwires and brackets. Results The brackets presented the following decreasing force ranking: monocrystalline, polycrystalline and polycrystalline metal-insert. The decreasing force ranking of the archwires was: rhodium coated NiTi (RC), non-coated NiTi (NC), teflon coated NiTi (TC), epoxy coated NiTi (EC) and fiber-reinforced polymer (FRP). At 3 mm of unloading the FRP archwire had a plastic deformation and produced an extremely low force in 2; 1 and 0.5 mm of unloading. Conclusion Combinations of the evaluated archwires and brackets will produce a force ranking proportional to the combination of their individual force rankings.

Force level of small diameter nickel-titanium orthodontic wires ligated with different methods.

BACKGROUND: The aim of this study was to compare the deflection force in conventional and thermally activated nickel-titanium (NiTi) wires in passive (Damon Q) and active (Bioquick) self-ligating brackets (SLB) and in conventional brackets (CB) tied by two different methods: elastomeric ligature (EL) and metal ligature (ML). METHODS: Two wire diameters (0.014 and 0.016 in.) and 10 specimens per group were used. The specimens were assembled in a clinical simulation device and tested in an Instron Universal Testing Machine, with a load cell of 10 N. For the testing procedures, the acrylic block representative of the right maxillary central incisor was palatally moved, with readings of the force at 0.5, 1, 2, and 3 mm, at a constant speed of 2 mm/min and temperature of 36.5 °C. RESULTS: The conventional NiTi released higher forces than the thermally activated NiTi archwires in large deflections. In general, the SLB showed lower forces, while the ML had higher forces, with both showing a similar force release behavior, constantly decreasing as the deflection decreased. The EL showed an irregular behavior. The active SLB showed smaller forces than passive, in large deflections. CONCLUSIONS: The SLB and the ML exhibit standard force patterns during unloading, while the elastomeric ligatures exhibit a randomly distributed force release behavior.

Evaluation of the force generated by gradual deflection of orthodontic wires in conventional metallic, esthetic, and self-ligating brackets.

OBJECTIVE:: The purpose of this study was to evaluate the deflection forces of Nitinol orthodontic wires placed in different types of brackets: metallic, reinforced polycarbonate with metallic slots, sapphire, passive and active self-ligating, by assessing strength values variation according to gradual increase in wire diameter and deflection and comparing different combinations in the different deflections. MATERIAL AND METHODS:: Specimens were set in a clinical simulation model and evaluated in a Universal Testing Machine (INSTRON 3342), using the ISO 15841 protocol. Data were subjected to One-way ANOVA, followed by Tukey tests (p<0.05). RESULTS:: Self-ligating brackets presented the most similar behavior to each other. For conventional brackets there was no consistent behavior for any of the deflections studied. CONCLUSIONS:: Self-ligating brackets presented the most consistent and predictable results while conventional brackets, as esthetic brackets, showed very different patterns of forces. Self-ligating brackets showed higher strength in all deflections when compared with the others, in 0.020-inch wires.

Evaluation of the force generated by gradual deflection of orthodontic wires in conventional metallic, esthetic, and self-ligating brackets

ABSTRACT Objective: The purpose of this study was to evaluate the deflection forces of Nitinol orthodontic wires placed in different types of brackets: metallic, reinforced polycarbonate with metallic slots, sapphire, passive and active self-ligating, by assessing strength values variation according to gradual increase in wire diameter and deflection and comparing different combinations in the different deflections. Material and Methods: Specimens were set in a clinical simulation model and evaluated in a Universal Testing Machine (INSTRON 3342), using the ISO 15841 protocol. Data were subjected to One-way ANOVA, followed by Tukey tests (p<0.05). Results: Self-ligating brackets presented the most similar behavior to each other. For conventional brackets there was no consistent behavior for any of the deflections studied. Conclusions: Self-ligating brackets presented the most consistent and predictable results while conventional brackets, as esthetic brackets, showed very different patterns of forces. Self-ligating brackets showed higher strength in all deflections when compared with the others, in 0.020-inch wires.

Overjet, overbite, and anterior crowding relapses in extraction and nonextraction patients, and their correlations.

INTRODUCTION: In this study, we aimed to compare the relapse of maxillary and mandibular anterior crowding, overjet, and overbite 5 years after treatment in subjects with Class I and Class II malocclusions treated with and without extractions, and also to evaluate the correlations among these factors. METHODS: The sample comprised 84 subjects with Class I and Class II malocclusions, treated with and without extractions. Group 1 comprised 44 subjects with an initial mean age of 12.96 years treated without extractions. Group 2 included 40 subjects with an initial mean age of 13.01 years treated with 4 premolar extractions. Data were obtained from dental casts at the pretreatment, posttreatment, and long-term posttreatment stages. Intergroup comparisons were performed with t tests. To verify the correlations among the relapse of overjet, overbite, and anterior crowding, the Pearson correlation test was used. RESULTS: Maxillary incisor irregularity and its relapse in the nonextraction group were significantly greater at the long-term posttreatment stage and the long-term posttreatment period, respectively. Long-term postreatment overjet changes were similar in the groups. Overbite and its relapse were significantly greater in the extraction group in the long-term posttreatment stage and period, respectively. There was a positive correlation of the relapse of mandibular incisor crowding with the relapse of overjet and overbite, and also a correlation of overjet and overbite relapses. CONCLUSIONS: There was greater maxillary crowding relapse in the nonextraction group and greater overbite relapse in the extraction group. There were significant and positive correlations of overjet and overbite relapses with mandibular anterior crowding relapse and consequently between overjet and overbite relapses.

Avaliação da força gerada pela deflexão gradual de fios ortodônticos em braquetes convencionais metálicos, estéticos e autoligáveis / Evaluation of the force generated by gradual deflection of orthodontic wires in conventional mettalic, esthetic and self-ligated brackets

PROPOSIÇÃO: O objetivo deste trabalho foi avaliar a força gerada pela deflexão de fios ortodônticos de Nitinol associados a diferentes tipos de braquetes por meio da avaliação dos valores da força através do aumento gradual do calibre e da deflexão dos fios e comparação entre as distintas combinações, nas diferentes deflexões. MATERIAL E MÉTODOS: Os corpos de prova foram montados em um modelo de simulação clínica e avaliados em uma máquina de ensaio universal INSTRON 3342, com célula de carga de 10N e, como protocolo, foi seguida a norma ISO 15.841. Foram confeccionados cinco destes modelos para a colagem de cada conjunto de acessórios a serem testados: metálico (Mini Diamond), policarbonato com fibra de vidro e canaleta metálica (Spirit), safira (Inspire ICE) e os autoligáveis passivo (Damon Q/Ormco) e ativo (In-Ovation R/GAC). Para os testes, o dispositivo de acrílico que representava o incisivo central direito foi movimentado no sentido palatino-vestibular, com leituras das resistências geradas nas deflexões de 3; 2; 1 e 0,5mm, com velocidade constante de 2mm/min. Os resultados foram avaliados por meio da análise de variância (ANOVA) a dois e a um critério, havendo diferença significante, a análise comparativa das médias foi feita por meio do teste de Tukey (p<0,05). RESULTADOS: A força de desativação foi gradativamente maior, com o aumento do calibre dos arcos e maior deflexão, nos diferentes tipos de braquetes. Nas combinações entre os diferentes tipos de braquetes selecionados com os fios de Nitinol verificou-se que os braquetes autoligáveis foram os que apresentaram os resultados mais parecidos entre si, mantendo-os decrescentes conforme a deflexão diminuía. Já, entre os braquetes convencionais Mini Diamond, Spirit e Inspire ICE verificou-se que não existe um padrão em nenhuma deflexão estudada. CONCLUSÕES: A avaliação dos valores da força, através do aumento gradual do calibre e da deflexão dos fios, demonstrou que a mesma foi crescente em todos...

OBJECTIVE: The purpose of this study was to evaluate the deflection forces of Nitinol orthodontic wires, placed in different kinds of brackets by assessing strength values variation according to gradual increase in the diameter and the deflection of the wires, comparing the different combinations, in the different deflections. MATERIAL AND METHODS: Specimens were mounted in a clinical simulation model and evaluated in a Universal Testing Machine (INSTRON 3342), using a 10 N load cell and, as a protocol, ISO 15841. Five of these models were prepared, each one for the bonding of each set of accessories to be tested: metallic (Mini Diamond), reinforced polycarbonate with metallic slots (Spirit), sapphire (Inspire ICE), and passive (Damon Q/Ormco) and active self-ligated (In-Ovation R/GAC). For performing the tests, the acrylic device corresponding to the right central incisor was moved in the buccal-lingual direction, and values of resistance generated for 3, 2, 1 and 0.5mm deflections, at a constant speed of 2mm/min, were registered. Data were subjected to Oneand Two-way ANOVA; since significant differences were observed, comparative analysis of mean values was performed by Tukey's post hoc test (p<0.05). RESULTS: Elastic deflection results showed that deactivation force increased with increase in the diameter of the wires and deflection in the different brackets evaluated. For the combinations of the different types of brackets with the Nitinol wires, it was found that self-ligating brackets were those with the most similar results to each other, which decreased as the deflection was decreased. For Mini Diamond, Spirit and Inspire ICE conventional brackets there was no pattern for any of the deflections studied. CONCLUSIONS: Strength values evaluation according to gradual increase in the diameter and the deflection of the wires showed that it increased in all evaluated brackets. Self-ligating brackets were those which presented the most consistent and...

Avaliação da força gerada pela deflexão gradual de fios ortodônticos em braquetes convencionais metálicos, estéticos e autoligáveis / Evaluation of the force generated by gradual deflection of orthodontic wires in conventional mettalic, esthetic and self-ligated brackets

PROPOSIÇÃO: O objetivo deste trabalho foi avaliar a força gerada pela deflexão de fios ortodônticos de Nitinol associados a diferentes tipos de braquetes por meio da avaliação dos valores da força através do aumento gradual do calibre e da deflexão dos fios e comparação entre as distintas combinações, nas diferentes deflexões. MATERIAL E MÉTODOS: Os corpos de prova foram montados em um modelo de simulação clínica e avaliados em uma máquina de ensaio universal INSTRON 3342, com célula de carga de 10N e, como protocolo, foi seguida a norma ISO 15.841. Foram confeccionados cinco destes modelos para a colagem de cada conjunto de acessórios a serem testados: metálico (Mini Diamond), policarbonato com fibra de vidro e canaleta metálica (Spirit), safira (Inspire ICE) e os autoligáveis passivo (Damon Q/Ormco) e ativo (In-Ovation R/GAC). Para os testes, o dispositivo de acrílico que representava o incisivo central direito foi movimentado no sentido palatino-vestibular, com leituras das resistências geradas nas deflexões de 3; 2; 1 e 0,5mm, com velocidade constante de 2mm/min. Os resultados foram avaliados por meio da análise de variância (ANOVA) a dois e a um critério, havendo diferença significante, a análise comparativa das médias foi feita por meio do teste de Tukey (p<0,05). RESULTADOS: A força de desativação foi gradativamente maior, com o aumento do calibre dos arcos e maior deflexão, nos diferentes tipos de braquetes. Nas combinações entre os diferentes tipos de braquetes selecionados com os fios de Nitinol verificou-se que os braquetes autoligáveis foram os que apresentaram os resultados mais parecidos entre si, mantendo-os decrescentes conforme a deflexão diminuía. Já, entre os braquetes convencionais Mini Diamond, Spirit e Inspire ICE verificou-se que não existe um padrão em nenhuma deflexão estudada. CONCLUSÕES: A avaliação dos valores da força, através do aumento gradual do calibre e da deflexão dos fios, demonstrou que a mesma foi crescente em todos...

OBJECTIVE: The purpose of this study was to evaluate the deflection forces of Nitinol orthodontic wires, placed in different kinds of brackets by assessing strength values variation according to gradual increase in the diameter and the deflection of the wires, comparing the different combinations, in the different deflections. MATERIAL AND METHODS: Specimens were mounted in a clinical simulation model and evaluated in a Universal Testing Machine (INSTRON 3342), using a 10 N load cell and, as a protocol, ISO 15841. Five of these models were prepared, each one for the bonding of each set of accessories to be tested: metallic (Mini Diamond), reinforced polycarbonate with metallic slots (Spirit), sapphire (Inspire ICE), and passive (Damon Q/Ormco) and active self-ligated (In-Ovation R/GAC). For performing the tests, the acrylic device corresponding to the right central incisor was moved in the buccal-lingual direction, and values of resistance generated for 3, 2, 1 and 0.5mm deflections, at a constant speed of 2mm/min, were registered. Data were subjected to Oneand Two-way ANOVA; since significant differences were observed, comparative analysis of mean values was performed by Tukey's post hoc test (p<0.05). RESULTS: Elastic deflection results showed that deactivation force increased with increase in the diameter of the wires and deflection in the different brackets evaluated. For the combinations of the different types of brackets with the Nitinol wires, it was found that self-ligating brackets were those with the most similar results to each other, which decreased as the deflection was decreased. For Mini Diamond, Spirit and Inspire ICE conventional brackets there was no pattern for any of the deflections studied. CONCLUSIONS: Strength values evaluation according to gradual increase in the diameter and the deflection of the wires showed that it increased in all evaluated brackets. Self-ligating brackets were those which presented the most consistent and...

Stability of Class II treatment with the Bionator followed by fixed appliances

Objective: This prospective study assessed the stability of Class II treatment with the Bionator, followed by fixed appliances, 10 years after treatment. Material and Methods: The experimental group comprised 23 patients of both sexes (10 boys, 13 girls) at a mean initial age of 11.74 years (late mixed or early permanent dentitions), treated for a mean period of 3.55 years who were evaluated at three stages: initial (T1), final (T2) and long-term posttreatment (T3). A total of 69 lateral cephalograms were evaluated and 69 dental casts were measured using the PAR index. The difference between initial and final PAR indexes, the percentage of occlusal improvement obtained with therapy and the percentage of relapse were calculated, using the PAR index. The variables were compared by repeated measures analysis of variance (ANOVA) followed by Tukey tests. Results: The significant improvement in apical base relationship, the palatal inclination of the maxillary incisors and the labial inclination of the mandibular incisors, and the significant improvement in molar relationship and reduction of overjet and overbite, obtained with treatment, remained stable in the long-term posttreatment period. There was also significant improvement in the occlusal relationships which remained stable in the long-term posttreatment period. The percentage of occlusal improvement obtained was of 81.78% and the percentage of relapse was of 4.90%. Conclusions: Treatment of Class II division 1 malocclusions with the Bionator associated with fixed appliances showed to be stable in the long-term posttreatment period. .

Propriedades dos fios de NiTi superelásticos termicamente ativados – uma revisão literária / Properties of thermally activated superelastic NiTi archwires – a literature review

A utilização de fios de níquel-titânio superelásticos (NiTi) consiste em uma nova opção disponível no mercado mundial para tratamentos ortodônticos, o que torna necessária a reunião de informações que possa auxiliar na tomada de decisões dos ortodontistas quanto à sua utilização ou não, conforme o caso clínico a ser trabalhado. Diante disso, são apresentadas, nesta revisão de literatura, algumas informações científicas sobre os fios de NiTi termicamente ativados, bem como suas propriedades físicas, suas diferenças entre carga e deflexão, e os resultados de alguns testes realizados. São discutidos aspectos quanto à melhor fase de utilização desses fios e, dentre as marcas que estão disponíveis no mercado, quais são as mais adequadas para a utilização nas diferentes fases de tratamento.

Superelastic nickel-titanium (NiTi) archwires are a brand new marketable option for orthodontic treatment, which makes the discussion of scientific information regarding their use essential in helping professionals to plan and perform evidence-based treatments. Therefore, this literature review ponders scientific information related to thermally activated superelastic NiTi archwires, taking into account their physical properties, the differences between load and deflection and the results of some accomplished studies. The moment best indicated for their application and, among the available trademarks, the most suitable ones for each treatment phase are mainly discussed.

Stability of Class II treatment with the Bionator followed by fixed appliances.

OBJECTIVE: This prospective study assessed the stability of Class II treatment with the Bionator, followed by fixed appliances, 10 years after treatment. MATERIAL AND METHODS: The experimental group comprised 23 patients of both sexes (10 boys, 13 girls) at a mean initial age of 11.74 years (late mixed or early permanent dentitions), treated for a mean period of 3.55 years who were evaluated at three stages: initial (T1), final (T2) and long-term posttreatment (T3). A total of 69 lateral cephalograms were evaluated and 69 dental casts were measured using the PAR index. The difference between initial and final PAR indexes, the percentage of occlusal improvement obtained with therapy and the percentage of relapse were calculated, using the PAR index. The variables were compared by repeated measures analysis of variance (ANOVA) followed by Tukey tests. RESULTS: The significant improvement in apical base relationship, the palatal inclination of the maxillary incisors and the labial inclination of the mandibular incisors, and the significant improvement in molar relationship and reduction of overjet and overbite, obtained with treatment, remained stable in the long-term posttreatment period. There was also significant improvement in the occlusal relationships which remained stable in the long-term posttreatment period. The percentage of occlusal improvement obtained was of 81.78% and the percentage of relapse was of 4.90%. CONCLUSIONS: Treatment of Class II division 1 malocclusions with the Bionator associated with fixed appliances showed to be stable in the long-term posttreatment period.

Cephalometric evaluation in different phases of Jasper jumper therapy.

INTRODUCTION: The aim of this study was to evaluate the dentoskeletal and soft-tissue effects of Class II malocclusion treatment with the Jasper jumper followed by Class II elastics at the different stages of therapy. METHODS: The sample comprised 24 patients of both sexes (11 boys, 13 girls) with an initial age of 12.58 years, treated for a mean period of 2.15 years. Four lateral cephalograms were obtained of each patient in these stages of orthodontic treatment: at pretreatment (T1), after leveling and alignment (T2), after the use of the Jasper jumper appliance and before the use of Class II intermaxillary elastics (T3), and at posttreatment (T4). Thus, 3 treatment phases could be evaluated: leveling and alignment (T1-T2), use of the Jasper jumper (T2-T3), and use of Class II elastics (T3-T4). Dependent analysis of variance (ANOVA) and Tukey tests were used to compare the durations of the 3 treatment phases and for intragroup comparisons of the 4 treatment stages. RESULTS: The alignment phase showed correction of the anteroposterior relationship, protrusion and labial inclination of the maxillary incisors, and reduction of overbite. The Jasper jumper phase demonstrated labial inclination, protrusion and intrusion of the mandibular incisors, mesialization and extrusion of the mandibular molars, reduction of overjet and overbite, molar relationship improvement, and reduction in facial convexity. The Class II elastics phase showed labial inclination of the maxillary incisors; retrusion, uprighting, and extrusion of the mandibular incisors; and overjet and overbite increases. CONCLUSIONS: The greatest amount of the Class II malocclusion anteroposterior discrepancy was corrected with the Jasper jumper appliance. Part of the correction was lost during Class II intermaxillary elastics use after use of the Jasper jumper appliance.

Estabilidade da correção da Classe II, 1ª divisão com o aparelho Bionator de Balters associado ao aparelho fixo / Stability of the correction of the Class II, division 1 malocclusion with the Balters Bionator associated to fixed appliances

Recursos ortopédicos e ortodônticos, utilizados de forma associada, têm se mostrado uma opção terapêutica eficiente no tratamento da má oclusão de Classe II, 1ª divisão desde que o paciente ainda apresente um potencial de crescimento favorável. Entretanto, as alterações nas relações esqueléticas, dentárias e tegumentares só podem ser consideradas satisfatórias caso permaneçam estáveis. Assim, este trabalho teve o propósito de avaliar cefalometricamente e por meio de modelos de estudo, a estabilidade das alterações decorrentes do tratamento com o aparelho Bionator de Balters, seguido do aparelho fixo, após um período médio de 10 anos. O grupo experimental compreendeu 23 pacientes que foram avaliados em três fases: inicial (T1), final (T2) e longo tempo pós-tratamento (T3). Foram avaliadas as telerradiografias em norma lateral (inicial, final e longo tempo pós-tratamento), totalizando 69 telerradiografias, e foram mensurados 69 modelos de estudo, avaliados nas fases previamente descritas, através do índice PAR. Também calculou-se a diferença entre o PAR inicial e o PAR final, a % de melhora obtida com esta terapia e a % de recidiva, ambas através do índice PAR. As variáveis analisadas foram comparadas por meio da análise de variância (ANOVA) para medidas repetidas e o teste de comparações múltiplas de Tukey. A terapia estudada não propiciou alterações no desenvolvimento maxilar. Observou-se um aumento na protrusão mandibular, bem como um maior incremento no comprimento efetivo da mandíbula. A relação maxilomandibular foi corrigida, notou-se uma melhora na convexidade facial, com a diminuição do ângulo ANB. Alterações significantes no padrão de crescimento craniofacial não foram observadas. Verificou-se, através da variável FMA e no período de longo tempo pós-tratamento, uma rotação do plano mandibular no sentido anti-horário. O posicionamento vertical da maxila (SN.PP) também não se alterou. Os incisivos superiores sofreram lingualização e retrusão...

Orthopedic and orthodontic approaches, used in an associated way, are being considered an efficient therapeutic option for the treatment of the Class II, division 1 malocclusion when the patient still presents a favorable growth potential. However, changes in skeletal, dental and soft tissue relationships only can be considered satisfactory if they remain stable. This study aimed to evaluate, cephalometrically and in dental casts, the stability of the changes resulting from the treatment with the Balters Bionator followed by the fixed appliances, after a mean period of 10 years. The experimental group comprised 23 patients who were evaluated in three stages: initial (T1), final (T2) and long-term posttreatment (T3). A total of 69 lateral cephalograms (initial, final and long-term posttreatment) were evaluated and also 69 dental casts were measured, in the stages previously described, using the PAR index. Furthermore, the difference between initial PAR and final PAR, the percentage of obtained improvement with the therapy and the percentage of relapse were calculated, using the PAR index. Evaluated variables were compared by the analysis of variance (ANOVA) for repeated measures and Tukey test. The studied therapy did not provide changes in maxillary development. An increase in mandibular protrusion, as well as a greater increase in effective length of the mandible, was observed. The maxillomandibular relationship was corrected, and an improvement in the facial convexity was observed, with a decrease of the ANB angle. Significant changes in craniofacial growth were not observed. The analysis of the FMA variable and of the long-term posttreatment revealed a rotation of the mandibular plane in a counterclockwise direction. The vertical positioning of the maxilla (SN.PP) also did not change. The maxillary incisors presented a palatal inclination and retrusion. The maxillary first molars showed a small increase in the vertical direction, similar...

Mordida aberta anterior: etiologia e tratamento / Anterior open bite: etiology and treatment

Os hábitos bucais deletérios interferem no desenvolvimento normal da oclusão e sua persistência induz más oclusões sendo, a mordida aberta, a mais freqüente. Quanto mais precoce o tratamento, menor a possibilidade de recidiva e maior a estabilidade. Dois relatos de casos foram apresentados. O primeiro caso mostra um plano de tratamento, em dentição mista, iniciado com a instalação do aparelho interceptador removível, com parafuso expansor, grade palatina, arco vestibular ativação dos grampos de Adams nos primeiros molares permanentes e grampos auxiliares entre os molares decíduos. O tratamento durou 5 meses. No segundo caso a paciente com dentição permanente apresentava má oclusão de Classe II divisão 1 subdivisão direita. Os dentes 16, 26, 36 e 46 foram bandados com os seus respectivos tubos voltados para a cervical, para a adaptação do arco extrabucal AEB (IHG) e uma PLA (Placa Lábio Ativa). Foi instalado o aparelho Hyrax, dento-suportado construído com fios rígidos e com parafuso o mais próximo possível do palato. Em seguida a remoção do disjuntor, foi feita uma avaliação e realizada as extrações dos dentes 14, 24 e 34 com finalidade de eliminar a discrepância dentária e cefalometria, corrigindo, assim, a linha média do paciente. O alinhamento e o nivelamento dos dentes foram realizados com fios redondos com periodicidade, durante o período de 8 meses e a contenção utilizada foi a mesma dos tratamentos ortodônticos convencionais com a placa de Hawley superior e barra 3x3 inferior. O tratamento foi de três anos.