Multidisciplinary Treatment: Follow-Up of Dental Autotransplantation for 10 Years.

The objective is to present a clinical case of dental autotransplantation managed with surgery, orthodontics, endodontics, periodontics, and aesthetic rehabilitation. A 10-year-old boy sought treatment after avulsion of the maxillary left central incisor, which was not reimplanted. Based on anamnesis, clinical examination, and complementary examinations, agenesis of the maxillary and mandibular second premolars except the mandibular right second premolar was observed. After a multidisciplinary planning, the space in the maxillary left central incisor region was opened to receive the transplanted mandibular right second premolar. The receptor site was created in a single surgical procedure. Pulp necrosis was noted in the transplanted tooth, which was treated endodontically, and the agenesis spaces were closed using fixed orthodontic appliances. After removing the appliance, gingivectomy with osteotomy was performed in the maxillary right central incisor and the transplanted tooth regions to harmonize the height and shape of the gingival contour. Next, aesthetic readjustment was performed with tooth whitening, using office and home techniques, followed by microabrasion of the vestibular surface of the maxillary right central incisor. Direct composite resin restorations were placed in the maxillary incisors, and the teeth were rehabilitated using incisal and palatal guides. A multidisciplinary approach is essential for reestablishing the function and aesthetics of complex cases involving dental autotransplantation.

Cone-beam computed tomography study of mandibular morphology and tooth compensation in asymmetrical patients.

INTRODUCTION: This study evaluated mandibular morphology and transverse dental compensation between symmetrical and asymmetrical subjects, allocated according to sagittal skeletal patterns. In addition, the hypothesis that mandibular morphology and dental compensations differed between symmetrical/asymmetrical groups and also among the different types of sagittal skeletal patterns was tested. METHODS: Cone-beam computed tomography images of 96 patients were included in this study and were divided into 2 groups according to the degree of menton deviation: a symmetrical group with deviation up to 2.0 mm (n = 48; mean age, 15 ± 6 years), and an asymmetrical group with deviation from 3.5 mm (n = 48; mean age, 16 ± 8 years). The 2 groups were divided in accordance with the ANB angle: Class I, II, and III. Skeletal and dental measurements were performed. Intergroup and intragroup analyses were carried out, using a 2-way analysis of variance to assess the interaction of factors: symmetry and sagittal skeletal pattern; and the Student t test for differences between deviated (Dv) and nondeviated (NDv) sides. RESULTS: Symmetrical/asymmetrical groups and Class I, II, and III groups were similar in relation to demographic aspects (P = 0.412 and P = 0.357 for sex and age, respectively). Asymmetrical patients had higher values for body length and mandibular ramus and condyle height on the NDv side (P = 0.011, P = 0.024, and P = 0.001, respectively). When comparing the different skeletal patterns, patients with a Class III relationship demonstrated higher values for mandibular ramus height. Intergroup analysis showed no differences in dental parameters. In the comparison between the sides, the asymmetrical group showed a significant difference in canine inclination (P = 0.008), mandibular ramus height (P = 0.004), condyle height (P = 0.010) and gonion to midsagittal plane distance (P = 0.018). CONCLUSIONS: Asymmetrical subjects showed higher values for canine inclination and mandibular body, ramus and condylar height on the NDv side. The hypothesis was partially confirmed that mandibular morphology and dental compensations are different between symmetrical/asymmetrical groups and among different sagittal skeletal patterns.

Prevalence and description of dental disorders in skulls of free-living wild primates from Paraná State, Brazil.

BACKGROUND: Non-human primates can present oral diseases. However, differences among the dentition of the various species make it difficult to understand their dental features and associated diseases. This research hypothesizes that the prevalence of dental disorders varies in the species studied according to distinct types of diet. METHODS: Forty-five syncraniums of the species Alouatta caraya, Alouatta guariba clamitans, Sapajus nigritus, Callithrix jacchus, and Callithrix penicillata were evaluated by visual inspection, magnifying glasses, and on cone-beam computed tomography. RESULTS: Disorders identified consisted of missing teeth before death, agenesis, dental calculus, dental wear, dental staining, dental fracture, exposure of pulp chamber, alveolar bone resorption, tooth discoloration, and persistence of deciduous teeth. Alouatta guariba clamitans presented the most disorders. CONCLUSIONS: The results suggest that neotropical primates have a high prevalence of dental changes, even in free-living conditions, and that the differences observed among them may be associated with different diet patterns.

Are temporomandibular disorders associated with facial asymmetry? A systematic review and meta-analysis.

OBJECTIVE: To assess scientific evidence of the association between temporomandibular joint (TMJ) disorders and facial asymmetry (FA). METHODS: A systematic review was performed in accordance with the PRISMA checklist. A search strategy was developed in electronic databases including MEDLINE, Scopus, Web of Science, Virtual Health Library and Cochrane Library until January 2020. Eligibility criteria included observational studies that investigated the occurrence of FA among patients with and without signs and symptoms of TMJ disorders. Risk of bias of individual studies was analysed after study selection and data collection processes according to Fowkes and Fulton guidelines. Four meta-analyses (MA) were performed to evaluate the association between TMJ disorders and linear/angular menton deviation, subgrouping the studies into unilateral and bilateral cases. The evidence was certainty-tested using the GRADE approach. RESULTS: The search retrieved 2371 studies, 31 of which were eligible for full-text reading. Seven cross-sectional clinical studies met the eligibility criteria and were included in the qualitative synthesis, comprising a total of 621 subjects (345 with TMJ disease and 276 in control group), four of which were classified as being methodologically sound. Five studies were eligible for quantitative synthesis. Linear and angular menton deviation was greater in individuals with unilateral TMJ disorders than controls (MD = 2.41 [0.33, 4.50] P = .02; I2  = 86% and MD = 2.68 [0.99, 4.38] P = .002; I2  = 0%, respectively). CONCLUSIONS: Despite the low certainty in evidence, the present study indicated that unilateral TMJ disorders are associated with FA. However, longitudinal studies with greater certainty of evidence should be conducted to achieve a stronger estimate of this association.

The characteristics of palate and upper dental arch can be an anatomical marker for men with schizophrenia? Case-control study: Palate can be a marker for schizophrenia?

AIMS: The aim of this study was to compare individuals with and without schizophrenia through the characteristics of the palate, such as width, length, depth, palate shape, and upper dental arch shape. METHODS AND RESULTS: The sample was divided into one case group (n = 45) and two control groups (n = 90; 45 individuals each group). Groups were paired by variables: sex, age, and malocclusion type. All analyses were performed on upper dental arch plaster models. All individuals were male and the mean age was 28.56 (SD: 7.82) years. The frequency of the malocclusion type observed was 54.1% (Class I), 22.2% (Class II), and 23.7% (Class III). Statistically significant difference was observed between the case and control groups for the variables palate shape (P = .004) and upper dental arch shape (P = .003). The case group had a higher frequency of the deep or grooved palate shape (57.8%) and parabolic dental arch shape (48.9%). There was no statistically significant difference for the palate width, length, and depth (P > .05). CONCLUSIONS: There was an evidence that the deep or grooved palate shape and parabolic dental arch shape are morphological characteristics of the palate in men with schizophrenia.

Radiographic analysis of dental maturation in children with amelogenesis imperfecta: A case-control study.

AIMS: To assess dental maturation in children with amelogenesis imperfecta (AI) and compare their estimated dental age with the age of non-AI children. METHODS AND RESULTS: Panoramic radiographs of children with (n = 27) and without (n = 54) AI were retrospectively collected in the ratio of 1:2. The former consisted of case group, while the latter figured as control group. Both groups were paired by sex and age (P > .05). Dental maturation was assessed in each radiograph using Demirjian's staging technique and Willems' method. Intra- and interexaminer reproducibility reached >0.8. The mean estimated dental age in subjects with AI was 12.5 ± 2.69 years, while in subjects without AI it was 11.73 ± 2.48 years (P = .21). The comparison of mean chronological (12.26 ± 2.6 years) and estimated dental age (12.5 ± 2.69 years) in subjects with AI did not reveal statistically significant differences (P = .38). CONCLUSION: This study highlights the similarity of dental maturation between subjects with and without AI from the radiographic perspective of crown-root formation.

Quantifying the scientific studies in forensic dentistry presented at meetings of the "Sociedade Brasileira de Pesquisa Odontológica" (SBPqO) between 2013 and 2018

Currently, Brazil hosts one of the biggest communities of Forensic Dentists worldwide. In practice, Forensic Dentistry may be performed within official forensic services and through ad hoc consultancy. Hence, Training and education with high-level scientific evidence is a must. This study aimed to quantify the scientific studies presented at meeting of the "Sociedade Brasileira de Pesquisa Odontológica" (SBPqO). The sample consisted of the annals of the 30th, 31st, 32nd, 33rd, 34th and 35th scientific meetings of the SBPqO published between 2013 and 2018. The annals were retrieved from the website of SBPqO (www.sbpqo.org.br) and were revisited by two examiners. A search string of keywords was used to detect eligible abstracts initially related to Forensic Dentistry. Titles and abstracts of the scientific studies initially detected were read and filtered for data extraction. Year of publication, university in which the study was carried out and field within Forensic Dentistry were recorded. In total, 199 abstract related to Forensic Dentistry were detected. Sequentially, 29, 28, 49, 38, 29, 26 abstract were published in 2013, 2014, 2015, 2016, 2017 and 2018, respectively. Forty-three institutions were detected in the search, most of them were public (n=29; 67.44%) ­ these universities were responsible for most of the abstracts (n=176, 88.44%). Anthropological studies were the most prevalent (n=69; 34.67%), especially those exclusively related to age estimation (n=35; 50.72%). Between 2013 and 2018, abstracts in Forensic Dentistry represented only 1.11% of the studies in Dentistry. The scenario depicted from the most recent annals of the SBPqO shows that the scientific literature in Forensic Dentistry produced by Brazilian institutions remains scarce. Efforts should be made to encourage and trigger more investigations in the field

Atualmente, o Brasil abriga uma das maiores comunidades de Odontolegistas em nível mundial. Na prática, a Odontologia Legal pode ser exercida, principalmente, em serviços de perícia oficial ou mediante consultoria ad hoc. Assim sendo, treinamento e educação com elevado padrão de evidência científica na área são fundamentais. Este estudo teve por objetivo a quantificação dos trabalhos científicos apresentados nos encontros anuais da Sociedade Brasileira de Pesquisa Odontológica (SBPqO). A amostra consistiu dos anais do 30º, 31º, 32º, 33º, 34º e 35º encontros científicos da SBPqO publicados entre 2013 e 2018. Os anais foram coletados do endereço eletrônico da SBPqO (www.sbpqo.org.br) e foram avaliados por dois examinadores. Uma trama de palavras-chave foi desenvolvida para viabilizar a detecção de resumos elegíveis inicialmente relacionados com a Odontologia Legal. Títulos e resumos foram detectados e lidos para a extração de dados. O ano de publicação, a universidade na qual o estudo foi conduzido e a subárea abordada da Odontologia Legal foram registrados. Sequencialmente, 29, 28, 49, 38, 29 e 26 resumos foram publicados anualmente de 2013 a 2018, respectivamente. Quarenta e três instituições de ensino foram detectadas, em sua maioria públicas (n=29, 67,44%) ­ estas universidades foram responsáveis pela maioria dos resumos (n=176, 88,44%). Estudos em Antropologia foram os mais prevalentes (n=69, 34,67%), especialmente aqueles que trataram exclusivamente do tema estimativa de idade (n=35, 50,72%). Entre 2013 e 2018 os resumos em Odontologia Legal representaram apenas 1.11% de todos os trabalhos apresentados nos eventos da SBPqO. O cenário apresentado com base nos mais recentes anais dos encontros científicos da SBPqO denota a evidente escassez de estudos em Odontologia Legal. Esforços devem ser encorajados para a promoção de mais estudos nesta área.

Influence of Primekote® polymer in orthodontic bonding / Influência do polímero Primekote® na colagem ortodôntica

Objective: The Primekote® (TP) polymer was incorporated to the of Orthodontic Bracket mesh base to improve bond strength and make it more efficient. The purpose of this study was to assess the shear bond strength and adhesive remnant index (ARI) of these brackets. Material and method: The test sample consisted of thirty bovine incisors divided into 2 groups: with a group with TP® brackets (n=15), and a control group with Morelli® brackets (n=15) without Primekote® technology. The TransbondTM XT was used as adhesive system in both groups, following the same protocol and manufacturer’s instructions. Specimens were stored in distilled water for 24 hours and then submitted to shear bond strength test in a universal testing machine (EMIC DL2000). The assessment of ARI was performed under stereomicroscope by two calibrated examiners. Result: No significant differences (p>0.05) in shear bond strength were found between the two groups according to the independent t-test. The Wilcoxon test was used to assess ARI data and statistical difference was found between Morelli® and TP® Nu-Edge brackets; the last one left less remaining adhesive on tooth surface. Conclusion: TP® brackets had higher adherence to the adhesive system as shown by lower ARI scores, but this does not improve its clinical performance.

Objetivo: Avaliar a resistência ao cisalhamento e o índice de remanescente adesivo (IRA) dos bráquetes que tiveram o polímero Primekote® incorporado a suas bases. Material e método: Foram confeccionados trinta corpos de prova com incisivos bovinos, divididos em dois grupos: o colado com bráquete TP® Nu-Edge(n=15) e grupo controle com bráquetes Morelli® (n=15) sem tratamento na base. O sistema adesivo TransbondTM XT foi utilizado nos dois grupos seguindo o mesmo protocolo de colagem e respeitando as instruções do fabricante. Os corpos de prova foram armazenados em água destilada por 24 horas, e posteriormente submetidos ao teste de cisalhamento na máquina de ensaios universais (EMIC-DL2000). O IRA foi avaliado por dois examinadores calibrados utilizando lupa estereoscópica com aumento de 20 vezes. Resultado: Na resistência ao cisalhamento o teste T-independente mostrou não haver diferença estatisticamente significante entre os grupos (p>0,05), ambos tiveram desempenho semelhante. O teste Wilcoxon foi utilizado nos valores obtidos no IRA revelando diferença estatística, sendo que os bráquetes TP® deixaram menos remanescente adesivo na superfície dental que os bráquetes Morelli®. Conclusão: Bráquetes TP® apresentaram maior adesão ao sistema adesivo pois foi encontrado menor IRA nos mesmos, porém esta característica não reflete em melhora no desempenho clínico.

New methodology for evaluating osteoclastic activity induced by orthodontic load.

Orthodontic tooth movement (OTM) is a dynamic process of bone modeling involving osteoclast-driven resorption on the compression side. Consequently, to estimate the influence of various situations on tooth movement, experimental studies need to analyze this cell. Objectives The aim of this study was to test and validate a new method for evaluating osteoclastic activity stimulated by mechanical loading based on the fractal analysis of the periodontal ligament (PDL)-bone interface. Material and Methods The mandibular right first molars of 14 rabbits were tipped mesially by a coil spring exerting a constant force of 85 cN. To evaluate the actual influence of osteoclasts on fractal dimension of bone surface, alendronate (3 mg/Kg) was injected weekly in seven of those rabbits. After 21 days, the animals were killed and their jaws were processed for histological evaluation. Osteoclast counts and fractal analysis (by the box counting method) of the PDL-bone interface were performed in histological sections of the right and left sides of the mandible. Results An increase in the number of osteoclasts and in fractal dimension after OTM only happened when alendronate was not administered. Strong correlation was found between the number of osteoclasts and fractal dimension. Conclusions Our results suggest that osteoclastic activity leads to an increase in bone surface irregularity, which can be quantified by its fractal dimension. This makes fractal analysis by the box counting method a potential tool for the assessment of osteoclastic activity on bone surfaces in microscopic examination.

New methodology for evaluating osteoclastic activity induced by orthodontic load

Orthodontic tooth movement (OTM) is a dynamic process of bone modeling involving osteoclast-driven resorption on the compression side. Consequently, to estimate the influence of various situations on tooth movement, experimental studies need to analyze this cell. Objectives The aim of this study was to test and validate a new method for evaluating osteoclastic activity stimulated by mechanical loading based on the fractal analysis of the periodontal ligament (PDL)-bone interface. Material and Methods The mandibular right first molars of 14 rabbits were tipped mesially by a coil spring exerting a constant force of 85 cN. To evaluate the actual influence of osteoclasts on fractal dimension of bone surface, alendronate (3 mg/Kg) was injected weekly in seven of those rabbits. After 21 days, the animals were killed and their jaws were processed for histological evaluation. Osteoclast counts and fractal analysis (by the box counting method) of the PDL-bone interface were performed in histological sections of the right and left sides of the mandible. Results An increase in the number of osteoclasts and in fractal dimension after OTM only happened when alendronate was not administered. Strong correlation was found between the number of osteoclasts and fractal dimension. Conclusions Our results suggest that osteoclastic activity leads to an increase in bone surface irregularity, which can be quantified by its fractal dimension. This makes fractal analysis by the box counting method a potential tool for the assessment of osteoclastic activity on bone surfaces in microscopic examination. .

Effect of Growth Hormone in Experimental Tooth Movement

The aim of this study was to evaluate, by histological analysis, the effect of growth hormone (GH) on periodontal ligament and alveolar bone during experimental tooth movement in rats. Eighty male Wistar rats divided into control (C) and experimental (E) groups were examined after 3, 7, 14 and 21 days under controlled climate conditions. Orthodontic force (30 cN) was applied on the maxillary first molar by an orthodontic appliance. Group E received 0.1 IU/kg/day of GH and Group C received 0.5 mL/kg/day of saline. The samples were processed and evaluated under optical microscopy and polarized light microscopy. The Kruskal Wallis test was applied to compare the intergroup variables at 5% significance level. Group E presented a larger number of osteoclasts on the 3rd and 7th days and Howship lacunae on the 3 rd day, a smaller number of blood vessels and greater amount of mature collagen on the 3 rd and 7 th days than Group C (p<0.05). It was concluded that GH accelerated and intensified bone resorption and produced delay in immature collagen formation during experimental tooth movement.

O objetivo deste estudo foi avaliar histologicamente o efeito do hormônio de crescimento (HC) no ligamento periodontal e osso alveolar, durante a movimentação dentária induzida em ratos. Oitenta ratos Wistar, machos, divididos nos grupos controle e experimental, foram observados nos dias 3, 7, 14 e 21. Foi aplicada força ortodôntica (30 cN) sobre o primeiro molar superior por meio de um dispositivo ortodôntico. No grupo experimental foi administrada 0,1 UI/kg/dia de HC e, no grupo controle, 0,5 mL/kg/dia de solução salina. As amostras foram processadas e avaliadas por microscopia de luz e luz polarizada. O teste de Kruskal Wallis foi utilizado para a comparação das variáveis intergrupos. Verificou-se que o grupo experimental apresentou maior quantidade de osteoclastos nos 3° e 7° dias e de lacunas de Howship no 3° dia, menor quantidade de vasos sanguíneos e maior quantidade de colágeno maduro nos 3° e 7° dias do que no grupo controle (p<0,05). Concluiu-se que o HC acelerou e intensificou a reabsorção óssea e produziu atraso na formação de colágeno imaturo, durante o movimento ortodôntico induzido.

Effect of growth hormone in experimental tooth movement.

The aim of this study was to evaluate, by histological analysis, the effect of growth hormone (GH) on periodontal ligament and alveolar bone during experimental tooth movement in rats. Eighty male Wistar rats divided into control (C) and experimental (E) groups were examined after 3, 7, 14 and 21 days under controlled climate conditions. Orthodontic force (30 cN) was applied on the maxillary first molar by an orthodontic appliance. Group E received 0.1 IU/kg/day of GH and Group C received 0.5 mL/kg/day of saline. The samples were processed and evaluated under optical microscopy and polarized light microscopy. The Kruskal Wallis test was applied to compare the intergroup variables at 5% significance level. Group E presented a larger number of osteoclasts on the 3rd and 7th days and Howship lacunae on the 3 rd day, a smaller number of blood vessels and greater amount of mature collagen on the 3 rd and 7 th days than Group C (p<0.05). It was concluded that GH accelerated and intensified bone resorption and produced delay in immature collagen formation during experimental tooth movement.

Friction between different wire bracket combinations in artificial saliva--an in vitro evaluation.

OBJECTIVE: The objective this work was to assess the friction coefficient between brackets and wires of different materials under conditions simulating the oral environment. MATERIAL AND METHODS: Stainless steel (SS) and titanium-molybdenum alloy (TMA) wires of 0.019x0.025-in diameter (American Orthodontics) and polycarbonate bracket (American Orthodontics), ceramic bracket (American Orthodontics), and metal bracket (3M Unitek) with slots of 0.022x0.030-in were used. The friction coefficient was assessed by means of mechanical traction with the system immersed in artificial saliva. The mean roughness of both wire surface and bracket slots was evaluated by using a surface profilometer. RESULTS: The system using TMA wire and polycarbonate bracket had the highest roughness (p<0.05). SS wire with ceramic bracket had the highest friction coefficient, whereas the use of metallic bracket yielded the lowest (p<0.05). However, it was observed a statistically significant difference in the system using TMA wire and ceramic bracket compared to that using TMA wire and polycarbonate bracket (p=0.038). CONCLUSIONS: Ceramic brackets in association with SS wire should be judiciously used, since this system showed a high friction coefficient.

Friction between different wire bracket combinations in artificial saliva: an in vitro evaluation

OBJECTIVE: The objective this work was to assess the friction coefficient between brackets and wires of different materials under conditions simulating the oral environment. MATERIAL AND METHODS: Stainless steel (SS) and titanium-molybdenum alloy (TMA) wires of 0.019x0.025-in diameter (American Orthodontics) and polycarbonate bracket (American Orthodontics), ceramic bracket (American Orthodontics), and metal bracket (3M Unitek) with slots of 0.022x0.030-in were used. The friction coefficient was assessed by means of mechanical traction with the system immersed in artificial saliva. The mean roughness of both wire surface and bracket slots was evaluated by using a surface profilometer. RESULTS: The system using TMA wire and polycarbonate bracket had the highest roughness (p<0.05). SS wire with ceramic bracket had the highest friction coefficient, whereas the use of metallic bracket yielded the lowest (p<0.05). However, it was observed a statistically significant difference in the system using TMA wire and ceramic bracket compared to that using TMA wire and polycarbonate bracket (p=0.038). CONCLUSIONS: Ceramic brackets in association with SS wire should be judiciously used, since this system showed a high friction coefficient.

The anterior dental cross-bite: the paradigm of interception in orthodontics / A mordida cruzada anterior: o paradigma da interceptação em ortodontia

OBJECTIVES: To present specific clinical interception procedures instituted to reduce malocclusionseverity on developmental stage. Anterior tooth cross-bite, involving one or two permanent teeth, is acommon form of malocclusion diagnosed in children about 6 years of age. RESULTS ANDDISCUSSION: Various devices can be suggested for single tooth cases, like removable cantilevereddouble-helix apparatus with digital springs, which is one of the most efficient to intercept malocclusion.In the other hand, fixed appliance does not depend on patient’s cooperation and have greater actionpower and liberates more continuous forces. CONCLUSION: Dental anterior cross-bite, involvingone tooth, can be corrected by means of the multi-loop arch wire with a double-helix, even in caseswhere adequate space for alignment is lacking.

OBJETIVOS: Apresentar procedimento de interceptação clínica específica para reduzir aseveridade da má oclusão no estágio de desenvolvimento. O cruzamento anterior, comprometendoum ou dois dentes permanentes, é forma comum de má-oclusão, diagnosticada em crianças emtorno de seis anos de idade. RESULTADOS E DISCUSSÃO: Vários dispositivos podem ser utilizados para casos de cruzamento de um dente apenas, como os aparelhos de duplo hélice emextremo livre, com molas digitais, um dos mais eficientes para interceptar más-oclusões. Poroutro lado, os aparelhos fixos não dependem da colaboração do paciente, tendo maior poder deação e de liberação de forças contínuas. CONCLUSÃO: Os cruzamentos anteriorescomprometendo um dente podem ser corrigidos por meio de arco com dobras múltiplas, comhélice dupla, mesmo em casos onde há deficiência de espaço para o alinhamento.

Arco helicoide fixo na eliminação do hábito de sucção de chupeta / Fixed helicoidal archwire in the elimination of pacifier-sucking habit

Os hábitos bucais deletérios podem quebrar o equilíbrio entre os músculos dos lábios, bochechas e língua e estimular o desenvolvimento de má-oclusões durante o desenvolvimento da criança alterando o esqueleto dentocraniofacial na fase de crescimento. O hábito de sucção de chupeta pode afetar os tecidos muscular, esquelético e dentário, com consequências na respiração, deglutição, fonação e oclusão. No primeiro ano de vida muitas crianças apresentam o hábito de sucção de chupeta o qual tende a desaparecer espontaneamente a partir dos três anos de idade, devido ao interesse por outras atividades. Porém, aqueles que persistirem com o hábito após essa idade, ou com frequência durante o dia ou à noite, torna-se prejudicial e capaz de provocar má-oclusões severas, como o overjet acentuado, diminuição do overbite, mordida aberta anterior, mordida cruzada posterior e postura inadequada da língua. A má-oclusão deve ser interceptada o mais precocemente possível para a obtenção de resultados mais rápidos e estáveis, em simbiose com o crescimento e desenvolvimento dentocraniofacial. Porém, a cooperação na eliminação do hábito é a condição principal. O artigo será ilustrado com um caso clínico com mordida aberta anterior devido a sucção de chupeta e tentativa inicial de remoção do hábito com aparelho removível, e definitiva com aparelho fixo, com configuração de helicoide, diferente da tradicional grade ou botão palatino.

The habits can break the balance between the muscles of the lips, cheeks and tongue and stimulate the abnormal growth of the jaws, during the development of the dentocraniofacial structures, being able to modify his function. The habit of suction of pacifier can affect the muscular, skeletal and dental tissues, with consequences in breathing, deglutition, phoning and occlusion. In the first year of life, 65% of the children present the suction of pacifier habit which has a tendency to disappear spontaneously after three years of age, due to the interest for other activities. However, in those who persist after this age, or sucks frequently during the day or at night, the habit becomes damaging and able to cause severe malocclusion such as severe overjet, open bite, posterior crossbite and inadequate tongue posture. The malocclusion must be intercepted as soon a possible and for getting the quickest and stable results in symbiosis with the dentocraniofacial growth and development. However, the cooperation for the elimination of the habit is the principal condition. The work will be illustrated with a clinical case of anterior open bite bite due to suction of pacifier with an initial attempt of habit removal by removable appliance, and the definitive interception with a fixed appliance, with a differentiated design of the traditional grill or button palatine.

Space closure after extraction of two central upper incisors and re-shaping of laterals.

A 13-year-old boy had fractured both maxillary central incisors when he was 8 years old, resulting in pulpar damage. At the time of the accident, root canal therapy was performed. Although the teeth were retrieved, their roots were short and not fully developed. Cephalometric analysis suggested extraction of the four first premolars to achieve aesthetic and functional objectives. To attend to the patient's chief complaint, and with his parents' approval, both upper central incisors were extracted followed by periodontal and cosmetic procedures to improve the patient's smile as well as his self-esteem and satisfaction.

The use of lidocaine as an anti-inflammatory substance: a systematic review.

OBJECTIVE: To investigate existence of evidence that supports the therapeutical use of lidocaine as an anti-inflammatory substance. METHODS: A search on health sciences databases was performed, including only papers published in English until May 2007 which reported in vivo experimental studies that tested lidocaine as an anti-inflammatory substance and used morphological and/or biochemical analysis. The keywords used were: "lidocaine & inflammation", "lidocaine & neutrophils" and "lidocaine & prostaglandin". The search results were previous selected by title and abstract, and then articles were read and those that met inclusion criteria were carefully analyzed and classified. RESULTS: Only 10 articles met the inclusion criteria, and were carefully read. They were ranked (A, B, and C) according to the level of evidence produced. Seven articles were classified as C, two classified as B, and one classified as A. Despite methodological differences, all of them, except for one, reported that lidocaine showed anti-inflammatory effects. CONCLUSIONS: According to the reviewed literature, lidocaine has a potential as an anti-inflammatory agent. However, there is still a lack of well-designed studies to support its clinical use, and none of them evaluated its effects on a mucous epithelium.