Evaluation of maxillary canine and molar movement during the first phase of extraction space closure: a multilevel analysis.

OBJECTIVE: This study was designed to analyze and compare the cusp and apex movements of the maxillary canines and first molars during canine retraction in the first step of extraction space closure, and to evaluate if these teeth follow a curvilinear (acceleration and/or deceleration) movement rate. MATERIAL AND METHODS: Twenty-five patients (23.3 ± 5.1 years of age) were enrolled. The retraction of the maxillary canines was accomplished using nickel-titanium closed coil springs (100gf) on 0.020-in stainless steel archwire. Oblique cephalograms were traced and superimposed on the anatomic best fit of the maxilla (before the retraction [T0], and after one month [T1], three [T3], five [T5] and seven [T7] months). Statistics was based in a normally distributed data. Multilevel procedures were used to derive polynomials for each of the measurements. Student's t-test and one-way repeated measures ANOVA were conducted. The level of significance of 5% was adopted. RESULTS: Canine cusps and apexes did not follow a quadratic curve regarding horizontal movement (neither accelerate nor decelerate). Canine and molar cusps showed more horizontal movement than apexes (4.80 mm vs. 2.78 mm, and 2.64 mm vs. 2.17 mm, respectively). CONCLUSIONS: Canine did not accelerate or decelerate overtime horizontally; the cusps and apexes of the canines and molars showed more horizontal movement and larger rate at the beginning of canine retraction, followed by significantly smaller and constant movement rate after the first month.

Evaluation of maxillary canine and molar movement during the first phase of extraction space closure: a multilevel analysis

ABSTRACT Objective: This study was designed to analyze and compare the cusp and apex movements of the maxillary canines and first molars during canine retraction in the first step of extraction space closure, and to evaluate if these teeth follow a curvilinear (acceleration and/or deceleration) movement rate. Material and Methods: Twenty-five patients (23.3 ± 5.1 years of age) were enrolled. The retraction of the maxillary canines was accomplished using nickel-titanium closed coil springs (100gf) on 0.020-in stainless steel archwire. Oblique cephalograms were traced and superimposed on the anatomic best fit of the maxilla (before the retraction [T0], and after one month [T1], three [T3], five [T5] and seven [T7] months). Statistics was based in a normally distributed data. Multilevel procedures were used to derive polynomials for each of the measurements. Student's t-test and one-way repeated measures ANOVA were conducted. The level of significance of 5% was adopted. Results: Canine cusps and apexes did not follow a quadratic curve regarding horizontal movement (neither accelerate nor decelerate). Canine and molar cusps showed more horizontal movement than apexes (4.80 mm vs. 2.78 mm, and 2.64 mm vs. 2.17 mm, respectively). Conclusions: Canine did not accelerate or decelerate overtime horizontally; the cusps and apexes of the canines and molars showed more horizontal movement and larger rate at the beginning of canine retraction, followed by significantly smaller and constant movement rate after the first month.

RESUMO Objetivo: O objetivo deste estudo foi analisar a movimentação das cúspides e dos ápices de caninos e primeiros molares superiores durante a retração de caninos na primeira fase do fechamento do espaço pós-extração, e avaliar se esses dentes apresentam mudança na taxa de movimentação (aceleração e/ou desaceleração). Material e Métodos: Vinte e cinco pacientes (idade = 23,3 ± 5,1 anos) foram incluídos. A retração dos caninos superiores foi realizada com molas helicoidais fechadas de níquel-titânio (100gf) em arco 0,020" de aço inoxidável. Foram feitos traçados cefalométricos de telerradiografias oblíquas e sobrepostos ao melhor ajuste anatômico da maxila (antes da retração [T0]; após um mês [T1], três meses [T3], cinco meses [T5] e sete meses [T7]). A estatística foi baseada em dados com distribuição normal. Procedimentos multiníveis foram usados para derivar polinômios para cada uma das medidas. Teste t de Student e ANOVA de uma via para medidas repetidas foram realizados, adotando-se um nível de significância de 5%. Resultados: As cúspides e os ápices dos caninos não seguiram uma curva quadrática em relação ao movimento horizontal (sem aceleração ou desaceleração). As cúspides dos caninos e molares apresentaram mais movimento horizontal do que os ápices (4,80 mm vs. 2,78 mm e 2,64 mm vs. 2,17mm, respectivamente). Conclusões: A movimentação horizontal dos caninos não acelerou ou desacelerou ao longo do tempo; as cúspides e os ápices dos caninos e molares apresentaram maior movimento horizontal e maior taxa de movimentação no início da retração dos caninos, seguida por uma taxa de movimentação significativamente menor e constante após o primeiro mês.

Comparison of anterior retraction and anchorage control between en masse retraction and two-step retraction: A randomized prospective clinical trial.

OBJECTIVES: The purpose of this two-arm parallel trial was to compare en masse (ER) and two-step retraction (TSR) during space closure. MATERIALS AND METHODS: Forty-eight adult patients with bimaxillary protrusion who were planned for treatment with extraction of four first premolars were enrolled. All patients were randomly allocated in a 1:1 ratio to either the ER (n = 24) group or the TSR (n = 24) group. The main outcome was the amount of posterior anchorage loss in the molars and the retraction of the incisors between ER and TSR; the difference in incisor and molar inclination was a secondary outcome. Lateral cephalometric radiographs and oblique cephalometric radiographs at 45° were taken before retraction (T1) and after space closure (T2). Cephalograms were digitized and superimposed on the anatomic best fit of the maxilla and mandible by one operator who was blinded to the treatment group. RESULTS: Neither incisor nor molar crown movements showed any significant differences between the ER and TSR. There were no significant differences in the tipping of incisors and molars between the two groups. CONCLUSIONS: No significant differences existed in the amount of retraction of incisors and anchorage loss of molars between ER and TSR. Changes in incisor and molar tipping were similar, with the crowns showing more movement than the apex.

Effect of clinical use of nickel-titanium springs.

INTRODUCTION: Our objectives were to determine whether there are changes on the load deflection rate (L/DP) and the average force (FP) of the superelastic pseudoplateau, and whether permanent deformation is changed in nickel-titanium closed-coil springs (CCSs) after 6 months of clinical use. METHODS: Twenty-two nickel-titanium CCSs (Sentalloy 100 g; Dentsply GAC, York, Pa) were subjected to tensile mechanical testing at 37°C on activations varying from 3.2 to 16.0 mm before and after 6 months of clinical use. A regression line was fitted over the most horizontal area of the unloading part of the stress-strain graph of every CCS, and its slope was used as L/DP. The FP was determined by the midpoint of the longest segment of the curve that could be fit within the regression line with a R(2) of at least 0.999, and permanent deformation was determined graphically by obtaining the strain value when the measured stress reached zero. The data were analyzed by 3 analyses of variance at 2 levels, with 5% of significance. RESULTS: Time and activation significantly influenced the variables tested (P < 0.001). Time increased the L/DP and permanent deformation but decreased the FP. Activation decreased L/DP, FP, and permanent deformation. Significant interactions between time and activation were detected for FP (P = 0.013) and deformation (P < 0.001). CONCLUSIONS: After 6 months of active clinical use, the analyzed springs had a significant but small increase in their L/DP; FP dropped up to 88%, and the CCSs deformed up to 1.26 mm.

Procedures adopted by orthodontists for space closure and anchorage control.

OBJECTIVE: The aim of this study was to identify the procedures adopted by Brazilian orthodontists in the following situations: extraction space closure, anchorage control in case of necessary anchorage for group A and frequency of skeletal anchorage use, especially in the upper jaw. METHODS: A questionnaire was sent to the e-mail address of all dentists registered in the Brazilian Federal Council of Dentistry. RESULTS: The results showed that most Brazilian orthodontists usually perform extraction space closure by means of sliding mechanics. The use of palatal bar, inclusion of second molars in the archwire and space closure performed in two phases are the most used techniques for anchorage control in the upper jaw. The skeletal anchorage is referenced by 36.5% of specialists as a routine practice for the upper arch anchorage. CONCLUSIONS: There is a wide variety of procedures adopted by Brazilian orthodontists for orthodontic space closure and anchorage control.

Procedures adopted by orthodontists for space closure and anchorage control

OBJECTIVE: The aim of this study was to identify the procedures adopted by Brazilian orthodontists in the following situations: extraction space closure, anchorage control in case of necessary anchorage for group A and frequency of skeletal anchorage use, especially in the upper jaw. METHOD: A questionnaire was sent to the e-mail address of all dentists registered in the Brazilian Federal Council of Dentistry. RESULTS: The results showed that most Brazilian orthodontists usually perform extraction space closure by means of sliding mechanics. The use of palatal bar, inclusion of second molars in the archwire and space closure performed in two phases are the most used techniques for anchorage control in the upper jaw. The skeletal anchorage is referenced by 36.5% of specialists as a routine practice for the upper jaw anchorage. CONCLUSIONS: There is a wide variety of procedures adopted by Brazilian orthodontists for orthodontic space closure and anchorage control.

OBJETIVO: esse trabalho tem o objetivo de identificar as condutas adotadas pelos ortodontistas brasileiros para o fechamento ortodôntico de espaços de extrações, controle de ancoragem em caso de necessidade de ancoragem do grupo A, e frequência de uso de ancoragem esquelética nesses casos, especialmente na arcada superior. MÉTODOS: um questionário foi enviado para o endereço eletrônico de todos os ortodontistas inscritos no Conselho Federal de Odontologia. RESULTADOS: os resultados mostraram que a maioria dos ortodontistas brasileiros usualmente faz fechamento de espaço de extrações com mecânicas de deslizamento. O uso de barra palatina, incorporação de segundos molares no arco e fechamento de espaço em duas fases são as condutas mais utilizadas para controle de ancoragem na arcada superior. A ancoragem esquelética é referenciada por 36,5% dos especialistas como forma rotineira de ancoragem na arcada superior. CONCLUSÕES: existe uma grande variedade de condutas adotas por ortodontistas brasileiros tanto para o fechamento ortodôntico de espaço quanto para o controle de ancoragem em casos de maior necessidade de retração anterior.

Transverse maxillary and mandibular growth during and after bionator therapy: study with metallic implants.

INTRODUCTION: This study evaluated posteroanterior cephalograms before and after treatment and long term follow-up of Class II division 1 patients treated with bionator. OBJECTIVE: The objective was to demonstrate the transverse growth of maxilla and mandible during and after bionator therapy. METHODS: Measurement of transverse dimensions between posterior maxillary and mandibular implants, as well as the distances between the buccal, gonial and antegonial points were recorded. Measurements were analyzed at three periods: T1 - before bionator therapy, T2 - after bionator therapy and T3 - 5.74 years after T2. RESULTS: There was statistically significant transverse increase due to growth and/or treatment for all variables, except for the distance between the anterior maxillary implants. CONCLUSIONS: During the study period only the anterior maxillary area did not show transverse growth.

Transverse maxillary and mandibular growth during and after Bionator therapy: study with metallic implants

INTRODUCTION: This study evaluated posteroanterior cephalograms before and after treatment and long term follow-up of Class II division 1 patients treated with bionator. OBJECTIVE: The objective was to demonstrate the transverse growth of maxilla and mandible during and after bionator therapy. METHODS: Measurement of transverse dimensions between posterior maxillary and mandibular implants, as well as the distances between the buccal, gonial and antegonial points were recorded. Measurements were analyzed at three periods: T1 = before bionator therapy, T2 = after bionator therapy and T3 = 5.74 years after T2. RESULTS: There was statistically significant transverse increase due to growth and/or treatment for all variables, except for the distance between the anterior maxillary implants. CONCLUSIONS: During the study period only the anterior maxillary area did not show transverse growth.

INTRODUÇÃO: esse estudo envolve a avaliação de telerradiografias posteroanteriores pré- e pós-tratamento com Bionator, bem como, em longo prazo, de pacientes Classe II divisão 1. OBJETIVO: o objetivo desse trabalho é demonstrar o crescimento transversal da maxila e mandíbula durante e após o uso do Bionator. MÉTODOS: as mensurações das distâncias transversais entre os implantes posteriores da maxila e mandíbula, bem como as das distâncias entre os pontos jugal, gônio e antigônio, foram tomadas em três tempos: T1, antes da terapia com Bionator; T2, após a terapia como Bionator; e T3, 5,74 anos após T2. RESULTADOS: ocorreu aumento transversal estatisticamente significativo por crescimento e/ou por tratamento em todas as variáveis estudadas, com exceção da distância entre os implantes anteriores da maxila. CONCLUSÕES: durante o período do estudo, somente a região anterior da maxila não apresentou crescimento transversal.

Controlling mechanical undesirable side effects with a tooth indicated for extraction: free anchorage.

This manuscript describes the use of a tooth indicated for extraction due to orthodontic reasons as an anchorage aid to receive undesirable side effects caused by orthodontic uprighting of a contralateral molar tooth. The mandibular right second molar was mesially tipped as a result of loss of the adjacent first molar. Since the treatment plan involved extraction of the mandibular left first premolar, undesirable side effects associated with the molar uprighting movement were transferred to this tooth. Once the second molar was vertical, the premolar was extracted and the treatment continued. The results suggest that treatment time can be reduced if undesirable orthodontic mechanical side effects can be directed to a tooth whose extraction is indicated.

Tooth separation: a risk-free procedure?

This article reports the case of a 12-year-old patient with tooth extrusion, pain, gingival bleeding, and localized periodontitis near the maxillary second premolar. Despite probing and radiographic examination, it was not possible to establish the etiology. Tooth extraction was indicated because of the severe tooth mobility and extrusion. Curettage of the tooth socket revealed a rubber separator. Preventive approaches are suggested to avoid iatrogenesis and legal problems.

Rapid palatal expansion: a comparison of two appliances

This study analyzed occlusal radiographs to compare the transverse changes produced in patients treated with rapid maxillary expansion using two types of appliances. The sample consisted of 31 children aged 7 to 10.6 years, of both genders, with posterior cross-bite. Fifteen children were treated with a tooth-borne expander and 16 were treated with a tooth-tissue-borne expander. Occlusal radiographs obtained at treatment onset and at the end of the retention period were digitized. The following variables were measured: intermolar distance (IMD), interapical distance (IApD), interbase distance (IBaD) and interarm distance (IArD). The results revealed increases in all measurements in both groups after rapid maxillary expansion. Comparison between groups revealed that the increases were greater in patients treated with the tooth-borne expander, except for the IArD measurement, which presented the same increase in both groups. Even though the IMD measurements differed between expanders, they were proportional to the activation of the appliances (IBaD). The increase in the IApD measurement was proportionally greater in the group treated with the tooth-borne expander (0.7:1.0) than in that treated with the tooth-tissue-borne expander (0.4:1.0). It was concluded that both appliances had similar effects, although the tooth-tissue-borne expander produced a lesser opening at the apical region of the incisors.

Rapid palatal expansion: a comparison of two appliances.

This study analyzed occlusal radiographs to compare the transverse changes produced in patients treated with rapid maxillary expansion using two types of appliances. The sample consisted of 31 children aged 7 to 10.6 years, of both genders, with posterior cross-bite. Fifteen children were treated with a tooth-borne expander and 16 were treated with a tooth-tissue-borne expander. Occlusal radiographs obtained at treatment onset and at the end of the retention period were digitized. The following variables were measured: intermolar distance (IMD), interapical distance (IApD), interbase distance (IBaD) and interarm distance (IArD). The results revealed increases in all measurements in both groups after rapid maxillary expansion. Comparison between groups revealed that the increases were greater in patients treated with the tooth-borne expander, except for the IArD measurement, which presented the same increase in both groups. Even though the IMD measurements differed between expanders, they were proportional to the activation of the appliances (IBaD). The increase in the IApD measurement was proportionally greater in the group treated with the tooth-borne expander (0.7:1.0) than in that treated with the tooth-tissue-borne expander (0.4:1.0). It was concluded that both appliances had similar effects, although the tooth-tissue-borne expander produced a lesser opening at the apical region of the incisors.

Estudo clínico do tempo de fechamento de espaço e do movimento dentário durante a retratação de caninos entre dois tipos de braquetes / Clinical study of canine space closure: time and movement with two different bracket types

O desenvolvimento tecnológico na fabricação de braquete trouxe consigo a ideia de que a tecnologia empregada no aparelho pode representar aumento na velocidade de movimentação dentária. O propósito deste estudo foi avaliar a taxa de movimentação mensal de caninos e a perda de ancoragem ocorrida durante o movimento de retração de caninos por deslizamento entre dois tipos de braquetes diferentes, um autoligado e outro convencionalmente ligado, bem como diferenças entre os arcos superior e inferior. A amostra consistiu de 25 pacientes biprotusos, portadores de má oclusão de classe I com necessidade de extração de quatro primeiros pré-molares para realização do tratamento ortodôntico, com apinhamento no arco superior e inferior menores que 4mm, idade variando entre 18 anos até 34 anos e sem ausências dentárias sendo facultativa a presença dos terceiros molares. Em todos eles foram colados dois braquetes autoligados, um no canino superior e outro no canino inferior de maneira randomizada e num sistema split-mouth. Os demais dentes receberam braquetes convencionais e tubos nos molares. Os primeiros pré-molares foram extraídos após o alinhamento e nivelamentos dos arcos e 7 a 15 dias após deu-se início à retração dos caninos. Telerradiografias laterais de 45º foram realizadas antes do início da retração e após a completa retração de cada canino. A superposição dos traçados cefalométricos iniciais e após a retração permitiu o cálculo da perda de ancoragem ocorrida e a quantidade de retração para cada canino. A divisão da quantidade de retração pelo tempo decorrido permitiu o cálculo da taxa de movimentação mensal dos caninos. Os resultados demonstraram que não existe diferença na taxa de movimentação mensal dos caninos e nem na perda de ancoragem entre os dois tipos de braquetes. Na comparação interarcos observou-se que a taxa de movimentação mensal dos caninos superiores é maior que a dos inferiores e a perda de ancoragem não foi estatisticamente diferente. Concluiu-se que a retração de caninos por deslizamento com braquetes autoligável ou convencional ocorre com a mesma taxa de movimentação e com a mesma perda de ancoragem. A taxa de movimentação mensal dos caninos inferiores é menor que a dos superiores mas sem diferença na quantidade de perda de ancoragem

The technological development in bracket manufacturing brought with it the belief that enhanced technology might translate as faster in tooth movement. The aim of this study was to evaluate the monthly rate of canine movement as well as the rate of anchorage loss during the retraction of canines by sliding mechanics with two different types of brackets: self-ligated and conventional and also, as well as differences between upper and lower arches. The sample comprised 25 biprotusive class I patients with need of four bicuspid extractions for orthodontic treatment, with upper and lower crowding less than 4 mm, age between 18 and 34 years old and no missing teeth except for the third molars. In all of them selfligated brackets were randomly bonded on the upper and lower canines in a split mouth design. The remaining teeth were bonded and banded with conventional brackets. First bicuspids were extracted after leveling and alignment and after 7 to 15 days canine retraction was initiated. Forty-five degree radiographic were taken before retraction and after complete canine retaraction. Cephalometrics tracings before and after canine retraction allowed the measurement of the resultant anchorage loss and the amount of canine retraction. By dividing the amount of canine retraction by it allowed the calculation of the canine movement monthly rate. The results showed that there is no difference between the rate of canine monthly movement and loss of anchorage between the two types of bracket. When arches were compared, upper canines were found to move faster than the lower ones and no difference was found on anchorage loss. It was concluded that canine retraction by sliding mechanics with either brackets occur at the same rate as well as the loss of anchorage of the molars. Upper canines move faster than the lower ones with no differences regarding the loss of anchorage

Aparelho extrabucal como recurso auxiliar para alinhamento e nivelamento no tratamento orto-cirúrgico de má oclusão Classe III esquelética / Headgear as an aid of alignment and leveling for skeletal Class III orthodontic surgical approach

Quando bem indicado, o tratamento ortodôntico cirúrgico consiste na abordagem ideal para adultos portadores de má oclusão Classe III esquelética. Para potencializar os resultados estéticos decorrentes da cirurgia ortognática, a fase de alinhamento e nivelamento do arco superior deve ser realizada com o mínimo de inclinação e projeção, ou até mesmo, retroinclinação dos incisivos superiores. No período pré-cirúrgico, a força extrabucal bilateral de 150 gF foi aplicada por 12 meses aos primeiros molares superiores de um paciente colaborador, do gênero masculino, 22 anos de idade, portador de má oclusão Classe III esquelética, para promover controle da inclinação mesial e da projeção dos dentes superiores. Os parâmetros oclusais requeridos para a translação cirúrgica das bases ósseas foram obtidos sem a necessidade de extrações, permitindo que o tempo total de tratamento fosse de 37 meses, tendo o paciente mostrado estabilidade no acompanhamento por 3 anos após remoção do aparelho. Esses achados mostram que apesar de depender grandemente da colaboração dos pacientes, quando bem indicado, o aparelho extrabucal consiste em uma alternativa para promover as descompensações dentárias no período pré-cirúrgico, a fim de possibilitar a correção cirúrgica das más oclusões Classe III esqueléticas

When well indicated, the orthodontic surgical approach is the ideal treatment mean for Skeletal Class III adult patients. To improve facial esthetic results from orthognatic surgery, the leveling and alignment of maxillary dental arch must be achieved with minimal inclination and projection or even retro-inclination of anterior upper teeth. During a pre-surgical phase of 12 months, headgear bilateral force of 150 g/F was applied to the upper molars of a 22 years old male compliant patient with Class III skeletal malocclusion, to provide an upper teeth control of mesial tipping and projection during alignment and leveling. The ideal occlusal parameters required for surgical procedure were achieved without dental extractions permitting a total treatment period of 37 months. The outcomes remained stable over 3 years follow up after the removal of the appliance. The results indicate that, although headgear use depends greatly on patient compliance, when well indicated it is an interesting alternativetopromote dentaldecompensationon pre-surgical period, in order to allow surgical correction of skeletal Class III malocclusion

Paresthesia during orthodontic treatment: case report and review.

Paresthesia of the lower lip is uncommon during orthodontic treatment. In the present case, paresthesia occurred during orthodontic leveling of an extruded mandibular left second molar. It was decided to remove this tooth from the appliance and allow it to relapse. A reanatomization was then performed by grinding. The causes and treatment options of this rare disorder are reviewed and discussed. The main cause of paresthesia during orthodontic treatment may be associated with contact between the dental roots and inferior alveolar nerve, which may be well observed on tomography scans. Treatment usually involves tooth movement in the opposite direction of the cause of the disorder.

Accidental swallowing of orthodontic expansion appliance key.

Ingestion of a foreign object, including a dental object, can lead to a trip to the emergency room. This article describes the accidental swallowing of a key that was used to activate a rapid maxillary expander. An orthodontic patient swallowed the key while trying to activate the appliance at home. The object's trajectory was followed on radiographs until it was eliminated. Possible clinical complications, legal implications of this situation, and practices for prevention are described.

Avaliação qualitativa em modelo experimental fotoelástico do sistema de força gerado pela mola "T" centralizada com pré-ativações preconizadas por Burstone / Qualitative evaluation in photoelastic experimental models of the force system generated by T-springs placed in the center of the interbracket space with pre-activations advocated by Burstone

OBJETIVO: avaliar o sistema de forças gerado pela mola T centralizada no espaço interbraquete, com pré-ativação preconizada por Burstone. MÉTODOS: utilizando-se modelos fotoelásticos, a mola T com pré-ativações preconizadas por Burstone, confeccionada com fio retangular de titânio-molibdênio (TMA) de secção 0,017"x 0,025", centralizada e com ativação de 6mm, 3mm e em posição neutra. Para melhor confiabilidade dos resultados, os testes foram repetidos em três modelos igualmente duplicados e confeccionados pelo mesmo operador. Utilizou-se uma distância interbraquetes de 27mm. Para compreensão dos resultados, as franjas foram visualizadas através do polariscópio, fotografadas e analisadas qualitativamente. RESULTADOS: por meio da análise qualitativa da ordem de franjas no modelo fotoelástico, notou-se que, nas extremidades de retração e ancoragem, ambas apresentaram simetria no sistema de força, em toda extensão radicular.

OBJECTIVE: To evaluate the force system generated by T-springs placed in the center of the interbracket space using the pre-activations advocated by Burstone. METHODS: Photoelastic models were used to assess T-springs fabricated with 0.017x0.025-in rectangular titanium-molybdenum alloy wire (TMA), centrally positioned, with 6.0 mm activation, 3 mm activation, and in neutral position. To ensure reliable results, tests were repeated on three photoelastic models equally duplicated and fabricated by the same operator. An interbracket distance of 27.0 mm was used. For a better understanding of the results, the fringes were viewed in a polariscope, then photographed and qualitatively analyzed. RESULTS: Through qualitative analysis of the fringe order in the photoelastic model it was noted that both the retraction and anchorage ends displayed force system symmetry across the full extent of the root.

Maxillary ulceration resulting from using a rapid maxillary expander in a diabetic patient.

One of the characteristics of diabetes mellitus is the exaggerated inflammatory response. The present report shows the reaction from the use of a rapid maxillary expander in a diabetic patient. A 9-year-old child presented an uncommon reaction to the treatment with a rapid maxillary expander, and on follow-up examination, it was discovered that the patient had diabetes mellitus. After controlling the disease, the proposed treatment was used without further incidents. The case calls attention to the presence of uncommon responses to treatment and the need for the orthodontist to suspect a patient's systemic compromise.

Avaliação das dimensões e relacionamentos dos arcos dentários após tratamento com Bionator de Balters / Evaluation of the dimensions and relationship of the dental archs after treatment with the Bionator of Balters appliance

O objetivo deste trabalho foi o de avaliar o efeito do tratamento com o aparelhofuncional Bionator de Balters nas alterações das dimensões e relacionamento dos arcos dentários em crianças com rná-oclusão Classe II, divisão 1 de Angle. O grupo experimental foi constituído de 36 pares de modelos de pacientes leucodermas com idades entre sete anos e dez meses e 11 anos e oito meses (dez do gênero feminino e oito do gênero masculino) que foram tratados durante 1,64 ano em média. A aplicação do teste de Levene mostrouevidências estatísticas de semelhança entre os grupos. Ocorreram alterações significantes (p < 0,005) nas variáveis indicativas de distância intermolares superiores, trespasse horizontal,comprimento total do arco superior, comprimento anterior do arco superior, comprimento posterior do arco superior, relação molar direita, relação molar esquerda, relação canino direita e relação canino esquerda. Por outro lado, não houve alteração significante em relação as medidas do arco inferior e distância intercaninos do arco superior. Conclui-se que o uso do aparelho Bionator de Balters teve efeito favorável na melhora da correção da má-oclusãode Classe II (melhora das relações molares e caninos) e um aumento transversal do arco superior, principalmente na região posterior do arco.

The deficiency of data in the literature took us to evaluate the Bionator ofBalters appliance in the alterations of the dimensions and the relationship of the dental archs in children with malocclusion Class II, division 1 of Angle. The experimental group wasconstituted by 36 pairs cast Caucasians patients, aged between 7years and 10 months - 11 years and 8 months, being 10 females and 8 males. The Levene's test showed statistical evidences of likeness among the groups. Statistical analysis was preceded and showedsignificant alterations (p < 0,005) in the variable indicatives of maxillary first molars' distance, overiet, upper arch totallength, upper arch anterior length, right molar relationship, left molarrelationship, right canine relationship and left canine relationship. On the other hand, there wasn't significant alteration related to the lower arch and maxillary intercanines distance. The Balters' Bionator appliance had a favorable effect in the improvement of the correctionof the malocclusion in Class II (foremost in molars and canines relationship) and transversal increase of the upper arch, mainly in the posterior area of arch.

Prevalência das más oclusões em crianças na Clínica de Graduação da Faculdade de Odontologia de Araraquara - UNESP / Prevalence of malocclusions in children in the Graduate Clinic of Araraquara College of Dentistry - UNESP

Este trabalho teve por objetivo avaliar em modelos de gesso as relações oclusais de crianças tratadas ou em tratamento ortodôntico na Clínica de Graduação da Faculdade de Odontologia de Araraquara - UNESP. Foram analisadas as relações verticais, ântero-posteriores e transversais dos modelos de estudo de 388 crianças por dois examinadores previamente calibrados. Os resultados foram analisados por meio de estatística descritiva e identificou-se maior prevalência de desvios da oclusão no sentido vertical seguido pelo desvio no sentido sagital e em menor prevalência no sentido transversal.

The aim of this study was to evaluate in dental models the occlusal relationship of children treated or in orthodontic treatment of the Undergraduate Clinic of Araraquara Dental School - UNESP. It was analyzed the vertical, anteroposterior and transversal relationships of the casts models of 388 children by two previous calibrated examiners. The results were analyzed by descriptive statistics and it was found higher prevalence of occlusal deviations in the vertical direction, followed by the sagital dimension and in lower prevalence of the transverse direction.