Influence of anxiety and catastrophizing on pain perception in orthodontic treatment and its association with inflammatory cytokines.

Pain is common in orthodontic treatment, is subject to individual variation, and is associated with anxiety and stress, which can potentially become catastrophizing. The aim of the present study was to determine the variability of pain response after the insertion of orthodontic separators and to assess the association of pain levels with dental anxiety, catastrophizing, tooth sensitivity, and genetic expression of cytokines. To this end, 70 patients of both genders were divided into two equal groups according to the elastomeric separator used: G1 (Dentaurum) and G2 (Orthometric). Two separators were inserted in the mesial and distal sides of the lower right first molar. Participants were instructed to rate the level of pain at T0 (before insertion), T1 (just after insertion), and T2 (24 hours after insertion) on a visual analog scale. The gingival crevicular fluid was collected at T0 and T2. The levels of anxiety, catastrophizing, tooth sensitivity, and cytokine expression were also assessed. Statistical analysis was performed with the Fisher-Freeman-Halton, chi-squared, Spearman's correlation, and dependent and independent t tests (α=5%). Pain intensity was higher at T2 than at T1, in both groups (P<.05). An association was established (P<.05) between pain intensity at T1 and catastrophizing, and at T2 with anxiety and catastrophizing. Within-group differences in cytokine expression were found between T0 and T2. There was no correlation between cytokine expression and pain levels, anxiety, catastrophizing, and sensitivity at T2. Tooth separation produced variable pain levels, which were influenced by anxiety and catastrophizing, however, pain level was not correlated with increased cytokine expression.

Influence of anxiety and catastrophizing on pain perception in orthodontic treatment and its association with inflammatory cytokines

Abstract Pain is common in orthodontic treatment, is subject to individual variation, and is associated with anxiety and stress, which can potentially become catastrophizing. The aim of the present study was to determine the variability of pain response after the insertion of orthodontic separators and to assess the association of pain levels with dental anxiety, catastrophizing, tooth sensitivity, and genetic expression of cytokines. To this end, 70 patients of both genders were divided into two equal groups according to the elastomeric separator used: G1 (Dentaurum) and G2 (Orthometric). Two separators were inserted in the mesial and distal sides of the lower right first molar. Participants were instructed to rate the level of pain at T0 (before insertion), T1 (just after insertion), and T2 (24 hours after insertion) on a visual analog scale. The gingival crevicular fluid was collected at T0 and T2. The levels of anxiety, catastrophizing, tooth sensitivity, and cytokine expression were also assessed. Statistical analysis was performed with the Fisher-Freeman-Halton, chi-squared, Spearman's correlation, and dependent and independent t tests (α=5%). Pain intensity was higher at T2 than at T1, in both groups (P<.05). An association was established (P<.05) between pain intensity at T1 and catastrophizing, and at T2 with anxiety and catastrophizing. Within-group differences in cytokine expression were found between T0 and T2. There was no correlation between cytokine expression and pain levels, anxiety, catastrophizing, and sensitivity at T2. Tooth separation produced variable pain levels, which were influenced by anxiety and catastrophizing, however, pain level was not correlated with increased cytokine expression.

Evaluating changes in the color and luminosity of dental enamel after orthodontic treatment: A clinical study.

The aims of this clinical study were to evaluate the Color change - ΔE (based on spectrophotometry and visual analysis) and luminosity - L* (based on spectrophotometry) of dental enamel surface (after orthodontic treatment) around the area where orthodontic brackets were fixed, based on different cementing materials such as a resin (R group) and resin-modified glass ionomer cement (RMGIC group). The split-mouth study initially comprised 14 patients. Orthodontic brackets were fixed to the upper central incisors with resin or RMGIC. The color of the buccal surface of each tooth was measured through spectrophotometry and visual examination before the bracket-fixation process. Four individuals were excluded during the follow-up; thus 10 patients were evaluated (n=10). Brackets were removed after 12 months of orthodontic treatment, tooth color measurement and visual examination were performed again, and Adhesive Remaining Index (ARI) was also measured. ΔE and L* results were subjected to Student's t-test and by repeated-measures analysis of variance, respectively (α=0.05). ARI data were analyzed in percentages. There was statistically significant difference in ΔE between groups; the R group showed statistically higher values of L* after orthodontic treatment. ARI of 2 and 3 prevailed in the RMGIC group, whereas the R group presented 0 and 1. After orthodontic treatment, the RMGIC group presented smaller changes in ΔE, and the increase in the white scale was observed on the enamel surface around the area where brackets were fixed in the R group. The visual analysis did not show color change on the evaluated teeth.

Evaluating changes in the color and luminosity of dental enamel after orthodontic treatment: A clinical study

Abstract The aims of this clinical study were to evaluate the Color change - ΔE (based on spectrophotometry and visual analysis) and luminosity - L* (based on spectrophotometry) of dental enamel surface (after orthodontic treatment) around the area where orthodontic brackets were fixed, based on different cementing materials such as a resin (R group) and resin-modified glass ionomer cement (RMGIC group). The split-mouth study initially comprised 14 patients. Orthodontic brackets were fixed to the upper central incisors with resin or RMGIC. The color of the buccal surface of each tooth was measured through spectrophotometry and visual examination before the bracket-fixation process. Four individuals were excluded during the follow-up; thus 10 patients were evaluated (n=10). Brackets were removed after 12 months of orthodontic treatment, tooth color measurement and visual examination were performed again, and Adhesive Remaining Index (ARI) was also measured. ΔE and L* results were subjected to Student's t-test and by repeated-measures analysis of variance, respectively (α=0.05). ARI data were analyzed in percentages. There was statistically significant difference in ΔE between groups; the R group showed statistically higher values of L* after orthodontic treatment. ARI of 2 and 3 prevailed in the RMGIC group, whereas the R group presented 0 and 1. After orthodontic treatment, the RMGIC group presented smaller changes in ΔE, and the increase in the white scale was observed on the enamel surface around the area where brackets were fixed in the R group. The visual analysis did not show color change on the evaluated teeth.

Resumo Os objetivos deste estudo clínico foram avaliar a alteração de cor - ΔE (baseada em espectrofotometria e análise visual) e luminosidade - L* (baseada em espectrofotometria) da superfície do esmalte dentário (após tratamento ortodôntico) ao redor da área onde os braquetes ortodônticos foram fixados, com base em diferentes materiais de cimentação, como resina (grupo R) e cimento de ionômero de vidro modificado por resina (grupo RMGIC). Estudo boca dividida foi inicialmente composto por 14 pacientes. Os braquetes ortodônticos foram fixados nos incisivos centrais superiores com resina ou RMGIC. A cor da superfície vestibular de cada dente foi mensurada por espectrofotometria e avaliada por exame visual antes do processo de fixação dos braquetes. Quatro indivíduos foram excluídos durante o acompanhamento; assim, 10 pacientes foram avaliados (n=10). Os braquetes foram removidos após 12 meses de tratamento ortodôntico, a mensuração da cor do dente e o exame visual foram realizados novamente, e o Índice de Remanescente do Adesivo (IRA) também foi mensurado. Os resultados ΔE e L* foram submetidos ao teste t de Student e à análise de variância para medidas repetidas, respectivamente (α=0.05). Os dados do ARI foram analisados em porcentagens. Houve diferença estatisticamente significativa no ΔE entre os grupos; o grupo R apresentou valores estatisticamente maiores de L* após o tratamento ortodôntico. O IRA 2 e 3 prevaleceu no grupo RMGIC, enquanto o grupo R apresentou 0 e 1. Após o tratamento ortodôntico, o grupo RMGIC apresentou menores alterações no ΔE e o aumento da escala branca foi observado na superfície do esmalte ao redor da área onde os braquetes foram fixados no grupo R. A análise visual não mostrou mudança de cor nos dentes avaliados.

Supernumerary: the Importance of Early Orthodontic Treatment / Supranumerário: a Importância do Tratamento Ortodôntico Precoce

The presence of supernumeraries may lead to irruptive problems, such as impacted teeth, functional and aesthetic disorders. The present study describes two clinical cases, with anterior teeth eruption disorders caused by additional dental elements, treated early. Patients presented with aesthetic involvement, with delay in the emergence of the upper incisors. The clinical and radiographic examinations detected the presence of obstacles to the teeth eruption. Early treatment with 2x4 appliance was realized, followed by final corrective orthodontics. After restoration of the dimension for retained teeth, there was spontaneous eruption in clinical case 1 and need of traction in clinical case 2. When patients reached the complete permanent dentition, a corrective phase was performed with the objective of detailing the dental occlusion and finishing the treatment. The early diagnosis of teeth impacted and supernumerary, provide the achievement of adequate occlusion and positive aesthetic of patients, with good prognosis, avoiding psychological and functional problems caused by absence of anterior teeth. (AU).

A presença de supranumerários pode ocasionar problemas irruptivos, como impacção de dentes, desordens funcionais e estéticas. O presente trabalho descreve dois casos clínicos abordados precocemente, com alterações na irrupção de dentes anteriores devido a presença de supranumerários. Os pacientes apresentavam queixas estéticas, com atraso no aparecimento dos incisivos superiores. Os exames clínico e radiográfico detectaram a presença de barreiras irruptivas. Realizou-se tratamento precoce com auxílio da mecânica 4x2, seguido pela ortodontia corretiva final. Após etapa de restabelecimento da dimensão para os dentes retidos, houve irrompimento espontâneo no caso clínico 1 e necessidade de tracionamento no caso clínico 2. Quando pacientes atingiram a dentição permanente completa, realizou-se uma fase corretiva com o objetivo de detalhamento da oclusão dentária e finalização do tratamento. O diagnóstico precoce de impacção dentária e detecção de supranumerários favoreceu a restituição de oclusão adequada e estética dos pacientes, com prognóstico muito favorável, evitando problemas psicológicos e funcionais provocados pela ausência de dentes anteriores. (AU).

Slot 0, 018" ou 0,022": por que existem duas opções ? Um guia para a escolha / The 0.018" or 0.022" slot systems: why two options are available? A guide for indications

The first Edgewise brackets were utilized with gold wire and the slot designed with 0.022" high to present sufficient rigidity. When gold was replaced by stainless steel, cheaper and stiffer, it was proposed to reduce the slot size to 0.018". The two different sizes of brackets are used in contemporary orthodontics and many clinical orthodontists are unaware of the advantages they may have. The aim of this paper is to present, based on the orthodontic literature, the main characteristics influenced by the brackets slot size and compile data to drive orthodontists in choosing the bracket that best meets their clinical needs.

Os primeiros braquetes Edgewise eram utilizados com fios de ouro e concebidos com o slot de 0,022" de altura, para que apresentassem rigidez suficiente. Com a substituição do ouro pelo aço inoxidável, mais barato e mais rígido, foi proposta a redução do slot para 0,018". As duas diferentes dimensões de braquetes são utilizadas na Ortodontia contemporânea e muitos ortodontistas clínicos desconhecem suas vantagens. O objetivo deste artigo foi apresentar, baseando-se na literatura ortodôntica, as principais características influenciadas pelo tamanho do slot dos braquetes e compilar os dados para direcionar o ortodontista na escolha do braquete que melhor atenda às suas necessidades clínicas.

Tratamento interdisciplinar da agenesia dos incisivos laterais superiores: interação entre Ortodontia, Implantodontia e Prótese / Interdisciplinary treatment of agenesis of the maxillary lateral incisors: interaction between Orthodontics, Implantology and Prosthesis

Atualmente, a busca pela estética tem aumentado a procura por tratamento ortodôntico na população adulta. A agenesia dentária tem uma grande influência na estética do sorriso. Consequentemente, na harmonia da face, a ausência dos incisivos laterais contribui de maneira significativa. Dentre as várias formas de tratamento, pode-se optar pelo fechamento de espaço, com substituição do incisivo lateral pelo canino ou abertura de espaço para uma posterior reabilitação implantoprotética. Neste artigo, foi descrito o tratamento da agenesia dos incisivos laterais superiores e revisadas na literatura as suas possibilidades de tratamento, com enfoque na abertura do espaço associado ao planejamento 3D e reabilitação estética através da reabilitação implantoprotética

Nowadays, the seek for aesthetics has been the subject of increased demand for orthodontic treatment in adults. The tooth agenesis has a great influence on the smile esthetics and consequently the harmony of the face, which is significantly affected by the absence of lateral incisors. Among the various treatment forms, the clinician can decide for space closure with replacement of the lateral incisor or canine space opening for later prosthetic implant rehabilitation. In this article we described the treatment of agenesis of the maxillary lateral incisors and made a literature review about the treatment options, focusing on space opening associated with the planning and 3-D aesthetic management through the prosthetic implant rehabilitatio

Estímulos vibratórios como acelerador de movimento na clínica diária. Já sabemos o suficiente? / Vibratory stimuli with the movement accelerator on the daily practice. How far we know?

O desejo de ter um tratamento ortodôntico mais rápido é comum a pacientes e profissionais, e muitos meios para acelerar o movimento dentário têm sido pesquisado em todo o mundo. Um dos recursos mais publicitados, se fundamenta na aplicação de estímulos vibratórios nos dentes para induzir uma resposta biológica mais rápida. Desta forma, este artigo objetivou discutir, através de revisão crítica da literatura atual se há segurança na aplicação deste estímulo na clínica diária.

The desire to have a short-term orthodontic treatment is common to both patients and orthodontists and many ways to accelerate tooth movement has been researched around the world. One of the most publicized ways is based on the application of vibratory stimuli to the teeth to induce faster biological response. The authors conducted a critical review of the current literature aiming to clarify whether is safety in the application of this stimulus in everyday practice.