Impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults : A cross-sectional study.

PURPOSE: The aim of this study was to investigate the impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults. METHODS: A cross-sectional study was conducted with a sample of 213 young adults aged 18-30 years. Dental occlusion data were assessed through clinical examination. A questionnaire was used to collect data on oral habits. Outcomes were collected using the Oral Health Impact Profile (OHIP-14) and Mini Sleep Questionnaire. RESULTS: Anterior open bite (adjusted odds ratio [OR] = 2.41, 95% confidence interval [CI] = 1.02-5.67, p = 0.044), swallowing disorders (adjusted OR = 2.39, 95% CI = 1.13-5.05, p = 0.022), and sleeping on hands were associated with a negative impact on oral health-related quality of life. Females (adjusted OR = 2.61, 95% CI = 1.10-6.17, p = 0.029), teeth grinding (adjusted OR = 2.78, 95% CI = 1.08-7.14, p = 0.034), biting lips or cheeks (adjusted OR = 4.28, 95% CI = 1.49-12.29, p = 0.007), and self-perception of need for orthodontic treatment (adjusted OR = 7.88, 95% CI = 2.12-29.30, p = 0.002) were associated as a risk for sleep disturbances. CONCLUSION: The findings suggest that oral habits and some types of malocclusions can impact oral health-related quality of life. In addition, sleep disturbances were associated with a greater need for orthodontic treatment and a habit of grinding teeth in young adults.

Occlusal Plane, Mandibular Position and Dentoalveolar Changes during the Orthodontic Treatment with the Use of Mini-Screws.

This study aimed to describe the changes produced on the occlusal plane (OP), the mandibular position and the dentoalveolar compensations of patients with distalization of the maxillary/mandibular arch assisted by mini-screws (MS). A descriptive case-series study was performed using the digital lateral cephalograms (DLC) of nine patients who underwent orthodontic treatment and required the use of MS for a complete distalization of the maxillary/mandibular arch. Records were collected at three different times (T1-T2-T3) and digitally analyzed (variables: Skeletal diagnosis; maxillary occlusal plane; position of the maxilla/mandible; and dentoalveolar changes of the distalization arch tracing the longitudinal axis of incisors/molars regarding the palatal/mandibular plane). Findings show that the OP varied from T1-T2-T3 in all cases, indicating its stepping or flattening. ODI, APDI, SNA, SNB, and ANB changed minimally in all cases, without variations in the mandibular position or in the skeletal diagnosis. Dentoalveolar measurements also showed differences between T1-T2-T3. In summary, conventional orthodontic treatment modified the OP during the first phase of treatment. Moreover, the distalization mechanics with MS changed the OP and produced dentoalveolar changes, mainly in the inclination of incisors and molars. Other measures considered in the study did not change substantially.

Aspectos clinicoepidemiológicos de adultos con guía anterior de la oclusión dentaria disfuncional

Introducción: Los dientes anteriores tienen una función predominante en el sistema estomatognático, esencial para la estética, la fonación y la masticación. Objetivo: Caracterizar a los adultos con guía anterior de la oclusión dentaria disfuncional según variables clínicas y epidemiológicas. Métodos: Se realizó un estudio descriptivo y transversal, desde octubre de 2021 hasta abril de 2022, en la Clínica Estomatológica Docente 3 de Octubre de Las Tunas. El universo estuvo conformado por 825 historias clínicas que contenían el diagnóstico de pacientes con bruxismo, oclusión traumática y trastornos temporomandibulares, quienes presentaban disfunción de la guía anterior de la oclusión dentaria. Mediante el muestreo no probabilístico intencional, fue seleccionada una muestra de 615 con fórmula dentaria íntegra o desdentamiento parcial de clase III de Kennedy y atención estomatológica concluida o inactivación de los procesos de caries e inflamatorios agudos. Resultados: Primaron el sexo femenino (54,8 %) y las edades de 40-49 años (33,5 %). El bruxismo prevaleció como diagnóstico clínico (41,9 %) con predominio del correspondiente al sueño (39,1 %), el secundario (51,2 %), el probable (59,7 %) y el moderado (69,4 %); entre sus clasificaciones más relevantes se destacó el sistema estomatognático disfuncional (84,4 %). Las manifestaciones clínicas dentarias predominantes fueron las facetas de desgaste (87,5 %). Conclusiones: La caracterización de los pacientes con guía anterior de la oclusión dentaria disfuncional permite establecer una panorámica actualizada de esta problemática de salud para un mejor seguimiento y tratamiento a dichos pacientes.

Introduction: Anterior teeth have a predominant function in the stomatognatic system, essential for the aesthetics, phonation and mastication. Objective: To characterize adults with anterior guide of dysfunctional dental occlusion according to clinical and epidemiological variables. Methods: A descriptive and cross-sectional study, was carried out from October, 2021 to April, 2022, in the 3 de Octubre Teaching Stomatological Clinic from Las Tunas. The universe was formed by 825 medical records that contained the diagnosis of patients with bruxism, traumatic occlusion and temporomandibular disorders who presented anterior guide of the dysfunctional dental occlusion. By means of the intentional non probabilistic sampling, a sample of 615 with entire dental formula or class III partial toothlessness of Kennedy and concluded stomatologic care or inactivation of the cavity and acute inflammatory processes was selected. Results: There was a prevalence of the female sex (54.8%) and the 40-49 age group (33.5%). Bruxism prevailed as clinical diagnosis (41.9%) with prevalence of the corresponding to sleep (39.1%), secondary (51.2%), probable (59.7%) and moderate (69.4%); among the most outstanding classifications was the dysfunctional stomatognatic system (84.4%). The predominant dental clinical manifestations were the wear facets (87.5%). Conclusions: The characterization of patients with anterior guide of the dysfunctional dental occlusion allows to establish an up-to-date panoramic of this health problem, for a better follow-up and treatment to these patients.

Histological changes in pulp-dentin complex in tooth subjected to traumatic occlusion and subluxation.

Background: This study evaluated the influence of traumatic occlusion in the dentin-pulp complex a molar teeth submitted to subluxation. Material and methods: Ninety Wistar rats were divided into groups Naïve (N), Subluxation (S) and Subluxation with traumatic occlusion (STO) and submitted to histological analysis after 7 and 21 days. A quantitative analysis was submitted to one-way ANOVA and Tukey's post-hoc test, and Chi-square and Bonferronís post-hoc test. Results: S and STO showed a significant increase in blood vessels area (p < 0.0005), amorphous fundamental substance (p < 0.0005) and reactionary dentin formation (p < 0.0005), as well as a decrease in the nuclear profile (p < 0.0005), odontoblast layer (p = 0.013 and p < 0.0005) by day 7 when compared with N. These changes normalized by day 21, except for the reactionary dentin (p < 0.0005) in both S and STO groups. Interestingly, the STO group exhibited significant changes in the increase of pulp calcification (p < 0.0005), presence of tubules with nuclei (p < 0.0005), and inflammatory infiltrate (p < 0.0005), as well reduction of nuclear profile (p < 0.0005), odontoblast layer (p < 0.0005) compared with N and S at day 21. Conclusions: STO impaired the defence response and decreased pulp regeneration capacity by increasing the inflammatory infiltrate and pulp calcification, and decreasing the nucleated cell number in the odontoblast layer and central pulp.

Influence of the radius of Monson's sphere and excursive occlusal contacts on masticatory function of dentate subjects.

OBJECTIVE: To determine the influence of the radius of Monson's sphere, the number of posterior laterotrusive, mediotrusive, and protrusive contacts, and the chewing rate on food comminution. DESIGN: Sixty healthy dentate subjects, aged 21.22 ± 2.30 years, were selected. The three-dimensional coordinates of the cusp tips of the lower canine, premolar, and molar teeth were identified from the subjects' digital models. Monson's sphere was designed using the simplex method for function minimisation by adjusting the coordinates on its surface. The contacts were verified using 12 µm metal strips in jaw excursions at 0.5, 1.0, 2.0, and 3.0 mm. The masticatory performance and efficiency, swallowing threshold, and chewing rate were assessed through particle size fractionation. Data were analysed with multiple linear regression (α = 0.05). RESULTS: The sphere's radius, laterotrusive and protrusive contacts at 0.5 mm, and chewing rate were found to be negative predictor variables for masticatory performance until 20 chewing cycles (R2 = 0.429). For 40 cycles, the radius and total contacts (0.5 mm) were also explanatory factors (R2 = 0.223). Only the radius (R2 = 0.176) and the chewing rate (R2 = 0.082) were found to be significant for 60 cycles and swallowing threshold, respectively. Masticatory efficiency was influenced by masticatory performance until 40 and 60 cycles, as well as the radius and total contacts at 2.0 and 3.0 mm (R2 = 0.958). CONCLUSION: A larger radius of Monson's sphere and a greater number of posterior excursive contacts were found to be related to better masticatory function.

Effect of artificial eccentric occlusal interferences on masticatory performance: A randomised double-blind clinical trial.

BACKGROUND: Occlusal interferences lead to changes in mandibular kinematics to compensate and improve function. However, the effects of different types of eccentric disturbance on the comminution capacity are not known. OBJECTIVE: To determine the immediate effect of eccentric occlusal interferences on masticatory performance. METHODS: This crossover clinical trial included 12 healthy dentate subjects aged 25.2 ± 3.3 years who were randomly submitted to seven types of occlusal interference: unilateral and bilateral laterotrusive and mediotrusive, protrusive, dummy and control (no interference). The interference forms were planned in a semi-adjustable articulator, fabricated with composite resin and adhered to the mandibular first molars such that subjects' maximum intercuspation was maintained. Masticatory performance and the chewing rate during 20 cycles were evaluated during subjects' comminution of silicone test food under one interference condition per test day; the multiple sieve method was applied to the comminuted particles. The interference was removed upon test completion, and a 1-week washout period was applied between tests. RESULTS: Comminuted median particle sizes were larger under unilateral (4.94 ± 0.41 mm) and bilateral (4.81 ± 0.49 mm) laterotrusive, bilateral mediotrusive (4.65 ± 0.50 mm) and protrusive (4.83 ± 0.54 mm) interferences (p < .05) than under the control (4.01 ± 0.52 mm) and dummy (4.18 ± 0.58 mm) conditions (p < .05). Only unilateral and bilateral laterotrusive interferences narrowed the comminuted particle size dispersion (p < .05). The chewing rate did not differ among conditions (p = .1944). CONCLUSION: Artificial eccentric interferences had an immediate adverse effect on masticatory performance by resulting in larger comminuted particles. CLINICAL TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (RBR-8g5zfg8).

Three-dimensional analysis of posterior tooth inclinations in transverse and sagittal relationships: A cross-sectional study.

OBJECTIVE: To compare tooth inclinations in different sagittal skeletal patterns and transverse maxillary relationships three-dimensionally. METHODS: A cross-sectional study carried out with 132 three-dimensional digital models in the complete permanent dentition divided into six groups (n=22); three groups with maxillary atresia: G1- skeletal class I, G2- skeletal class II and G3-skeletal class III; three groups without maxillary atresia: G4- skeletal class I; G5- skeletal class II and G6- skeletal class III. The comparison between the skeletal pattern was performed by the non-parametric tests of Kruskal Wallis and Dunn and between the groups by the non-parametric test of Mann Whitney. RESULTS: Subjects with skeletal class II and maxillary atresia had a greater lingual inclination of the maxillary teeth than those with class I and III; Subjects with skeletal class II without atresia had a less lingual inclination of the mandibular molars than the other classes (p<0.05). The maxillary premolars showed no variation in dental inclination with atresia, independent of the skeletal class in G1, G2, and G3 (p>0.05). The mandibular premolars showed that the groups without atresia G4, G5, and G6 presented no significant difference (p>0.05). Lower premolars in skeletal class III malocclusion individuals with atresia had a more negative inclination than the others. CONCLUSION: There is a difference in the inclination of posterior teeth between individuals with and without maxillary atresia and skeletal classes I, II, and III.

Impact of Compensating Curves on Mastication of Complete Denture Wearers: A Randomised Triple-Blind Clinical Trial.

INTRODUCTION: The application of occlusal concepts in prosthodontics is still under debate.This study assessed the impact of compensating curves on the comminution of complete denture wearers. METHODS: Seven edentulous subjects, aged 64.6 ± 2.0 years, were rehabilitated with new muco-supported complete dentures and tested in two occlusal plane settings: with and without compensating curves. A randomised triple-blind clinical trial was conducted, considering one-week and one-month as adaptation periods for dentures. After each trial, the subjects were crossed over to their respective groups. One-week was also chosen as the washout period, and after that, the subjects were re-examined. The masticatory performance and swallowing threshold were determined while chewing Optocal test food. The multiple sieve method was used for fractionation and granulometry. RESULTS: During the masticatory performance and swallowing threshold estimates, no differences were found between the median particle sizes obtained with the both occlusal plane conditions (P ⟩ 0.05). However, the swallowing threshold improved after one month, resulting in smaller particle sizes. Moreover, the chewing rates for the both test foods were also increased (P ⟨ 0.05). CONCLUSIONS: These findings suggest that the compensating curves did not have an impact on the masticatory function of subjects wearing complete dentures.

Occlusion development after premature loss of deciduous anterior teeth: preliminary results of a 24-month prospective cohort study

ABSTRACT Objective: This study aimed to evaluate occlusion development after premature loss or extraction of deciduous anterior teeth, by means of a prospective cohort study. Methods: Fifteen infants and children aged 1 to 5 years old were longitudinally assessed (with loss or extraction of deciduous anterior teeth [n = 9], and without tooth losses [n = 6]). Photographs and dental casts at the baseline and after 24 months of follow-up were performed. Dental casts were scanned, and linear measurements were made on the digitalized models (missing tooth space, arch perimeter, arch length, arch width, intercanine length and intercanine width). The t-test was used for groups comparisons (α = 0.05). Results: Individuals' mean age at baseline was 2.93 (± 1.18) years. No statistically significant differences were observed in the missing tooth space in the group with tooth loss during the 24 months of follow-up (p > 0.05). Arch perimeter, arch length, arch width, intercanine length and intercanine width did not show differences between the groups (p > 0.05). Qualitative photographic evaluation revealed other changes in the dental arches and occlusion, such as exfoliation and eruption of deciduous teeth, eruption of permanent teeth, self-correction or establishment of malocclusion, among others. Conclusion: The results suggest that the premature loss of deciduous anterior teeth does not affect the perimeter, length and width of the dental arches; however, other alterations that lead to malocclusion could be established.

RESUMO Objetivo: Este estudo teve como objetivo avaliar o desenvolvimento da oclusão após perda prematura ou extração de dentes decíduos anteriores, por meio de um estudo de coorte prospectivo. Métodos: Quinze bebês e crianças de 1 a 5 anos foram avaliados longitudinalmente (com perda ou extração de dentes anteriores decíduos [n = 9] e sem perdas dentárias [n = 6]). Foram realizadas fotografias e modelos dentais no início e após 24 meses de acompanhamento. Os modelos dentários foram escaneados e medidas lineares foram feitas nos modelos digitalizados (espaço dentário perdido, perímetro da arcada, comprimento da arcada, largura da arcada, comprimento intercaninos e largura intercaninos). O teste t foi utilizado para comparações entre grupos (α = 0,05). Resultados: A média de idade dos indivíduos no início do estudo foi de 2,93 (± 1,18) anos. Não foram observadas diferenças estatisticamente significativas no espaço dentário perdido no grupo com perda dentária durante os 24 meses de acompanhamento (p > 0,05). O perímetro da arcada, comprimento da arcada, largura da arcada, comprimento intercaninos e largura intercaninos não apresentaram diferenças entre os grupos (p> 0,05). A avaliação fotográfica qualitativa revelou alterações nas arcadas dentárias e na oclusão, como: esfoliação e erupção de dentes decíduos, erupção de dentes permanentes, autocorreção ou estabelecimento de má oclusão, entre outras. Conclusão: Os resultados sugerem que a perda prematura de dentes anteriores decíduos não afeta o perímetro, comprimento e largura das arcadas dentárias; entretanto, outras alterações que levam à má oclusão poderiam ser estabelecidas.

Erich arch bars vs intermaxillary fixation screws for mandibular fracture reduction during ORIF: a randomized clinical trial.

OBJECTIVE: This randomized clinical trial aimed to compare the efficacy of Erich arch bars (EAB) and intermaxillary fixation (IMF) screws in reducing mandibular fractures during open reduction and internal fixation (ORIF). METHODS: A total of 28 patients with mandibular fractures were randomly allocated to either the EAB group or the IMF screws group. The study evaluated various parameters including occlusal stability, complications, duration of application, oral hygiene status, quality of life, and patient characteristics. RESULTS: The study found no significant differences in occlusal stability between the EAB and IMF screw groups. However, the application and removal times were longer for EAB compared to IMF screws. The EAB group showed a higher presence of biofilm on teeth, indicating poorer oral hygiene status compared to the IMF screws group. In terms of quality of life, patients in the EAB group reported worse results in the "handicap" domain at the 15th postoperative day. No significant differences were observed in other quality-of-life parameters. Patient characteristics were well distributed between the two groups, enhancing the reliability of the results. CONCLUSION: Both EAB and IMF screws demonstrated comparable occlusal stability for minimally displaced mandibular fractures. However, IMF screws offered advantages such as shorter application and removal times, better oral hygiene maintenance, and potentially improved quality of life in the "handicap" domain. Further studies with larger sample sizes are necessary to validate these findings and explore the stability of IMF methods in cases requiring postoperative malocclusion correction or prolonged IMF.

Noncarious cervical lesions in the aging population analyzed through digital scanning: occlusal risk factors, dimensions, and morphology.

OBJECTIVES: To evaluate noncarious cervical lesions (NCCL) in older adults by analyzing each lesion's morphology, dimension, and occlusal risk factors using intraoral scanning and clinical evaluation. MATERIALS AND METHODS: Individuals over 60 treated at the School of Dentistry in Minas Gerais, Brazil, were invited to participate in this cross-sectional study. We clinically evaluated 1245 teeth for the presence of NCCL and dentin hypersensitivity (DH) in 53 individuals. Three-dimensional models were obtained using Omnicam, and occlusal risk factors were evaluated through the presence of wear facets, intense occlusal contacts, and interferences. The 3Shape 3DViewer software was used to classify NCCL morphology and to measure their height. NCCL depth, width, and area measurements were determined using ImageJ. Descriptive analyses were performed. The Kolmogorov-Smirnov test showed that quantitative data exhibited non-normal distribution. For bivariate analyses of quantitative data, the Mann-Whitney test was employed. The results were reported with mean, standard deviation, median, minimum, and maximum. For bivariate analyses of categorical data, the Pearson chi-square test was used. The results were reported with frequencies (counts) and percentages. A regression model evaluating the association between occlusal risk factors and the absence/presence of NCCL was built. RESULTS: Most participants were female (58.5%), with a mean age of 66. The frequency of NCCL was 28.27%, corresponding to 352 teeth. Of these, 68.18% exhibited saucer morphology and 31.82% wedge-shaped morphology. The frequency of DH was 13.92% in teeth with NCCL. Saucer NCCL exhibited significantly greater height (p = 0.02), while wedge-shaped lesions showed greater depth (p < 0.001). Also, teeth with NCCL had a higher proportion of wear facets (66.8%; p < 0.001), intense occlusal contacts (39.8%; p = 0.008), and occlusal interferences (21.9%; p = 0.05). The regression model showed that teeth with wear facets were 1.50 times more likely to exhibit NCCL than teeth without wear facets (p < 0.001). Teeth with intense occlusal contact were 1.22 times more likely to exhibit NCCL than teeth without intense occlusal contact (p = 0.031). CONCLUSIONS: NCCL is a common dental condition in the older adults evaluated in this study. Wedge-shaped NCCL exhibited greater depth, while saucer NCCL had more expressive height. Occlusal risk factors may represent a crucial mechanism for the occurrence of NCCL in this population. CLINICAL RELEVANCE: Understanding the mechanisms involved in developing NCCL is helpful in diagnostic and preventive practices. The study showed the importance of dental occlusion and characteristics of different NCCL morphologies that help the clinician in decision-making.

Técnicas de montagem em articulador para confecção de placas oclusais pelo fluxo digital: efeito no tempo de trabalho / Articulator assembly techniques for manufacturing occlusal splints using digital flow: effect on working time

Objetivo: Avaliar a influência de diferentes tipos de registros interoclusais e técnicas de montagem em articulador virtual no tempo de confecção clínico e laboratorial de placas oclusais estabilizadoras confeccionadas por fluxo de trabalho digital (CAD/CAM). Metodologia: Trata-se de um ensaio clínico, onde a amostra foi constituída por 30 pacientes com diagnóstico de um provável bruxismo do sono, os quais foram randomizados aleatoriamente em dois grupos de acordo com a técnica de montagem do modelo no articulador virtual: GP (grupo plano horizontal) e GM (grupo mesa de camper). Também foram avaliados três diferentes tipos de registros interoclusais para confecção de placas oclusais impressas, sendo: "máxima intercuspidação habitual" (MIH), "dispositivo anterior de registro" (DAR) e "palhetas oclusais"; e as técnicas de desenho das placas oclusais sendo essas etapas subdivididas em suavização e delimitação, montagem do modelo do modelo superior no articulador (variando em plano horizontal e mesa de camper), desenho da placa e ajustes finais. A partir disso, foram analisados os tempos (em minutos e segundos) necessários para a realização das etapas clínicas e laboratoriais (etapas CAD ­ obtenção dos arquivos e desenho da placa). Os dados foram avaliados estatisticamente pelos testes T, ANOVA e Tukey pelo software Statistical Package for Social Sciences 22.0. Resultados: Observou-se diferença estatística no tempo de registro interoclusal, onde MIH (47,94seg) e palheta (01:03,01min) foram realizados em um menor tempo quando comparado com o DAR (03:09,26min) (<0,001). O tempo da etapa de montagem no articulador foi estatisticamente maior quando o registro foi realizado em MIH e a montagem foi realizada levantando no pino no articulador (01:59,62min), comparando ao DAR (01:07,82min) e a palheta (01:06,43min) (<0,001), apresentando também diferença no tempo de desenho (p=0,045) e tempo total das etapas (p=0,033). Conclusão: Dentro das limitações do estudo, pode-se afirmar que utilizar a palheta oclusal ou registrar em MIH apresentaram um menor tempo clínico quando comparada à técnica do DAR. Levantar o pino no articulador levou a um maior tempo de montagem dos modelos, independente do modelo ter sido montado no plano horizontal ou na mesa de camper, aumentado o tempo na etapa CAD (AU).

Objective: To evaluate the influence of different types of interocclusal registrations and assembly techniques in a virtual articulator on the clinical and laboratory preparation time of stabilizing occlusal splints made by digital workflow (CAD/CAM). Methodology: This is a clinical trial, where the sample consisted of 30 patients diagnosed with sleep bruxism, who were randomly randomized into two groups according to the technique of mounting the model on the articulator virtual: GP (flat horizontal group) and GM (camper's table group). Three different types of interocclusal records were also evaluated for making printed occlusal plates, namely: "maximum habitual intercuspation" (MIH), "anterior recording device" (DAR) and "occlusal reeds"; and the techniques for designing the occlusal splints, these steps being subdivided into smoothing and delimitation, mounting the model of the upper model on the articulator (varying in the horizontal plane and camper's table), designing the plate and final adjustments. Based on this, the times (in minutes and seconds) required to perform the clinical and laboratory steps were analyzed. Data were statistically evaluated by T, ANOVA and Tukey tests using the Statistical Package for Social Sciences 22.0 software. Results: There was a statistical difference in the time of interocclusal registration, where MIH (47.94sec) and reed (01:03.01min) were performed in a shorter time when compared to the DAR (03:09.26min) (<0.001 ). The time of the assembly step on the articulator was statistically longer when the registration was performed in MIH and the assembly was performed by lifting the pin on the articulator (01:59.62min), comparing to the DAR (01:07.82min) and the reed (01:07.82min) 01: 06.43min) (<0.001), also showing difference in design (p=0.045) and total time of steps (p=0.033). Conclusion: Within the limitations of the study, it can be stated that using the occlusal palette or registering in MIH demonstrated a shorter clinical time when detected using the RAD technique. Lifting the pin on the articulator led to a longer time to assemble the models, regardless of whether the model was mounted in the horizontal plane or on the camper's table, it increased the time in the CAD step (AU).

Knowledge, Attitudes, and Practices on New Treatment Modalities for Temporomandibular Dysfunctions and Orofacial Pain / Conocimientos, Actitudes y Prácticas sobre Nuevas Nodalidades de Tratamiento de las Disfunciones Tempomanibulares y el Dolor Orofacial

The present study proposed to describe, through a literature review, the use of new therapeutic management which allows for offering a better quality of life to individuals affected by these pathologies. A bibliographic search was conducted in the main health databases PUBMED (www.pubmed.gov) and Scholar Google (www.scholar.google.com.br), in which studies published from 1987 to 2023 were collected. In the first stage, the list of retrieved articles was examined by reading the titles and abstracts. In the second stage, the studies were selected by reading the full contents. Two authors (JDMM and DAQ) performed stages 1 and 2. Experimental, clinical, case-control, randomized controlled, and laboratory cohort studies, case reports, systematic reviews, and literature reviews, which were developed in living individuals, were included. Therefore, articles that did not deal with the subject in question, letters to the editor, opinion articles, duplicated literature in databases, and literature that did not address the variables under study, we re excluded. Contemporary dentistry uses alternative treatments capable of improving the patient's condition since a cure is not always possible. Therefore, the possibility of improving the quality of life becomes an important point to be reached. Evidence-based healthcare has made great advances in recent decades, especially in the areas of orofacial pain, TMD, and occlusion, especially related to orthodontic, prosthetic, and restorative care.

En el presente estudio se propuso describir, a través de una revisión bibliográfica, el uso de nuevos manejos terapéuticos que permitan brindar una mejor calidad de vida a los individuos afectados por estas patologías. Se realizó una búsqueda bibliográfica en las principales bases de datos de salud PUBMED (www.pubmed.gov) y Scholar Google (www.scholar.google.com.br), en las que se recopilaron estudios publicados entre 1987 y 2023. En la primera etapa, se examinó la lista de artículos recuperados mediante la lectura de los títulos y resúmenes. En la segunda etapa, los estudios fueron seleccionados mediante la lectura del contenido completo. Dos autores (JDMM y DAQ) realizaron las etapas 1 y 2. Se incluyeron estudios de cohortes experimentales, clínicos, de casos y controles, controlados aleatorios y de laboratorio, informes de casos, revisiones sistemáticas y revisiones de la literatura, que se desarrollaron en individuos vivos. Por lo tanto, se excluyeron artículos que no trataran el tema en cuestión, cartas al editor, artículos de opinión, literatura duplicada en bases de datos y literatura que no abordara las variables en estudio. La odontología contemporánea utiliza tratamientos alternativos capaces de mejorar el estado del paciente, ya que no siempre es posible la curación. Por lo tanto, la posibilidad de mejorar la calidad de vida se convierte en un objetivo importante. La atención médica basada en la evidencia ha logrado grandes avances en las últimas décadas, especialmente en las áreas de dolor orofacial, TMD y oclusión, especialmente en relación con la atención de ortodoncia, prótesis y restauración.

[Dental occlusal disruptor as a strategy to moderate caloric intake: two case report]. / Disruptor oclusal dental como estrategia para moderar ingesta calórica: reporte de dos casos.

Background: Obesity is a global public health challenge, closely related with the progression of other diseases. In recent years, odontology has intervened against obesity through the implementation of intraoral devices that contribute with weight control treatments. Objective: To study the use of a dental occlusal disruptor as a strategy to moderate caloric intake. Material and methods: Pilot study which included 2 patients. It was used a dental occlusal disruptor that has an impact on the smaller amount of food at each bite. Patients attended five appointments in which a stomatological evaluation was carried out and anthropometric measurements were taken. All adverse effects were reported in each patient's clinical history. Results: Patients presented weight and body fat loss, increased muscle mass and decreased both body mass index and waist and hip measurements. Conclusions: The use of the disruptor does not alter the stomatological assessment, it promotes masticatory regulation and the decrease in body weight. It is necessary to analyze its use in a larger number of patients.

Introducción: la obesidad es un reto para la salud pública mundial y está relacionada con la aparición y progresión de diversas enfermedades. En los últimos años, la odontología ha intervenido en el combate a la obesidad mediante la implementación de aditamentos intraorales que coadyuvan en el tratamiento del control de peso. Objetivo: estudiar el uso de un disruptor oclusal dental como estrategia para moderar la ingesta calórica. Material y métodos: estudio piloto que incluyó 2 pacientes. Se empleó un disruptor oclusal dental que incide en que la cantidad de alimento en cada bocado sea menor. Los pacientes acudieron a 5 citas para valoración estomatológica y toma de medidas antropométricas. Se reportaron todos los efectos adversos en la historia clínica de cada paciente. Resultados: ambos pacientes presentaron pérdida de peso y de grasa corporal, aumento de masa muscular y disminución tanto del índice de masa corporal como de mediciones de cintura y cadera. Conclusiones: el uso del disruptor no altera la valoración estomatológica, propicia la regulación masticatoria y promueve la disminución del peso corporal. Es necesario analizar su uso en mayor número de pacientes.

Frecuencia y distribución de los diagnósticos de los desórdenes funcionales oclusales en pacientes atendidos en la Clínica Dental Docente de la Universidad Peruana Cayetano Heredia / Frequency and Distribution of Diagnoses of Functional Occlusal Disorders among Patients Treated at the Teaching Dental Clinic of the Peruvian Cayetano Heredia University

RESUMEN Objetivo : El objetivo del presente estudio es determinar la frecuencia y distribución de los diagnósticos de los desórdenes funcionales oclusales en los pacientes atendidos en pregrado y posgrado de Rehabilitación Oral de la Clínica Dental Docente de la Universidad Peruana Cayetano Heredia, durante los años 2016 y 2017. Material y métodos : La investigación es descriptiva, retrospectiva, observacional y transversal. Las variables son los diagnósticos de los desórdenes funcionales oclusales, clasificados por género, edad, nivel de estudio y sede. Se empleó la base de datos de todas las historias clínicas digitalizadas con presentación de caso planificada y aceptada por el docente tutor y acta de compromiso aceptada por el paciente. Resultados : Se encontró que el diagnóstico con mayor porcentaje fue el de oclusión colapsada con 38,69 % (n = 166); en segundo lugar, se diagnosticó la desarmonía oclusal con 36,13 % (n = 155); luego sigue el diagnóstico de colapso posterior de mordida con 10,72 % (n = 46); el diagnóstico de edéntulo total superior e inferior alcanzó 7,69 % (n = 33); oclusión traumática, 5,83 % (n = 25); y la menor frecuencia la tiene el síndrome de combinación con 0,93 % (n = 4). Conclusiones : Del total de pacientes (n = 429), el género con mayor frecuencia fue el sexo femenino. La edad promedio fue de 56,79 años, encontrándose el mayor porcentaje de pacientes evaluados entre los 60 y 69 años de edad. Los estudiantes de pregrado fueron los que asignaron la mayor cantidad de diagnósticos. La sede de San Martín de Porres fue donde se realizaron la mayor cantidad de diagnósticos de pacientes.

ABSTRACT Objective : The objective of the present study was to determine the frequency and distribution of diagnoses of functional occlusal disorders among patients treated in undergraduate and postgraduate oral rehabilitation at the Teaching Dental Clinic of the Peruvian Cayetano Heredia University between 2016 and 2017. Material and methods : The research was descriptive, retrospective, observational, and cross-sectional. The variables considered were the diagnoses of functional occlusal disorders, classifying them by gender, age, educational level, and location. A database comprising all digitized medical records was used with a case presentation planned and accepted by the tutoring teacher and a certificate of commitment accepted by the patient. Results : It was found that the most common diagnosis was collapsed occlusion (38.69% of diagnoses, n = 166), followed by occlusal disharmony (36.13%, n = 155), posterior bite collapse (10.72%, n = 46), upper and lower total edentulous (7.69%, n = 33), traumatic occlusion (5.83%, n = 25), and the combination syndrome (0.93%, n = 4). Conclusions : Most of the patients analyzed (n = 429) were women. The average age was 56.79 years, with most patients analyzed aged between 60 and 69. Undergraduate students made the highest number of diagnoses. Most diagnoses were made at the San Martín de Porres center.

Association of breastfeeding duration with the development of non-nutritive habits, and transversal and vertical occlusal alterations in preschool children: A cross-sectional study.

BACKGROUND: Breastfeeding has multiple nutritional, immunological and psychological benefits, as well as a positive influence on the development of the stomatognathic system. OBJECTIVES: The present study attempted to determine the relationship between the duration of breastfeeding and the development of non-nutritive habits, and transversal and vertical occlusal alterations in preschool children. MATERIAL AND METHODS: This cross-sectional study involved 155 preschoolers aged 2-5 years from 3 public schools in Lima, Peru. The sample was divided into 2 groups with regard to the duration of breastfeeding: group A (n = 50) included infants that had been breastfed for up to 6 months; and group B (n = 105) included infants that had been breastfed for 6-12 months. Two trained and calibrated dentists evaluated each group, and clinically determined the presence or absence of transversal or vertical occlusal alterations. Likewise, the children's parents or caregivers were consulted to determine the development of non-nutritive habits. RESULTS: A significant association was found between breastfeeding duration and the development of the oral breathing habit; groups A and B showed a prevalence of 30.0% and 16.2%, respectively (p = 0.048). Likewise, breastfeeding duration affected the appearance of oral breathing (OR (odds ratio) = 0.84; 95% CI (confidence interval): 0.74-0.96; p = 0.011). Furthermore, the use of a bottle for more than 24 months significantly influenced the appearance of oral habits (OR = 3.55; 95% CI: 1.20-10.55; p = 0.022) and open bite (OR = 12.12; 95% CI: 1.16-126.31; p = 0.037). CONCLUSIONS: Breastfeeding duration of 6-12 months was shown to be a protective factor in preventing the appearance of oral breathing. Posterior crossbite (PCB), open bite and deep bite seemed not to be influenced by breastfeeding duration. However, the use of a bottle for more than 24 months significantly influenced the appearance of anterior open bite.

To evaluate whether there is a relationship between occlusion and body posture as delineated by a stabilometric platform: A systematic review.

OBJECTIVE: To evaluate whether there is a relationship between occlusion and body posture evaluated using a stabilometric platform. METHODS: Observational studies that analyzed the relationship between dental occlusion (changes in mandibular position and/or dental malocclusion) and body posture evaluated with a stabilometric platform in patients older than 13 years without orthodontic or orthopedic intervention and systemically healthy were considered eligible for inclusion. PubMed, EMBASE, Science Direct, LILACS, and Google Scholar databases were searched to obtain articles published from September 2019 up to March 2020. RESULTS: Twelve articles met the inclusion criteria, of which 66.7% showed a relationship between dental occlusion and body posture, and 33.3% found no relationship. The marked heterogeneity between studies did not allow data to be combined for meta-analyses. CONCLUSION: For the mandibular positions, the postural changes were mainly in the mediolateral direction, while in the malocclusions, they were in the anteroposterior direction.

Tratamento da atresia maxilar associada à sobremordida acentuada em paciente Classe II de Angle ­ relato de caso / Tratamento da atresia maxilar associada à sobremordida acentuada em paciente Classe II de Angle ­ relato de caso

Resumo O tratamento precoce das más oclusões é preconizado principalmente pela possibilidade de tratamento ortopédico. Uma Classe II não tratada pode trazer prejuízos na fala, deglutição, respiração e, consequentemente, na qualidade de vida do paciente. Quando há alterações transversais, verticais e anteroposteriores associadas, os tratamentos tornam-se mais desafiadores. O objetivo desse estudo foi apresentar um caso clínico de um paciente com má oclusão de Classe II em fase de crescimento, com mordida cruzada posterior unilateral, falta de espaço na arcada superior e sobremordida profunda associada à curva de Spee acentuada no arco mandibular. Com o tratamento planejado, foi alcançado um resultado estético e funcional adequado com correção da Classe II de Angle, criação de espaço no arco para alinhamento dos caninos, correção da mordida cruzada e da sobremordida acentuada. Concluiu-se que a disjunção palatina para correção de mordida cruzada posterior e o uso de mecânica com cantilevers para correção precoce da curva de Spee foram satisfatórios neste caso clínico. Conhecer biomecânica e seus efeitos otimizam o tratamento (AU)

Abstract The early treatment of malocclusions is recommended by the possibility of orthopedic treatment. An untreated Class II can impair speech, swallowing, breathing and, consequently, the patient's quality of life. When transverse, vertical, and anteroposterior changes are associated, treatments become more challenging. This study aimed to present a clinical case of a patient with Class II malocclusion in the growth phase, with unilateral posterior crossbite, lack of space in the upper arch, and deep overbite associated with the sharp Spee curve in the mandibular arch. With the planned treatment, an adequate aesthetic and functional result was achieved with Angle Class II correction, creating space in the arch for alignment of the canines, correction of the cross bite, and the marked overbite. It was concluded that the palatal disjunction for posterior crossbite correction and the use of cantilever mechanics for early correction of the Spee curve were satisfactory in this clinical case. Knowing biomechanics and its effects optimize the treatment (AU)

Consequências da perda/extração precoce de dente(s) decíduo(s) anterior(es) em bebês e crianças / Consequences of premature loss/extraction of primary anterior teeth in babies and children

Avaliaram-se consequências da perda precoce de dentes decíduos anteriores por meio de três fases. Na 1a, realizou-se levantamento da evidência científica disponível por meio de revisão sistemática e meta-análise (RS), revisão crítica da literatura (RC) e e-book. A RS foi dividida em seleção dos artigos, extração de dados, risco de viés, meta-análise e certeza da evidência; na RC, realizou-se compilação dos dados e análise crítica. Por fim, as informações foram organizadas em e-book com fins educativos. Na 2a, realizaram-se dois estudos (Es) de concordância e reprodutibilidade, para avaliar instrumentos em modelos de estudo (Es1) e na clínica (Es2). No Es1, dois avaliadores treinados e calibrados realizaram mensurações diretamente com paquímetro digital e compasso de pontas secas em 40 modelos de gesso de bebês/crianças com idade entre 1 e 5 anos, com e sem perdas dentárias, comparados à medidas digitais feitas em software pós escaneamento 3D. Foram avaliadas 6 medidas dentárias lineares (MDL): espaço mésio-distal da perda dentária (EPD) (se houvesse), perímetro do arco, comprimento do arco, largura do arco, comprimento intercaninos e largura intercaninos. O Es2 comparou paquímetro digital e compasso de pontas secas para mensuração clínica do EPD realizada por dois operadores independentes em 15 bebês/crianças com idade entre 2 a 6 anos. Na 3a, estudo longitudinal de coorte avaliou consequências da perda precoce anterior nos arcos dentários e no desenvolvimento da oclusão de outros 15 bebês/crianças de 1 a 5 anos comparados à bebês/crianças sem perdas dentárias após 24 meses de acompanhamento. Foram realizados exame de oclusão, mensuração clínica do EPD com paquímetro digital e documentação com fotografias intrabucais e confecção de modelos de estudo pela impressão dos arcos. Essas etapas foram realizadas no tempo zero (T0) e repetidas após 24 meses (T1). Os modelos foram escaneados em scanner ótico 3D e realizaram-se MDL em software digital. As medidas digitais foram repetidas após 1 mês para avaliação do erro do método. A análise estatística de cada fase foi desenvolvida individualmente utilizando: coeficiente de correlação intraclasse (CCI), Bland-Altman, teste-t, Shapiro-Wilk e teste de Levene's, adotando nível de significância de 0,05%. Dos estudos selecionados na meta-análise (n=4), verificouse que crianças que perderam dentes decíduos anteriores apresentaram maior chance de sofrer distorção da fala do que crianças sem perdas com baixa certeza de evidência (OR 5,466 [1,689, 17,692] p=0,005). Por outro lado, não houve diferença estatística entre esta perda e omissão ou substituição de fonemas, ambos com muito baixa certeza de evidência. Com relação ao Es1, o CCI inter-examinador foi considerado excelente variando de 0,93 a 1,00 e a concordância entre os instrumentos foi boa com média da diferença variando de -0,034mm (-1,077; 1,145) a -1,002mm (-2,632; 0,627). No Es2, o CCI inter-examinador também foi excelente com valor médio de 0,99 e houve concordância entre os instrumentos. No estudo de coorte, não houve diferença clínica significativa no EPD (p=0,938). Valores CCI intraexaminador foram variaram de 0,73 a 1,00. A precisão do método foi adequada, sem evidência de viés de proporção. Não houve diferenças estatisticamente significativas nas MDL tanto do grupo exposto quanto do não-exposto (p>0,05). Alterações nos arcos dentários e no desenvolvimento da oclusão puderam ser evidenciadas por meio da análise descritiva, incluindo: esfoliação e erupção de dentes decíduos, erupção de dentes permanentes, autocorreção e estabelecimento de maloclusões, entre outros. A presente tese concluiu que a perda precoce anterior pode causar distorção da fala, com baixa certeza de evidência. Demonstrou que MDL podem ser realizadas com boa concordância e reprodutibilidade em modelos de gesso com paquímetro digital e compasso de pontas secas e em modelos digitais com software. Demonstrou que, paquímetro digital e compasso de pontas secas podem ser utilizados com boa concordância e reprodutibilidade para mensuração clínica do EPD. Por fim, não houve diferenças nos arcos dentários e no desenvolvimento da oclusão de bebês/crianças com perda precoce anterior em comparação aos sem perdas. Entretanto, alterações fisiológicas e patológicas foram diagnosticadas clinicamente em ambos os grupos, destacando a importância da análise clínica e qualitativa. AU)

Consequences of premature loss of primary anterior teeth were evaluated through three phases. In 1st, a survey of available scientific evidence was conducted through systematic review and meta-analysis (SR), critical literature review (CR), and e-book development. SR was divided into article selection, data extraction, risk of bias, meta-analysis, and certainty of evidence; while CR was composed by data compilation and critical analysis. Finally, all data were organized into an e-book for educational purposes. In 2nd, two studies (S) of agreement and reproducibility were performed to evaluate measurement instruments in study models (S1) and in the clinic (S2). In S1, two trained and calibrated operators performed dental linear measurements (DLM) with compass and digital caliper directly on 40 plaster models of infants/children aged from 1 to 5 years old, with and without tooth losses, compared to digital measurements made in software after 3D scanning. Two trained and calibrated operators measured models with compass, digital caliper, and digital software. Six DLM were evaluated: missing tooth space (MTS) (if any), arch perimeter, arch length, arch width, intercanine length and intercanine width. S2 compared compass and digital caliper for clinical measurement of MTS in 15 infants/children aged between 2 and 6 years old. In 3rd, a longitudinal observational cohort study was conducted to evaluate consequences of premature anterior loss on dental arches and occlusion development in 15 infants/children aged 1 to 5 years compared to participants without teeth losses. Occlusion examination was performed, MTS measurement with digital caliper, and recording through intraoral photographs and study models preparation by impression of upper and lower arches. These steps were performed at baseline (T0) and repeated after a minimum of 24 months (T1). The models were scanned with a 3D optical scanner and DLM were performed with digital software. All digital measurements were repeated after 1 month to evaluate method error. Statistical analysis of each phase was individually Shapiro-Wilk and Levene's test, adopting a significance level of 0.05%. From the studies selected in meta-analyses (n = 4), it was found that children who lost primary anterior teeth had a greater chance of suffering speech distortion than children without tooth loss with low certainty of evidence (OR 5.466 [1.689, 17.692] p=0.005). On the other hand, there was no statistical difference between tooth loss and phoneme omission and substitution, both with very low certainty of evidence. Regarding E1, inter-rater ICC was considered excellent varying from 0.93 to 1.00 and agreement between the instruments was good, varying from 0.034mm (-1.077; 1.145) a -1.002mm (-2.632; 0.627). In E2, inter-rater ICC was also considered excellent with mean value being 0.99 and there was no statistically significant difference between the instruments, also indicating agreement, regardless of the operator. In cohort study, there was no significant change in clinical MTS measurement (p = 0.938). ICC values ranged from 0.73 to 1.00. Method accuracy was adequate and there was no evidence of proportion bias. There were no statistically significant changes in DLM of both exposed and non-exposed groups (p>0.05). Changes in dental arches and occlusion development were evidenced by descriptive analysis, including: exfoliation and eruption of primary teeth, eruption of permanent teeth, self-correction and establishment of malocclusion, among others. In this thesis, it was concluded that premature loss of primary anterior teeth could cause speech distortion, with low certainty of evidence. It was shown that DLM could be performed with good agreement and reproducibility both on plaster models with compass and digital caliper, and on digital models with software. It was also demonstrated that both compass and digital caliper could be used with good agreement and reproducibility for MTS measurements. Finally, there were no statistically changes in dental arches and occlusion development of infants and children with premature loss of primary anterior teeth compared to those without losses. However, physiological and pathological changes were clinically diagnosed in both groups, highlighting the importance of clinical follow-up and descriptive analysis. (AU)

Correção da inclinação frontal do plano oclusal com utilização de mini-implantes / Correction of frontal inclination of the occlusal plane with the use of mini-implants

Resumo O objetivo deste trabalho é relatar o caso clínico de uma paciente de 21 anos, dolicofacial, classe II com impacção de incisivo lateral superior esquerdo e queixa de inclinação do plano oclusal em vista frontal do sorriso. O tratamento ortodôntico foi realizado com aparelho fixo da prescrição Roth e alinhamento e nivelamento com fios de NiTi. Ao chegar no fio retangular, um mini-implante interradicular foi instalado entre incisivo lateral e canino superior direito (dentes 12 e 13) como ancoragem para mecânica intrusiva nessa região. Ainda durante essa fase, foi realizada a extrusão do dente 23 para nivelamento da margem gengival em relação aos incisivos. Após 11 meses, a inclinação do plano oclusal em vista frontal sorrindo foi corrigida e iniciada a fase de finalização. Ao final do tratamento, foi realizada a reanatomização do dente 23 transformando-o em incisivo lateral, o que resultou em um sorriso estético e harmônico. Por meio desse caso clínico, conclui-se que a inclinação frontal do plano oclusal de origem dentoalveolar pode ser corrigida com a ajuda da ancoragem esquelética em casos onde haja boa exposição gengival na região anterior (AU)

Abstract The objective of this study is to report a clinical case of 21-year-old female, hyperdivergent Class II patient with impaction of the maxillary left lateral incisor and a complaint of inclination of the occlusal plane in a frontal view of the smile. Orthodontic treatment was performed with a Roth prescription fixed appliance and alignment and leveling with NiTi wires. Upon reaching the rectangular wire, an interradicular mini-implant was inserted between the maxillary right lateral incisor and the maxillary right canine (teeth 12 and 13) as an anchorage for intrusive mechanics in this region. Also, during this phase, the extrusion of tooth 23 was performed to level the gingival margin in relation to the incisors. After 11 months, the inclination of the occlusal plane in a smiling frontal view was corrected and the finishing phase began. At the end of the treatment, tooth 23 was re-anatomized, transforming it into a lateral incisor, which resulted in an aesthetic and harmonious smile. Through this clinical case, it is concluded that the frontal inclination of the occlusal plane of dentoalveolar origin can be corrected with the help of skeletal anchorage in cases where there is good gingival exposure in the anterior region. (AU)