Changes in the arch width and buccal corridor after fixed orthodontic treatment with Damon self-ligating system: premolar extraction vs. non-extraction.

INTRODUCTION: Extraction vs. non-extraction is a crucial decision in orthodontic therapy. OBJECTIVE: The aim of the present study was to investigate the changes in the dental arch width and buccal corridor after orthodontic treatment using extraction and non-extraction therapy with Damon self-ligating system. MATERIAL AND METHODS: This retrospective study consisted of 35 patients (20 female and 15 male patients with median age of 12.5 years), treated by extracting 4 or 2 premolars, and 37 patients (16 female and 21 male patients with the median age of 12.8 years), treated without premolar extraction. Both groups were treated with Damon self-ligating system. Plaster models before (T0) and after (T1) treatment were measured, and the arch width values were determined at the level of the first molars, second premolars, canines and palatal rugae. Buccal corridor width was measured using the extraoral images at T0 and T1. Paired t-test was used for the analysis of the normally distributed data, and Wilcoxon Mann-Whitney U test was used for the data with non-normal distribution. Values of p<0.05 were set as statistically significant. RESULTS: The upper intercanine width increased significantly in both groups (p<0.01). In the non-extraction group, the arch width increased significantly in the maxillary second premolar and first molar region (p<0.01) as well as in the region of the canines (p=0.04), second premolars (p=0.01) and first molars (p<0.01) of the mandible. The buccal corridor decreased significantly in the non-extraction group (p<0.01). CONCLUSION: Premolar extraction in combination with Damon self-ligating system did not lead to reduction of the dental arch width in the maxilla, nor did it increase the size of the buccal corridors.

Accuracy of arch expansion with two thermoplastic materials in Invisalign® patients: EX30® and SmartTrack®.

OBJECTIVE: The purpose of this retrospective study was to compare accuracy of arch expansion using two different thermoplastic materials in Invisalign aligners: EX30® (Polyethylene Terephthalate Glycol, or PETG) and SmartTrack® (polyurethane). METHODS: The study sample comprised 65 adult patients consecutively treated with Invisalign from two private practices: group 1 - treated with EX30® (358 teeth) and group 2 - treated with SmartTrack® (888 teeth). Six hundred and twenty-three measurements were assessed in three digital models throughout treatment: model 1 - initial, model 2 - predicted tooth position, and model 3 - achieved position. Sixteen reference points per arch were marked and, after best alignment, 2 points per tooth were copied from one digital model to another. Linear values of both arches were measured for canines, premolars, and first molars: on lingual gingival margins and cusp tips of every tooth. Comparisons were performed by Wilcoxon and Mann-Whitney test. RESULTS: Both termoplastic materials presented significant differences between predicted and achieved values for all measurements, except for the lower molar cusp tip in the SmartTrack® group. There is no statistical difference in the accuracy of transverse expansion between these two materials. Overall accuracy for EX30® aligners in maxilla and mandible were found to be 37 and 38%, respectively; and Smarttrack® presented an overall accuracy of 56.62% in the maxilla and 68.72% in the mandible. CONCLUSIONS: It is not possible to affirm one material expands better than the other. Further controlled clinical studies should be conducted comparing SmartTrack® and EX30® under similar conditions.

The efficiency of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization.

OBJECTIVE: To assess the effectiveness of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization. METHODS: Seventeen patients aged between 12.5 and 24 years underwent distalization with a customized distalizer. Lateral cephalogram and cast analysis were performed before and after distalization. Linear and angular parameters of the upper first molar, first premolar, and central incisor were assessed. RESULTS: Distalization with the force passing near the center of resistance (CRes) of the upper first molars resulted in distal movement, with minimal distal tipping (2.8 ±â€Š0.45°, p< 0.05). However, distalization passing occlusal to the CRes led to greater distal tipping (13.6 ±â€Š1.63°, p< 0.05). Statistically significant spontaneous distal tipping and distal movement of the upper first premolars occurred, with a mean of 6.2 ±â€Š1.24° (p< 0.05) and 0.68 ±â€Š0.34 mm (p< 0.05), respectively. The positional change of the upper central incisors presented a mean of -0.23 ±â€Š0.1 mm (p> 0.05) and 2.65 ±â€Š1.1° (p< 0.05). Upper first molar intrusion was statistically significant, with a mean of 0.88 ±â€Š0.2 mm (p< 0.05). Upper right and left first molars rotation towards palatal midline presented mean of 4.1 ±â€Š0.19° (p< 0.05) and 3.4  ±â€Š0.1° (p< 0.05), respectively. Additionally, the distance between upper right and left first molars increased significantly, with a mean of 2.54 ±â€Š0.01 mm (p< 0.05). CONCLUSION: The study successfully demonstrated the efficiency of molar distalization without anchorage loss using a customized distalizer anchored on palatal miniscrews.

Accuracy of Invisalign® aligners in adult patients: a retrospective study of angular tooth movements.

OBJECTIVE: This retrospective study aimed to assess the predictability of Invisalign® aligners regarding rotational, mesio-distal and buccal-lingual tip movements. METHODS: Two materials were included in the analysis - EX30, used until 2013; and SmartTrack, in current use. The study comprised 56 adult patients treated with Invisalign Comprehensive. Data sample were assessed on three sets of digital models; model 1 - initial, model 2 - predicted, and model 3 - achieved. Sixty reference points were marked in each dental arch, and two reference planes assisted the superimposition. The degree of rotation, mesio-distal and buccal-lingual tip was obtained via trigonometric calculations, through a previously published validated method. The accuracy of outcomes was compared according to the types of tooth movement and teeth groups,and the influence of predetermined variables on movement accuracy was also investigated. RESULTS: Rotation and mesio-distal tip did not present any significant difference when comparing EX30 and SmartTrack groups. Only buccal-lingual tip presented a significant difference, incisor and canine groups treated with EX30 aligners presented an increase in accuracy (p= 0.007 and p = 0.007, respectively). For each additional degree planned for rotation movements, there was an increase of 0.35° in the discrepancy, and an increase of 0.40° and 0.41° for mesio-distal and buccal-lingual tip, respectively. EX30 and SmartTrack discrepancies were compared by multilevel linear regression. CONCLUSION: EX30 aligners reached higher accuracy for buccal-lingual tip in anterior teeth. However, for rotation and mesio-distal tip, SmartTrack and EX30 are similarly accurate. The total amount of planned movement has a significant impact on accuracy rates, with a decrease in accuracy for every additional degree.

Craniomandibular transverse tomographic evaluation after anterior open bite orthodontic treatment with miniplates anchorage.

BACKGROUND: Skeletal anterior open bite (SAOB) represents one of the most complex and challenging malocclusions in orthodontics. Orthodontic treatment supported by miniplates enable to reduce the need for orthognathic surgery. Transverse dimension may be affected by intrusion biomechanics. This study aims to assess transverse bone alterations in patients with SAOB who underwent orthodontic treatment with absolute anchorage using four miniplates. METHODS: A total of 32 patients of both sexes, with an average age of 33.8 years, diagnosed with SAOB and treated orthodontically with four miniplates (one in each hemiarch), were selected for this study. Tomographic examinations were performed before (T1) and after (T2) orthodontic treatment. Linear measurements (width of the maxillary base, maxillary alveolar, maxillary root, maxillary dental cusp, mandibular alveolar) and angular measurements (maxillary intermolar angle) were assessed in these images. The Shapiro-Wilks normality tests were applied to verify data distribution, and the paired t-test was used to compare the initial and final measures obtained. RESULTS: Among the evaluated parameters, the maxillary alveolar width, maxillary dental cusp width, mandibular alveolar cusp width, and intermolar angle showed statistically significant differences between T1 and T2 (p < 0.05). However, maxillary base and maxillary root widths showed no significant difference (p > 0.05). CONCLUSIONS: Intrusion and distalization with miniplates in SAOB therapy may lead to significant expansive changes, due to molars cusps width and buccal inclination increase restricted at the alveolar level.

Comparison of the efficiency of initial dental alignment with Invisalign® aligners changed every 7 or 14 days in mature adults: Randomized clinical trial.

OBJECTIVE: To compare the anterior crowding correction after sequential use of the first 5 aligners between two aligner exchange protocols (7 and 14 days) in mature adult patients. MATERIALS AND METHODS: Thirty-six patients over 35 years who received orthodontic treatment with Invisalign® were randomly allocated to two different aligner replacement sequence protocols: Group 1: exchange every 7 days (n = 18); and Group 2: exchange every 14 days (n = 18). All patients were scanned with iTero Element 5D® (Align Technology) in two treatment times: at pre-treatment (T1) and after using the first five aligners (T2). Little's Irregularity Index (LII) and arch widths were evaluated with OrthoCAD software. Intra and intergroup comparisons were performed with the dependent and independent t-tests. The results were considered significant for P < .05. RESULTS: Thirty-five patients completed the study. Both groups' maxillary and mandibular Irregularity Indexesi were significantly lower at T2. There was no significant difference in inter-canine, inter-premolar, and intermolar distances. G2 (14 days) presented a greater decrease in mandibular irregularity than G1 (7 days). CONCLUSION: Both exchange protocols (7 and 14 days) effectively correct anterior crowding in the initial phase of orthodontic treatment with aligners in mature adult patients. However, the 14-day exchange protocol provided a greater correction in mandibular anterior crowding in the evaluated period than the 7-day exchange protocol.

Histological Evaluation of the Effect of Alendronate on the Maxillary Bone of Wistar Rats Combined with Orthodontic Movement of Intense Force / Evaluación Histológica del Efecto del Alendronate en el Hueso Maxilar de Ratas Wistar Combinado con Movimiento de Ortodoncia de Fuerzas Intensas

SUMMARY: To evaluate the histological adverse effects of alendronate administered systemically and topically in combination with orthodontic movement by intense force. Thirty-six 24-week-old female Wistar rats, ovariectomized, were used and divided into three groups (n = 12/group): control, locally treated with saline (0.07 ml/kg/week) (group 1) and experimental, treated with alendronic acid systemically (0.07 mg/kg/week) (group 2) and locally (7 mg/kg/week) (group 3). At 14 days, an orthodontic anchor was installed in the right first molar, and a force of 144 cN was applied for 28 days. The samples were processed for histological evaluation. Descriptive statistics, Shapiro-Wilk tests, one-way ANOVA with Bonferroni correction, one-way repeated measures ANOVA and chi-square tests were performed. All tests were statistically significant at p <0.05. The adverse events found in all groups were inflammation and osteoclastic activity. In the bisphosphonate-treated groups, there were statistically significant differences (p = 0.005) in the osteoclastic activity between the two hemiarcates. All rats in group 2 presented paralytic ileus. Compared to local administration, systemic treatment with alendronic acid produces more adverse effects, such as inflammation, fibrinoid necrosis, and osteoclastic activity. During the application of intense forces, it was not possible to show that there is necrosis associated with bisphosphonates.

Evaluar los efectos adversos histológicos del alendronato administrado sistémica y tópicamente en combinación con movimientos ortodóncicos de fuerza intensa. Treinta y seis ratas Wistar hembras de 24 semanas de edad, ovariectomizadas, fueron utilizadas y divididas en tres grupos (n = 12/grupo): control, tratado localmente con solución salina (0,07 ml/kg/semana) (grupo 1) y experimental, tratados con ácido alendrónico por vía sistémica (0,07 mg/kg/semana) (grupo 2) y local (7 mg/kg/semana) (grupo 3). A los 14 días se instaló un anclaje de ortodoncia en el primer molar derecho y se aplicó una fuerza de 144 cN durante 28 días. Las muestras fueron procesadas para evaluación histológica. Se realizó estadística descriptiva, pruebas de Shapiro-Wilk, ANOVA de una vía con corrección de Bonferroni, ANOVA de medidas repetidas de una vía y pruebas de chi-cuadrado. Todas las pruebas fueron estadísticamente significativas con un p <0,05. Los eventos adversos encontrados en todos los grupos fueron inflamación y actividad osteoclástica. En los grupos tratados con bisfosfonatos hubo diferencias estadísticamente significativas (p = 0,005) en la actividad osteoclástica entre los dos hemiarcados. Todas las ratas del grupo 2 presentaron íleo paralítico. En comparación con la administración local, el tratamiento sistémico con ácido alendrónico produce más efectos adversos, como inflamación, necrosis fibrinoide y actividad osteoclástica. Durante la aplicación de fuerzas intensas, no fue posible demostrar que existe necrosis asociada con los bisfosfonatos.

Channa Striata and Hyperbaric Oxygen Therapy Combination for Pressure Areas in Orthodontic Treatment

ABSTRACT Objective: To study the effect of using a combination of Channa Striata gel and hyperbaric oxygen therapy on pressure areas during orthodontic treatment. Material and Methods: The study was conducted using the ARRIVE Essential 10 guidelines. In this study, 35 3-4 months male guinea pigs (Cavia Cobaya) weighing 300-400 grams were used and divided into 5 groups (n=7). Decalcification was performed to dissolve the dental calcium and jawbone to cut the tissue properly. The decalcification was performed for 30 days. Then preparations were made with HE (Hematoxylin Eosin), observed using a microscope, and counted the number of osteoclasts and macrophages on a light microscope with 400 times magnification. The results of the preparations were analyzed using the SPSS program. Results: The Kruskal-Wallis test of macrophage cells and the ANOVA test of osteoclast cells showed significant results between all groups (p<0.05). Conclusion: The effect of hyperbaric oxygen therapy 2,4 ATA administered on days 8-14 and Channa Striata extract gel administered on days 3-14 can increase the number of macrophages in the periodontal ligament and osteoclasts in the alveolar bone in the pressure area during orthodontic tooth movement.

Expansion treatment using Invisalign®: Periodontal health status and maxillary buccal bone changes. A clinical and tomographic evaluation.

The aim of this study was to evaluate changes in periodontal status and maxillary buccal bone by considering clinical and tomographic parameters during the first year of orthodontic expansion with Invisalign® aligners. Upper first (1PM) and upper second (2PM) premolars of 19 patients with orthodontic expansion requirement treated with Invisalign® aligners were evaluated. Plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) and cone beam tomographic (CBCT) records were collected at 76 sites before starting treatment (T0) and at 12 months (T1). Bone height was measured from cementoenamel junction (CEJ) to the crest cortical bone (CC). Bone thickness was measured at two levels: 4 mm (CEJ+4) and 6 mm (CEJ+6) apical to the CEJ. A descriptive analysis was made of the variations of bone thickness and height in a series of cases. The average expansion was 1.93 mm for 1PM and 167 mm for 2PM. Arithmetic mean of distance CEJ-CC in 1PM was 3.05 mm at T0, and remained at 3.05 mm at T1. Arithmetic mean of distance CEJ-CC in 2PM was 2.06 mm at T0 and 2.31 at T1. Post-expansion, most of the analyzed sites (86%) exhibited a bone thickness of ≥0.5 mm. The greatest variations between T0 and T1 were observed at the level of 1PM CEJ+ 4 and 2PM CEJ+ 6. The minimal changes in the clinical records (GI, PI, PPD and CAL) between T0 and T1 were compatible with the maintenance of gingivalperiodontal health. Invisalign® for expansion movements did not produce substantial changes in the evaluated periodontal clinical parameters or in the bone measurements. Removable appliances reduce plaque retentive factors and favor adequate oral hygiene.

El objetivo de este estudio fue evaluar los cambios en el estado periodontal y hueso facial maxilar a través de parámetros clínicos y tomográficos durante la expansión ortodóncica con alineadores Invisalign® en el primer año de tratamiento. Se evaluaron los primeros (1PM) y segundos (2PM) premolares superiores pertenecientes a 19 pacientes con requerimiento de expansión ortodóncica tratados con alineadores Invisalign®. Se registraron los índices de placa (IP), índice gingival (IG), profundidad al sondaje (PS) y nivel de inserción (NI) y registros tomográficos de haz cónico (CBCT) en 76 sitios antes de comenzar el tratamiento (T0) y a los 12 meses (T1). Se midió la altura ósea desde el límite amelocementario (LAC) hasta la cortical de la cresta (CC) y el espesor en dos niveles; a 4 mm (LAC+4) y a 6 mm (LAC+6) hacia apical del LAC. Se realizó un análisis descriptivo de las variaciones de la altura y espesor óseo en una serie de casos. La expansión promedio para 1PM fue de 1,93 mm y para 2PM fue de 1,67 mm. La media aritmética de LAC-CC en primeros premolares fue de 3,05 mm en T0 y se mantuvo el valor de 3,05 mm en T1. La media aritmética de LAC-CC en segundos premolares fue de 2,06 mm en T0 y 2,31 en T1. Post expansión, la mayoría de los sitios (86%) analizados exhibieron un espesor óseo ≥0,5 mm. Las mayores variaciones entre T0 y T1 se observaron a nivel de 1PM CEJ+4 y 2PM CEJ+6. Los registros clínicos (PI, GI, PPD y CAL) evidenciaron mínimos cambios entre T0 y T1, compatibles con el mantenimiento de la salud gíngivo-periodontal. El uso de Invisalign ® para movimientos de expansión no produjo cambios sustanciales en los parámetros clínicos periodontales evaluados ni en las mediciones óseas. La aparatología removible reduce los factores retentivos de placa bacteriana y facilita una adecuada higiene oral.

Prospective clinical study of transverse development with orthodontics with self-ligating brackets.

Orthodontics with low friction, low force, passive self-ligating brackets produces alveolar-dental remodeling, resulting in an increase in the transverse diameter of the dental arches, especially in the premolar sector. The aim of this study was to compare the modifications of the transverse diameter in the pre- and post-dental alignment cast models with orthodontics with passive self-ligating brackets in patients with moderate to severe dental discrepancy. The study included 28 patients of both sexes aged 16 to 48 years with dental discrepancies between -6 and -16 mm, treated with self-ligating Damon brackets and thermally activated Nickel- Titanium-Copper arches. With a digital pachymeter, Mitutoyo brand, five measurements were taken per dental arch: distance between canines (C), first premolars (1PM), second premolars (2 PM), first molars (1M) and second molars (2M), before and after orthodontic alignment. The variations were statistically evaluated by Student T Test for paired samples. Average distance between teeth varied with dental alignment in both jaws. The greatest increases in transverse diameter were recorded in the premolar areas. Minor though statistically significant variations also occurred in the 2M of the maxilla and in the C of the mandible In alignment with passive self-ligating brackets, there is an increase in the transverse diameter due to the development of the dental arches, mainly in the premolar sector of both jaws and also at the level of the canines in the mandible.

La ortodoncia con brackets autoligables pasivos, de baja fricción y baja fuerza, produce remodelación alvéolodentaria; con aumento del diámetro transversal de las arcadas, especialmente en el sector de los premolares. El objetivo de este trabajo fue comparar las modificaciones del diámetro transversal en los modelos de yeso pre y post alineación dentaria con ortodoncia con brackets autoligables pasivos en pacientes con discrepancia dentaria moderada a severa. El estudio incluyó 28 pacientes de ambos sexos de entre 16 y 48 años de edad con discrepancia dentaria entre -6 y -16mm, tratados con brackets autoligables sistema Damon y arcos termo activables de Níquel-Titanio-Cobre. Con un paquímetro digital marca Mitutoyo, se tomaron 5 medidas por arcada: distancia entre caninos (C), primeros y segundos premolares (1 PM y 2 PM) y primeros y segundos molares (1M y 2M); pre y post alineación ortodóncica. Las variaciones registradas fueron evaluadas estadísticamente mediante Student T Test para muestras apareadas. La distancia promedio entre dientes varió con la alineación dentaria en ambos maxilares. Los mayores aumentos del diámetro transversal se registraron en las zonas de los premolares. Se produjeron también variaciones menores, aunque estadísticamente significativas, en los 2M del maxilar superior y en los C del maxilar inferior. En la alineación con brackets autoligables pasivos, hay incremento del diámetro transversal por desarrollo de las arcadas, principalmente en el sector premolar de ambos maxilares y en el maxilar inferior también a nivel de los caninos.

Expansion treatment using Invisalign®: Periodontal health status and maxillary buccal bone changes. A clinical and tomographic evaluation / Tratamiento de expansión con Invisalign®: estado de salud periodontal y cambios óseos maxilares. Evaluación clínica y tomográfica

ABSTRACT The aim of this study was to evaluate changes in periodontal status and maxillary buccal bone by considering clinical and tomographic parameters during the first year of orthodontic expansion with Invisalign® aligners. Upper first (1PM) and upper second (2PM) premolars of 19 patients with orthodontic expansion requirement treated with Invisalign® aligners were evaluated. Plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) and cone beam tomographic (CBCT) records were collected at 76 sites before starting treatment (T0) and at 12 months (T1). Bone height was measured from cementoenamel junction (CEJ) to the crest cortical bone (CC). Bone thickness was measured at two levels: 4 mm (CEJ+4) and 6 mm (CEJ+6) apical to the CEJ. A descriptive analysis was made of the variations of bone thickness and height in a series of cases. The average expansion was 1.93 mm for 1PM and 167 mm for 2PM. Arithmetic mean of distance CEJ-CC in 1PM was 3.05 mm at T0, and remained at 3.05 mm at T1. Arithmetic mean of distance CEJ-CC in 2PM was 2.06 mm at T0 and 2.31 at T1. Post-expansion, most of the analyzed sites (86%) exhibited a bone thickness of ≥0.5 mm. The greatest variations between T0 and T1 were observed at the level of 1PM CEJ+ 4 and 2PM CEJ+ 6. The minimal changes in the clinical records (GI, PI, PPD and CAL) between T0 and T1 were compatible with the maintenance of gingivalperiodontal health. Invisalign® for expansion movements did not produce substantial changes in the evaluated periodontal clinical parameters or in the bone measurements. Removable appliances reduce plaque retentive factors and favor adequate oral hygiene.

RESUMEN El objetivo de este estudio fue evaluar los cambios en el estado periodontal y hueso facial maxilar a través de parámetros clínicos y tomográficos durante la expansión ortodóncica con alineadores Invisalign® en el primer año de tratamiento. Se evaluaron los primeros (1PM) y segundos (2PM) premolares superiores pertenecientes a 19 pacientes con requerimiento de expansión ortodóncica tratados con alineadores Invisalign®. Se registraron los índices de placa (IP), índice gingival (IG), profundidad al sondaje (PS) y nivel de inserción (NI) y registros tomográficos de haz cónico (CBCT) en 76 sitios antes de comenzar el tratamiento (T0) y a los 12 meses (T1). Se midió la altura ósea desde el límite amelocementario (LAC) hasta la cortical de la cresta (CC) y el espesor en dos niveles; a 4 mm (LAC+4) y a 6 mm (LAC+6) hacia apical del LAC. Se realizó un análisis descriptivo de las variaciones de la altura y espesor óseo en una serie de casos. La expansión promedio para 1PM fue de 1,93 mm y para 2PM fue de 1,67 mm. La media aritmética de LAC-CC en primeros premolares fue de 3,05 mm en T0 y se mantuvo el valor de 3,05 mm en T1. La media aritmética de LAC-CC en segundos premolares fue de 2,06 mm en T0 y 2,31 en T1. Post expansión, la mayoría de los sitios (86%) analizados exhibieron un espesor óseo ≥0,5 mm. Las mayores variaciones entre T0 y T1 se observaron a nivel de 1PM CEJ+4 y 2PM CEJ+6. Los registros clínicos (PI, GI, PPD y CAL) evidenciaron mínimos cambios entre T0 y T1, compatibles con el mantenimiento de la salud gíngivo-periodontal. El uso de Invisalign ® para movimientos de expansión no produjo cambios sustanciales en los parámetros clínicos periodontales evaluados ni en las mediciones óseas. La aparatología removible reduce los factores retentivos de placa bacteriana y facilita una adecuada higiene oral.

Prospective clinical study of transverse development with orthodontics with self-ligating brackets / Estudio clínico prospectivo del desarrollo transversal con ortodoncia con brackets autoligables

ABSTRACT Orthodontics with low friction, low force, passive self-ligating brackets produces alveolar-dental remodeling, resulting in an increase in the transverse diameter of the dental arches, especially in the premolar sector. The aim of this study was to compare the modifications of the transverse diameter in the pre- and post-dental alignment cast models with orthodontics with passive self-ligating brackets in patients with moderate to severe dental discrepancy. The study included 28 patients of both sexes aged 16 to 48 years with dental discrepancies between -6 and -16 mm, treated with self-ligating Damon brackets and thermally activated Nickel- Titanium-Copper arches. With a digital pachymeter, Mitutoyo brand, five measurements were taken per dental arch: distance between canines (C), first premolars (1PM), second premolars (2 PM), first molars (1M) and second molars (2M), before and after orthodontic alignment. The variations were statistically evaluated by Student T Test for paired samples. Average distance between teeth varied with dental alignment in both jaws. The greatest increases in transverse diameter were recorded in the premolar areas. Minor though statistically significant variations also occurred in the 2M of the maxilla and in the C of the mandible In alignment with passive self-ligating brackets, there is an increase in the transverse diameter due to the development of the dental arches, mainly in the premolar sector of both jaws and also at the level of the canines in the mandible.

RESUMEN La ortodoncia con brackets autoligables pasivos, de baja fricción y baja fuerza, produce remodelación alvéolodentaria; con aumento del diámetro transversal de las arcadas, especialmente en el sector de los premolares. El objetivo de este trabajo fue comparar las modificaciones del diámetro transversal en los modelos de yeso pre y post alineación dentaria con ortodoncia con brackets autoligables pasivos en pacientes con discrepancia dentaria moderada a severa. El estudio incluyó 28 pacientes de ambos sexos de entre 16 y 48 años de edad con discrepancia dentaria entre -6 y -16mm, tratados con brackets autoligables sistema Damon y arcos termo activables de Níquel-Titanio-Cobre. Con un paquímetro digital marca Mitutoyo, se tomaron 5 medidas por arcada: distancia entre caninos (C), primeros y segundos premolares (1 PM y 2 PM) y primeros y segundos molares (1M y 2M); pre y post alineación ortodóncica. Las variaciones registradas fueron evaluadas estadísticamente mediante Student T Test para muestras apareadas. La distancia promedio entre dientes varió con la alineación dentaria en ambos maxilares. Los mayores aumentos del diámetro transversal se registraron en las zonas de los premolares. Se produjeron también variaciones menores, aunque estadísticamente significativas, en los 2M del maxilar superior y en los C del maxilar inferior. En la alineación con brackets autoligables pasivos, hay incremento del diámetro transversal por desarrollo de las arcadas, principalmente en el sector premolar de ambos maxilares y en el maxilar inferior también a nivel de los caninos.

Class II malocclusion treatment changes with the Jones jig, Distal jet and First Class appliances.

Objective Maxillary molar distalization with intraoral distalizer appliances is a non-extraction orthodontic treatment used to correct molar relationship in patients with Class II malocclusion presenting maxillary dentoalveolar protrusion and minor skeletal discrepancies. This study compares the changes caused by three distalizers with different force systems. Methodology 71 patients, divided into three groups, were included. The Jones jig group (JJG, n=30; 16 male, 14 female, 13.17 years mean age) was treated with the Jones jig for 0.8 years. The Distal jet group (DJG, n=25; 8 male, 17 female, 12.57 years mean age) was treated with the Distal jet for 1.06 years. The First Class group (FCG, n=16; 6 male, 10 female, 12.84 years mean age) was treated with the First Class for 0.69 years. Intergroup treatment changes were compared using one-way ANOVA, followed by post-hoc Tukey's tests. Results Intergroup comparisons showed significantly greater maxillary incisor protrusion in DJG than in FCG (2.56±2.24 mm vs. 0.74±1.39mm, p=0.015). The maxillary first premolars showed progressive and significantly smaller mesial angulation in JJG, FCG and DJG, respectively (14.65±6.31º, 8.43±3.99º, 0.97±3.16º; p<0.001). They also showed greater mesialization in JJG than FCG (3.76±1.46 mm vs. 2.27±1.47 mm, p=0.010), and greater extrusion in DJG compared to JJG (0.90±0.77 mm vs 0.11±0.60 mm, p=0.004). The maxillary second premolars showed progressive and significantly smaller mesial angulation and mesialization in JJG, FCG and DJG, respectively (12.77±5.78º, 3.20±3.94º, -2.12±3.71º and 3.87±1.34 mm, 2.25±1.40 mm, 1.24±1.26 mm, respectively; p<0.001). DJG showed smaller distal angulation of maxillary first molars (-2.14±5.09º vs. -7.73±4.28º and -6.05±3.76º, for the JJG and FCG, respectively; p<0.001) and greater maxillary second molars extrusion (1.17±1.41 mm vs -0.02±1.16 mm and 0.16±1.40 mm, for the JJG and FCG, respectively; p=0.003). Overjet change was significantly larger in DJG compared to FCG (1.79±1.67 mm vs 0.68±0.84; p=0.046). Treatment time was smaller in FCG (0.69±0.22 years vs 0.81±0.33 years and 1.06±0.42 years, comparing it with the JJG and DJG, respectively; p=0.005). Conclusion The three appliances corrected the Class II molar relationship by dentoalveolar changes. The Distal jet produced smaller molar distal angulation than the Jones jig and First Class. The First Class appliance showed less anchorage loss, greater percentage of distalization and shorter treatment time than the Jones jig and Distal jet.

Comparison of the dentoskeletal and soft tissue changes with the cervical headgear and Jones Jig followed by fixed appliances in Class II malocclusion patients: A retrospective study.

OBJECTIVE: To retrospectively compare the dentoskeletal and soft tissue changes of patients with Class II malocclusion treated with cervical headgear and Jones Jig appliances, followed by fixed appliances. MATERIAL AND METHODS: The sample comprised 46 Class II malocclusion patients divided into two groups. Patients with Class II malocclusion based on the ANB angle and plaster model analyses, needing non-extraction orthodontic treatment, absence of mandibular crowding and no previous orthodontic treatment were eligible to be selected. Group 1 consisted of 25 patients treated with cervical headgear (CH) followed by fixed appliances for a mean period of 3.26 years and group 2 consisted of 21 patients treated with the Jones Jig (JJ) appliance for a mean of 4.29 years. Lateral cephalograms were evaluated at the beginning and at the end of orthodontic treatment. For intergroup comparisons, t and Mann-Whitney tests were performed. RESULTS: The cervical headgear group produced significantly greater maxillary anterior displacement restriction (SNA; CH: -0.97°±1.33; JJ: 0.07°±1.73; P=0.025), apical base discrepancy improvement (ANB; CH: -1.52°±1.25; JJ: 0.36°±1.46; P=0.006), FMA reduction (CH: -0.78°±2.68; JJ: 1.07°±2.84; P=0.028) and distal mandibular molar angulation (Md6.PM; CH: 6.97°±3.66; JJ: 2.77°±6.87; P=0.013) than the Jones Jig group. CONCLUSIONS: Both distalizers followed by fixed appliances were effective to correct Class II malocclusion. The cervical headgear group presented skeletal effects with less treatment time and there were no significant intergroup differences regarding soft tissue changes.

Una Descripción General y Actualizada de Miniplacas y Minitornillos. Efectos Dentoalveolares y Esqueléticos / A General and Updated Description of Miniplates and Miniscrews. Dentoalveolar and Skeletal Effects

RESUMEN: En ortodoncia, las miniplacas se utilizan como dispositivo de anclaje temporal (TAD) para la realización de movimientos dentales que permiten el uso de fuerzas ortopédicas en ellos. En comparación con los mini tornillos, las miniplacas tienen la ventaja de una tasa de falla muy baja, pero la desventaja es que para la extracción se necesita el mismo acto quirúrgico que se realizó para la instalación. El objetivo de este estudio es realizar una revisión bibliográfica de las indicaciones de miniplacas en pacientes con mordidas abiertas, clase II y anomalías de clase III, y buscar cómo las miniplacas han mejorado los tratamientos de ortodoncia. La información principal se reunió buscando en PubMed con las palabras clave enumeradas a continuación. Afirmamos que las miniplacas están indicadas para la retracción en masa de la arcada, donde se observó que la fuerza de 150 g aplicada en los molares superiores es suficiente no solo para empujar los molares hacia atrás en una clase I corregida, sino también para iniciar la retracción de premolares, caninos e incisivos. En pacientes con mordida abierta, las miniplacas se definen como un método seguro, una alternativa rápida y menos costosa a la cirugía ortognática. Y en pacientes de las clases II y III se utilizan sin producir efectos dentoalveolares que sustituyan a los dispositivos extraorales como máscaras, con dispositivos intraorales y elásticos (BAMP).

ABSTRACT: In orthodontics, miniplates are used as a Temporary Anchoring Device (TAD) for the purpose dental movements, allowing the use of orthopedic forces. In comparison with mini-screws, miniplates have the advantage of a very low rate of failure. Nonetheless, their removal requires the same surgical procedure as during installation, which is an obvious disadvantage. The aim of this study is to review the indications of miniplates in patients with open bite, class II and class III anomalies, and review how miniplates improved orthodontics treatments. Information was obtained by a search in PubMed with the keywords listed below. Miniplates are indicated for retraction in mass of the arcade, where it was seen that the force of 150 g applied on maxillary molars, is sufficient not only to push the molars back into a corrected class I, but also to initiate retraction of premolars, canines, and incisors. In open-bite patients, mini plates, are achieved as a safe method, that is quick and a less expensive alternative to orthognathic surgery. Further, in class II and III patients they are used without producing dentoalveolar effects replacing extraoral devices as facemasks, with intraoral devices and elastics. (BAMP).

Class II malocclusion treatment changes with the Jones jig, Distal jet and First Class appliances

Abstract Objective Maxillary molar distalization with intraoral distalizer appliances is a non-extraction orthodontic treatment used to correct molar relationship in patients with Class II malocclusion presenting maxillary dentoalveolar protrusion and minor skeletal discrepancies. This study compares the changes caused by three distalizers with different force systems. Methodology 71 patients, divided into three groups, were included. The Jones jig group (JJG, n=30; 16 male, 14 female, 13.17 years mean age) was treated with the Jones jig for 0.8 years. The Distal jet group (DJG, n=25; 8 male, 17 female, 12.57 years mean age) was treated with the Distal jet for 1.06 years. The First Class group (FCG, n=16; 6 male, 10 female, 12.84 years mean age) was treated with the First Class for 0.69 years. Intergroup treatment changes were compared using one-way ANOVA, followed by post-hoc Tukey's tests. Results Intergroup comparisons showed significantly greater maxillary incisor protrusion in DJG than in FCG (2.56±2.24 mm vs. 0.74±1.39mm, p=0.015). The maxillary first premolars showed progressive and significantly smaller mesial angulation in JJG, FCG and DJG, respectively (14.65±6.31º, 8.43±3.99º, 0.97±3.16º; p<0.001). They also showed greater mesialization in JJG than FCG (3.76±1.46 mm vs. 2.27±1.47 mm, p=0.010), and greater extrusion in DJG compared to JJG (0.90±0.77 mm vs 0.11±0.60 mm, p=0.004). The maxillary second premolars showed progressive and significantly smaller mesial angulation and mesialization in JJG, FCG and DJG, respectively (12.77±5.78º, 3.20±3.94º, -2.12±3.71º and 3.87±1.34 mm, 2.25±1.40 mm, 1.24±1.26 mm, respectively; p<0.001). DJG showed smaller distal angulation of maxillary first molars (-2.14±5.09º vs. -7.73±4.28º and -6.05±3.76º, for the JJG and FCG, respectively; p<0.001) and greater maxillary second molars extrusion (1.17±1.41 mm vs -0.02±1.16 mm and 0.16±1.40 mm, for the JJG and FCG, respectively; p=0.003). Overjet change was significantly larger in DJG compared to FCG (1.79±1.67 mm vs 0.68±0.84; p=0.046). Treatment time was smaller in FCG (0.69±0.22 years vs 0.81±0.33 years and 1.06±0.42 years, comparing it with the JJG and DJG, respectively; p=0.005). Conclusion The three appliances corrected the Class II molar relationship by dentoalveolar changes. The Distal jet produced smaller molar distal angulation than the Jones jig and First Class. The First Class appliance showed less anchorage loss, greater percentage of distalization and shorter treatment time than the Jones jig and Distal jet.

High Mobility Group Box 1 and Heat Shock Protein-70 Expression Post (-)-Epigallocatechin-3-Gallate in East Java Green Tea Methanolic Extract Administration During Orthodontic Tooth Movement in Wistar Rats

Abstract Objective: To investigate the expression of High Mobility Group Box 1 (HMGB1) and Heat Shock Protein-70 (HSP-70) during orthodontic tooth movement (OTM) after (-)- Epigallocatechin-3-Gallate (EGCG) in East Java Green Tea (Camelia Sinensis) Methanolic Extract (GTME) administration in vivo. Material and Methods: 28 Wistar rats (Rattus Novergicus) was used and divided into 4 groups accordingly: K- without EGCG and OTM; K+ with OTM, without EGCG for 14 days; T1with OTM for 14 days and EGCG for 7 days; treatment group 2 (T2) with OTM and EGCG for 14 days. OTM animal model was achieved through the installation of the OTM device by means of NiTi close coil spring with 10g force placed between the first incisor and first maxillary molars. The samples were terminated on Day 14. The pre-maxillary was isolated for the immunohistochemical examination. Analysis of Variance (ANOVA) then continued with Tukey Honest Significant Difference (HSD) (p<0.05) was performed to analyze the data. Results: The highest HMGB1 and HSP-70 expression were found in the K+ group pressure side, meanwhile the lowest HMGB1 and HSP-70 expression were found in K- group tension side in the alveolar bone. There was a significant decrease of HMGB1 and HSP-70 expression in T2 compared to T1 and K+ with significant between groups (p<0.05; p=0.0001). Conclusion: The decreased expression of HMGB1 and HSP-70 in alveolar bone of OTM wistar rats due to post administration of GTME that consisted EGCG.

Pain Perception and Rate of Canine Retraction Through Self-Ligating Brackets and Conventional Elastomeric Ligation System: A Split Mouth Study

Abstract Objective: To evaluate the rate of tooth movement and the pain perception via self-ligating (SL) and conventional elastomeric ligation brackets (CB) system. Material and Methods: This study has been conducted at the Orthodontic Department of Baqai Dental College, Baqai Medical University. The sample size of this study comprised 40 patients, falling between the age of 12-30 years without any sex discrimination. Shapiro-Wilk was used to check the distribution of data. Non-parametric Mann Whitney U test was applied to evaluate the pain associated with SL and CB brackets system. To analysis the canine retraction Wilcoxon test was applied for the comparison of CB and SL brackets system. For all statistical analyses, the p-value of <0.05 was considered significant. Results: Pain level associated with retraction via CB and SL shows significant differences. However, the rate of canine retraction via CB and SL shows no significant differences at stages T0-T1 and T1-T2. However, stage T2-T3 shows a significant difference. Conclusion: As pain during orthodontic treatment is mostly associated with the level of compression of the periodontal ligament, it may be hypothesized that lower frictional forces generate less compression of the periodontal ligament and blood vessels, and so alter the type of pain experienced.

Avaliação macroscópica, bioquímica e comportamental do efeito de termogênicos em ratos submetidos à movimentação ortodôntica / Macroscopic, biochemical and behavioral evaluation of the effect of thermogenics in rats undergoing orthodontic movement

Introdução: Considerando que a cafeína aumenta o metabolismo, muito se tem questionado se os termogênicos à base dessa substância apresentariam também alguma influência sob a taxa de movimentação ortodôntica e comportamento de roedores. Objetivo: Avaliar o efeito de duas marcas comerciais de termogênicos sobre o comportamento, o metabolismo e a movimentação ortodôntica em ratos. Metodologia: Tratou-se de um estudo experimental, in vivo, randomizado, com base descritiva e inferencial. A amostra foi constituída de 19 ratos machos Wistar (Ratus norvegicus albinus) saudáveis, entre 7 e 12 semanas de idade, os quais foram submetidos a movimentação dentária ortodôntica contínua dos primeiros permanentes molares superiores, do lado esquerdo, durante o período de 21 dias. Os ratos foram divididos aleatoriamente em 3 grupos: Grupo controle (GC) - Ratos submetidos apenas à movimentação ortodôntica e à ingestão diária de água (n=7); Grupo experimental Termogênico C4 (GT1) - Ratos submetidos à movimentação ortodôntica e à dose diária de termogênico C4 (n=8) e Grupo experimental Termogênico PRE-HD (GT2) - Ratos submetidos à movimentação ortodôntica e à dose diária de termogênico PRE-HD (n=4). A análise de movimentação ortodôntica foi feita obtendo-se a diferença da distância (em mm) da distal do 1˚ molar superior esquerdo à mesial do 2˚ molar superior do mesmo lado, medida realizada na região cervical com o auxílio de um compasso de ponta seca; a análise sistêmica foi realizada por meio de testes bioquímicos e do leucograma e o estudo comportamental através do teste de campo aberto. Resultados: Não houve diferença estatisticamente significativa entre os grupos GT1, GT2 e GC quanto à quantidade de movimentação ortodôntica (p>0,005). Com relação ao teste de campo aberto, houve diferença estatisticamente significativa (p <0,005) entre os grupos para as variáveis: movimentos ambulatórios, movimentos em pé, quantidade de pulos, distância percorrida, velocidade da distância percorrida e movimentos realizados no centro e nas bordas. E no tocante aos efeitos sistêmicos, o leucograma e os testes bioquímicos realizados não exibiram resultados significativos. Conclusão: O uso de termogênicos não exerce influência sobre a taxa de movimentação ortodôntica em ratos e não produz alterações sistêmicas relevantes, no entanto, é capaz de afetar vários aspectos do comportamento desses animais (AU).

Introduction: Considering that caffeine increases metabolism, much has been questioned whether thermogenics based on this substance would also have some influence on the rate of orthodontic movement and rodent behavior. Objective: To evaluate the effect of two thermogenic brands on behavior, metabolism and orthodontic movement in rats. Methodology: This was an experimental, in vivo, randomized study, with descriptive and inferential basis. The sample consisted of 19 healthy male Wistar rats (Ratus norvegicus albinus) between 7 and 12 weeks of age, which were submitted to continuous orthodontic movement of the first permanent maxillary molars on the left side during the 21 day period. The rats were randomly divided into 3 groups: Control group (CG) - Rats submitted only to orthodontic movement and daily water intake (n = 7); Experimental group Thermogenic C4 (GT1) - Rats undergoing orthodontic movement and daily dose of thermogenic C4 (n = 8) and experimental Group Thermogenic PRE-HD (GT2) - Rats submitted to orthodontic movement and daily dose of thermogenic PRE-HD (n = 4). The analysis of orthodontic movement was done by obtaining the difference in distance (in mm) from the distal of the 1˚ molar left superior to the mesial of the 2˚ molar superior of the same side, a measurement performed in the cervical region with the aid of a tip compass dry; the systemic analysis was performed through biochemical and leukogram tests and the behavioral study through the open field test. Results: There was no statistically significant difference between groups GT1, GT2 and CG regarding the amount of orthodontic movement (p> 0.005). Regarding the open field test, there was a statistically significant difference (p <0.005) between the groups for the variables: ambulatory movements, standing movements, number of jumps, distance traveled, speed of distance traveled and movements performed in the center and on the edges.Regarding the systemic effects, the leukogram and the biochemical tests performed did not show significant results. Conclusion: The use of thermogenics has no influence on the rate of orthodontic movement in rats and does not produce relevant systemic changes, however, it is capable of affecting several aspects of the behavior of these animals (AU).