Evidence of Association between MTRR and TNF-α Gene Polymorphisms and Oral Health-Related Quality of Life in Children with Anterior Open Bite.

Genetic polymorphisms could explain the inter-individual differences in the oral health-related quality of life (OHRQoL) of children with anterior open bite (AOB). OBJECTIVE: To assess the impact of AOB on OHRQoL in children and to evaluate whether MTR (rs1805087), MTRR (rs1801394), TGFß1 (rs1800469) and TNF-α (rs1799964, rs1799724 and rs1800629) genes are potential biomarkers for OHRQoL in children with AOB. STUDY DESIGN: A cross-sectional study was performed with 173 children aged between 2-6 years. The Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS) was applied. Genetic polymorphisms were analyzed using real-time PCR. Mann-Whitney U-test and Chi-square were used. RESULTS: The overall mean ECOHIS scores were 5.49 (SD= 5.72) and 3.45 (SD = 4.49) (p < 0.01) in the AOB and control groups, respectively. Children with the CC genotype of TNF-α (rs1799724) had a significantly higher psychological QoL level. The MTRR AA genotype group showed a lower QoL level in the child subscale (p = 0.006), function (p = 0.017), and psychological (p = 0.006) domains. There was no significant difference between OHRQoL and the genetic polymorphisms in MTR and TGFß1. CONCLUSIONS: Genetic polymorphisms in TNF-α and MTRR are associated with the impact on the OHRQoL in children with AOB.

Assessing the association between vitamin D receptor and dental age variability.

OBJECTIVES: To explore the association between genetic polymorphisms in vitamin D receptor (VDR), vitamin D serum levels, and variability in dental age. MATERIAL AND METHODS: This cross-sectional study was based on an oral examination, panoramic radiograph analysis, and genotype analysis from biological samples. Dental age was evaluated using two different methods: Demirjian et al. (Hum Biol 45:211-227, 1973) and Hofmann et al. (J Orofac Orthop.78:97-111, 2017). The genetic polymorphisms BglI (rs739837) and FokI (rs2228570) in VDR were genotyped through real-time PCR. The vitamin D level was also measured in the serum. Delta (dental age-chronological age) was compared among genotypes in VDR in the co-dominant model. Multiple linear regression analysis was also performed. An established alpha of 5% was used. RESULTS: Genotype distributions of BglI and FokI were not associated with dental maturity (p > 0.05). In the logistic regression analyses, genotypes in BglI and FokI and vitamin D levels were not associated with variability in dental age (p > 0.05). CONCLUSIONS: The genetic polymorphisms BglI and FokI in VDR and the vitamin D levels were not associated with variability in dental age. CLINICAL RELEVANCE: To unravel the factors involved in dental maturity can improve dental treatment planning in pediatric and orthodontic practice.

Interceptação da mordida aberta anterior na dentição mista ­ relato de caso / Anterior open bite interception in mixed dentition ­ case report

Resumo A mordida aberta anterior (MAA) merece destaque ímpar, já que além de ser a mais frequente entre as discrepâncias verticais e comprometer a estética dental, interfere também na função mastigatória e na fala do paciente, afetando consequentemente a sua auto-estima. Por seu caráter multifatorial, essa má oclusão pode ser causada por diversas razões, tais como a herança genética ou desenvolvimento maxilofacial inerente a cada individuo. O presente trabalho teve como objetivo descrever o tratamento de um paciente com MAA. O paciente BS de 7 anos e 5 meses de idade possuía má oclusão de Classe I com mordida aberta anterior (-2,8 mm). O plano de tratamento foi dividido em duas fases: na primeira, foi utilizado o aparelho de Haas com grade lingual na arcada superior; na arcada inferior, utilizou-se um expansor removível. Na sequência do tratamento, instalou-se o aparelho fixo em ambas as arcadas. O tratamento teve duração de 9 (nove) meses e conseguiu o fechamento da mordida aberta anterior. A segunda fase iniciou-se após a irrupção dos segundos molares permanentes e teve duração de 13 meses. Como conclusão se observou que o tratamento da mordida aberta anterior em duas fases foi uma excelente escolha para o tratamento do paciente aqui relatado. Na primeira fase, a mordida foi fechada e as arcadas foram alargadas para permitir o posicionamento adequado de todos os dentes permanentes, que tiveram seu posicionamento perfeitamente detalhado na segunda fase.(AU)

Abstract The anterior open bite (AOB) deserves unique attention as in addition to being the most frequent among vertical discrepancies and compromising dental aesthetics, it interferes in the patient chewing function and speech, consequently affecting their self-esteem. Due to its multifactorial character, this malocclusion can be caused by several reasons, such as genetic inheritance or maxillofacial development inherent to each individual. This study aimed to describe the treatment of a patient with AOB. Patient BS 7-year and 5-month-old had a Class I malocclusion with anterior open bite (-2.8 mm). The treatment plan was divided into two phases: In the first, the Haas appliance with fixed palatine crib in the upper arch was used; in the lower arch, a removable expander was used. Following the treatment, the fixed appliance was installed in both arches. The treatment lasted 9 months and achieved AOB closure. The second phase started after the eruption of the second permanent molars and lasted 13 months. In conclusion, it was observed that the treatment of AOB in two phases was an excellent choice for the patient treatment reported here. In the first phase, the bite was closed, and the arches were widened to allow the proper positioning of all the permanent teeth, which had their positioning perfectly detailed in the second phase.(AU)

Lack of association between delayed tooth emergence and single nucleotide polymorphisms in estrogen receptors

Abstract The purpose of the study was to investigate the association between single nucleotide polymorphisms (SNPs) in genes encoding estrogen receptors (ESR1 and ESR2, respectively) and delayed tooth emergence (DTE). This cross-sectional study was composed of biological unrelated children of both sexes, age ranging from 11 to 13 years old. DTE was defined when the successor primary tooth was still present in the oral cavity after its exfoliation time or the absence of the permanent tooth emergence into the oral cavity. Children were diagnosed with DTE when they had at least one delayed permanent tooth, according to age of exfoliation of each tooth proposed by The American Dental Association. Genomic DNA from saliva was used to evaluate the SNPs in ESR1 (rs9340799 and rs2234693) and ESR2 (rs1256049 and rs4986938) using Real-Time PCR. Chi-square or Fisher exact tests and Logistic Regression adjusted by age and gender were performed. SNP-SNP interaction was accessed by multifactor dimensionality reduction (MDR) analysis also adjusted by gender and age. The established alpha of this study was 5%. Among 537 included children, 296 (55%) were in the "DTE" group and the 241 (45%) were in the "Control" group. Age and gender were not statistically different among the groups (p>0.05). Genotype distribution of the SNPs rs9340799, rs2234693, rs1256049 and rs4986938 were not associated with DTE (p> 0.05). The models elected by MDR were not statistically significant either. Conclusions: The studied SNPs in ESR1 and ESR2 were not associated with permanent DTE.

RESUMO O objetivo do presente estudo foi investigar a associação entre polimorfismos de nucleotídeo único (SNPs) em genes que codificam receptores de estrógeno (ESR1 e ESR2, respectivamente) e o retardo na emergência dentária (DTE). Este estudo transversal foi composto por crianças biológicas não relacionadas de ambos os sexos, com idades entre 11 e 13 anos. O DTE foi definido pela presença do dente decíduo na cavidade bucal após seu tempo e também, quando as crianças apresentaram pelo menos um dente permanente com atraso. O DNA genômico foi usado para avaliar os SNPs em ESR1 (rs9340799 e rs2234693) e ESR2 (rs1256049 e rs4986938) usando PCR em tempo real. Foram realizados testes Qui-quadrado ou exato de Fisher e Regressão Logística ajustados por idade e sexo. A interação SNP-SNP foi acessada pela análise de redução de dimensionalidade multifatorial (MDR), também ajustada por sexo e idade. O alfa de 5% foi estabelecido. Entre 537 crianças incluídas, 296 (55%) estavam no grupo "DTE" e 241 (45%) estavam no grupo "Controle". A idade e o sexo não foram estatisticamente diferentes entre os grupos (p> 0,05). A distribuição de genótipos dos SNPs rs9340799, rs2234693, rs1256049 e rs4986938 não foi associada ao DTE (p> 0,05). Os modelos eleitos pelo MDR também não foram estatisticamente significativos. Conclusões: Os SNPs estudados na ESR1 e ESR2 não foram associados ao DTE na dentição permanente.

Correlation between Insulin-Like Growth Factor I and Skeletal Maturity Indicators.

Objective: The purpose of this study was to evaluate the correlation between the growth maturity indicators in orthodontic patients. Design: This cross-sectional study was performed on 37 orthodontic patients (17 males and 20 females). An anamnesis, clinical and image examination, and blood sample collection were performed. The inclusion criteria were non-syndromic Class II patients of both gender, age ranging between 10 to 16 years. The lateral cephalometric radiographs were evaluated using 6-stage cervical vertebrae maturation (CVM) technique. The hand-wrist radiographs were staged using the 11-stage skeletal maturation indicator (SMI) technique. Blood was collected in the same week of the images to quantify IGF-1 levels in serum. Data were tested for normality by Shapiro-Wilk test. The Pearson test was used to determine the correlation strength between the variables (alpha of 5%). Results: A strong correlation was observed only between SMI stages and CVM stages in the total sample (r=0.864; p<0.0001) and according to the gender (r=0.793; p<0.0001 for females; and r=0.753; p<0.0001 for males). IGF-1 was only moderately correlated with SMI stages and CVM stages. Conclusion: Hand-wrist and cervical vertebral stages were strongly correlated among them, however, IGF-1 was only moderately correlated with both skeletal maturity indicators.

Potential interactions among single nucleotide polymorphisms in bone- and cartilage-related genes in skeletal malocclusions.

OBJECTIVE: To investigate SNPs in bone- and cartilage-related genes and their interaction in the aetiology of sagittal and vertical skeletal malocclusions. SETTINGS AND SAMPLE POPULATION: This study included 143 patients and classified as follows: skeletal class I (n = 77), class II (n = 47) and class III (n = 19); maxillary retrusion (n = 39), protrusion (n = 52) and well-positioned maxilla (n = 52); mandibular retrognathism (n = 50), prognathism (n = 50) and well-positioned mandible (n = 43); normofacial (n = 72), dolichofacial (n = 55) and brachyfacial (n = 16). MATERIALS AND METHODS: Steiner's ANB, SNA, SNB angles and Ricketts' NBa-PtGn angle were measured to determine the skeletal malocclusion and the vertical pattern. Nine SNPs in BMP2, BMP4, SMAD6, RUNX2, WNT3A and WNT11 were genotyped. Chi-squared test was used to compare genotypes among the groups. Multifactor dimensionality reduction (MDR) and binary logistic regression analysis, both using gender and age as co-variables, were also used. We performed Bonferroni correction for multiple testing. RESULTS: Significant associations at P < .05 were observed for SNPs rs1005464 (P = .042) and rs235768 (P = .021) in BMP2 with mandibular retrognathism and for rs59983488 (RUNX2) with maxillary protrusion (P = .04) as well as for rs708111 (WNT3A) with skeletal class III (P = .02; dominant model), rs1533767 (WNT11) with a brachyfacial skeletal pattern (P = .01, OR = 0.10; dominant model) and for rs3934908 (SMAD6) with prognathism (P = .02; recessive model). After the Bonferroni correction, none of the SNPs remained associated. The MDR predicted some interaction for skeletal class II, dolichofacial and brachyfacial phenotypes. CONCLUSION: Our results suggest that SNPs in BMP2, BMP4, SMAD6, RUNX2, WNT3A and WNT11 could be involved in the aetiology of sagittal and vertical malocclusions.

Lack of association between delayed tooth emergence and single nucleotide polymorphisms in estrogen receptors.

The purpose of the study was to investigate the association between single nucleotide polymorphisms (SNPs) in genes encoding estrogen receptors (ESR1 and ESR2, respectively) and delayed tooth emergence (DTE). This cross-sectional study was composed of biological unrelated children of both sexes, age ranging from 11 to 13 years old. DTE was defined when the successor primary tooth was still present in the oral cavity after its exfoliation time or the absence of the permanent tooth emergence into the oral cavity. Children were diagnosed with DTE when they had at least one delayed permanent tooth, according to age of exfoliation of each tooth proposed by The American Dental Association. Genomic DNA from saliva was used to evaluate the SNPs in ESR1 (rs9340799 and rs2234693) and ESR2 (rs1256049 and rs4986938) using Real-Time PCR. Chi-square or Fisher exact tests and Logistic Regression adjusted by age and gender were performed. SNP-SNP interaction was accessed by multifactor dimensionality reduction (MDR) analysis also adjusted by gender and age. The established alpha of this study was 5%. Among 537 included children, 296 (55%) were in the "DTE" group and the 241 (45%) were in the "Control" group. Age and gender were not statistically different among the groups (p>0.05). Genotype distribution of the SNPs rs9340799, rs2234693, rs1256049 and rs4986938 were not associated with DTE (p> 0.05). The models elected by MDR were not statistically significant either. Conclusions: The studied SNPs in ESR1 and ESR2 were not associated with permanent DTE.

Correlação entre maturidade dentária e índice de massa corporal em pacientes com má oclusão de Classe II / Correlation between dental maturity and body mass index in Angle Class II patients

Resumo Objetivo: Avaliar a correlação entre o Índice de Massa Corporal (IMC) e o desenvolvimento dentário em pacientes portadores de má oclusão de Classe II. Materiais e Métodos: Tratou-se de um estudo retrospectivo com uma amostra de 37 pacientes portadores de má oclusão de Classe II, que estavam em tratamento ortodôntico. Os dados idade, gênero, peso e altura foram coletados dos prontuários, juntamente com a tomada tomográfica inicial. O desenvolvimento dentário foi avaliado pelo método de Demirjian et al. (1973). O coeficiente de correlação de Pearson foi utilizado para determinar a força de correlação entre as variáveis. A significância estatística considerada foi p <0,05 bicaudal. Resultados: A amostra foi constituída por pacientes entre 10 e 16 anos. A maioria dos pacientes (78,4%) apresentou IMC dentro da normalidade. Observou-se correlação fraca sem significância estatística entre o desenvolvimento dentário e o IMC nos pacientes avaliados (r=-0,10; p=0,55). Conclusão: Não houve correlação entre o IMC e o desenvolvimento dentário para a amostra estudada (AU)

Abstract Objective: To evaluate the correlation between the Body Mass Index (BMI) and dental development in patients with Class II malocclusion. Materials and Methods: This was a retrospective study with a sample of 37 patients presenting Class II malocclusion, who were undergoing orthodontic treatment. The age, gender, weight and height data were collected from the medical records, together with the initial CT scan. Dental development was assessed using the method of Demirjian et al. (1973). Pearson's correlation coefficient was used to determine the correlation strength between variables. The statistical significance considered was p <0.05 two-tailed. Results: The sample consisted of patients between 10 and 16 years old. The majority of the patients (78.4%) had a normal BMI. There was a weak correlation without statistical significance between tooth development and BMI in the evaluated patients (r=-0.10; p=0.55). Conclusion: There was no correlation between BMI and dental development for the sample studied.(AU)

Orthodontic Treatment of Ankylosed Maxillary Incisor through Osteogenic Distraction and Simplified Biomechanics.

Ankylosed teeth may have a significant esthetic and functional impact especially at the anterior segment of the upper arch. Treatment of ankylosed teeth is challenging. The objective of this case report is to describe a clinical case in which an ankylosed tooth was treated with the use of osteogenic distraction associated with simplified orthodontic biomechanics. A 17-year-old female Caucasian patient presented with a Class II malocclusion, severe maxillary dental crowding, moderate mandibular dental crowding, anterior open bite, upper midline deviation to the right, and upper right central incisor in infraocclusion due to ankylosis. Treatment involved the use of the ankylosed tooth as anchorage for the distalization of the right upper segment to correct the Class II malocclusion and to create space prior to surgery. After one week of surgical osteotomy, traction of the tooth and bone segment was initiated with the use of intermaxillary elastics. The ankylosed tooth was moved to the desired position. Bone formation and mucogingival tissue adaptation were observed. Thus, esthetic and functional improvement was achieved. Osteogenic distraction associated with simplified orthodontic biomechanics is an alternative to the treatment of ankylosed teeth which can replace the use of distractor screws, making treatment simpler and more accessible.

Tratamento orto-cirúrgico da mordida aberta anterior ­ relato de caso / Ortho-surgical treatment of anterior open bite ­ case report

A mordida aberta anterior (MAA) é uma má oclusão cujo prognóstico pode variar de deficiente a bom dependendo de fatores como etiologia, gravidade e fase em que ocorre o tratamento. A interceptação da MAA em uma época precoce, eliminando-se todos os seus fatores etiológicos, aumenta o sucesso e a estabilidade da correção. Mordidas abertas anteriores esqueléticas graves em pacientes que não estão em fase de crescimento frequentemente requerem tratamento ortodôntico associado à cirurgia ortognática. Este trabalho teve como objetivo descrever um caso clínico de uma paciente adulta com MAA esquelética, tratada com uma abordagem orto-cirúrgica com multissegmentação da maxila. A paciente ­ sexo feminino, 18 anos, leucoderma ­ buscou tratamento ortodôntico com queixa de recidiva de tratamento de MAA. Considerando a idade da paciente, a alteração esquelética e o histórico de recidiva, optou-se pelo tratamento orto-cirúrgico, com avanço, intrusão e expansão da maxila, bem como correção da inclinação do plano palatino. O tempo de tratamento foi de 24 meses. Ao final do tratamento a paciente apresentou melhora da oclusão e da estética facial e do sorriso. Um ano após o final do tratamento, os resultados mostraram-se estáveis. (AU)

Prognosis of anterior open bite (AOB) can vary from deficient to good depending on factors such as etiology, severity, and phase in which treatment occurs. The interception of AOB in an early age, eliminating all its etiological factors, increases the success and stability of the correction. Severe skeletal AOB in patients who are not in the growth phase often require orthodontic treatment associated with orthognathic surgery. This study aimed to describe a clinical case of an adult patient with skeletal AOB treated with an ortho-surgical approach with maxillary multiple-segment osteotomy surgery. The patient - female, 18 years old, leucoderma - sought orthodontic treatment with complaint of relapse of AOB treatment. Considering the patient's age, skeletal alteration, and history of relapse, we opted for ortho-surgical treatment, with advancement, intrusion and expansion of the maxilla as well as correction of the palatal plane inclination. The treatment time was 24 months. At the end of the treatment, the patient presented improvement of occlusion and facial and smile aesthetics. One year after the end of treatment, the results were stable.(AU)

Tratamento orto-cirúrgico em paciente adulto com má oclusão de Classe II e retrognatismo mandibular / Orthosurgical treatment in adult patient with Class II malocclusion and mandibular retrognathism

O tratamento da má oclusão de Classe II é de grande interesse para o ortodontista clínico, pois é vasto o número de pacientes com essa má oclusão que busca tratamento. Existem diversas formas de abordagem para o tratamento da Classe II, porém, para pacientes adultos com comprometimento esquelético, a cirurgia ortognática é a mais indicada. Este trabalho teve por objetivo descrever o caso clínico de uma paciente adulta, com má oclusão de Classe II, divisão 1, e retrognatismo mandibular. A paciente buscava retratamento ortodôntico em função da sua insatisfação com a estética facial. Foi planejado um tratamento orto-cirúrgico. O preparo para a cirurgia ortognática envolveu o alinhamento e nivelamento dos dentes, buscando realizar descompensações dentárias, com aparatologia fixa. A cirurgia abrangeu o avanço mandibular e maxilar e a mentoplastia. Ao final do tratamento, foi obtida uma oclusão adequada, selamento labial espontâneo e grande melhora no perfil facial da paciente.(AU)

Class II malocclusion treatment is of great interest to the clinical orthodontist, since the number of patients with this malocclusion who seek treatment is large. There are several approaches to Class II treatment, but for adult patients with skeletal involvement, orthognathic surgery is indicated. This study aimed to describe the clinical case of an adult patient with Class II division 1 malocclusion and mandibular retrognathism. The patient sought orthodontic retreatment due to her dissatisfaction with facial aesthetics. Ortho-surgical treatment was planned. Orthognathic surgery preparation involved teeth alignment and leveling, in order to perform dental decompensations with fixed apparatus. The surgery included mandibular and maxillary advancement and mentoplasty. At the end of the treatment, adequate occlusion, spontaneous labial sealing, and great improvement in the patient's facial profile were obtained.(AU)

Recommendations for the Prevention of Bisphosphonate-Related Osteonecrosis of the Jaw: A Systematic Review.

OBJECTIVES: The aim of this study was to assess the quality of and outline the differences among recommendations of published clinical practice guidelines (CPGs) for the management of bisphosphonate-associated osteonecrosis of the jaw. METHODS: We conducted a systematic literature search in PubMed, Cochrane, Embase, Web of Science, and Google web site. We selected CPGs supported by a nongovernmental organization or national institutes, related to bisphosphonate-associated osteonecrosis of the jaw in adults, in English language, and dated from January 2008 onward. The validity of each included CPG was appraised according to 2 validated appraisal tools for CPG that were independently used by 2 reviewers. RESULTS: We identified 724 articles, of which 13 were included based on our eligibility criteria. Most CPGs were of good quality based on the appraisal tools for CPGs used in this study. CONCLUSION: We did not find consensus on all the recommendations of the evaluated CPGs. Thus, each clinical case must be assessed individually, considering the risks and benefits on the proposed dental treatment.

Tratamento orto-cirúrgico de má oclusão de Classe I com retrognatismo mandibular ­ relato de caso / Orthodontic surgical treatment of Class I malocclusion with mandibular retrognathia ­ case report

Muitos pacientes adultos que buscam tratamento ortodôntico apresentam problemas dentários e esqueléticos. Para esses pacientes, o tratamento orto-cirúrgico é uma alternativa que promove inúmeros benefícios. Este trabalho teve por objetivo relatar o tratamento de um paciente adulto com má oclusão de Classe I com retrognatismo mandibular. O paciente era do sexo masculino, leucoderma, com 21 anos de idade. Sua queixa era de que os dentes anteriores estavam muito mal posicionados. No exame clínico, observou-se que o paciente apresentava perfil convexo e ausência de selamento labial. A relação molar era de Classe I. Havia apinhamento na região anterior dos arcos superior (-2,5mm) e inferior (-6,0 mm). A telerradiografia lateral e o traçado cefalométrico mostraram que o paciente apresentava retrusão mandibular. A maxila estava bem posicionada e os incisivos superiores e inferiores protruídos. Optou-se pelo tratamento com a exodontia de dois pré-molares inferiores, cirurgia ortognática de avanço da mandíbula e mentoplastia. O tratamento resultou numa oclusão adequada, além de uma grande melhora no perfil do paciente e na capacidade de obter selamento labial sem forçar os músculos peribucais. Pode-se concluir que a extração de dois pré-molares inferiores seguida do avanço cirúrgico da mandíbula constitui-se numa excelente solução para os casos de Classe I com retrusão mandibular em pacientes adultos. (AU)

Many adult patients seeking orthodontic treatment have dental and skeletal problems. For these patients ortho-surgical treatment is an alternative that promotes numerous benefits. This study aimed to report the treatment of an adult patient with Class I malocclusion with mandibular retrognathism. The patient was male, caucasian, 21 years old. His complaint was that his anterior teeth were very poorly positioned. At the clinical examination, it was observed that the patient had a convex profile and absence of labial sealing. The molar relationship was Class I. There was crowding in the anterior region of the upper (-2.5mm) and lower (-6.0mm) arches. Lateral teleradiography and cephalometric tracing showed that the patient presented mandibular retrusion. The maxilla was well positioned and the upper and lower incisors were protruded. Treatment chosen was extraction of two lower premolars, mandible orthognathic advancement and mentoplasty. After treatment an adequate occlusion was observed, in addition to a great improvement in patient's profile and in the ability to obtain lip seal without forcing the peribucal muscles. It can be concluded that the extraction of two lower premolars followed by the mandibular surgical advancement constitute an excellent solution for Class I cases with mandibular retrusion in adult patients (AU)

Método digital para a colagem indireta de bráquetes ­ relato de caso / Digital method for indirect bracket bonding ­ case report

Dentre os grandes desafios da Ortodontia, o posicionamento correto dos bráquetes durante a colagem do aparelho fixo é fundamental para o sucesso da biomecânica e a finalização satisfatória do tratamento. A colagem indireta de bráquetes possibilita um posicionamento mais preciso, além de reduzir o tempo clínico e promover maior conforto para o paciente. As tecnologias digitais ampliaram as possibilidades de realizar diferentes procedimentos na Ortodontia e permitiram o aprimoramento das técnicas de colagem indireta. O objetivo deste estudo foi demonstrar, por meio de um caso clínico, um método de colagem indireta de bráquetes com a utilização de tecnologias digitais. A paciente, 12 anos de idade, sexo feminino, apresentava perfil equilibrado, má oclusão de Classe I e apinhamento leve superior e inferior. Durante o planejamento do caso, optou-se pela colagem indireta de bráquetes. Foram realizados exames de tomografia computadorizada e escaneamento intrabucal. O posicionamento dos bráquetes foi planejado de forma virtual, por meio da sobreposição das imagens tomográficas e do modelo virtual. As moldeiras de transferência foram obtidas por impressão 3D. A aplicação das tecnologias digitais na colagem indireta de bráquetes elimina a necessidade das etapas laboratoriais, tornando o procedimento mais prático, rápido, preciso e confortável para o paciente. (AU)

Among the great challenges of Orthodontics, the correct positioning of brackets during fixed appliance installation is fundamental for the success of biomechanics and the satisfactory treatment finalization. Indirect bracket bonding allows more precise bracket positioning, as well as reducing clinical time and promoting greater comfort for the patient. Digital technologies have expanded the possibilities of performing different procedures in Orthodontics and have allowed the improvement of indirect bonding techniques. The objective of this study was to demonstrate, through a clinical case, a method of indirect bracket bonding with the use of digital technologies. The patient, 12 years old, female, presented a balanced profile, Class I malocclusion and upper and lower light crowding. During the planning of the case, we opted for the indirect bracket bonding. Computed tomography and intraoral scans were performed. The positioning of the brackets was planned in a virtual way, by means of the overlapping of the tomographic images and the virtual model. Transfer trays were obtained by 3D printing. The application of digital technologies in indirect bracket bonding eliminates the need for laboratory steps, making the procedure more practical, fast, accurate, and comfortable for the patient. (AU)