Ortodontia brasileira: ainda há boas safras / Brazilian orthodontics: still there are good vintages

O presente artigo relata o caso clínico ortodôntico de uma paciente adulta, tratada por Ortodontia fixa, com extração de quatro primeiros pré-molares e mecânica Straight Wire/Tweed. Destaca-se a importância do diagnóstico, baseado na avaliação clínica e análise da documentação ortodôntica; e da disciplina na aplicação do plano de tratamento, para contemplar a demanda estética e funcional da paciente e do ortodontista.

Paraconsistent artificial neural network as auxiliary in cephalometric diagnosis.

This work presents an application of the paraconsistent artificial neural network (PANN) in the analysis of cephalometric variables and provides an orthodontic diagnosis. An expert's analysis is subject to the inherent imprecision of measurements, registers, and individual variability of physician visual analysis. Patient input cephalometric values are compared with means drawn from individuals considered normal in the cephalometric point of view by the PANN. This reference is constituted by individuals from 6 to 18 years old, both genders. The applied cephalometric analysis was targeted to measure skeletal and dental discrepancies and established a cephalometric diagnosis. The analysis results in degrees of skeletal, anteroposterior, and dental discrepancy, pertinent to upper and lower incisors. A sample of 120 orthodontic patients was processed by the proposed model and three orthodontic experts. Comparisons between the model and the human expert's performance provided kappa indexes that varied from moderate to almost perfect agreement. The agreement between the model and specialist's performance was equivalent. In addition, the model pointed out contradictions presented in the data that were not noticed by the orthodontists, which highlight the contribution that this kind of system could carry out in the orthodontics decision support.

Influence of occlusal plane inclination on ANB and Wits assessments of anteroposterior jaw relationships.

INTRODUCTION: Although assessments of anteroposterior relationships are vital for orthodontic treatment planning, they cannot be precisely achieved by current cephalometric and noncephalometric resources. ANB angle and the Wits appraisal are the most popular cephalometric measurements applied in clinical orthodontics, although they have drawbacks. Facial vertical features, especially the occlusal plane angle, play an important role in their assessment, contributing to their unreliability. METHODS: To further understand the influence of occlusal plane inclination, ANB angle and the Wits appraisal were analyzed in cephalo-lateral radiographs of 122 finished orthodontic patients in 2 groups: high occlusal plane angle and low occlusal plane angle. RESULTS: There was a tendency for inconsistency between ANB and Wits assessments in the high occlusal plane angle group and a tendency for consistency in the low occlusal plane angle group. Cranial base influences on ANB and Wits assessments were investigated by subdividing the groups. Any of the considered cranial base factors was decisive for lack or presence of consistency between ANB and Wits assessments. CONCLUSIONS: The clinician should beware of possible misinterpretations when using ANB and Wits to assess the anteroposterior relationship of the jaws, especially in high occlusal plane angle patients.

Buccolingual inclinations of posterior teeth in subjects with different facial patterns.

This study compared the buccolingual inclination of the posterior teeth in subjects with a horizontal growth pattern (proportionally short lower anterior face height) with that of subjects with a vertical growth pattern (proportionally long lower anterior face height). Seventy subjects with permanent dentition were divided into 2 groups. Group I comprised 35 subjects (16 male, 19 female) with Class II Division 2 malocclusion with a horizontal growth pattern, and group II comprised 35 subjects (15 male, 20 female) with a vertical growth pattern. Buccolingual inclinations of the first molar and second premolar were indirectly assessed on photocopies of buccolingual sections of these teeth by measuring their occlusal surface (represented by an imaginary line connecting the lingual and buccal cusps) inclination. The groups were compared with t tests (P <.05). The maxillary posterior teeth of subjects with a vertical growth pattern had a significantly greater buccal inclination compared with those of subjects with a horizontal growth pattern. However, there were no statistically significant differences in the inclinations of the mandibular posterior teeth between the 2 groups.