Effects of rapid maxillary expansion with six months of retention and no further orthodontic treatment / Efeitos da expansão rápida da maxila com 6 meses de contenção e sem posterior tratamento ortodôntico

Previous investigations addressing the long-term effects of rapid or slow expansion on the face and teeth involved the use of a orthodontic fixed appliance following expansion therapy. The present study evaluated changes in dentoskeletal aspects following rapid maxillary expansion (RME) and determine the stability of these changes over three years of follow up. Ten children with bilateral posterior crossbite were evaluated (experimental group). Dental casts and lateral cephalograms were evaluated prior to RME (T0) as well as three months (T1), one year (T2) and three years (T3) after RME. The measures were compared to a control group composed of 21 individuals using ANOVA and the Student's t-test (p > 0.05). Changes on the transverse plane revealed significant expansion of the upper dental arch three months after RME, stable after three years. Expansion at the cusp level was similar to that at the gingival level. No significant changes were found in the angular and linear cephalometric measures among T0, T1, T2 and T3, and in comparison to the control group (p > 0.05). We concluded that early RME produces stable transverse increases in the upper arch after three years without significantly altering sagittal and vertical dentoskeletal relationships, and neither inclined teeth.

A expansão rápida ou lenta da maxila seguida do uso de aparelhos ortodônticos fixos altera a face e os dentes. Este estudo avaliou as mudanças dentoesqueléticas após a expansão rápida da maxila (ERM) e determinou a estabilidade dessas mudanças em três anos de acompanhamento. Dez crianças com mordida cruzada posterior bilateral foram avaliadas (grupo experimental). Modelos de estudo e telerradiografias laterais foram avaliadas antes da ERM (T0), assim como três meses (T1), um ano (T2) e três anos (T3) após a ERM. As medidas foram comparadas às de um grupo controle composto de 21 pacientes por meio do teste ANOVA e teste t Student (p > 0,05). As mudanças no plano transversal revelaram uma expansão significante no arco superior três meses após a ERM, que se manteve estável após três anos. A expansão ao nível das cúspides foi similar à do nível gengival. Mas nenhuma diferença significante foi encontrada estre as medidas cefalométricas angulares e lineares ao longo dos períodos T0, T1, T2, e T3 e nem quando se comparou essas medidas às do grupo controle (p > 0,05). Conclui-se que A ERM precoce produz aumentos transversais estáveis no arco superior sem alterar significantemente as relações sagitais e verticais dentoesqueléticas e nem inclinar dentes.

Prevalence of malocclusion in people with disabilities / Prevalência de más oclusões em pessoas com deficiência

Objetivo: Avaliar a prevalência de má oclusão em pacientes com deficiências. Materiais e Métodos: A amostra foi composta por 98 pacientes com o diagnóstico prévio da deficiência. Os pacientes foram distribuídos em três grupos: deficiência intelectual (DI), paralisia cerebral (PC) e síndrome de Down (SD). Eles foram avaliados de acordo com a classificação de Angle para má oclusão, presença ou ausência de mordida cruzada posterior, mordida cruzada anterior e mordida aberta anterior. A análise estatística dos dados foi realizada utilizando o teste de Kruskal Wallis com nível de significância de 5%. Resultados: A Classe II foi mais frequente nos três grupos (PC 45,45%, DI 40,43% and SD 50,00%); a mordida cruzada anterior e posterior foram mais prevalentes na SD (p < 0,0001). A mordida aberta anterior foi mais prevalente na PC (p < 0,0001). Conclusão: Pacientes com deficiência apresentam altas taxas de má oclusão e compreender esta condição é essencial para estabelecer o tratamento mais adequado.

Objective: To evaluate the prevalence of malocclusion in patients with disabilities. Material and Methods: The sample consisted in 98 patients of who had a previous diagnosis of disability. Patientes were divided into three groups: Intelectual Disabilities (ID), Cerebral Palsy (CP) and Down Syndrome (DS). They were evaluated according to Angle malocclusion classification, presence or absence of posterior crossbite, anterior crossbite and anterior open bite. Statistical analysis of the data was performed using the Kruskal Wallis test at 5% significance level. Results: Class II malocclusion was more frequent in the three groups (CP 45.45%, ID 40.43% and DS 50.00%); the anterior and the posterior crossbite were more prevalent in DS (p < 0.0001). The anterior open bite was more prevalent in CP (p < 0.0001). Conclusion: Patients with disabilities have high rate of malocclusion and understanding this condition is essential to establish appropriate treatment

Hábitos bucais deletérios em pessoas com deficiência / Oral habits in people with disabilities

Pessoas com deficiências apresentam alto índice de más oclusões, o que pode estar relacionado ao crescimento e desenvolvimento anormais, além da alta incidência de hábitos bucais deletérios (HBD). Os dados sobre a distribuição dos HBD nos diferentes tipos de síndrome ou deficiência são escassos, portanto, o objetivo desse trabalho foi avaliar a prevalência dos HBD em pacientes com deficiências. A amostra foi composta por 100 pacientes, sendo 56 do sexo masculino (56%) e 44 do sexo feminino (44%), com idade média de 33,5 anos. Em relação ao tipo de deficiência, 47 pacientes apresentavam Retardo Mental (RM), 35 Paralisia Cerebral (PC) e 18 Síndrome de Down (SD). Constatou-se que 24 pacientes (24%) não apresentavam nenhum HBD, sendo 19 com RM, 3 com SD e 2 com PC. Quanto ao número de HBD, 35 pacientes (35%) foram diagnosticados com 1 HBD, 23 (23%) com 2 HBD e 18 (18%) com 3 ou mais HBD. Na PC, a respiração bucal foi o HBD mais prevalente (54,3%), seguido da interposição lingual (42,9%). A respiração bucal também foi o HBD mais frequente nos pacientes com RM (34%), já nos pacientes com SD, chama atenção o grande número de indivíduos que apresentaram interposição lingual (61,1%) e respiração bucal (50%). O alto índice de HBD comprova a necessidade de maior atenção dos profissionais para o desenvolvimento de procedimentos interceptores e corretivos específicos para os pacientes com deficiência. Além disso, os responsáveis devem ser orientados sobre as consequências dos hábitos mais prevalentes (AU).

People with disabilities have a high rate of malocclusion, which may be related to abnormal growth and development, and the high incidence of oral habits (OH). Data on the distribution of OH in the different types of syndrome or disability are limited, so the aim of this study was to evaluate the prevalence of OH in patients with disabilities. The sample consisted in 100 patients, 56 male (56%) and 44 female (44%), mean age of 33.5 years old. Regarding the type of disability, 47 patients had Mental Retardation (MR), 35 Cerebral Palsy (CP) and 18 Down Syndrome (DS). It was found 24 patients (24%) did not have any HBD, 19 with RM, 3 with SD, and 2 PC. As the number of OH, 35 patients (35%) were diagnosed with 1 OH, 23 (23%) 2 OH, and 18 (18%) had 3 OH or more. In PC, mouth breathing was the most prevalent OH (54.3%), followed by tongue thrusting (42.9%). Mouth breathing was also the most frequent in patients with MR (34%), while in patients with SD, the large number of individuals had tongue thrusting (61.1%) and mouth breathing (50%). The high level of OH proves the need for greater attention of professionals for the development of specific interceptors and corrective procedures for patients with disabilities. In addition, those responsible must be informed about the consequences of the most prevalent habits (AU).

Effect of alendronate sodium on tooth movement in ovariectomized rats.

OBJECTIVES: The aim of the present study was to evaluate the effect of two different dosages of alendronate on induced orthodontic movement in an experimental model involving rats with osteoporosis following ovariectomy. DESIGN: Female Wistar rats (Rattus norvegicus) eight weeks of age were divided into four groups (n=12/group): ovariectomized (OVX group); ovariectomized and treated with alendronate sodium at 1mg/kg (Group OVX+ALN1); ovariectomized and treated with alendronate sodium at 2mg/kg (Group OVX+ALN2); and sham operated (control). Three months after ovariectomy, the maxillary right first molar was submitted to movement for five and seven days. After the death of the animals, the maxilla were removed and processed for microscopic evaluation. The maxillary left first molar (without movement) was used for comparison purposes in all groups. The samples were processed for the quantification of alveolar bone and tooth movement. RESULTS: Intragroup comparisons showed significant movement after five and seven days (p<0.05) for all groups. Comparison among groups revealed greater tooth movement in the OVX group (p<0.05), on day 7. CONCLUSIONS: Both alendronate sodium doses similarly decreased tooth movement in ovariectomized rats (p>0.05). Movement in ovariectomized+alendronate groups were also smaller than non-ovariectomized rats, however without statistical difference.

Remodelação óssea com as forças contínua, contínua interrompida e intermitente: movimentação dentária induzida em ratos / Bone remodeling with continuous, interrupted continuous and intermittent forces: tooth movement in rats

Introdução: A aplicação de diferentes tipos de força pode provocar comportamentos distintos no osso alveolar. Proposição: avaliar se o lado contra-lateral (CL) a movimentação dentária induzida pode ser usado como grupo controle e a variação da quantidade de tecido ósseo frente a aplicação dos diferentes tipos de força em molares murinos. Métodos: Utilizou-se 60 ratos machos (Wistar-Rattus norvergicus), com aproximadamente 90 dias de idade e peso de 300g, divididos em 4 grupos de acordo com o tipo de força; Grupos controle (C), força contínua (FC), força contínua interrompida (FCI) e força intermitente (FI). As forças foram aplicadas nos períodos de 5, 7 e 9 dias (n=6) e analisou-se a quantidade de tecido ósseo alveolar. Os dados foram tabulados e realizou-se o teste estatístico com nível de significância de 5% (p<0,05). Resultados: houve diferença estatisticamente significante nos percentuais de colágeno entre os grupos C (80% ±0,01) e FC (62,2% ±0,15) e que o grupo CL foi estatisticamente igual aos demais grupos. A imunomarcação de OPG, o grupo C e o CL se comportaram de forma semelhante. A RANKL, na face mesial do grupo CL se comportou de forma semelhante ao FC e sua face distal diferiu dos demais grupos. A face distal do grupo C obteve score semelhante a face distal do grupo FC. A análise do tecido ósseo inter-grupos mostrou que aos 5 dias de MDI houve diminuição significante dos percentuais de osso dos grupos FC (62% ±0,14), FCI (55% ±0,07) e FI (54% ±0,05) em relação ao grupo C (80% ± 0,01) (p<0,05). Aos 7 dias de movimentação, essa diminuição ainda era significante nos grupos FC (64% ± 0,1) e o FI (38% ± 0,1) quando comparados ao grupo C (80% ± 0,01) e também houve diferença estatisticamente significante entre o FC (64% ± 0,1) e FI (38% ± 0,1) (p<0,05). Aos 9 dias de movimentação, essa diminuição foi significante entre os grupos FC (68% ± 0,03) e FCI (51% ± 0,13), e C (80% ± 0,01) e FCI (51% ± 0,13). A análise do tecido ósseo intra-grupos revelou uma...

Introduction: There are few researches about the behavior of the alveolar bone in relationship of three different types of forces. Objective: To evaluate if the bone on the contralateral side to orthodontic tooth movement can be used as the control group (CL) and the amount of bone tissue during the application of different types of force in rats molars. Methods: 60 male rats (Rattus norvegicus Wistar), with approximately 90 days of age and weight of 300g, divided into 4 groups according to the type of force: control group (C), continuous force (CF), intermittent continuous force (ICF) and interrupted force (IF); The groups were distributed in periods of 5, 7 and 9 days (n = 6). Were analyzed the amount of bone tissue of right upper first molar. The evaluation were conducted with Anova and Tukey’s tests a significance level of 5% (p <0.05). Results: The collagen analysis demonstrated a statistically significant difference between the C group (80 ± 0.01%) and CF (62.2 ± 0.15%), whereas no significant differences were found between the CL group and the other groups. Immunolabeling for OPG was similar in the C and CL groups. RANKL on the mesial face was similar in the CL and CF group. However, significant differences were found between the CL group and the other groups on the distal face, whereas no significant difference on the distal face was found between the C and CF group. The intergroup bone tissue analysis showed that the five days of induced tooth movement (ITM) was no significant decrease in bone percentage of CF groups (62% ± 0.14), ICF (55% ± 0.07) and IF (54% ± 0, 05) in the C group (0.01 ± 80%) (p <0.05). At 7 days of ITM, this reduction was still significant in the CF group (64% ± 0.1) and IF (38% ± 0.1) compared to C group (80% ± 0.01) and there was also difference statistically significant between CF (64 ± 0.1%) and IF (38% ± 0.1) (p <0.05). After 9 days of ITM, this decrease was significant between the CF group (68% ± 0.03) and ICF (51% ± 0.13)...

Remodelação óssea com as forças contínua, contínua interrompida e intermitente: movimentação dentária induzida em ratos / Bone remodeling with continuous, interrupted continuous and intermittent forces: tooth movement in rats

Introdução: A aplicação de diferentes tipos de força pode provocar comportamentos distintos no osso alveolar. Proposição: avaliar se o lado contra-lateral (CL) a movimentação dentária induzida pode ser usado como grupo controle e a variação da quantidade de tecido ósseo frente a aplicação dos diferentes tipos de força em molares murinos. Métodos: Utilizou-se 60 ratos machos (Wistar-Rattus norvergicus), com aproximadamente 90 dias de idade e peso de 300g, divididos em 4 grupos de acordo com o tipo de força; Grupos controle (C), força contínua (FC), força contínua interrompida (FCI) e força intermitente (FI). As forças foram aplicadas nos períodos de 5, 7 e 9 dias (n=6) e analisou-se a quantidade de tecido ósseo alveolar. Os dados foram tabulados e realizou-se o teste estatístico com nível de significância de 5% (p<0,05). Resultados: houve diferença estatisticamente significante nos percentuais de colágeno entre os grupos C (80% ±0,01) e FC (62,2% ±0,15) e que o grupo CL foi estatisticamente igual aos demais grupos. A imunomarcação de OPG, o grupo C e o CL se comportaram de forma semelhante. A RANKL, na face mesial do grupo CL se comportou de forma semelhante ao FC e sua face distal diferiu dos demais grupos. A face distal do grupo C obteve score semelhante a face distal do grupo FC. A análise do tecido ósseo inter-grupos mostrou que aos 5 dias de MDI houve diminuição significante dos percentuais de osso dos grupos FC (62% ±0,14), FCI (55% ±0,07) e FI (54% ±0,05) em relação ao grupo C (80% ± 0,01) (p<0,05). Aos 7 dias de movimentação, essa diminuição ainda era significante nos grupos FC (64% ± 0,1) e o FI (38% ± 0,1) quando comparados ao grupo C (80% ± 0,01) e também houve diferença estatisticamente significante entre o FC (64% ± 0,1) e FI (38% ± 0,1) (p<0,05). Aos 9 dias de movimentação, essa diminuição foi significante entre os grupos FC (68% ± 0,03) e FCI (51% ± 0,13), e C (80% ± 0,01) e FCI (51% ± 0,13). A análise do tecido ósseo intra-grupos revelou uma...

Introduction: There are few researches about the behavior of the alveolar bone in relationship of three different types of forces. Objective: To evaluate if the bone on the contralateral side to orthodontic tooth movement can be used as the control group (CL) and the amount of bone tissue during the application of different types of force in rats molars. Methods: 60 male rats (Rattus norvegicus Wistar), with approximately 90 days of age and weight of 300g, divided into 4 groups according to the type of force: control group (C), continuous force (CF), intermittent continuous force (ICF) and interrupted force (IF); The groups were distributed in periods of 5, 7 and 9 days (n = 6). Were analyzed the amount of bone tissue of right upper first molar. The evaluation were conducted with Anova and Tukey’s tests a significance level of 5% (p <0.05). Results: The collagen analysis demonstrated a statistically significant difference between the C group (80 ± 0.01%) and CF (62.2 ± 0.15%), whereas no significant differences were found between the CL group and the other groups. Immunolabeling for OPG was similar in the C and CL groups. RANKL on the mesial face was similar in the CL and CF group. However, significant differences were found between the CL group and the other groups on the distal face, whereas no significant difference on the distal face was found between the C and CF group. The intergroup bone tissue analysis showed that the five days of induced tooth movement (ITM) was no significant decrease in bone percentage of CF groups (62% ± 0.14), ICF (55% ± 0.07) and IF (54% ± 0, 05) in the C group (0.01 ± 80%) (p <0.05). At 7 days of ITM, this reduction was still significant in the CF group (64% ± 0.1) and IF (38% ± 0.1) compared to C group (80% ± 0.01) and there was also difference statistically significant between CF (64 ± 0.1%) and IF (38% ± 0.1) (p <0.05). After 9 days of ITM, this decrease was significant between the CF group (68% ± 0.03) and ICF (51% ± 0.13)...

Analysis of correlation between initial alveolar bone density and apical root resorption after 12 months of orthodontic treatment without extraction

OBJECTIVE: The aim of the present study was to investigate the correlation between initial alveolar bone density of upper central incisors (ABD-UI) and external apical root resorption (EARR) after 12 months of orthodontic movement in cases without extraction. METHODS: A total of 47 orthodontic patients 11 years old or older were submitted to periapical radiography of upper incisors prior to treatment (T1) and after 12 months of treatment (T2). ABD-UI and EARR were measured by means of densitometry. RESULTS: No statistically significant correlation was found between initial ABD-UI and EARR at T2 (r = 0.149; p = 0.157). CONCLUSION: Based on the present findings, alveolar density assessed through periapical radiography is not predictive of root resorption after 12 months of orthodontic treatment in cases without extraction. .

OBJETIVO: avaliar a correlação entre a densidade óssea alveolar inicial dos incisivos centrais superiores (DOA-IS) e a reabsorção radicular apical externa (RRAE) após 12 meses de movimentação ortodôntica em casos sem extração. MÉTODOS: quarenta e sete pacientes ortodônticos (maiores que 11 anos) foram submetidos ao exame periapical dos incisivos superiores no pré-tratamento (T1) e 12 meses após (T2). Mensurou-se a RRAE no intervalo de 12 meses, bem como a densidade óssea alveolar inicial da região apical desses dentes por meio da fotodensitometria. RESULTADOS: não houve correlação estatisticamente significativa entre a DOA-IS inicial e a RRAE em T2 (r = 0,149; p = 0,157). CONCLUSÃO: a densidade alveolar avaliada pela radiografia periapical não se apresentou como fator de interferência ou preditivo para reabsorção radicular após 12 meses de tratamento ortodôntico sem extração. .

Analysis of correlation between initial alveolar bone density and apical root resorption after 12 months of orthodontic treatment without extraction.

OBJECTIVE: The aim of the present study was to investigate the correlation between initial alveolar bone density of upper central incisors (ABD-UI) and external apical root resorption (EARR) after 12 months of orthodontic movement in cases without extraction. METHODS: A total of 47 orthodontic patients 11 years old or older were submitted to periapical radiography of upper incisors prior to treatment (T1) and after 12 months of treatment (T2). ABD-UI and EARR were measured by means of densitometry. RESULTS: No statistically significant correlation was found between initial ABD-UI and EARR at T2 (r = 0.149; p = 0.157). CONCLUSION: Based on the present findings, alveolar density assessed through periapical radiography is not predictive of root resorption after 12 months of orthodontic treatment in cases without extraction.

Effects of rapid maxillary expansion on middle ear function: one-year follow-up.

OBJECTIVE: To evaluate the effects of rapid maxillary expansion (RME) on middle ear function before, after, 3 months and one year from expansion procedure. PATIENTS AND METHODS: Eighteen patients with mean age of 8.1 years (±3.7) and posterior cross-bite were followed from pre expansion to one year after RME, regarding their hearing quality and middle ear function. Nine of them presented middle ear dysfunction (MED) and nine presented normal function (NF) before rapid maxillary expansion. Audiometric and tympanometric exams were taken before rapid maxillary expansion, after RME (15 days), 3 months and one year after rapid maxillary expansion. RESULTS: Among those in the MED group, no patient had acoustic reflex (AR) before rapid maxillary expansion; 67% presented type C tympanometric curve, 22% had type A and 11% had As type tympanometric curve. One year after rapid maxillary expansion, all patients presented AR and showed type A tympanometric curves. In NF group, all patients showed AR and type A tympanometric curves in all records. In both groups no audiograms presented significant variations along study. CONCLUSION: Rapid maxillary expansion has no deleterious effect in hearing quality and seems to improve middle ear function in children with posterior cross-bite in a one-year perspective.

Effect of teriparatide on induced tooth displacement in ovariectomized rats: a histomorphometric analysis.

INTRODUCTION: The aim of this study was to evaluate morphologically the effect of teriparatide on induced orthodontic movement of the maxillary first molars in ovariectomized rats. METHODS: Ovariectomized Wistar rats (n = 16), ovariectomized rats treated with teriparatide (n = 16), and nonovariectomized rats (n = 16) had orthodontic tooth movement for 5 and 7 days. The group treated with teriparatide received a subcutaneous injection (Forteo, Eli Lilly, Indianapolis, Ind; 30 µg/kg/day) for 90 days after the ovariectomy. Histologic sections obtained from the maxilla were prepared for the morphometric analysis of dental movement, the thickness of the periodontal ligament, and the number of osteoclasts in the pressure and tension areas of the apex of the root and alveolar crest in the distal root of the maxillary first molars. RESULTS: The ovariectomized rats treated with teriparatide had similar responses at 5 and 7 days after the induced dental movements compared with the untreated ovariectomized group. Both ovariectomized groups had greater molar movement on day 7 day compared with the controls (P <0.05). There were no statistically significant differences between groups in the spacing of the periodontal ligament or the number of osteoclasts in the areas studied. CONCLUSIONS: These data suggest that the treatment of osteoporosis with teriparatide is a good alternative for patients undergoing orthodontic treatment.

Tomografia computadorizada volumétrica de feixe cônico como método imaginológico auxiliar no diagnóstico de anquilose dentária: relato de caso clínico / Cone beam computed tomography as an imaging method to help at the diagnosis of dental ankylosis: a report of clinical case

O presente estudo apresenta um caso clínico de diagnóstico de anquilose alveolodentária com auxílio da tomografia computadorizada de feixe cônico.