Does Infant Orthopedics and Neonate Lip Surgery Influence the Occlusal Relationship in Patients With Unilateral Cleft Lip and Palate (UCLP)?

OBJECTIVE: To compare occlusal relationship in patients undergoing neonate versus conventional lip surgery (LS) with and without infant orthopedics (IO) by assessment of dental arch relationship in individuals with complete unilateral cleft lip and palate. MATERIAL AND METHODS: Three groups treated by different protocols; Group I: neonate LS (1-15 days) + IO and palatoplasty (13-31 months); Group II: LS (3-12 months) + IO and palatoplasty (15-35 months); and Group III: LS (3-6 months) without IO and palatoplasty (12-18 months). The 112 intraoral photographs of individuals of all groups, obtained between 6 and 12 years of age, were assessed by the occlusal index for intraoral photograph rating. The groups were compared by the χ2 test. The correlation between surgical timing and the scores was tested by the Spearman test (P < .05). RESULTS: Group I presented the highest percentage of score 5, group II exhibited highest percentage of score 1, and group III presented the lowest percentage of score 5 according to the χ2 test (P = .029). The Spearman correlation test revealed statistically significant difference between timing of LS and the occlusal index. The earlier the surgical timing, the higher the occlusal index (P = .019). CONCLUSIONS: Infant orthopedics has demonstrated the possibility of postponing primary plastic surgeries. Patients submitted to late lip and palate repair had the best prognosis, while patients undergoing lip repair from 1 to 15 days of life, even operating the palate later, had the worst prognosis. Neonate LS negatively influenced the occlusal relationships.

Assessment of a novel type of oral appliance for the treatment of severe obstructive sleep apnea syndrome: a case series / Avaliação de um novo tipo de aparelho intraoral para o tratamento de casos graves de síndrome de apneia obstrutiva do sono: série de casos

Aim: This study aimed to evaluate the respiratory parameters among patients diagnosed with severe obstructive sleep apnea (OSA) syndrome treated with a novel design of an oral appliance (OA): a lingual orthosis. Methods: A case series study was conducted with 11 patients suffering from severe OSA, apnea-hypopnea index (AHI) > 30 events/h. All patients underwent pre- and post-treatment overnight polysomnography and were diagnosed by a physician based on polysomnography indexes. All selected patients had a history of nonadherence to continuous positive airway pressure devices. Results: Before treatment, the mean AHI of the sample was 65.9 ± 30.5. After reaching the optimal OA titration, the polysomnography (PSG) showed an average AHI of 10.1 ± 5.5 (p<0.001). There was a significant reduction in obstructive events that decreased from 60.0 ± 31.7 to 8.5 ± 3.8 events/hour (p<0.001). The minimal oxyhemoglobin saturation showed significant improvement after the OA treatment, increasing from 74.3 ± 7.8 to 83.4 ± 4.9 (p<0.05). Conclusion: Lingual orthosis was effective in resolving severe OSAS, showing satisfactory results within the present sample. Further studies are needed in order to broaden the knowledge regarding the effectiveness of this oral appliance.

Objetivo: Este estudo teve como objetivo avaliar os parâmetros respiratórios de pacientes diagnosticados com síndrome de apneia obstrutiva do sono (SAOS) de gravidade severa, tratados com um novo tipo de aparelho intraoral (AIO): uma órtese lingual. Métodos: Foi realizado um estudo de série de casos com 11 pacientes que sofriam de SAOS grave, índice de apneia-hipopnéia (IAH) > 30 eventos/ h. Todos os pacientes foram submetidos a polissonografia (PSG) de noite inteira pré e pós-tratamento e foram diagnosticados por um médico com base nos índices da PSG. Todos os pacientes selecionados apresentaram história de não adesão para dispositivos de pressão positiva contínua nas vias aéreas. Resultados: Antes do tratamento, o IAH médio da amostra foi de 65,9 ± 30,5. Depois de atingir a titulação ótima do AIO, a PSG mostrou um IAH médio de 10,1 ± 5,5 (p < 0,001). Houve uma redução significativa nos eventos obstrutivos que diminuíram de 60,0 ± 31,7 para 8,5 ± 3,8 eventos / hora (p < 0,001). A saturação mínima de oxihemoglobina mostrou melhora significativa após o tratamento, tendo sofrido um aumento de 74,3 ± 7,8 para 83,4 ± 4,9 (p < 0,05). Conclusão: A órtese lingual foi efetiva no tratamento da SAOS grave, mostrando resultados satisfatórios para a amostra atual. São necessários mais estudos para ampliar o conhecimento sobre a eficácia deste AIO.

Influence of different methods of cleaning custom bases on the shear bond strength of indirectly bonded brackets.

OBJECTIVE: To determine the influence on shear bond strength and bond failure location of four cleaning methods for orthodontic bracket custom bases. DESIGN: In vitro laboratory study. MATERIAL AND METHODS: Eighty bovine teeth were divided at random into four groups. The bracket custom bases were cleaned with different methods: group 1 with methyl methacrylate monomer, group 2 with acetone, group 3 with 50 µm aluminium oxide particles and group 4 with detergent. The brackets were indirectly bonded onto the teeth with the Sondhi Rapid-Set self-curing adhesive. The maximum required shear bond strength to debond the brackets was recorded. The bond failure location was evaluated using the Adhesive Remnant Index (ARI). One-way analysis of variance (ANOVA) analysis (P<0·05) was used to detect significant differences in the bond strength. Kaplan-Meier survival plots and log-rank test were done to compare the survival distribution between the groups. The Kruskal-Wallis test (P<0·05) was used to evaluate the differences in the ARI scores. RESULTS: The mean bond strengths in groups 1, 2, 3 and 4 were 23·7±5·0, 25·3±5·1, 25·6±3·7 and 25·7±4·2 MPa, respectively. There were no significant statistically differences in either the bond strength or the ARI score between the groups. CONCLUSION: The four custom base-cleaning methods presented the same efficiencies on indirect bond of the brackets; thus, practitioners can choose the method that works best for them.