Biomechanical analysis of total arch maxillary distalization using infrazygomatic crest miniscrews: a finite element analysis study.

AIM: To evaluate the maxillary incisors and canine's immediate movement tendency using three different power arms (PA) height levels during total arch maxillary distalization supported on infrazygomatic crest (IZC) miniscrews according to finite element analysis (FEA). METHODS: Three finite element models of the maxilla were developed based on CBCT imaging of a teenage male patient presenting a Class II Division 1 malocclusion in the early permanent dentition. Maxillary complex, periodontium, orthodontic accessories, IZC miniscrews and an orthodontic wire were digitally created. The PAs were placed between canines and lateral incisors and projected at 4, 7, and 10 mm height distances. After that, distalization forces were simulated between PA and IZC miniscrews. RESULTS: The anterior teeth deformation produced in the FEA models was assessed according to a Von Mises equivalent. The stress was measured, revealing tendencies of initial maxillary teeth movement. No differences were found between the right and left sides. However, there was a significant difference among models in the under-stress areas, especially the apical and cervical root areas of the maxillary anterior teeth. More significant extrusion and lingual tipping of incisors were observed with the 4 mm power arm compared to the 7 mm and 10 mm ones. The 10 mm power arm did not show any tendency for extrusion of maxillary central incisors but a tendency for buccal tipping and intrusion of lateral incisors. CONCLUSION: The maxillary incisors and canines have different immediate movement tendencies according to the height of the anterior point of the en-masse distalization force application. Based on the PA height increase, a change from lingual to buccal tipping and less extrusion tendency was observed for the incisors, while the lingual tipping and extrusion trend for canines increased.

Exploring men's health in medium and high complexity care in Brazil: A deductive thematic analysis of social determinants.

Background: Men's health is influenced by a complex interplay of social, economic, and cultural determinants. Understanding how these aspects affect the health of adult cisgender men in medium and high-complexity healthcare settings is essential for improving healthcare services and promoting better health outcomes. Objective: This study aimed to analyze the health status of adult cisgender men in medium and high-complexity healthcare settings based on social determinants and conditioners. Methods: This study employed a qualitative design involving 45 adult cisgender men receiving care in medium/high complexity services in Bahia, Brazil. Semi-structured interviews were conducted from July 2019 to February 2020, and data were interpreted based on Dahlgren and Whitehead's Model of Social Determinants of Health using deductive thematic analysis. Results: Proximal determinants included biological aspects, preventive behaviors, lifestyle/social life, and aging processes. Intermediate factors included work conditions, access/utilization of healthcare services/medications, and psychosocial factors. Macro determinants involved income distribution, power dynamics, resource allocation, health inequalities/iniquities, morbidity, culture, political decisions, environmental factors, and structural elements. Conclusion: The health status of men in medium/high complexity care was profoundly influenced by structural social determinants. These determinants impacted healthcare attention, service organization, cultural influences, the reproduction of hegemonic masculinity patterns, lifestyle, social support, and socioeconomic conditions necessary to realize the right to health. Nursing practices should conduct comprehensive assessments that extend beyond physical health indicators.

Current status of the biomechanics of extra-alveolar miniscrews.

Temporary skeletal anchorage devices such as miniscrews are frequently used nowadays. Compared to miniplates, miniscrews are much less expensive and technically easier to place and remove; they are popular and can be easily placed by an orthodontist. Extra-alveolar miniscrews offer benefits compared to inter-radicular miniscrews, such as reduced risk of root damage and the lack of interference with the mesiodistal tooth movement. They are particularly useful for addressing anchorage loss issues and enabling specific tooth movements such as total arch maxillary and mandibular retraction, posterior distalization, molar protraction, molar intrusion, occlusal plane control, and midline correction. The present paper discusses the current biomechanics principles related to the use of extra-alveolar miniscrews placed in the infrazygomatic and mandibular buccal shelf.

Neutrophil extracellular traps (NETs), transfusion requirements and clinical outcomes in orthotopic liver transplantation.

Inflammatory phenomena have a direct impact on the prognosis of orthotopic liver transplantation (OLT). Neutrophil extracellular traps (NETs) contribute to OLT inflammation and hemostasis imbalance in OLT. The association between NETosis, clinical outcomes and transfusion requirements is not determined. To evaluate NETs release during OLT and the effect of NETosis ontransfusion requirements and adverse outcomes in a prospective cohort of patients submitted to OLT. We quantified citrullinated histones (cit-H3) and circulating-free-DNA (cf-DNA) in ninety-three patients submitted to OLT in three periods: pre-transplant, after graft reperfusion and before discharge. NETs markers were compared between these periods using ANOVA test. The association of NETosis and adverse outcomes was evaluated using regression models adjusted for age, sex and corrected MELD. We observed a peak of circulating NETs following reperfusion, evidenced by a 2.4-fold increase in cit-H3 levels in the post-graft reperfusion period (median levels of cit-H3 pre transplant: 0.5 ng/mL, after reperfusion: 1.2 ng/mL and at discharge 0.5 ng/mL, p < 0.0001). We observed an association between increased levels of cit-H3 and in-hospital death (OR = 1.168, 95% CI 1.021-1.336, p = 0.024). No association was found between NETs markers and transfusion requirements. There is a prompt release of NETs after reperfusion that is associated with poorer outcomes and death. Intraoperative NETs release seems to be independent of transfusion requirements. These findings highlight the relevance of inflammation promoted by NETS and its impact on OLT adverse clinical outcomes.

Dental arch changes comparison between Expander with Differential Opening, Hyrax-type and Haas-type expanders: A prospective clinical study.

OBJECTIVE: Compare changes in arch form after RME achieved by Expander with Differential Opening (EDO), Hyrax-type and Haas-type expanders. MATERIALS AND METHODS: Dental models were obtained from 61 patients aged 7-11 years before expansion (T1) and 6 months after the active phase when the appliances were removed (T2). The groups were formed according to the expander used: EDO (n = 18, mean age: 9.46 ± 0.82 years), Hyrax-type (n = 22, mean age: 9.62 ± 1.57 years) and Haas-type (n = 21, mean age: 9.29 ± 1.05 years). The expander`s activation protocol consisted of 7 mm, except for EDO`s anterior screw, which was 9 mm. The measurements of upper and lower intercanine distance, inter-first permanent molar, arch perimeter and length, maxillary canine and first-permanent molar inclination, and palatal depth were performed using the OrthoAnalyzer 3D software. Intergroup comparisons of T1 and between changes (T2-T1) were performed using ANOVA followed by Tukey. RESULTS: In the upper intercanine distance EDO provided a greater increase than Haas-type. In the distance between upper fist permanent molars EDO showed higher values than Haas-type and Hyrax-type. In the lower intercanine distance and maxillary arch length, Haas-type promoted higher increase than EDO. CONCLUSIONS: The EDO promoted greater transverse changes in anterior region than Haas-type and greater transverse changes in posterior region of the maxilla than both conventional expanders. The appliance used for RME influences dental arch changes after treatment; therefore, it is recommended to individualize the choice of expander depending on the clinical necessity of each case.

Total arch maxillary distalization using infrazygomatic crest miniscrews in the treatment of Class II malocclusion: a prospective study.

OBJECTIVES: To evaluate treatment effects in Class II patients using infrazygomatic crest (IZC) miniscrews (MS). MATERIALS AND METHODS: A prospective sample of 25 adolescents (14 females and 11 males; mean age: 13.6 ± 1.5 years) who underwent maxillary dentition distalization treatment with IZC MSs were recruited. Lateral cephalograms and digital models at the beginning of treatment (T1) and after Class II molar correction (T2) were obtained. To compare cephalometric and digital model changes, paired t-test and Wilcoxon test were used. A significance level of 5% was used. RESULTS: All patients achieved Class II molar correction over a mean period of 7.7 ± 2.5 months. The IZC MS therapy provided 4 mm of distalization; there was 1.2 mm of intrusion of the first molar with 11.2° distal tipping. The maxillary incisors were retracted 4.7 mm and tipped lingually 13.4°. Overjet and overbite showed a reduction of 3.6 mm and 2.4 mm, respectively. The occlusal plane rotated clockwise 2.8°. The upper lip was retracted by 1 mm and the nasolabial angle increased 5.1°. There was an increase in the interpremolar and intermolar distances. CONCLUSIONS: Total arch distalization of the maxillary dentition using IZC MS was effective in the treatment of Class II malocclusions.

Technological advances in the serological diagnosis of Chagas disease in dogs and cats: a systematic review.

BACKGROUND: Chagas disease (CD) is caused by Trypanosoma cruzi, which is transmitted mainly through the feces/urine of infected triatomine bugs. The acute phase lasts 2-3 months and is characterized by high parasitemia and nonspecific symptoms, whereas the lifelong chronic phase features symptoms affecting the heart and/or digestive tract occurring in 30-40% of infected individuals. As in humans, cardiac abnormalities are observed in T. cruzi-infected dogs and cats. We reviewed the technological advances in the serological diagnosis of CD in dogs and cats. METHODS: A review of the published literature during the last 54 years (1968-2022) on the epidemiology, clinical features, diagnosis, treatment and prevention of CD in dogs and cats was conducted. RESULTS: Using predefined eligibility criteria for a search of the published literature, we retrieved and screened 436 publications. Of these, 84 original studies were considered for inclusion in this review. Dogs and cats are considered as sentinels, potentially indicating an active T. cruzi transmission and thus the risk for human infection. Although dogs and cats are reputed to be important for maintaining the T. cruzi domestic transmission cycle, there are no commercial tests to detect past or active infections in these animals. Most published research on CD in dogs and cats have used in-house serological tests prepared with native and/or full-length recombinant antigens, resulting in variable diagnostic performance. In recent years, chimeric antigens have been used to improve the diagnosis of chronic CD in humans with encouraging results. Some of them have high performance values (> 95%) and extremely low cross-reactivity rates for Leishmania spp., especially the antigens IBMP-8.1 to IBMP-8.4. The diagnostic performance of IBMP antigens was also investigated in dogs, showing high diagnostic performance with negligible cross-reactivity with anti-Leishmania infantum antibodies. CONCLUSIONS: The development of a commercial immunodiagnostic tool to identify past or active T. cruzi infections in dogs and cats is urgently needed. The use of chimeric recombinant T. cruzi antigens may help to fill this gap and is discussed in this review.

Modelling kidney outcomes based on MELD eras - impact of MELD score in renal endpoints after liver transplantation.

BACKGROUND: Acute kidney injury is a common complication in solid organ transplants, notably liver transplantation. The MELD is a score validated to predict mortality of cirrhotic patients, which is also used for organ allocation, however the influence of this allocation criteria on AKI incidence and mortality after liver transplantation is still uncertain. METHODS: This is a retrospective single center study of a cohort of patients submitted to liver transplant in a tertiary Brazilian hospital: Jan/2002 to Dec/2013, divided in two groups, before and after MELD implementation (pre-MELD and post MELD). We evaluate the differences in AKI based on KDIGO stages and mortality rates between the two groups. RESULTS: Eight hundred seventy-four patients were included, 408 in pre-MELD and 466 in the post MELD era. The proportion of patients that developed AKI was lower in the post MELD era (p 0.04), although renal replacement therapy requirement was more frequent in this group (p < 0.01). Overall mortality rate at 28, 90 and 365 days was respectively 7%, 11% and 15%. The 1-year mortality rate was lower in the post MELD era (20% vs. 11%, p < 0.01). AKI incidence was 50% lower in the post MELD era even when adjusted for clinically relevant covariates (p < 0.01). CONCLUSION: Liver transplants performed in the post MELD era had a lower incidence of AKI, although there were more cases requiring dialysis. 1-year mortality was lower in the post MELD era, suggesting that patient care was improved during this period.

Retrospective comparison of dental and skeletal effects in the treatment of Class II malocclusion between Herbst and Xbow appliances.

INTRODUCTION: The purpose of this research was to compare dentoskeletal changes produced by Herbst and Xbow appliances in late mixed/early permanent dentition patients with Class II Division 1 malocclusion to an untreated control group. METHODS: The retrospective cohort consisted of 41 patients treated with the Herbst appliance on average for 14 months (mean age of 11.3 years), 41 patients treated with Xbow appliance on average for 14 months (mean age of 11.11 years), and an untreated control sample of 25 patients followed on average for 21 months (mean age of 11.9 years). All patients had Class II Division 1 malocclusion characteristics. Lateral cephalometric radiographs were taken before and after phase 1 treatment/follow-up. Data were analyzed by an analysis of variance followed by Tukey post-hoc tests. RESULTS: Although there was a high equivalence among the groups in the pretreatment cephalometric values, 4 variables showed differences (U6-FHp, L6-FHp, LAFH, and PP-U1). When comparing the mean changes (before and after phase 1 treatment/follow-up), incisor mandibular plane angle (IMPA), Wits appraisal, L6-FHp, Co-Pog, and PP-U1 measurements showed statistically significant differences. In addition, more relative mesial movement of the mandibular molars (an additional 2.4 mm) and a larger increase in mandibular length (an additional 3.2 mm) was noted for the Herbst group. CONCLUSIONS: Class II correction using Herbst and Xbow occurred in both groups through improvement in the maxillomandibular relationship and labial inclination of the mandibular incisors, as well as a relatively increased mesialization of the mandibular molars. Although both appliances improve occlusal features, the portrayed changes were not always similar. Herbst seems to produce more mandibular size increase over a similar treatment period.

Effects of orthodontic treatment with aligners and fixed appliances on speech.

OBJECTIVES: To evaluate effects of orthodontic treatment with aligners and conventional fixed appliances on production of speech. MATERIALS AND METHODS: This was a parallel, randomized clinical trial. Patients with Angle Class I malocclusion, moderate crowding, and no speech impairment were randomly allocated to two groups: patients with orthodontic aligners (OAs; n = 20; mean age = 23.60 ± 5.65 years) and those with conventional fixed appliances (n = 20; mean age = 20.56 ± 4.51 years) and treated at the University of North Parana's clinic in Londrina, Brazil. Evaluation of speech production was performed semiobjectively by a speech therapist (myofunctional orofacial examination) and subjectively (self-assessment) at five time points: baseline, immediately after insertion of appliances, and subsequently at 3, 30, and 180 days after insertion. For intergroup comparison, independent t, χ2, Fisher exact, and Mann-Whitney tests were used; for intragroup comparison, the Friedman test was applied (α = 5%). RESULTS: In the semiobjective evaluation, patients with OAs exhibited a change in production of speech production, compared with patients with fixed appliances, immediately and 3 days after insertion of appliances (P < .001). Thirty days after insertion, the groups were similar (P = .487), an outcome that was unchanged at 180 days. However, in the self-assessments, patients in both groups reported significant speech difficulties immediately and 3 days after insertion of appliances, but such impairment was no longer perceived at 30 days or 180 days. CONCLUSIONS: Although the speech therapist identified changes in speech production at the start of treatment in the OA group only, patient self-assessments demonstrated that orthodontic treatment, regardless of the type of appliance used, interfered with their perception of speech.

Perceived pain during rapid maxillary expansion in children with different expanders.

OBJECTIVES: To evaluate and compare the intensity of pain caused by rapid maxillary expansion (RME) with two expanders: Hyrax and Haas type, in growing patients. MATERIALS AND METHODS: Thirty-nine patients (23 girls and 16 boys) with an average age of 9.3 years (SD = 1.39 years) were randomized into two groups and treated with Hyrax- and Haas-type expanders. In both groups, initial activation of the expander screw was one full turn on the first day followed by 2/4 of a turn two times a day (morning and night) for 7 days. Inclusion criteria were patients presenting with a posterior crossbite or maxillary atresia between 7 and 12 years old. To evaluate the intensity of pain during the active phase of the treatment, a combination of the Numerical Rating Scale and Wong-Baker Faces Pain Scale was used. Mann-Whitney test was used to compare the two treatment groups. RESULTS: There was significant inverse correlation between days following insertion and pain. During the expansion period, 100% of the children reported some pain. Hyrax expander subjects reported greater pain than those treated with the Haas-type expander only on the first day. The level of pain remained greater in girls throughout treatment. CONCLUSIONS: Pain was reported regardless of the type of expander and was higher in the Hyrax group only on the first day of activation.

Genomic variations in patients with myelodysplastic syndrome and karyotypes without numerical or structural changes.

Myelodysplastic syndrome (MDS) is an onco-hematologic disease with distinct levels of peripheral blood cytopenias, dysplasias in cell differentiation and various forms of chromosomal and cytogenomic alterations. In this study, the Chromosomal Microarray Analysis (CMA) was performed in patients with primary MDS without numerical and/or structural chromosomal alterations in karyotypes. A total of 17 patients was evaluated by GTG banding and eight patients showed no numerical and/or structural alterations. Then, the CMA was carried out and identified gains and losses CNVs and long continuous stretches of homozygosity (LCSHs). They were mapped on chromosomes 1, 2, 3, 4, 5, 6, 7, 9, 10, 12, 14, 16, 17, 18, 19, 20, 21, X, and Y. Ninety-one genes that have already been implicated in molecular pathways important for cell viability were selected and in-silico expression analyses demonstrated 28 genes differentially expressed in mesenchymal stromal cells of patients. Alterations in these genes may be related to the inactivation of suppressor genes or the activation of oncogenes contributing to the evolution and malignization of MDS. CMA provided additional information in patients without visible changes in the karyotype and our findings could contribute with additional information to improve the prognostic and personalized stratification for patients.

Evaluation of drug-induced liver injury as etiology for acute liver failure in Brazil.

INTRODUCTION AND OBJECTIVES: Little is known about the etiology of acute liver failure (ALF) in Latin America. The objective of this paper is to investigate the main etiologies of ALF in Brazil, including Drug Induced Liver Injury (DILI) using stringent causality criteria. PATIENTS OR MATERIAL AND METHODS: All the cases of individuals who underwent liver transplantation (LT) in 12 centers in Brazil for ALF were reviewed. When DILI was stated as the cause of ALF, causality criteria were applied on site by the main investigator in order to rule out other etiologies. RESULTS: 325 individuals had ALF mainly for unknown reasons (34%), DILI (27%) and AIH (18%). Reassessment of the 89 cases of DILI, using stringent causality criteria, revealed that in only 42 subjects could DILI be confirmed as the cause of ALF. Acetaminophen (APAP) toxicity (n = 3) or DILI due to herbal and dietary supplements (HDS) (n = 2) were not commonly observed. CONCLUSIONS: Undetermined etiology and DILI are the main causes of ALF in Brazil. However, APAP toxicity and DILI due to HDS are mostly uncommon.

Comparison between Milan and UCSF criteria for liver transplantation in patients with hepatocellular carcinoma: a systematic review and meta-analysis.

BACKGROUND: Liver transplantation is the main treatment for hepatocellular carcinoma (HCC). However, because of the limited supply of transplant organs, it is necessary to adopt a criterion that selects patients who will achieve adequate survival after transplantation. The aim of this review is to compare the two main staging criteria of HCC for the indication of liver transplantation (Milan and UCSF) and to analyze the post-transplantation survival rate at 1, 3 and 5 years. METHODS: This is a systematic review and meta-analysis in which scientific articles from 5 databases (PubMed, Lilacs, Embase, Central, and Cinahl) were analyzed. The studies included in the review consisted of liver transplantation in patients with HCC in different subgroups according to donor type (deceased × living), population (eastern × western) and tumor evaluation (radiological × pathological) and adopted the Milan or UCSF criteria for the indication of the procedure. RESULTS: There was no significant difference between the Milan and UCSF criteria in the overall survival rate at 1, 3 or 5 years, and the overall estimated value found was 1.03 [0.90, 1.17] at 1 year, 1.06 [0.96, 1.16] at 3 years and 1.04 [0.96, 1.12] at 5 years. Regarding the analysis of the subgroups, no significant difference was observed in any of the subgroups with a follow-up of 1, 3 or 5 years. CONCLUSIONS: Both the Milan and UCSF criteria have equivalent survival rate. Thus, less restrictive method would not result in a great loss in the final overall survival rate and would benefit a greater number of patients.

Evaluation of pain intensity in patients treated with aligners and conventional fixed appliances: Randomized clinical trial.

OBJECTIVE: This randomized clinical trial aimed to compare the pain intensity in patients treated with orthodontic aligners and conventional fixed appliances. SETTING AND SAMPLE POPULATION: This study was a randomized clinical trial. The sample comprised 39 patients randomly allocated into 2 groups: OA (orthodontic aligners, n = 20) and FA (Fixed Appliance, n = 19). MATERIAL AND METHODS: The pain intensity was measured by the visual analogue scale (VAS) in the following periods: T0 (baseline), T1 (seven days after appliance placement) and seven days after each return on the first (T2), third (T3) and sixth (T4) months. The following variables were also investigated in the baseline: conditioned pain modulation, anxiety levels, hypervigilance and catastrophizing. The VAS measurements between groups were compared by the Mann-Whitney test. Comparisons between periods within each group were performed by the Friedman test. Data regarding catastrophizing and hypervigilance were compared by the t test. All tests were applied at a significance level of 5%, with 95% confidence interval. RESULTS: Both groups presented similar levels of anxiety, hypervigilance, catastrophizing and conditioned pain modulation. Both groups did not differ concerning the pain intensity in all periods. The intragroup evaluation revealed statistical differences between days in the FA group at all moments evaluated, for the OA group, similar findings between days were found for the T1 evaluation; however, at the 6-month period (T4), the pain levels varied over these days without statistical difference. Higher levels of pain were observed in the first seven days after appliance placement. CONCLUSION: The pain intensity, usually mild, was not influenced by the appliance design, although different patterns of reported pain seem to occur between groups.

Frequency of awake bruxism behaviour in orthodontic patients: Randomised clinical trial: Awake bruxism behaviour in orthodontic patients.

INTRODUCTION: The influence of aligners on the activity of the masticatory muscles is still controversial, especially regarding the behaviour associated with awake bruxism (AB). OBJECTIVE: To compare the frequency of AB behaviours between patients treated with aligners and fixed appliances. METHODS: The sample comprised 38 Class I patients (mean age 22.08 years), divided by simple randomisation into two groups: OA group; orthodontic aligners (n 19) and FA group; fixed appliance (n 19). The frequency of AB was investigated by the ecological momentary assessment using an online device (mentimeter), during 7 following days at different timepoints, before and after appliance placement and in the 2nd, 3rd, 4th and 6th months of orthodontic treatment. These variables were also evaluated: level of anxiety by the State-Trait Anxiety Inventory, stress by the Perceived Stress Scale, catastrophising related to pain and degree of hypervigilance by the Pain Vigilance and Awareness Questionnaire, and the presence of facial pain evaluated by the DC/TMD. RESULTS: There was no difference between groups in the frequency of AB behaviours, with mean of 53.5% for group OA and 51.3% for FA. The most frequent behaviour was slightly touching the teeth, and in FA group, there was a significant reduction in this behaviour soon after appliance placement. The groups did not differ concerning the degree of anxiety, stress, catastrophising, hypervigilance and facial pain. CONCLUSION: The orthodontic treatment performed with aligners or fixed appliances did not influence the frequency of AB during the 6 months of treatment. REGISTRY OF CLINICAL TRIALS: (REBEC): RBR-9zytwf.

A prospective clinical trial of the effects produced by the Connecticut intrusion arch on the maxillary dental arch.

OBJECTIVE: To assess and compare the effects produced in the maxillary dental arch by means of Connecticut intrusion arch (CIA) with or without a cinch back on the distal end of the tube of the first molars. MATERIALS AND METHODS: This study included 44 patients with a mean age of 13.1 ± 1.8 years treated for deep bite with a CIA randomly divided into two groups: group 1 (G1), 22 patients with initial mean age of 12.72 ± 1.74 years treated with the CIA in the upper arch without a cinch back on the distal surface of the tube of the first molars, and group 2 (G2), 22 patients with an initial mean age of 13.67 ± 2.03 years treated with the CIA with a cinch back. Lateral cephalograms were available before treatment (T1) and after intrusion of maxillary incisors (T2). The mean treatment period was 5.5 ± 1.45 months. Intragroup and intergroup changes in the maxillary incisor and molar positions were analyzed by paired and independent t-tests associated with the Holm-Bonferroni correction method for multiple comparisons (P < .05). RESULTS: There were significant differences between groups in terms of maxillary incisor displacement. The maxillary incisors flared labially (2.17°) and proclined (1.68 mm) in group 1, whereas a palatal inclination (-1.99°) and retroclination (-1.13 mm) was observed in group 2. No significant differences were found for the molar positions between the groups. CONCLUSIONS: The presence or absence of a distal bend in CIA affects incisor tipping and proclination during intrusion mechanics.

Self-perception of facial esthetics by patients with different profiles compared with assessments of orthodontists and lay people.

INTRODUCTION: This study evaluated the perception of facial esthetics of patients with different profiles as assessed by orthodontists, lay people, and patients. METHODS: The sample comprised 120 patients (81 females, 39 males; mean age, 26.3 years) selected from private practices at the onset of orthodontic treatment. The patients were divided into 3 groups of 40 according to the type of facial profile. The groups were composed of straight, concave, and convex profiles, on the basis of the facial convexity angle (G.Sn.Pog') measured on the initial cephalometric tracings. Patients analyzed only their frontal (smiling and at rest) and profile facial photographs and evaluated the pleasantness of these images on a 5-point Likert scale. A group of 30 orthodontists and 30 lay people also evaluated the patients' facial pleasantness, using the same scale. Factorial analysis of variance (convexity and sex) was used to evaluate the differences between the convexities, and analysis of variance mixed model (type of evaluator and sex) to compare the 3 categories of evaluators, using the aligned rank transform technique. The correlation between the convexity angle and facial pleasantness was assessed by the Spearman correlation coefficient. RESULTS: Patients and lay people assigned higher pleasantness scores than orthodontists, with statistically significant differences for all evaluations, except for the frontal analysis of the convex group. The correlation coefficients regarding profile convexity and facial pleasantness were negative, indicating a tendency that more convex or concave facial profiles received lower pleasantness scores; however, this correlation was only significant in the evaluation of profile photographs by orthodontists. CONCLUSIONS: Patients with different profiles were scored with acceptable faces by lay people and patients themselves. Orthodontists' perceptions were different; they attributed lower pleasantness scores. Discrepant profiles affect facial esthetics in the profile view when judged by orthodontists.

Bone dehiscence formation during orthodontic tooth movement through atrophic alveolar ridges.

OBJECTIVES: To test the null hypothesis that there is no difference in bone dehiscence formation before and after orthodontic tooth movement through an atrophic alveolar ridge. MATERIAL AND METHODS: This longitudinal retrospective study evaluated pretreatment and posttreatment cone-beam computed tomography imaging of 15 adult patients. Twenty-five teeth were moved through the atrophic alveolar bone, whereas 25 teeth not subjected to translational movement were considered controls. The distances between the cementoenamel junction and the alveolar bone crest were assessed at the mesial, distal, buccal, and lingual surfaces of all of these teeth. Data were compared using the Wilcoxon test. The Spearman correlation test and multivariate linear regression analysis were also performed. RESULTS: In general, crestal bone height was reduced around 0.5 mm in all groups in every direction. Median buccal dehiscence increased significantly (+2.25 mm) (P < .05) in teeth moved through the atrophic ridge. Control teeth also had buccal crest loss (+0.83 mm), but this was not statistically different from that of the experimental teeth. Lingual dehiscence increased significantly for the experimental (+0.17 mm) and control (+0.65 mm) groups. Mesial bone height decreased more in the control group (-0.44mm) than in the experimental group (-0.14mm). There was moderate correlation between amount of tooth movement and alveolar bone loss. CONCLUSIONS: The null hypothesis was rejected as dehiscence increased after tooth movement through an atrophic alveolar ridge, mainly in the buccal plate.

Dimensional stability of alginate molds scanned at different storage times / Estabilidade dimensional de moldes de alginato digitalizados em diferentes tempos de armazenamento

ABSTRACT The aim of this study was to evaluate the precision and accuracy of molds made with four commercial brands of alginate scanned at different times using digital model analysis. Eighty molds of a standard Typodont were made using 4 types of alginate (CCC: Cavex Color Change; IA: Identic Alginate; HY5: Hydrogum 5 and JP: Jeltrate Plus). The molds were scanned at four times: immediately (T1), 24h (T2), 72h (T3) and 120h (T4) after molding. Measurements were taken in three dimensions: anteroposterior, transverse and vertical. Significant differences in dimensional changes were noted between the materials over time (p <0.05). Anteroposterior dimensional variation was noted between times, especially for IA and JP. For transverse and vertical variables, a difference was found between the groups, especially at 24 h, 72 h and 120 h. CCC presented significant dimensional shrinkage only at T120 (transverse). IA and JP presented larger dimensional distortions in the vertical measurements. The molding materials used were not dimensionally stable when evaluated after 120 hours of molding. However, such evidence suggests that alginates with longer storage time, such as Cavex Color Change, are more accurate than conventional alginates.

RESUMO O objetivo do presente estudo foi avaliar a precisao e acurácia por meio de análise de modelos digitais de moldes digitalizados obtidos com quatro marcas comerciais de alginato em diferentes tempos. Oitenta moldes de um Typodont padrao foram obtidos utilizando 4 tipos de alginato (CCC: Cavex Color Change; IA: Identic Alginate; HY5: Hydrogum 5 e JP: Jeltrate Plus). Os moldes foram escaneados em quatro tempos: mediatamente (T1), 24h (T2), 72h (T3) e 120h (T4) após a moldagem. As medidas foram feitas em très dimensoes: ântero-posterior, transversal e vertical. Diferenças significativas nas mudanças dimensionais foram observadas entre os materiais ao longo do tempo (p <0,05). Variação dimensional ântero-posterior foi observada entre os tempos, principalmente para IA e JP. Para as variáveis transversal e vertical houve diferenga entre os grupos, principalmente em 24h, 72h e 120h. CCC apresentou contração dimensional significativa apenas em T120 (transversal). IA e JP apresentaram maiores distorções dimensionais na vertical. Os materiais de moldagem utilizados nao foram dimensionalmente estáveis quando avaliados após 120 horas de moldagem. No entanto, tais evidencias sugerem que os alginatos com maior tempo de armazenamento, como Cavex Color Change, sao mais precisos do que os alginatos convencionais.