Biomechanical behavior of three maxillary expanders in cleft lip and palate: a finite element study.

This study evaluated the stress distribution in the dentoalveolar and palatal bone structures during maxillary expansion in a 17-year-old male patient with bilateral cleft lip and palate (BCLP) using expanders with dental (HYRAX) and skeletal anchorage (MARPE). For the generation of the specific finite element models, cone-beam computed tomography was used, and the DICOM files were exported to Mimics 3-Matic (Materialise) and Patran (MSC Software) software. Three specific three-dimensional models were generated: A) HYRAX: conventional four-banded hyrax screw (9 mm); B) MARPE-DS: 3 miniscrews (1.8 mm diameter - 5.4 mm length) and four-banded dental anchorage; and C) MARPE-NoDS: 3 miniscrews without dental anchorage. Maxillary expansion was simulated by activating the expanders transversely 1 mm on the "X" axis. HYRAX resulted in higher levels of deformation predominantly in the dentoalveolar region. MARPE-DS showed stress in the dentoalveolar region and mainly in the center of the palatal region, at approximately 4,000 µÎµ. MARPE-NoDS exhibited evident stress only in the palatal region. High stress levels in the root anchoring teeth were observed for HYRAX and MARPE-DS. In contrast, MARPE-NoDS cause stress on the tooth structure. The stress distribution from the expanders used in the BLCP showed asymmetric expansive behavior. During the initial activation phase of expansion, the HYRAX and MARPE-DS models produced similarly high strain at the dentoalveolar structures and upper posterior teeth displacement. The MARPE-NoDS model showed restricted strain on the palate.

Factors associated with the stability of compensatory orthodontic treatment of Class III malocclusion in the permanent dentition.

INTRODUCTION: This study aimed to assess the stability of compensatory treatment of Class III malocclusion in permanent dentition. METHODS: Thirty-six patients (21 women and 15 men; mean age, 20 years) with Class III malocclusion were subjected to the compensatory treatment of permanent dentition and followed up for at least 3 years after orthodontic treatment (T3). Multivariate Poisson regression was performed to assess the influence of clinical, cephalometric, and dental cast variables at the beginning (T1) and the end of treatment on the stability of Class III malocclusion. RESULTS: Overjet changed from -0.25 mm (-3 to 0.5 mm) at T1 to 1.4 mm (1-2.5 mm) at the end of treatment and 0.8 mm (0-1.5 mm) at T3. Clinical relapse (overjet <1 mm and/or canine Class III relations) was observed in 11 patients (30.6%). Patients treated with extraction of mandibular premolars (risk ratio [RR] = 2.13 × 10-07, P <0.001), with better orthodontic end outcomes (RR = 1.16, P = 0.009) and which had lower maxillary incisor inclination at T1 (RR = 1.08, P = 0.035) showed a lower risk of relapse. Demographic (sex, age), clinical (length of treatment and posttreatment, number of treatment phases, time of Class III elastics), cephalometric (SNA, SNB, ANB, Wits appraisal, SNGoGn, IMPA), and dental cast (peer assessment rating index and arch dimensions) variables were not significantly associated with clinical relapse at T3. CONCLUSIONS: The stability of compensatory treatment of Class III malocclusion in permanent dentition is multifactorial, with few predictive variables. Patients treated with extraction and better orthodontic finishing had a lower risk of relapse, whereas larger maxillary incisor inclination at baseline increased the risk of relapse.

Class III malocclusion with maxillary deficiency, mandibular prognathism and facial asymmetry.

This article reports the clinical case of a female patient with history of unsuccessful orthodontic treatment. She presented with Class III malocclusion, mandibular and maxillary constriction, anterior crossbite and facial asymmetry resulting from laterognathism triggered by hyperactivity of the condyle revealed by vertical elongation of the right mandibular ramus. Patient's treatment consisted of orthodontic mechanics and two orthognathic surgical interventions with satisfactory and stable outcomes. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), as part of the requirements for obtaining the BBO Diplomate title.

Class III malocclusion with maxillary deficiency, mandibular prognathism and facial asymmetry

ABSTRACT This article reports the clinical case of a female patient with history of unsuccessful orthodontic treatment. She presented with Class III malocclusion, mandibular and maxillary constriction, anterior crossbite and facial asymmetry resulting from laterognathism triggered by hyperactivity of the condyle revealed by vertical elongation of the right mandibular ramus. Patient's treatment consisted of orthodontic mechanics and two orthognathic surgical interventions with satisfactory and stable outcomes. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), as part of the requirements for obtaining the BBO Diplomate title.

RESUMO Este artigo relata o caso clínico de uma paciente do sexo feminino, com história de insucessos em tratamentos ortodônticos pregressos. Apresentava má oclusão de Classe III, com atresia de ambas as arcadas dentárias, mordida cruzada anterior e assimetria facial, proveniente de laterognatismo desencadeado por uma hiperatividade condilar, manifestada pelo alongamento vertical do ramo mandibular direito. Seu tratamento envolveu a mecanoterapia ortodôntica e duas intervenções cirúrgicas ortognáticas, com resultados considerados satisfatórios e estáveis. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

Cone-beam computed tomography evaluation of dentoskeletal effects produced by the bonded expander and hyrax: a pilot study / Avaliação por tomografia computadorizada de feixe cônico dos efeitos dentoesqueléticos produzidos pelo expansor colado e hyrax: um estudo piloto

The dentoskeletal effects produced by the bonded expander, principally the vertical ones, are controversial in the literature when compared with the effects produced by the hyrax, and have also been scarcely studied by means of cone-beam computed tomography (CBCT). This study aimed to evaluate the horizontal and vertical dentoskeletal effects produced by the bonded expander and by the hyrax using CBCT. The study sample consisted of ten patients, divided equally into two groups according to facial and cephalometric features: group 1, vertical facial growth pattern (two males, three females; mean age, 7.7 years) and group 2, normal facial growth pattern (three males, two females; mean age, 8.3 years), treated by bonded expander and hyrax, respectively. The patients were subjected to a CBCT scan before expansion and another scan four months after the end of the activations, when the expander was removed. Within each group and between the groups the horizontal and vertical effects were assessed using Student's t-test. The sample size was predetermined, and 5 patients were needed in each group to detect the differences at P < 0.05 with 90% power. Among the horizontal changes assessed, the nasal floor width (P = 0.03) and the greater internal width in the posterior region (P = 0.00) showed a statistically significant increase only for group 1, and the mandibular molar verticality showed a statistically significant increase only for group 2. The vertical changes showed no statistical differences within groups (P > 0.05). Comparing the two groups there were no statistical differences for any assessed change (P > 0.05). Considering there were no differences of the effects between the appliances, the bonded expander produced no greater vertical control compared to the hyrax. Nevertheless, further study is recommended in a larger sample size using CBCT.

Os efeitos dentoesqueléticos produzidos pelo expansor colado, principalmente os efeitos verticais, são controversos na literatura quando comparados aos efeitos produzidos pelo expansor hyrax, e pouco estudado por meio de tomografia computadorizada de feixe cônico (TCFC). O objetivo deste estudo foi avaliar os efeitos dentoesqueléticos horizontais e verticais produzidos pelo expansor colado e pelo hyrax, utilizando-se TCFC. A amostra do estudo consistiu de cinco pacientes, divididos igualmente em dois grupos de acordo com as características faciais e cefalométricas: grupo 1, padrão de crescimento facial vertical (dois do sexo masculino, três do sexo feminino, idade média 7,7 anos), e grupo 2, padrão de crescimento facial normal (três do sexo masculino, duas do sexo feminino, idade média 8,3 anos) tratados com expasor colado e hyrax, respectivamente. Os pacientes foram submetidos à escaneamento de TCFC antes da expansão e após quatro meses da última ativação, quando o expansor foi removido. Nas comparações intra e inter-grupos, os efeitos horizontais e verticais foram avaliados por meio do teste t de Student. O tamanho da amostra foi pré-determinado, e cinco pacientes foram necessários em cada grupo para detectar diferenças para P < 0,05 e com 90% de poder. Dentre as alterações horizontais avaliadas, a largura do assoalho nasal (P = 0,03) e a maior largura nasal interna na região posterior (P = 0,00) mostraram aumento estatisticamente significante apenas para o grupo 1, e a verticalização do molar inferior mostrou aumento estatisticamente significante apenas no grupo 2 (P = 0,01). As alterações verticais avaliadas não demonstraram diferença estatística intra-grupos. Na comparação inter-grupos não foi encontrada diferença estatística em nenhum parâmetro avaliado (P > 0,05). Dado que não houve diferença na comparação inter-grupos, o expansor colado não produziu maior controle vertical em relação ao hyrax. No entanto, é recomendada a realização de mais estudos com maior amostra utilizando-se TCFC.

Temporomandibular disorder and anxiety, quality of sleep, and quality of life in nursing professionals.

To evaluate the association between temporomandibular disorder (TMD) and anxiety, quality of sleep, and quality of life in nursing professionals at the Hospital de Clínicas de Uberlândia of the Universidade Federal de Uberlandia--HCU-UFU (Medical University Hospital of the Federal University of Uberlândia), four questionnaires were given to nursing professionals. The questionnaires were completed by 160 of these professionals. The Fonseca's questionnaire was used to evaluate the presence and severity of TMD, the IDATE was used to evaluate anxiety, the SAQ was used to evaluate quality of sleep, and the SF-36 was used to evaluate quality of life. Forty-one nurses (25.6%) reported having no TMD (Fonseca's questionnaire score ≤ 15), 66 (41.3%) had mild TMD (Fonseca's questionnaire score 20-40), 39 (24.4%) had moderate TMD (Fonseca's questionnaire score 45-65), and 14 (8.8%) had severe TMD (Fonseca's questionnaire score ≥ 70). According to Fonseca's questionnaire, the presence of TMD was associated with trait anxiety, but the TMD severity was associated with state anxiety classification (mild, moderate, severe). The SAQ score differed significantly from Fonseca classification. The Fonseca's questionnaire score correlated negatively with the score of each dimension of the SF-36 (r = -0.419 to -0.183). We conclude that TMD is common among nursing professionals; its presence was associated with trait anxiety, and its severity was associated with state anxiety. Hence, the presence of TMD may reduce quality of sleep and quality of life.

Cone-beam tomography assessment of the condylar position in asymptomatic and symptomatic young individuals.

STATEMENT OF PROBLEM: Studies of the condyle-mandibular fossa relationship are common, although the role of this relationship in the development of a temporomandibular disorder remains controversial. PURPOSE: The purpose of this study was to quantitatively evaluate the condyle-mandibular fossa relationship in young individuals with intact dentitions and compare it to that between individuals with and without symptoms of temporomandibular disorder. MATERIAL AND METHODS: Volunteers were classified as asymptomatic (n=20) or symptomatic (n=20) according to research diagnostic criteria for temporomandibular disorders. Each participant underwent 2 cone beam-computed tomography scans of the middle and lower third of the face: 1 scan of the maximum intercuspation position and 1 of the centric relationship position. The distance between the condyle and mandibular fossa was measured on frontal and lateral images of the temporomandibular joint. The condylar position was compared across groups (asymptomatic, symptomatic) by using the Mann-Whitney U test (α=.05). Within each group, the condylar position was compared across maximum intercuspation and centric relationship positions by using the Mann-Whitney U test (α=.05). RESULTS: No statistically significant differences were found in condylar positions between centric relationships and maximum intercuspation in either asymptomatic or symptomatic young adults, and no significant differences were found between asymptomatic and symptomatic young adults. CONCLUSIONS: The condyle-mandibular fossa relationships of these young adults were similar in the centric relationships and maximum intercuspation positions when evaluated by computed tomography. The presence or absence of temporomandibular disorder was not correlated with the condyle position in the temporomandibular joint.

Temporomandibular disorder and anxiety, quality of sleep, and quality of life in nursing professionals

To evaluate the association between temporomandibular disorder (TMD) and anxiety, quality of sleep, and quality of life in nursing professionals at theHospital de Clínicas de Uberlândiaof theUniversidade Federal de Uberlândia – HCU-UFU (Medical University Hospital of the Federal University of Uberlândia), four questionnaires were given to nursing professionals. The questionnaires were completed by 160 of these professionals. The Fonseca’s questionnaire was used to evaluate the presence and severity of TMD, the IDATE was used to evaluate anxiety, the SAQ was used to evaluate quality of sleep, and the SF-36 was used to evaluate quality of life. Forty-one nurses (25.6%) reported having no TMD (Fonseca’s questionnaire score ≤ 15), 66 (41.3%) had mild TMD (Fonseca’s questionnaire score 20–40), 39 (24.4%) had moderate TMD (Fonseca’s questionnaire score 45–65), and 14 (8.8%) had severe TMD (Fonseca’s questionnaire score ≥ 70). According to Fonseca’s questionnaire, the presence of TMD was associated with trait anxiety, but the TMD severity was associated with state anxiety classification (mild, moderate, severe). The SAQ score differed significantly from Fonseca classification. The Fonseca’s questionnaire score correlated negatively with the score of each dimension of the SF-36 (r = –0.419 to –0.183). We conclude that TMD is common among nursing professionals; its presence was associated with trait anxiety, and its severity was associated with state anxiety. Hence, the presence of TMD may reduce quality of sleep and quality of life.

TMJ response to mandibular advancement surgery: an overview of risk factors.

OBJECTIVE: In order to understand the conflicting information on temporomandibular joint (TMJ) pathophysiologic responses after mandibular advancement surgery, an overview of the literature was proposed with a focus on certain risk factors. METHODS: A literature search was carried out in the Cochrane, PubMed, Scopus and Web of Science databases in the period from January 1980 through March 2013. Various combinations of keywords related to TMJ changes [disc displacement, arthralgia, condylar resorption (CR)] and aspects of surgical intervention (fixation technique, amount of advancement) were used. A hand search of these papers was also carried out to identify additional articles. RESULTS: A total of 148 articles were considered for this overview and, although methodological troubles were common, this review identified relevant findings which the practitioner can take into consideration during treatment planning: 1- Surgery was unable to influence TMJ with preexisting displaced disc and crepitus; 2- Clicking and arthralgia were not predictable after surgery, although there was greater likelihood of improvement rather than deterioration; 3- The amount of mandibular advancement and counterclockwise rotation, and the rigidity of the fixation technique seemed to influence TMJ position and health; 4- The risk of CR increased, especially in identified high-risk cases. CONCLUSIONS: Young adult females with mandibular retrognathism and increased mandibular plane angle are susceptible to painful TMJ, and are subject to less improvement after surgery and prone to CR. Furthermore, thorough evidenced-based studies are required to understand the response of the TMJ after mandibular advancement surgery.

TMJ response to mandibular advancement surgery: an overview of risk factors

Objective: In order to understand the conflicting information on temporomandibular joint (TMJ) pathophysiologic responses after mandibular advancement surgery, an overview of the literature was proposed with a focus on certain risk factors. Methods: A literature search was carried out in the Cochrane, PubMed, Scopus and Web of Science databases in the period from January 1980 through March 2013. Various combinations of keywords related to TMJ changes [disc displacement, arthralgia, condylar resorption (CR)] and aspects of surgical intervention (fixation technique, amount of advancement) were used. A hand search of these papers was also carried out to identify additional articles. Results: A total of 148 articles were considered for this overview and, although methodological troubles were common, this review identified relevant findings which the practitioner can take into consideration during treatment planning: 1- Surgery was unable to influence TMJ with preexisting displaced disc and crepitus; 2- Clicking and arthralgia were not predictable after surgery, although there was greater likelihood of improvement rather than deterioration; 3- The amount of mandibular advancement and counterclockwise rotation, and the rigidity of the fixation technique seemed to influence TMJ position and health; 4- The risk of CR increased, especially in identified high-risk cases. Conclusions: Young adult females with mandibular retrognathism and increased mandibular plane angle are susceptible to painful TMJ, and are subject to less improvement after surgery and prone to CR. Furthermore, thorough evidenced-based studies are required to understand the response of the TMJ after mandibular advancement surgery. .

Identification of occlusal prematurity by clinical examination and cone-beam computed tomography.

The aim of this study was to evaluate the ability to identify occlusal prematurity by images from paraxial slices of cone-beam computed tomography (CBCT). For such purpose, a pilot study was performed in which 16 asymptomatic young patients were subjected to a clinical examination, including a careful occlusal analysis and then individual deprogrammer devices ("Lucia's JIG") were fabricated. Premature contacts were clinically identified in centric relation (CR) for each patient by jaw manipulation and interocclusal marking with articulating paper (Accufilm). Subsequently, these devices were adjusted in CR and used during the tomographic exams in such a way that CBCT in CR could be obtained. After routine processing, the images were analyzed in order to identify occlusal prematurity on the displayed images by 30 professionals divided according to areas of activity (occlusion specialist, general practitioner and radiologist; n=10 per area) and time of professional experience (less than 5, between 5 and 10, and over 10 years). By comparing the premature contacts identified in the clinical analysis and CBCT images, an agreement index between these two variables was calculated. Data were analyzed statistically by ANOVA and Scott-Knott test (α=0.05). The results showed that the identification of occlusal prematurity by paraxial CBCT slices was proven to be a method of average reliability.

Identification of occlusal prematurity by clinical examination and cone-beam computed tomography

The aim of this study was to evaluate the ability to identify occlusal prematurity by images from paraxial slices of cone-beam computed tomography (CBCT). For such purpose, a pilot study was performed in which 16 asymptomatic young patients were subjected to a clinical examination, including a careful occlusal analysis and then individual deprogrammer devices (“Lucia's JIG”) were fabricated. Premature contacts were clinically identified in centric relation (CR) for each patient by jaw manipulation and interocclusal marking with articulating paper (Accufilm). Subsequently, these devices were adjusted in CR and used during the tomographic exams in such a way that CBCT in CR could be obtained. After routine processing, the images were analyzed in order to identify occlusal prematurity on the displayed images by 30 professionals divided according to areas of activity (occlusion specialist, general practitioner and radiologist; n=10 per area) and time of professional experience (less than 5, between 5 and 10, and over 10 years). By comparing the premature contacts identified in the clinical analysis and CBCT images, an agreement index between these two variables was calculated. Data were analyzed statistically by ANOVA and Scott-Knott test (α=0.05). The results showed that the identification of occlusal prematurity by paraxial CBCT slices was proven to be a method of average reliability.

O objetivo deste estudo foi avaliar a capacidade de identificação de prematuridades oclusais por meio de imagens obtidas de cortes paraxiais de tomografias computadorizadas de feixe cônico. Para este fim, realizou-se um estudo piloto em que 16 pacientes jovens assintomáticos foram submetidos ao exame clínico, incluindo análise oclusal criteriosa, e em seguida foram confeccionados dispositivos desprogramadores individuais (“JIG de Lucia”). Mediante manipulação mandibular e marcação interoclusal com papel carbono (Accufilm) identificou-se clinicamente o contato prematuro em relação cêntrica (RC) de cada paciente. Posteriormente estes dispositivos foram ajustados na posição de contato cêntrico e utilizados durante os exames tomográficos para que se pudessem obter imagens tomográficas na posição de relação cêntrica. Após o processamento das imagens, estas foram analisadas com o intuito de identificar prematuridades oclusais nas imagens visualizadas por 30 profissionais divididos de acordo com as áreas de atuação (Oclusão, Clínica Geral e Radiologia, n=10 para cada área) e tempo de exercício profissional (<5; entre 5 e 10; e >10 anos). Mediante comparação entre os contatos prematuros identificados na análise clínica oclusal e as imagens tomográficas apontadas pelos profissionais como áreas de contatos prematuros, foram calculados os índices de concordância entre essas duas variáveis. Os dados obtidos foram analisados estatisticamente pela Análise de Variância ANOVA e teste de Scott-Knott (α=0,05). Os resultados deste estudo demonstraram que a identificação de prematuridades oclusais por meio de cortes paraxiais de tomografias computadorizadas de feixe cônico mostrou-se como um método de confiabilidade média.

Assessment of the mandibular symphysis of Caucasian Brazilian adults with well-balanced faces and normal occlusion: the influence of gender and facial type

OBJECTIVE: This study aimed to establish cephalometric reference values for mandibular symphysis in adults. Dentoalveolar, skeletal and soft tissue variables were measured considering the influence of gender and facial type. METHODS: The sample consisted of sixty cephalometric radiographs of white Brazilian adult patients, with a mean age of 27 years and 6 months, who had not undergone orthodontic treatment and who presented well-balanced faces and normal occlusion. The sample was standardized according to gender (30 males and 30 females) and facial type (20 were dolichofacial, 20 mesofacial and 20 brachyfacial). RESULTS: The results showed that male and female symphyses are similar, except for symphyseal height, which was greater in males. In terms of facial type, the dolichofacial group presented narrower symphysis in dentoalveolar and basal areas, with a more accentuated lingual dentoalveolar inclination. CONCLUSION: The brachyfacial group showed broader symphysis in the dentoalveolar and basal areas and a greater buccal dentoalveolar inclination. The projection of the chin was 6.67 mm below the subnasal vertical line and there was no significant difference between the genders or facial types.

Cone-beam tomography assessment of condylar position discrepancy between centric relation and maximal intercuspation.

The magnitude of occasional discrepancies between the centric relation and maximal intercuspation positions remains a controversial subject. This study quantitatively evaluated the possible discrepancies in the condyle/mandibular fossa relationship between these positions using cone-beam computed tomography. Twenty young and asymptomatic volunteers were distributed equally into normal occlusion and Angle Class I, II and III malocclusion groups. They were submitted to one tomographic scan in maximal intercuspation and one in centric relation. Measurements were performed on lateral and frontal cuts of the patients' temporomandibular joints, and the data collected were compared using Student's t test at a significance level of 5%. The results showed that there were no statistically significant differences between the centric relation and maximal intercuspation positions in young and asymptomatic patients with practically intact dentitions using cone-beam computed tomography.

Cone-beam tomography assessment of condylar position discrepancy between centric relation and maximal intercuspation

The magnitude of occasional discrepancies between the centric relation and maximal intercuspation positions remains a controversial subject. This study quantitatively evaluated the possible discrepancies in the condyle/mandibular fossa relationship between these positions using cone-beam computed tomography. Twenty young and asymptomatic volunteers were distributed equally into normal occlusion and Angle Class I, II and III malocclusion groups. They were submitted to one tomographic scan in maximal intercuspation and one in centric relation. Measurements were performed on lateral and frontal cuts of the patients' temporomandibular joints, and the data collected were compared using Student's t test at a significance level of 5%. The results showed that there were no statistically significant differences between the centric relation and maximal intercuspation positions in young and asymptomatic patients with practically intact dentitions using cone-beam computed tomography.

Considerações mecânicas para tratamentos ortodônticos compensatórios de más oclusões de classe II e III / Biomechanics considerations on class II and class III compensatory treatment

Os tratamentos ortodônticos compensatórios para pequenas e moderadas discrepâncias maxilomandibulares, nas más oclusões de Classes II e III, são uma realidade. Como consequência, inúmeras prescrições têm sido propostas como forma de conduzir o posicionamento dentário até esse fim, alterando angulações e/ou inclinações de determinados braquetes. Entretanto, devido à variabilidade de arranjos interoclusais exigidos pelos diferentes graus de severidade dessas más oclusões, tais prescrições podem encontrar-se além ou aquém dos níveis de compensação necessários para a sua correção. O objetivo desse artigo é discutir os aspectos anatomomecânicos capazes de potencializar ou restringir a expressão dessas prescrições, conforme a necessidade compensatória imposta pelas relações dentoesqueléticas em questão.

Ajuste oclusal como terapia complementar do tratamento ortodôntico / Occlusal adjustment as a complementary therapy of the orthodontic treatment

Na odontologia, a ausência de equilíbrio oclusal apresenta-se como ameaça à estabilidade e sucesso dos resultados provenientes de reabilitações protéticas extensas ou tratamentos Ortodônticos/Ortopédicos. Quando isto acontece, independente do resultado estático ser considerado satisfatório, uma provável presença de contatos prematuros pode alterar o posicionamento mandibular, seja na condição de repouso e/ou durante a realização de seus movimentos funcionais. Nestas situações, a eliminação das referidas interferências deve ser realizada por meio de desgastes ou acréscimos nas superfícies oclusais, permitindo maior condição de estabilidade ao posicionamento dentário previamente estabelecido. Assim, o objetivo deste trabalho é evidenciar a aplicabilidade do ajuste oclusal como possível método terapêutico complementar de otimização dos aspectos estáticos e funcionais obtidos pela intervenção Ortodôntica, mediante o relato de 02 casos clínicos.

Cooperação mínima utilizando o pêndulo de Hilgers / Minimal compliance using Hilger's pendulum appliance

Os autores discorreram sobre a utilização do aparelho Pêndulo de Hilgers na prática ortodôntica contemporânea. Foram considerados os aspectos relativos ao conceito de cooperação mínima, o manejo clínico desta terapia, seus efeitos no complexo dentofacial, suas indicações e contra-indicações e intercorrências clínicas mais comuns

Aproximação da cortical palatina versus reabsorção radicular externa: existe esta correlação durante o tratamento ortodontico? / Aproximation of palatal cortex versus external root resorption: is there a correlation during orthodontic treatment?

A RRE é uma iatrogenia que acomete preferencialmente os incisivos superiores durante o tratamento ortodôntico. O objetivo desse artigo foi rever a literatura no que concerne a influência da cortical palatina sobre o desenvolvimento de RRE durante a fase de retração anterior dos incisivos superiores. Foi evidenciado que o risco de reabsorção radicular está aumentando nestas condições, especialmente em casos de camuflagem ortodôntica da má-oclusão de Classe II com padrão vertical. Supõe-se que uma extensa zona da hialinização seja formada próxima à área de maior densidade óssea. Em decorrência desse conhecimento, sugere-se um plano de tratamento que respeite os limites morfológicos de rebordo alveolar, sem dispensar o periódico controle radiográfico

Expansäo rápida da maxila: estudo cefalométrico prospectivo / Rapid mavillary expansion: a prospective study

O objetivo deste trabalho foi constatar cefalometricamente as alteraçöes dentoesqueléticas proveniente da expansäo rápida da maxila, bem como verificar a estabilidade das mesmas. A amostra constitui de 15 pacientes leucodermas, brasileiros, na faixa etária de 11 a 17 anos, com atresia lateral de maxila e submetidos à expansäo rápida deste osso; avaliados nas fases de pré e pós-expansäo, pós-contençäo e 1 ano após a expansäo. Os resultados obtidos permitiram-nos concluir que as alteraçöes introduzidas pela expansäo rápida da maxila näo foram significantes no exame cefalométrico lateral da face, e além disso, apresentaram tendência à recidiva