Versatilidade de ligaduras elastoméricas na correção de rotações unitárias / The versatility of elastomeric ligatures in the correction of single tooth rotations

Resumo Introdução: As ligaduras elastoméricas, também conhecidas popularmente como "elastics", são amplamente utilizadas na ortodontia fixa há bastante tempo. Contudo, além da função de apreender o arco aos slots dos bráquetes, elas também podem ser utilizadas para correção de pequenas giroversões dentárias. Diversas marcas comerciais já desenvolveram um modelo específico de acessório elastomérico para desempenhar essa função, nomeado como "rotator"; porém, por ter um tamanho padronizado, acabam provocando sobrecorreção do movimento em determinadas situações da prática clínica. Descrição da técnica: Desta maneira, o objetivo deste artigo é ilustrar a utilização e versatilidade dos famosos "elastics", posicionados de três formas diferentes nas aletas dos bráquetes, para realizar a correção de pequenas giroversões unitárias na ortodontia fixa. Conclusão: A versatilidade de seu uso permite diferentes magnitudes de correção com praticidade (AU)

Abstract Introduction: Elastomeric ligatures, popularly known as "elastics" have been widely used in orthodontic treatment with fixed appliances for a long time. However, in addition to the function of fixating the archwires to the bracket slots, they may also be used for the correction of minor tooth rotations. Various commercial brands have developed a specific model of elastomeric accessory to perform this function, known as "rotation wedge". However, as they are of a standardized size, they end up causing overcorrection of the movement in certain clinical situations. Technique description: This article aimed to illustrate the use and versatility of the famous "elastics", positioned in 3 different ways on the bracket tie wings to effectuate correction of small single tooth rotations in orthodontic treatment with fixed appliances. Conclusion: The versatility of their use allows different magnitudes of correction with practicality. (AU)

Long term dental transversal stability of Class II division 1 treated with cervical headgear.

INTRODUCTION: In several conditions, outcome stability is a great challenge for Orthodontics. Previous studies have reported that relapse commonly occurs along the years after orthodontic treatment finishing. OBJECTIVE: The aim of the present study was to evaluate in the long-term transversal dental arch changes of Class II division 1 patients treated with cervical headgear and fixed appliance. METHODS: Plaster study casts of 20 patients treated with cervical headgear without dental extractions were 3D-scanned and evaluated in three distinct times: initial (T1), immediate post-treatment (T2) and long-term retention (T3 - minimum 20 years). Transversal teeth distance of maxillary and mandibular canines, premolars and first molars were measured. RESULTS: A statistically significant increase during treatment was observed for all maxillary teeth transversal distances (p< 0.05). In turn, a significant reduction was observed in the long term (p< 0.05). For the mandibular teeth, canine transversal distance presented statistically significant constriction in the retention period (p< 0.05). Mandibular first molars distance was significantly expanded by treatment (p< 0.05) and remained stable in the long term. The changes observed for the other teeth or other times were considered not statistically relevant. CONCLUSIONS: For the accessed sample, transversal changes occurred during treatment and retention phases in Class II division 1 patients treated with cervical headgear and fixed appliance. Relapse was considered statistically relevant, even with the institution of a retention protocol.

Long term dental transversal stability of Class II division 1 treated with cervical headgear

ABSTRACT Introduction: In several conditions, outcome stability is a great challenge for Orthodontics. Previous studies have reported that relapse commonly occurs along the years after orthodontic treatment finishing. Objective: The aim of the present study was to evaluate in the long-term transversal dental arch changes of Class II division 1 patients treated with cervical headgear and fixed appliance. Methods: Plaster study casts of 20 patients treated with cervical headgear without dental extractions were 3D-scanned and evaluated in three distinct times: initial (T1), immediate post-treatment (T2) and long-term retention (T3 - minimum 20 years). Transversal teeth distance of maxillary and mandibular canines, premolars and first molars were measured. Results: A statistically significant increase during treatment was observed for all maxillary teeth transversal distances (p< 0.05). In turn, a significant reduction was observed in the long term (p<0.05). For the mandibular teeth, canine transversal distance presented statistically significant constriction in the retention period (p<0.05). Mandibular first molars distance was significantly expanded by treatment (p<0.05) and remained stable in the long term. The changes observed for the other teeth or other times were considered not statistically relevant. Conclusions: For the accessed sample, transversal changes occurred during treatment and retention phases in Class II division 1 patients treated with cervical headgear and fixed appliance. Relapse was considered statistically relevant, even with the institution of a retention protocol.

RESUMO Introdução: Em várias condições, a estabilidade dos resultados é um grande desafio para a Ortodontia. Estudos prévios relataram que a recidiva ocorre, comumente, ao longo dos anos, após o término do tratamento ortodôntico. Objetivo: O objetivo da presente pesquisa foi avaliar as alterações transversais da arcada dentária em longo prazo de pacientes Classe II, divisão 1, tratados com aparelho extrabucal cervical e aparelho fixo. Métodos: Modelos de gesso de 20 pacientes tratados com AEB cervical, sem extrações dentárias, foram escaneados e avaliados em três momentos distintos: inicial (T1), pós-tratamento imediato (T2) e acompanhamento de longo prazo (T3, mínimo de 20 anos). A distância transversal entre os caninos superiores e inferiores, pré-molares e primeiros molares foi medida. Resultados: Foi observado aumento estatisticamente significativo durante o tratamento para todas as distâncias transversais dos dentes superiores (p < 0,05). Por sua vez, foi observada redução significativa em longo prazo (p < 0,05). Para os dentes inferiores, a distância transversal intercaninos apresentou constrição estatisticamente significativa no período de contenção (p < 0,05). A distância dos primeiros molares inferiores aumentou significativamente com o tratamento (p < 0,05) e permaneceu estável em longo prazo. As alterações observadas para os outros dentes ou outros tempos foram consideradas sem significância estatística. Conclusões: Para a amostra estudada, as alterações transversais ocorreram durante as fases de tratamento e contenção em pacientes Classe II, divisão 1, tratados com aparelho extrabucal de tração cervical e aparelho fixo. A recidiva foi considerada estatisticamente significativa, mesmo com a instituição de um protocolo de contenção.

Tooth extractions in Orthodontics: first or second premolars?

Tooth crowding and protrusions demand rigorous attention during orthodontic planning that includes the extraction of first and second premolars. Some characteristics, such as dentoalveolar bone discrepancies, maxillomandibular relations, facial profile, skeletal maturation, dental asymmetries and patient cooperation, are important elements of an orthodontic diagnosis. This study discusses the options of treatments with extractions and describes the correction of a Class I malocclusion, bimaxillary protrusion, severe anterior crowding in both dental arches and tooth-size discrepancy, using first premolar extractions.

Digital models: How can dental arch form be verified chairside?

ABSTRACT Introduction: Plaster dental casts are routinely used during clinical practice to access maxillary dental arch form and assist on fabrication of individualized orthodontic archwires. Recently introduced, digital model technology may offer a limitation for the obtainment of a dental physical record. In this context, a tool for dental arch form assessment for chairside use is necessary when employing digital models. In this regard, paper print of the dental arch seems thus to be useful. Methods: In the present study, 37 lower arch models were used. Intercanine and intermolar widths and dental arch length measurements were performed and compared using plaster dental casts, digital models and paper print image of the models. Ortho Insight 3D scanner was employed for model digitalization. Results: No statistically significant differences were noted regarding the measurements performed on the plaster or digital models (p> 0.05). Paper print images, however, showed subestimated values for intercanine and intermolar widths and overestimated values for dental arch length. Despite being statistically significant (p< 0.001), the differences were considered clinically negligible. Conclusion: The present study suggests that paper print images obtained from digital models are clinically accurate and can be used as a tool for dental arch form assessment for fabrication of individualized orthodontic archwires.

RESUMO Introdução: os modelos de gesso são usados rotineiramente, durante a prática clínica, para avaliação da forma da arcada inferior e para auxiliar na confecção de arcos ortodônticos individualizados. A tecnologia dos modelos digitais, introduzida recentemente, pode oferecer uma limitação na obtenção de um registro físico da arcada dentária. Assim, quando se utilizam modelos digitais, faz-se necessária uma ferramenta clínica para obtenção da forma da arcada. Com essa finalidade, poderia-se imprimir, em papel, uma imagem da arcada dentária obtida a partir do modelo de gesso. Métodos: nesse estudo, 37 modelos da arcada inferior foram utilizados, nos quais foram realizadas medições das distâncias intercaninos, intermolares e comprimento da arcada; sendo, então, comparadas entre modelos de gesso, modelos digitalizados com um scanner Ortho Insight 3D e imagens impressas em folha de papel A4. Resultados: não foram encontradas diferenças estatisticamente significativas nas medidas realizadas nos modelos de gesso e modelos digitais (p > 0,05). As imagens impressas, contudo, mostraram valores subestimados para as distâncias intercaninos e intermolares, e superestimados para o comprimento da arcada. Apesar de serem estatisticamente significativas (p< 0,001), as diferenças foram consideradas clinicamente insignificantes. Conclusão: o presente estudo sugere que as imagens obtidas por meio dos modelos digitais e impressas em papel são clinicamente acuradas e podem ser utilizadas como uma ferramenta auxiliar na confecção dos arcos ortodônticos individualizados.

Digital models: How can dental arch form be verified chairside?

INTRODUCTION: Plaster dental casts are routinely used during clinical practice to access maxillary dental arch form and assist on fabrication of individualized orthodontic archwires. Recently introduced, digital model technology may offer a limitation for the obtainment of a dental physical record. In this context, a tool for dental arch form assessment for chairside use is necessary when employing digital models. In this regard, paper print of the dental arch seems thus to be useful. METHODS: In the present study, 37 lower arch models were used. Intercanine and intermolar widths and dental arch length measurements were performed and compared using plaster dental casts, digital models and paper print image of the models. Ortho Insight 3D scanner was employed for model digitalization. RESULTS: No statistically significant differences were noted regarding the measurements performed on the plaster or digital models (p> 0.05). Paper print images, however, showed subestimated values for intercanine and intermolar widths and overestimated values for dental arch length. Despite being statistically significant (p< 0.001), the differences were considered clinically negligible. CONCLUSION: The present study suggests that paper print images obtained from digital models are clinically accurate and can be used as a tool for dental arch form assessment for fabrication of individualized orthodontic archwires.

Instalação de mini-implantes: qual a melhor imagem radiográfica para avaliação do espaço interradicular? / Mini-implants placement: which is the best x-ray imagine for interradicular

O objetivo desse estudo foi comparar a eficácia entre a tomografia computadorizada de feixe cônico (padrão-ouro) e as radiografias periapical, interproximal e panorâmica digitais para avaliação do espaço inter-radicular com vistas à instalação de mini-implantes. Métodos: a amostra foi composta por 40 sítios eleitos nos espaços inter-radiculares na região posterior. Os pontos de inserção para instalação dos mini-implantes foram representados por guta-percha em moldeira de acetato que os pacientes usavam durante as radiografias e a tomografia. Através do programa Adobe Acrobat 9 Pro Extend foram feitas medidas interradiculares no sentido horizontal nos três métodos radiográficos e comparadas com as da tomografia, que foram realizadas pelo Kodak Dental Imaging Software 3D. A comparação utilizou o coeficiente de Lin. Resultados: foi observada diferença estatisticamente significante entre a tomografia computadorizada e as radiografias panorâmicas (27,8% - P > 0,05). Conclusões: a radiografia interproximal foi o método mais preciso; a radiografia panorâmica e a periapical não são recomendadas para verificação do espaço inter-radicular, pois apresentaram alteração da dimensão dessa região no sentido horizontal.(AU)

The objective of this study was to compare the assessment of interradicular space for mini-implants fitting between the cone beam computed tomography (gold standard) and periapical, interproximal and panoramic digital radiographies. Methods: The sample consisted of 40 elected interradicular sites in the posterior area of five patients. These areas were represented by gutta percha points in acetate trays that patients used when radiographies and tomographies were taken. Horizontal measures, between dental roots, in three radiographic methods were obtained by Adobe Acrobat 9 Pro Extend program and compared with the tomography obtained by Kodak Dental Imaging Software 3D. The comparison was done by Lin coefficient correlation. Results: there was not stastistically difference between tomoghaphy and interproximal radiography (8,4% - p < 0,05). Conclusions: the interproximal radiography was the most accurate radiographic method; the panoramic and periapical radiographies are not recommended for interradicular space verification, because they present horizontal dimension alterations in this region. (AU)

An interview with Hyeon-Shik Hwang.

It gives me great pleasure to interview Dr. Hyeon-Shik Hwang, an innovative orthodontist who has developed many creative techniques over his career. Dr. Hwang was born in Korea and received his DDS and PhD degrees from Yonsei University in Seoul. He is professor and chairman of the Department of Orthodontics at Chonnam National University School of Dentistry, Gwangju, Korea. Dr. Hwang, as a faculty at the university hospital, has maintained a successful clinical practice for more than 25 years. He has treated many adult patients focusing on esthetics and periodontal health and has developed many clinical techniques to improve the effectiveness and efficiency of treatment to the benefit of both the patient and practitioner. Dr. Hwang is also interested in the evaluation of facial asymmetry two- and three-dimensionally. As one of the early adopters of cone-beam volume imaging, he has given special emphasis on the management of surgical cases. He is married to Jung-Un Park with whom he has two sons. His favorite hobbies are photography and listening to music. When I was presented to him in a congress, it was a great pleasure meeting someone who I already admired for his singular work. Later on, his humbleness and knowledge made me marvel at him even more. I hope that all readers of Dental Press Journal of Orthodontics also enjoy the teachings from this brilliant Korean orthodontist! Guilherme Thiesen - interview coordinator.

Impact of metal and ceramic fixed orthodontic appliances on judgments of beauty and other face-related attributes.

INTRODUCTION: Physical attributes, behavior, and personal ornaments exert a direct influence on how a person's beauty and personality are judged. The aim of this study was to investigate how people who wear a fixed orthodontic appliance see themselves and are seen by others in social settings. METHODS: A total of 60 adults evaluated their own smiling faces in 3 different scenarios: without a fixed orthodontic appliance, wearing a metal fixed orthodontic appliance, and wearing an esthetic fixed orthodontic appliance. Furthermore, 15 adult raters randomly assessed the same faces in standardized front-view facial photographs. Both the subjects and the raters answered a questionnaire in which they evaluated criteria on a numbered scale ranging from 0 to 10. The models judged their own beauty, and the raters assigned scores to beauty, age, intelligence, ridiculousness, extroversion, and success. RESULTS: The self-evaluations showed decreased beauty scores (P <0.0001) when a fixed orthodontic appliance, especially a metal one, was being worn. There was no statistically significant difference between the 3 situations in the 6 criteria analyzed. CONCLUSIONS: A fixed orthodontic appliance did not affect how personal attributes are assessed. However, fixed orthodontic appliances apparently changed the subjects' self-perceptions when they looked in the mirror.

Effects of chin advancement surgery in hyoid bone and tongue positions and in the dimension of the oropharynx

INTRODUÇÃO: a cirurgia de avanço de mento isolado tem sido cada vez mais indicada para a correção de deficiência anterior da mandíbula, harmonizando o perfil e gerando alterações funcionais. OBJETIVO: essa pesquisa teve a finalidade de avaliar os efeitos da cirurgia de avanço de mento no tamanho da orofaringe e nas posições do osso hioide e da língua. MÉTODOS: a amostra constou de 22 radiografias cefalométricas de perfil de 11 indivíduos que se submeteram à cirurgia de mentoplastia de avanço isolada. Dessas radiografias, 11 retratavam o período imediatamente pré-cirúrgico (T0) e 11 o pós-cirúrgico de, pelo menos, quatro meses (T1). As radiografias foram digitalizadas e transferidas para o programa Radiocef Studio 2.0, por meio do qual foram feitas as medições entre os pontos demarcados. RESULTADOS: verificaram-se diferenças estatisticamente significativas entre T0 e T1 quanto à posição do osso hioide e da língua no sentido horizontal e ao tamanho da orofaringe. O osso hioide se apresentou posicionado mais anterior em T1 (p = 0,01), assim como a língua, aumentando o tamanho da orofaringe (p = 0,01). CONCLUSÃO: houve aumento do espaço aéreo da orofaringe com o posicionamento mais anterior da base da língua, bem como a reposição do osso hioide anteriormente.

INTRODUCTION: Advancement genioplasty has been increasingly indicated for the correction of anterior mandibular deficiency as it balances the patient's profile and generates functional changes. OBJECTIVE: Thus, the aim of this study was to assess the effects of advancement genioplasty in the oropharyngeal size and in the position of the hyoid bone and tongue. METHODS: The sample comprised 22 lateral cephalometric radiographs of 11 individuals who had undergone advancement genioplasty alone. Eleven of these radiographs depicted the immediate preoperative period (T0) and the other 11 the postoperative period after at least four months (T1). The radiographs were scanned and exported to the Radiocef Studio 2.0® software (Radio Memory Ltda., Belo Horizonte, MG, Brazil). The landmarks were then identified and automatically measured by the program. RESULTS: The results showed statistically significant differences between the horizontal position of the hyoid bone and tongue and in the oropharyngeal size. The hyoid bone and tongue were repositioned anteriorly after surgery (p = 0.01), thereby increasing the dimension of the oropharyngeal airspace (p = 0.01). CONCLUSIONS: The oropharyngeal dimension increased as the tongue base and hyoid bone were repositioned more anteriorly.

Brachycephalic, dolichocephalic and mesocephalic: is it appropriate to describe the face using skull patterns?

The use of a standardized terminology in the medical sciences is essential for both clinical practice and scientific research. In addition to facilitating communication between professionals, it enhances the reliability of comparisons made between studies from different areas, thereby contributing to a higher level of scientific evidence. Examples of attempts made to standardize the terminology in other areas dedicated to the study of craniofacial morphology can be found in the literature. On the other hand, one can find in the orthodontic literature a variety of terms that render the consensus and communication between orthodontists and other researchers even more problematic. As an example, one could cite the use of the terms brachyfacial, mesofacial and dolichofacial, which form part of a cranial index terminology used to describe facial types. Thus, a reflection on the origin and differences of the terms used to describe the human facial phenotype may pave the way toward a consensus regarding the meaning that best represents the craniofacial patterns.

A padronização da nomenclatura utilizada nas ciências médicas é fundamental tanto para a prática clínica quanto para a pesquisa científica. Além de facilitar a comunicação entre os profissionais, aumenta a confiabilidade da comparação entre trabalhos de diferentes áreas, favorecendo um melhor nível de evidência científica. Exemplos de esforços, em áreas também voltadas ao estudo da morfologia craniofacial, no sentido de uniformização da terminologia podem ser encontrados na literatura médica. Por outro lado, observa-se na literatura ortodôntica uma diversidade de termos que torna mais difícil o consenso e a comunicação entre ortodontistas e demais pesquisadores. Como exemplo, pode-se citar o uso dos termos braquifacial, mesofacial e dolicofacial, terminologia relativa ao índice craniano utilizada para descrever o tipo facial. Sendo assim, a reflexão sobre a origem e diferenças dos termos utilizados para descrever o fenótipo facial humano pode ser útil ao consenso do significado que melhor representa o padrão craniofacial.

Effect of dental bleaching after bracket bonding and debonding using three different adhesive systems

OBJECTIVE: To evaluate the influence of bonding and debonding of orthodontic brackets on dental in-home bleaching, taking into account three different adhesive systems. METHODS: Forty-four bovine incisors were divided into four groups according to the primer system used for orthodontic bracket bonding. Following the debonding of orthodontic brackets, the teeth were stored in staining solution for 96 hours. Then, teeth were whitened using 10% carbamide peroxide for two weeks at a 6-hour-a-day regime. Standardized digital photographs were taken at the following intervals: T0 (initial); T1 (after debonding); T2 (after pigmentation); T3, T4 and T5 representing 1, 7, and 14 days of bleaching. Repeatability and stability tests were carried out to check the method accuracy. Images were analyzed using Adobe Photoshop 7.0 software considering (L*a*b*)color coordinate values and a modified color difference total (Δ;E'). RESULTS: The results of this study (ANOVA and Tukey; p < 0.01) demonstrated that after 7 days of bleaching, experimental groups showed significantly less teeth whitening compared to the control group. However, there were no significant color differences between the groups after 14 days, according to values of lightness (L*). CONCLUSIONS: Regardless of the adhesive primer system applied, bonding and debonding of orthodontic brackets alters the outcome of tooth whitening in the first 7 days of bleaching, however it has no influence on the whitening of the dental structure after 14 days of in-home dental bleaching with 10% carbamide peroxide.

OBJETIVO: o objetivo desse estudo foi avaliar a influência da colagem e descolagem de braquetes ortodônticos no clareamento caseiro, considerando três diferentes sistemas adesivos. MÉTODOS: quarenta e quatro incisivos bovinos foram divididos em quatro grupos, de acordo com o sistema adesivo utilizado para colagem dos braquetes. Após a descolagem dos braquetes, os dentes foram pigmentados por 96 horas e depois clareados com peróxido de carbamida a 10% por 6 horas diárias, durante duas semanas. Foram realizadas fotografias digitais padronizadas nos tempos: T0 (inicial); T1 (após descolagem); T2 (após pigmentação); T3, T4 e T5 representando 1, 7 e 14 dias de clareamento. Testes de repetitividade e de estabilidade foram realizados para avaliar a acurácia do método. As imagens foram avaliadas pelo software Adobe Photoshop 7.0, considerando os parâmetros de cor (L*a*b*) e a diferença total de cor adaptada para esse estudo (Δ;E'). RESULTADOS: os resultados do presente estudo (ANOVA e Tukey; p < 0,01) demonstraram que, após uma semana de clareamento, os grupos experimentais apresentaram uma resposta mais lenta ao clareamento que o grupo controle. Contudo, após 14 dias, não houve diferença cromática significativa entre os grupos, observada pelos valores de luminosidade (L*). CONCLUSÕES: independentemente do sistema adesivo utilizado, a colagem e descolagem de braquetes ortodônticos altera os resultados de obtenção de cor com sete dias de avaliação. Contudo, após 14 dias não se observa nenhuma diferença de cor na estrutura dentária clareada pela técnica caseira.

Estudo da proporção carga, deflexão da alça “T” confeccionada com fios de aço inoxidável e beta-titânio / Study on the load, deflection rate of T-Loop made with stainless steel wire and beta-titanium

Avaliou-se a proporção carga/deflexão da alça ortodôntica em forma de “T” confeccionada com fio retangular de secção transversal 0,019” x 0,025” de ligas de aço inoxidável e beta-titânio de diferentes marcas comerciais. Foram confeccionadas 20 alças para fechamento de espaço provenientes de quatro grupos experimentais de acordo com a liga do fio ortodôntico e com a marca comercial utilizada na confecção da alça: G1 - aço inoxidável da marca comercial Morelli®; G2 - aço inoxidável da marca Ortho Organizers®; G3 - beta-titânio da Ormco™ e G4 - beta-titânio da Ortho Organizers®. As alças foram submetidas ao ensaio mecânico no qual as deflexões de 1,0 mm; 1,5 mm; 2,0 mm; 2,5 mm e 3,0 mm foram procedidas. A carga horizontal liberada pelas alças de beta-titânio, frente às diversas deflexões, foi menor em relação às alças de aço inoxidável com diferença estatisticamente significante (p<0,05). O comportamento dos fios de aço inoxidável Morelli® e Ortho Organizers® foi semelhante nas deflexões de 1,5 mm e 2,5 mm; nas demais ativações o fio da Morelli® conferiu menor proporção carga/deflexão à mola. Os fios de beta-titânio apresentaram resultados semelhantes nas ativações de 1,0 mm, 1,5 mm e 2,0 mm; nas demais ativações o fio da Ormco™ proporcionou menor valor de carga/deflexão do que o fio da Ortho Organizers®. Para a configuração de mola utilizada neste experimento a utilização de fios de beta-titânio confere menor proporção carga/deflexão e proporciona a liberação de força mais leve e constante em comparação aos fios de aço inoxidável.

It was assessed the load-deflection rate of beta-titanium and stainless steel T-loops constructed from 0.019”x0.025” orthodontic archwires of different manufactures. Twenty retraction loop springs were allocated into 4 experimental groups according to the trademark and alloy of the wire used: G1 - stainless steel from Morelli®; G2 - stainless steel from Ortho Organizers®; G3 - beta-titanium from Ormco™; G4 - beta-titanium from Ortho Organizers®. The specimens were submitted to the mechanical test in which the 1.0 mm; 1.5 mm; 2.0 mm; 2.5 mm; and 3.0 mm deflections proceeded. The horizontal load of beta-titanium T-loops was lower than the stainless steel for all deflections evaluated; with statistical significant difference (p<0.05). Tthe stainless steel groups (G1 and G2) showed similar behavior within the 1.5 mm and 2.5 mm deflections and the Morelli® wire (G1) lead the lower horizontal load within the other deflections. The beta-titanium alloy springs showed similar load values within the 1.0 mm, 1.5 mm, and 2.0 mm deflections and the Ormco™ T-loop presented lower load values compared to the Ortho Organizers® within the 2.5 mm and 3.0 mm deflections. For the T-loop sprig configuration the beta-titanium wire leads to lower load-deflection rate and leaches more constant and lower forces than the stainless steel wire.

Gingival esthetics: an orthodontic and periodontal approach

INTRODUCTION: Currently, people's esthetic requirements and expectations have increased substantially. Therefore, dentists have been seeking ways to provide excellent treatment results which, consequently, increasingly require a well organized transdisciplinary approach. The link between orthodontics and periodontics became evident from the moment professionals began to understand the biology of tooth movement. As regards smile esthetics, however, such cooperation is now essential. OBJECTIVE: To show clinically how and when orthodontists and periodontists should work jointly to enhance smile esthetics based on the display and harmony of the gingival contour.

INTRODUÇÃO: nos dias atuais, as expectativas e exigências estéticas das pessoas têm aumentado substancialmente. Por isso, a Odontologia vem buscando maneiras de oferecer tratamentos com resultados excelentes e, consequentemente, necessita trabalhar, cada vez mais, de modo transdisciplinar. A inter-relação da Ortodontia com a Periodontia é evidente desde quando se compreendeu a biologia da movimentação dentária; contudo, em se tratando de estética do sorriso, tornou-se fundamental. OBJETIVO: evidenciar, clinicamente, como e quando a Ortodontia e a Periodontia devem trabalhar de modo integrado para a obtenção de sorrisos mais estéticos, considerando-se a exposição e a harmonia do contorno gengival.

Preparation and evaluation of orthodontic setup

INTRODUCTION: An orthodontic or diagnostic setup consists in cutting and realigning the teeth in plaster models, making it an important resource in orthodontic treatment planning. OBJECTIVE: The aim of this article is to provide a detailed description of a technique to build an orthodontic setup model and a method to evaluate it. CONCLUSIONS: Although laborious, orthodontic setup procedure and analysis can provide important information such as the need for dental extractions, interproximal stripping, anchorage system, among others.

Effectiveness of CO2 laser in removal of papillary gingival hyperplasia

INTRODUCTION: Laser applications have increased in a variety of dental procedures, especially in surgeries of soft tissues. Radiation is not invasive and is very well tolerated by tissues. CO2 laser acts in small vessels promoting blood coagulation, making it possible to work in a controlled way. Patients undergoing fixed orthodontic therapy often present injuries of gingival hyperplasia, originating esthetical and functional problems. OBJECTIVE: This study aimed at evaluating the CO2 laser effectiveness in removal of hyperplasia lesions in gingival papilla regions of patients with fixed orthodontic appliances. For this, ten patients were chosen and in these 75 teeth with gingival hyperplasia were identified. Measures from the papilla to incisal edge were performed with the use of a digital caliper. Besides that, the individuals were submitted to previous examinations to the surgical procedure with laser: Full blood count, blood coagulation profile and fasting blood glucose. After this, patients were submitted to the surgery for lesion removal, carried out at the Laser Center of FOUFBA, utilizing a CO2 laser machine (Sharplan 20C, Tel Aviv, Israel). RESULTS: It was showed that laser provided a significant increase (p<0,001) in the distance from the papilla to the incisal edge of the teeth, with no tissue contraction, aspects which were maintained for over two months. CONCLUSION: It can be concluded that CO2 laser has proved to be effective in removal of papillary gingival hyperplasia lesions.

Reabilitação oral com implantes em pacientes com displasia ectodérmica / Oral rehabilitation in patients with ectodermal dysplasia: a case report

A displasia ectodérmica (DE) é uma desordem genética com amplo espectro de manifestações clínicas. A hipodontia ou anodontia é uma característica intrabucal muito frequente. Este achado cria a necessidade de reabilitação, não só com o objetivo de devolver a função mastigatória, mas com o intuito de resgatar a estética e a autoestima destes pacientes. Desde 1988, tem sido relatado na literatura a reabilitação de indivíduos com DE através de implantes osseointegrados, visto que há vantagens em relação à retenção (função), considerando as próteses convencionais. O objetivo deste artigo foi realizar um relato de caso de um paciente, de 21 anos, sexo masculino, diagnosticado com displasia ectodérmica hipohidrótica (DEH) e severa hipodontia, que recebeu quatro implantes dentários entre os forâmenes mentuais.

The ectodermal dysplasia (ED) is a genetic disorder with ample spectrum of clinical manifestations. Also, hypodontia or anodontia is a very frequent intra-oral finding. In this way, not only masticatory function must be developed, but also esthetics and patient self-esteem. Since 1988, rehabilitation of ED individuals with osseointegrated implants has been proposed due to their inherent advantages when compared to the conventional complete dentures. The aim of this paper is to report a 20 years-old male patient diagnosed with hypohidrotic ectodermal dysplasia (HED) and severe hypodontia receiving four dental implants in between the mental foramina.

Coleta e cultura de células-tronco obtidas da polpa de dentes decíduos: técnica e relato de caso clínico / Collection and culture of stem cells derived from dental pulp of deciduous teeth: technique and clinical case report

INTRODUÇÃO: as células-tronco (CT) possuem capacidade de induzir a regeneração tecidual e, portanto, apresentam um potencial terapêutico. Assim como a medula óssea e o cordão umbilical, a polpa dentária é uma das fontes disponíveis de CT. O seu fácil acesso e o fato de os dentes decíduos não serem órgãos vitais, que normalmente são descartados após a esfoliação, provêm um atrativo para testes de segurança e viabilidade terapêutica dessas células. OBJETIVOS: descrever a coleta, o isolamento e o cultivo de CT obtidas da polpa de dentes decíduos, assim como a sua caracterização por meio de citometria de fluxo e da indução da diferenciação em linhagens osteogênica e adipogênica. MÉTODOS: as CT foram obtidas de forma relativamente simples e apresentaram boa capacidade proliferativa, mesmo a partir de pouca quantidade de tecido pulpar. RESULTADOS: a análise por citometria de fluxo confirmou as características de CT mesenquimais, com baixos níveis de expressão dos antígenos CD34 e CD45, que são marcadores de células hematopoiéticas, e altos níveis de expressão dos antígenos CD105, CD166, CD90 e CD73, que são marcadores de CT mesenquimais. A plasticidade das células foi confirmada pela identificação de depósitos de cálcio nas culturas que receberam meio osteogênico, e de acúmulo lipídico intracelular nas culturas que receberam meio adipogênico. CONCLUSÕES: as CT de dentes decíduos têm um potencial promissor de aplicação em regeneração tecidual. Sendo assim, é importante difundir entre os cirurgiões-dentistas o conhecimento sobre a existência e as características dessa fonte de CT, discutindo a técnica utilizada, suas limitações e possíveis indicações.

INTRODUCTION: Stem cells (SCs) are capable of inducing tissue regeneration and are, therefore, potentially therapeutic. Similarly to bone marrow and umbilical cords, dental pulp is one of the available sources of SCs. The fact that these cells are easily accessible and that deciduous teeth are not vital organs, and are normally discarded after exfoliation, make them particularly attractive for use in safety and viability tests. OBJECTIVE: To describe the collection, isolation and culture of SCs obtained from the pulp of deciduous teeth as well as their characterization by flow cytometry, and the induction of differentiation into osteogenic and adipogenic lineages. METHODS: SCs were obtained in a relatively straightforward manner and showed good proliferative capacity, even from a small amount of pulp tissue. RESULTS: Analysis by flow cytometry confirmed the characteristics of mesenchymal SCs with low expression of CD34 and CD45 antigens, which are markers for hematopoietic cells, and high levels of expression of CD105, CD166, CD90 and CD73 antigens, which are markers for mesenchymal SCs. Cell plasticity was confirmed by identifying calcium deposits in cultures that received osteogenic medium, and intracellular lipid accumulation in adipogenic cultures that received adipogenic medium. CONCLUSIONS: SCs collected from deciduous teeth show promising potential for application in tissue regeneration. Therefore, it is important that knowledge about the existence and characteristics of this source of stem cells be disseminated among dentists and that the technique, its limitations and possible indications are highlighted and discussed.

The role of orthodontics as an auxiliary tool to lip augmentation.

In recent years, facial esthetics excellence has become a major focus in health professional offices and for the public worldwide. Among the main concerns of the patients is lip augmentation, since it has been associated with beauty and youth. This procedure has been increasingly performed and studied by dermatologists and plastic surgeons. Although good outcomes for lip augmentation have been achieved with different techniques, literature shows several complications and collateral effects. This paper demonstrates, through two clinical cases, how Orthodontics may be an excellent tool to assist in lip augmentation, highlighting the need for an interdisciplinary approach to enhance a more effective strategy to achieve facial esthetics goals.

Board Brasileiro de Ortodontia e Ortopedia Facial: certificando excelência / Brazilian Board of Orthodontics and Facial Orthopedics: certifying excellence

O Board Brasileiro de Ortodontia e Ortopedia Facial (BBO) é uma entidade de Certificação Nacional de padrão de excelência clínica no exercício da especialidade. O artigo, ora apresentado, traz o histórico da criação do BBO, sua estrutura e as fases que compõem a avaliação para obtenção da Certificação. Apresenta, ainda, o relato do primeiro exame aplicado no Brasil. O objetivo é multiplicar o conhecimento, entre os profissionais da área, sobre a importância da Certificação BBO como garantia do mais alto grau de qualidade no tratamento ortodôntico.

The Brazilian Board of Orthodontics and Facial Orthopedics (BBO) is the institution that certifies the standards of clinical excellence in the practice of this specialty. This article describes the history of BBO's creation and the examination structure and phases to obtain the BBO Certification. It also presents a detailed report of the first exam applied in Brazil. Its purpose is to expand the knowledge, among professionals in the area, about the importance of BBO Certification as assurance of the highest level of quality in orthodontic treatments.