Avaliação tomográfica da via aérea orofaríngea após tratamento ortocirúrgico em paciente padrão II ­ relato de caso / Tomographic assessment of the oropharyngeal airway after orthosurgical treatment in class II patient ­ case report

Resumo O avanço cirúrgico maxilomandibular é uma alternativa de tratamento eficaz em pacientes com desarmonias esqueléticas anteroposteriores e essa abordagem terapêutica tem repercussões sobre a via aérea superior em indivíduos com padrão esquelético de Classe II. O presente estudo tem como objetivo relatar o tratamento ortodôntico-cirúrgico de um paciente com má oclusão esquelética de Classe II e avaliar as mudanças volumétricas da via aérea superior através de Tomografia Computadorizada de Feixe Cônico (TCFC). Métodos: Realizou-se o tratamento ortodôntico pré-cirúrgico e tratamento cirúrgico para avanço maxilo-mandibular, impacção da maxila e mentoplastia. Obtiveram-se imagens tridimensionais por TCFC nos períodos pré-operatório e pós-operatório (3 meses) da cirurgia. Resultados: Mudanças significativas em medidas de área e volume da orofaringe no pós-operatório foram identificadas. Observou-se um aumento de 56% no volume da via aérea superior e de 150% na área de mínima secção transversal. Conclusão: O presente estudo evidenciou ganhos dimensionais importantes na via aérea superior após o procedimento ortodôntico-cirúrgico instituído para o caso (AUU)

Abstract The maxillomandibular surgical advancement is an effective treatment alternative in patients with anteroposterior skeletal disharmonies and this therapeutic approach has repercussions on the upper airway of individuals with a Class II skeletal pattern. The present study aims to report the orthodontic-surgical treatment of a patient with Class II skeletal malocclusion and to evaluate the volumetric changes of the upper airway using Cone Beam Computed Tomography (CBCT). Methods: Pre-surgical orthodontic treatment and surgical treatment for maxillomandibular advancement, maxillary impaction, and mentoplasty were performed. Three-dimensional CBCT images were obtained preoperatively and postoperatively (3 months) after surgery. Results: Significant changes in postoperative oropharyngeal area and volume measurements were identified. An increase of 56% in the volume of the upper airway and of 150% in the minimum cross-sectional area was observed. Conclusion: The present study showed important dimensional gains in the upper airway after the orthodontic-surgical procedure set up for the case (AU)

Versatility of Chitosan-Based Biomaterials and Their Use as Scaffolds for Tissue Regeneration.

Chitosan is a naturally occurring polysaccharide obtained from chitin, present in abundance in the exoskeletons of crustaceans and insects. It has aroused great interest as a biomaterial for tissue engineering on account of its biocompatibility and biodegradation and its affinity for biomolecules. A significant number of research groups have investigated the application of chitosan as scaffolds for tissue regeneration. However, there is a wide variability in terms of physicochemical characteristics of chitosan used in some studies and its combinations with other biomaterials, making it difficult to compare results and standardize its properties. The current systematic review of literature on the use of chitosan for tissue regeneration consisted of a study of 478 articles in the PubMed database, which resulted, after applying inclusion criteria, in the selection of 61 catalogued, critically analysed works. The results demonstrated the effectiveness of chitosan-based biomaterials in 93.4% of the studies reviewed, whether or not combined with cells and growth factors, in the regeneration of various types of tissues in animals. However, the absence of clinical studies in humans, the inadequate experimental designs, and the lack of information concerning chitosan's characteristics limit the reproducibility and relevance of studies and the clinical applicability of chitosan.

A eficácia do sistema Invisalign na estética e função – revisão sistemática / The efficacy of Invisalign system in aesthetics and function – a systematic review

O sistema Invisalign é um método de movimentação ortodôntica baseado em uma tecnologia 3D, que consiste em uma alternativa para pacientes que almejam a estética e o restabelecimento funcional. Nesse contexto, objetivou-se descrever os efeitos do tratamento com Invisalign, o grau de motivação dos pacientes e a relação entre outras mecânicas ortodônticas. Pesquisaram-se as palavras-chaves Invisalign, treatment outcomes, esthetics e malocclusion no Pubmed, obtendo-se 93 resultados. Foram selecionados 16 artigos entre 2004 e 2014 com base em títulos e resumos. Destes, 12 consistiam em estudos clínicos e quatro em relatos de casos. Um estudo mostrou que a experiência profissional pode estar relacionada ao índice de sucesso do tratamento com alinhadores. Em relação ao ClinCheck, dois estudos demonstraram uma maior precisão durante a constrição lingual ou rotação de caninos. Dois estudos constataram que procedimentos, como desgaste interproximal e protrusão, contribuíram para melhores finalizações dos tratamentos. Comparando as técnicas ortodônticas, três estudos demonstraram que o sistema Invisalign obteve bons resultados no nivelamento dos arcos, porém, o tratamento convencional ou autoligado proporciona maiores benefícios para a correção da má-oclusão e para uma maior estabilidade no período de pós-tratamento. Dois estudos destacaram que o aparelho lingual e o aparelho fixo proporcionaram níveis mais elevados de dor, quando comparado aos alinhadores. Quatro relatos de casos evidenciaram que a utilização de acessórios e a realização de redução interproximal podem favorecer para correção de apinhamento, sobremordida e sobressaliência. Em suma, os estudos mostraram que o sistema Invisalign possui muitas vantagens, entretanto, é necessário que a técnica seja indicada corretamente...

Invisalign is a method of orthodontic movement based on a 3D technology that is an alternative for patients who aims the aesthetic and functional recovery. In this context, the objective was to describe the effects of treatment with Invisalign, the degree of motivation of patients and the relationship between other orthodontic mechanics. The study was carried keywords Invisalign, treatment outcomes, aesthetics, malocclusion in Pubmed, obtaining 93 results. We selected 16 articles (2004-2014) based on titles and abstracts. These, twelve consisted in clinical studies and four in case reports. One study showed that professional experience may be related to the success rate of treatment with aligners. Regarding Clincheck, two studies demonstrated greater accuracy during lingual constriction or rotation of canines. Two studies found that procedures such as interproximal wear and protrusion, lead to better treatments submissions. Comparing orthodontic techniques, three studies demonstrated that the Invisalign system obtained good results in leveling of the arches, but the conventional treatment or self-ligated provide greater benefits for the correction of malocclusion and greater stability in the post-treatment. Two studies highlighted that the lingual braces and fixed appliance provided higher levels of pain, compared to aligners. Four case reports showed that the use of accessories and performing interproximal reduction may favor to correct crowding, overbite and overjet. In short, studies have shown that the Invisalign system has many advantages, however it is necessary that the technique is correctly indicated...

A atorvastatina e o alendronato interferem na movimentação dentária induzida em ratos viaredução das atividades inflamatória e reabsortiva e aumento do anabolismo ósseo

A movimentação dentária induzida (MDI) envolve processos inflamatórios e de remodelação óssea nos sítios de compressão e tração. Durante o tratamento ortodôntico, fármacos podem modular a taxa de movimentação.Nesse contexto, investigou-se a atorvastatina (ATV), o alendronato (ALD) ou sua combinação (ATV+ALD) na MDI em ratos. Inicialmente, grupos de 6 animais com MDI foram eutanasiados na 6ª h e nos dias 1, 4, 7, 11, 14 e 21, e tiveram suas hemimaxilas analisadas quanto a distância entre molares e incisivos, histomorfometria do ligamento periodontal (LP) das raízes distovestibular, distolingual e intermediária, e atividade de mieloperoxidase (MPO; Ux103/mg de gengiva). Para a abordagem farmacológica, os animais durante 28 d receberam por gavagem água destilada (H2Od; 2 ml/kg/d), ATV (1, 3 e 9 mg/kg/d), ALD (1 e 7 mg/kg/sem) ou combinação de suas menores doses (ATV+ALD), sendo 11 d antes da eutanásia, submetidos à MDI. Foram avaliados além da distância entre molares e incisivos, a histomorfometria e MPO, os níveis de IL-1β(pg/mg de gengiva), imunomarcações para RANKL, OPG e TRAP, e níveis séricos de fosfatase alcalina óssea (FAO; U/l); (Comissão de Ética em Pesquisa Animal-UFC nº 21/14)...

The induced tooth movement (MDI) depends oninflammatoryand bone remodelingprocesses in sites of compression and traction. During orthodontic treatment, drugs canmodulatethe movement ́s rate.In this context, we investigated the influence of atorvastatin (ATV), alendronate (ALD), or combination of these drugs (ATV+ALD) on MDI in rats.First, groups of animals (n=6/group) were euthanized at the 6thhour, and on the 1st, 4st, 7st, 11st, 14stand 21stdays, and they had their hemimaxillas analyzed for the distance between molars and incisors, histomorphometry of periodontal ligament (PL) of distobuccal, intermediate and distolingualroots, and myeloperoxidase activity (MPO; x 103U/mg of tissue). For pharmacological approach, the animals received by gavage during 28 d distilled water (H2Od, 2 ml/kg/d), ATV (1, 3 and 9 mg/kg/d), ALD (1 and 7 mg/kg/wk), or thecombination of lower doses of these drugs (ATV+ALD). Then, the rats weresubmitted to MDI 11 days prior to euthanasia. The distance between molars and incisors, histomorphometry, MPO, IL-1β levels (pg/mg of tissue), immunostaining for RANKL, OPG and TRAP, and serum levels of bone alkaline phosphatase (BALP; U/l)were evaluated. This study was approved by the Ethical aspects: Ethics Committee on Animal Research-UFC No. 21/14...

Relationship between Periodontitis and Rheumatoid Arthritis: Review of the Literature.

Periodontitis (PD) and rheumatoid arthritis (RA) are immunoinflammatory diseases where leukocyte infiltration and inflammatory mediators induce alveolar bone loss, synovitis, and joint destruction, respectively. Thus, we reviewed the relationship between both diseases considering epidemiological aspects, mechanical periodontal treatment, inflammatory mediators, oral microbiota, and antibodies, using the keywords "periodontitis" and "rheumatoid arthritis" in PubMed database between January 2012 and March 2015, resulting in 162 articles. After critical reading based on titles and abstracts and following the inclusion and exclusion criteria, 26 articles were included. In the articles, women over 40 years old, smokers and nonsmokers, mainly constituted the analyzed groups. Eight studies broached the epidemiological relationship with PD and RA. Four trials demonstrated that the periodontal treatment influenced the severity of RA and periodontal clinical parameters. Nine studies were related with bacteria influence in the pathogenesis of RA and the presence of citrullinated proteins, autoantibodies, or rheumatoid factor in patients with PD and RA. Five studies investigated the presence of mediators of inflammation in PD and RA. In summary, the majority of the articles have confirmed that there is a correlation between PD and RA, since both disorders have characteristics in common and result from an imbalance in the immunoinflammatory response.