Hábitos bucais como fatores de risco para a mordida aberta anterior: uma revisão de literatura / Oral habits as risk factors for anterior open bite: a literature revision

A mordida aberta anterior (MAA) pode ser definida como a presença de um trespasse vertical negativo existente entre as bordas incisais dos dentes anteriores superiores e inferiores. É uma má oclusão que acomete tanto o gênero masculino quanto o feminino, principalmente na infância e durante a troca de dentição. A proposta deste estudo foi realizar uma revisão narrativa sobre os hábitos bucais deletérios que causam a MAA. Para a realização deste trabalho foram utilizadas as bases de dados PUBMED, SciELO e LILACS, além de acervo bibliográfico presente na biblioteca da Universidade Camilo Castelo Branco – Campus Fernandópolis/SP, utilizando-se as palavras-chave: Mordida aberta, Etiologia e Hábitos, entre o período de 2004 a 2015. Os ortodontistas precisam conhecer os hábitos bucais deletérios, pois o conceito de prevenção resulta na melhor qualidade de vida através do estabelecimento de condições adequadas de alimentação, respiração e fala, favorecendo a harmonia e o equilíbrio entre esqueleto, tecidos moles, morfologia e volume dentário, os quais têm interferência direta sobre a oclusão. Esta má oclusão quando diagnosticada e interceptada precocemente, aumenta a probabilidade de sucesso da terapêutica ortodôntica

The anterior open bite (AOB) can be defined as the presence of an existing ‘no vertical overlap’ of incisors edges of the upper, lower and front teeth. It is a malocclusion that affects both the male and the female, especially in childhood and during the changing of teeth. The aim of this study was to perform a narrative review of the deleterious oral habits that cause AOB. To carry out this research we used PUBMED, SciELO and LILACS databases, plus bibliographic presented in the library of Universidade Camilo Castelo Branco - Campus Fernandópolis / SP. Using the keywords Open bite; Etiology and Habits, from 2004 to 2015. It is important for orthodontists get to know the deleterious oral habits, since it is known that any previous interventions to prevent them result in improved quality of life through the establishment of appropriate supply conditions, breathing and speaking, that support harmony and the balance of skeleton, soft tissues, morphology and dental volume, which have a direct interference in occlusion. It concluded that this type of malocclusion when diagnosed and early intercepted increases the likelihood

Aplicações clínicas dos mini-implantes ortodônticos no tratamento ortodôntico / Clinical applications of orthodontic mini-implants in orthodontic treatment

A ancoragem esquelética revolucionou os conceitos dos tratamentos ortodônticos no que diz respeito à ancoragem. Os micro-parafusos ortodônticos de titânio se destacam devido a sua grande aplicabilidade clínica á simplicidade cirúrgica, baixo custo, praticidade, boa aceitação por parte do paciente, tornando os tratamentos mais eficientes e previsíveis. O objetivo deste trabalho é expor, baseado na literatura recente, a utilização dos mini-implantes nos tratamentos ortodônticos proporcionando movimentações dentárias e minimizando os efeitos indesejados nas unidades de reação

The skeletal anchorage revolutionized the concepts of orthodontic treatments with respect to the anchorage. Orthodontic titanium micro-screws stand out due to their great clinical applicability will surgical simplicity, low cost, practicality, good acceptance by the patient, making them more efficient and predictable treatment. The aim of this study is to expose, based on recent literature, the use of mini-implants in orthodontic treatments providing dental movements and minimizing unwanted effects on reaction units

Efeito transversal da placa labioativa aberta associada à extensão lingual – estudo em modelos digitais / Transverse effect of the expanded lip bumper associated to the lingual extension – a digital model study

O objetivo do presente estudo clínico foi avaliar as dimensões transversais do arco dentário inferior com o uso da placa labioativa aberta e fixa associada à extensão lingual de canino decíduo a primeiro molar permanente. Material e métodos: a amostra constou de 14 pacientes no estágio de dentadura mista e com idade média de oito anos e seis meses. Todos os pacientes realizaram expansão rápida da maxila e expansão lenta do arco inferior com a placa labioativa. Modelos de gesso foram obtidos nas fases de pré-tratamento e pós-tratamento, e digitalizados com o auxílio do scanner 3Shape R700 3D (3Shape A/S, Copenhagen, Dinamarca). Medições transversais foram realizadas para as distâncias entre as pontas de cúspide dos caninos decíduos, pontas de cúspide mesiovestibulares dos molares decíduos e primeiro molar permanente, e ponto médio cervical da face vestibular. O teste t foi utilizado para determinar se o aumento nas larguras transversais foi significativo. Resultados: observou-se um aumento transversal estatisticamente signifi cativo (p < 0,05), que variou de 4,11 mm a 4,51 mm nos referenciais utilizados no nível das pontas de cúspide. Conclusão: a placa labioativa aberta e fixa apresentou um efeito transversal significativo em aproximadamente seis meses de tratamento...

The aim of the current clinical study was to evaluate the transverse dimensions of the lower dental arch with the use of the fixed and expanded lip bumper associated to the lingual extension from the deciduous canine to the permanent first molar. Methods: the sample was comprised of 14 patients in the mixed dentition with a mean age of 8 years and 6 months. All patients were submitted to rapid palatal expansion and dentoalveolar expansion of the lower dental arch with a lip bumper. Pre-treatment and post-treatment cast models were obtained and digitized with the 3Shape R700 3D (3Shape A/S, Copenhagen, Denmark) scanner. Transverse distances between the cusp tips of the canines, the mesial buccal cusps of the deciduous molars and of the permanent first molars and between the cervical middle points of the buccal aspects of these teeth were measured. The t tests were performed to determine whether an increase in transverse distances was signifi cant. Results: a statistically significant transverse increase (p < 0,05) ranging from 4.11 mm to 4.51 mm was observed in the cusp tips. Conclusion: the fixed and expanded lip bumper presented a significant transverse effect within approximately 6 months of treatment...

Morphometric analysis of long-term dentoskeletal effects induced by treatment with Balters bionator.

OBJECTIVE: To evaluate the long-term effects of the standard (Class II) Balters bionator in growing patients with Class II malocclusion with mandibular retrusion by using morphometrics (thin-plate spline [TPS] analysis). MATERIALS AND METHODS: Twenty-three Class II patients (8 male, 15 female) were treated consecutively with the Balters bionator (bionator group). The sample was evaluated at T0, start of treatment; T1, end of bionator therapy; and T2, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T0); at posttreatment, 12 years 3 months (T1); and at long-term follow-up, 18 years 2 months (T2). The control group consisted of 22 subjects (11 male, 11 female) with untreated Class II malocclusion. Lateral cephalograms were analyzed at the three time points for all groups. TPS analysis evaluated statistical differences (permutation tests) in the craniofacial shape and size between the bionator and control groups. RESULTS: TPS analysis showed that treatment with the bionator is able to produce favorable mandibular shape changes (forward and downward displacement) that contribute significantly to the correction of the Class II dentoskeletal imbalance. These results are maintained at a long-term observation after completion of growth. The control group showed no statistically significant differences in the correction of Class II malocclusion. CONCLUSIONS: This study suggests that bionator treatment of Class II malocclusion produces favorable results over the long term with a combination of skeletal and dentoalveolar shape changes.

Ocorrência de reabsorção radicular no tratamento ortodôntico: revisão crítica da literatura / Occurrence of root resorption during the orthodontic treatment: critical literature review

A reabsorção radicular é uma das possíveis sequelas de maior complexidade para o ortodontista, pela dificuldade de detecção e por ser assintomática. Sua presença está ligada a uma origem multifatorial, uma complexa combinação das atividades biológicas, variáveis anatômicas, fisiológicas, genéticas e as forças mecânicas. Dessa forma, o objetivo deste estudo foi realizar uma revisão crítica da literatura referente à reabsorção radicular frente à movimentação ortodôntica. Foram incluídos artigos publicados entre 2004 a 2014, indexados na base de dados PUBMED. Os descritores utilizados continham no DeCs, sendo adotados como critérios de inclusão: ensaios clínicos em humanos, apenas artigos que apresentavam ideias claras e objetivas, artigos que apresentavam idioma Inglês. A estratégia de busca utilizada resultou em 24 artigos e depois de aplicados os critérios de inclusão e exclusão, restaram 11 artigos, com base nos resultados, concluiu-se que forças pesadas, de intrusão, inclinação e torque levam a um maior grau de reabsorção radicular; sua etiologia é multifatorial, o controle radiográfico periódico durante o tratamento é necessário e mais estudos são sugeridos para identificar mais especificamente as causas e os fatores de risco para a reabsorção radicular

The root resorption is one of the possible sequels of greater complexity to the orthodontist, the difficulty of detection and be asymptomatic. The presence, during the orthodontic treatment, is linked to a multifactorial origin, a complex combination of biological activities, anatomical, physiological, genetic variables and mechanical forces. Thus, the aim of this study was perform to critical literature review related to root resorption in orthodontic movement. Were included articles published between 2004 to 2014, indexed in the PUBMED database. Used descriptors contained in the Mesh, being adopted as inclusion criteria: clinical trials in humans, only articles that had clear ideas and objective, articles with English language. The search strategy used resulted in 24 articles and after applied the inclusion and exclusion criteria, 11 articles remained. Based on the results of this study it was concluded that heavy forces of intrusion, inclination and torque leads to a greater degree of root resorption; its etiology is multifactorial, the periodic radiographic control during treatment is needed and further studies are suggested to identify more specifically the causes and risk factors for root resorption

Atendimento e protocolo indicados na odontologia à gestante: revisão da literatura / Service and protocol indicated in dentistry to pregnant women: literatura review

O objetivo deste artigo consiste em discorrer sobre o de atendimento e protocolo indicados na Odontologia à Gestante. Trata-se de uma revisão de literatura, realizada na Biblioteca Virtual de Saúde (BVS), nas seguintes bases de dados: Scientific Eletronic Library Online (SCIELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Os critérios de inclusão dos artigos foram: idioma em português acerca da temática citada acima e artigos na íntegra indexados no período de 2003 a 2013. Os descritores utilizados foram os seguintes: Protocolo. Gestante. Odontologia. Os resultados mostram que a gestação é um período peculiar na vida da mulher, no entanto a mesma muitas vezes tem dificuldades em realizar um tratamento odontológico pelo motivo de a grande parte dos cirurgiões-dentistas tem algum receio. Concluiu-se que embora as dúvidas que pairam entre os profissionais, desde que os procedimentos odontológicos, sejam corretamente realizados não geram males ao feto, sobretudo quando executados no período gestacional. Além disso, o cirurgiãodentista deve ser criterioso na indicação das intervenções odontológicas na gravidez

The purpose of this article is to discuss the service and indicated protocol in dentistry to the pregnant women. This is a literature review conducted in Virtual Health Library (VHL) on the following databases: Scientific Electronic Library Online (SCIELO), Latin American literature and Caribbean Health Sciences (LILACS).The inclusion criteria of the articles were: language in Portuguese on the theme mentioned above and full articles indexed from 2003 to 2013. The descriptors used were as follows: Protocol. Pregnant woman. Dentistry. The results showed that gestation is a peculiar period in a woman’s life, however it often have difficulties to perform a dental treatment by reason of the large number of dentists have some fear. It was concluded that although the doubts among traders, since dental procedures are properly carried out not generate evils to the fetus, particularly when performed during pregnancy. Furthermore, the dentist should exercise caution in indication of dental interventions in pregnancy

Comparative study on direct and indirect bracket bonding techniques regarding time length and bracket detachment.

OBJECTIVE: The aim of this study was to assess the time spent for direct (DBB - direct bracket bonding) and indirect (IBB - indirect bracket bonding) bracket bonding techniques. The time length of laboratorial (IBB) and clinical steps (DBB and IBB) as well as the prevalence of loose bracket after a 24-week follow-up were evaluated. METHODS: Seventeen patients (7 men and 10 women) with a mean age of 21 years, requiring orthodontic treatment were selected for this study. A total of 304 brackets was used (151 DBB and 153 IBB). The same bracket type and bonding material were used in both groups. Data were submitted to statistical analysis by Wilcoxon non-parametric test at 5% level of significance. RESULTS: Considering the total time length, the IBB technique was more time-consuming than the DBB (p < 0.001). However, considering only the clinical phase, the IBB took less time than the DBB (p < 0.001). There was no significant difference (p = 0.910) for the time spent during laboratorial positioning of the brackets and clinical session for IBB in comparison to the clinical procedure for DBB. Additionally, no difference was found as for the prevalence of loose bracket between both groups. CONCLUSIONS: The IBB can be suggested as a valid clinical procedure since the clinical session was faster and the total time spent for laboratorial positioning of the brackets and clinical procedure was similar to that of DBB. In addition, both approaches resulted in similar frequency of loose brackets.

Cephalometric evaluation of the predictability of bimaxillary surgical-orthodontic treatment outcomes in long face pattern patients: a retrospective study.

OBJECTIVE: The aim of this study was to compare by means of McNamara as well as Legan and Burstone's cephalometric analyses, both manual and digitized (by Dentofacial Planner Plus and Dolphin Image software) prediction tracings to post-surgical results. METHODS: Pre and post-surgical teleradiographs (6 months) of 25 long face patients subjected to combined orthognathic surgery were selected. Manual and computerized prediction tracings of each patient were performed and cephalometrically compared to post-surgical outcomes. This protocol was repeated in order to evaluate the method error and statistical evaluation was conducted by means of analysis of variance and Tukey's test. RESULTS: A higher frequency of cephalometric variables, which were not statistically different from the actual post-surgical results for the manual method, was observed. It was followed by DFPlus and Dolphin software; in which similar cephalometric values for most variables were observed. CONCLUSION: It was concluded that the manual method seemed more reliable, although the predictability of the evaluated methods (computerized and manual) proved to be reasonably satisfactory and similar.

Comparative study on direct and indirect bracket bonding techniques regarding time length and bracket detachment

OBJECTIVE: The aim of this study was to assess the time spent for direct (DBB - direct bracket bonding) and indirect (IBB - indirect bracket bonding) bracket bonding techniques. The time length of laboratorial (IBB) and clinical steps (DBB and IBB) as well as the prevalence of loose bracket after a 24-week follow-up were evaluated. METHODS: Seventeen patients (7 men and 10 women) with a mean age of 21 years, requiring orthodontic treatment were selected for this study. A total of 304 brackets were used (151 DBB and 153 IBB). The same bracket type and bonding material were used in both groups. Data were submitted to statistical analysis by Wilcoxon non-parametric test at 5% level of significance. RESULTS: Considering the total time length, the IBB technique was more time-consuming than the DBB (p < 0.001). However, considering only the clinical phase, the IBB took less time than the DBB (p < 0.001). There was no significant difference (p = 0.910) for the time spent during laboratorial positioning of the brackets and clinical session for IBB in comparison to the clinical procedure for DBB. Additionally, no difference was found as for the prevalence of loose bracket between both groups. CONCLUSION: the IBB can be suggested as a valid clinical procedure since the clinical session was faster and the total time spent for laboratorial positioning of the brackets and clinical procedure was similar to that of DBB. In addition, both approaches resulted in similar frequency of loose bracket.

OBJETIVO: avaliar o tempo necessário para realização da colagem de braquetes pelas técnicas direta (CDB) e indireta (CIB), mensurando o tempo despendido entre a parte laboratorial (CIB) e a parte clínica (CDB e CIB), e a prevalência de descolamentos durante o período de observação de 24 semanas. MÉTODOS: dezessete pacientes (7 homens e 10 mulheres), com idade média de 21 anos, com necessidade de tratamento ortodôntico, foram selecionados para participar desse estudo. Foram utilizados um total de 304 braquetes, sendo que 151 foram colados pela técnica de CDB e 153 pela CIB, com o mesmo tipo de braquete e material de colagem. Os dados foram submetidos ao teste não paramétrico de Wilcoxon, com significância de 5%. RESULTADOS: o tempo total para realização da CIB foi maior em relação à CDB (p < 0,001). Levando em consideração apenas a fase clínica, foi observado que o tempo para CIB foi menor em relação a CDB (p < 0,001). A comparação entre o tempo despendido para o posicionamento dos braquetes em laboratório mais o tempo em clínica para CIB com o tempo em clínica para a CDB revelou que não houve diferença significativa (p = 0,910), nem tampouco quanto à prevalência de descolamento dos braquetes. CONCLUSÃO: a CIB apresenta-se como uma utilidade clínica singular, pois o tempo em clínica foi menor que o da CDB. O tempo despendido no posicionamento dos braquetes no laboratório e de execução clínica da CIB foi semelhante ao tempo gasto pela CDB, a quantidade de descolamentos foi semelhante entre as técnicas.

Effect of moisture on dental enamel in the interaction of two orthodontic bonding systems.

OBJECTIVE: The purpose of this study was to assess by means of scanning electron microscopy (SEM) the remaining adhesive interface after debonding orthodontic attachments bonded to bovine teeth with the use of hydrophilic and hydrophobic primers under different dental substrate moisture conditions. MATERIAL AND METHODS: Twenty mandibular incisors were divided into four groups (n = 5). In Group I, bracket bonding was performed with Transbond MIP hydrophilic primer and Transbond XT adhesive paste applied to moist substrate, and in Group II a bonding system comprising Transbond XT hydrophobic primer and adhesive paste was applied to moist substrate. Brackets were bonded to the specimens in Groups III and IV using the same adhesive systems, but on dry dental enamel. The images were qualitatively assessed by SEM. RESULTS: The absence of moisture in etched enamel enabled better interaction between bonding materials and the adamantine structure. The hydrophobic primer achieved the worst micromechanical interlocking results when applied to a moist dental structure, whereas the hydrophilic system proved versatile, yielding acceptable results in moist conditions and excellent interaction in the absence of contamination. CONCLUSIONS: The authors assert that the best condition for the application of primers to dental enamel occurs in the absence of moisture.

Cephalometric evaluation of the predictability of bimaxillary surgical-orthodontic treatment outcomes in long face pattern patients: a retrospective study

OBJECTIVE: The aim of this study was to compare by means of McNamara as well as Legan and Burstone's cephalometric analyses, both manual and digitized (by Dentofacial Planner Plus and Dolphin Image software) prediction tracings to post-surgical results. METHODS: Pre and post-surgical teleradiographs (6 months) of 25 long face patients subjected to combined orthognathic surgery were selected. Manual and computerized prediction tracings of each patient were performed and cephalometrically compared to post-surgical outcomes. This protocol was repeated in order to evaluate the method error and statistical evaluation was conducted by means of analysis of variance and Tukey's test. RESULTS: A higher frequency of cephalometric variables, which were not statistically different from the actual post-surgical results for the manual method, was observed. It was followed by DFPlus and Dolphin software; in which similar cephalometric values for most variables were observed. CONCLUSION: It was concluded that the manual method seemed more reliable, although the predictability of the evaluated methods (computerized and manual) proved to be reasonably satisfactory and similar.

OBJETIVOS: a proposta desse trabalho foi comparar, por meio das análises cefalométricas de McNamara, Legan e Burstone, os traçados de previsão manuais e os digitalizados pelos programas Dentofacial Planner Plus e Dolphin Imaging, com os resultados pós-cirúrgicos. MÉTODOS: foram selecionadas as telerradiografias pré- e pós-cirúrgicas (seis meses) de 25 pacientes face longa submetidos a cirurgia ortognática combinada. Foram realizados os traçados de previsão manual e computadorizados de cada paciente, comparando-os, cefalometricamente, com os resultados pós-cirúrgicos. Esse protocolo foi repetido para avaliação do erro do método e realizou-se a avaliação estatística por meio da análise de variância e sobreteste de Tukey. RESULTADOS: observou-se uma maior frequência de variáveis cefalométricas que não diferiram estatisticamente do resultado pós-cirúrgico real para o método manual, seguido dos programas DFPLus e Dolphin; observando-se valores cefalométricos similares para a maioria das variáveis. CONCLUSÃO: concluiu-se que o método manual pareceu mais fidedigno, embora a previsibilidade dos métodos avaliados (computadorizados e manual) tenha se mostrado razoavelmente satisfatória e similar.

Effect of moisture on dental enamel in the interaction of two orthodontic bonding systems

OBJECTIVE: The purpose of this study was to assess by means of scanning electron microscopy (SEM) the remaining adhesive interface after debonding orthodontic attachments bonded to bovine teeth with the use of hydrophilic and hydrophobic primers under different dental substrate moisture conditions. MATERIAL AND METHODS: Twenty mandibular incisors were divided into four groups (n=5). In Group I, bracket bonding was performed with Transbond MIP hydrophilic primer and Transbond XT adhesive paste applied to moist substrate, and in Group II a bonding system comprising Transbond XT hydrophobic primer and adhesive paste was applied to moist substrate. Brackets were bonded to the specimens in Groups III and IV using the same adhesive systems, but on dry dental enamel. The images were qualitatively assessed by SEM. RESULTS: The absence of moisture in etched enamel enabled better interaction between bonding materials and the adamantine structure. The hydrophobic primer achieved the worst micromechanical interlocking results when applied to a moist dental structure, whereas the hydrophilic system proved versatile, yielding acceptable results in moist conditions and excellent interaction in the absence of contamination. CONCLUSION: The authors assert that the best condition for the application of primers to dental enamel occurs in the absence of moisture.

OBJETIVO: a proposta desse estudo foi avaliar, por meio de microscopia eletrônica de varredura (MEV), a interface adesiva após a descolagem de acessórios ortodônticos, fixados em dentes bovinos com emprego de adesivo hidrofílico e hidrofóbico, em condições distintas de umidade do substrato dentário. MÉTODOS: foram utilizados 20 incisivos inferiores, divididos em quatro grupos (n = 5): Grupo I , empregou-se o sistema de colagem contendo o primer hidrofílico Transbond MIP e a pasta adesiva Transbond XT, aplicados em substrato úmido; Grupo II, empregou-se o sistema de colagem primer hidrofóbico Transbond XT e pasta adesiva em substrato úmido; Grupos III e IV, os braquetes foram colados com os mesmos sistemas de união dos Grupos I e II, porém com esmalte dentário seco. Removidos os acessórios, avaliou-se em MEV, em diferentes magnificações, a interface adesiva e a interação dos sistemas adesivos com o esmalte dentário. As imagens foram avaliadas qualitativamente, observando-se o embricamento mecânico para o adesivo hidrófilo em quaisquer condições de substrato. RESULTADOS: a falta de umidade no esmalte condicionado permitiu uma melhor interação entre os materiais de ligação e a estrutura adamantina. O adesivo hidrofóbico apresentou o pior resultado de interação micromecânica quando aplicado a uma estrutura dentária úmida; já o sistema hidrofílico mostrou-se versátil, obtendo resultados aceitáveis em condições de umidade e excelente interação na ausência de contaminação. CONCLUSÃO: os autores afirmam que a melhor condição do esmalte dentário para a aplicação de primers é com a ausência de umidade.

Morphometric analysis of treatment effects of the Balters bionator in growing Class II patients.

OBJECTIVE: To investigate the effects of the standard (Class II) Balters bionator in growing patients with Class II malocclusion with mandibular retrusion by using morphometrics (thin-plate spline [TPS] analysis). MATERIALS AND METHODS: Thirty-one Class II patients (17 male and 14 female) were treated with the Balters bionator (bionator group). Mean age at the start of treatment (T0) was 10.3 years, while it was 13 years at the end of treatment (T1). Mean treatment time was 2 years and 2 months. The control group consisted of 22 subjects (14 male and 8 female) with untreated Class II malocclusion. Mean age at T0 was 10.2 years, while it was 12.2 years at T1. The observation period lasted 2 years on average. TPS analysis evaluated statistical (permutation tests) differences in the craniofacial shape and size between the bionator and control groups. RESULTS: Through TPS analysis (deformation grids) the bionator group showed significant shape changes in the mandible that could be described as a mandibular forward and downward displacement. The control group showed no statistically significant differences in the correction of Class II malocclusion. CONCLUSIONS: Bionator appliance is able to induce significant mandibular shape changes that lead to the correction of Class II dentoskeletal disharmony.

Estudo cefalométrico comparativo dos traçados preditivos e resultados ortodôntico-cirúrgicos em pacientes com face longa / Cephalometric comparative evaluation of predictibility for surgical orthodontic treatment in long face patients

O objetivo desta pesquisa foi comparar, por meio deanálises cefalométricas, os traçados preditivos (pelo método manuale pelos programas Dentofacial Planner Plus e Dolphin Image) comos resultados pós-cirúrgicos, avaliando assim a previsibilidade dostraçados preditivos. Foram selecionadas as telerradiografias pré epós-cirúrgicas (seis meses após a cirurgia ortognática) de 25 pacientestratados com cirurgia ortognática combinada. Foram realizados os traçadospreditivos para cada método e estes foram comparados com osresultados pós-cirúrgicos. Este protocolo foi repetido para a avaliaçãodo erro do método, e a estatística instituída utilizou-se da análise devariância. Os resultados mostraram maior frequência de aproximaçõespara os valores cefalométricos dos resultados pós-cirúrgicos quandoo método manual foi empregado (50% de similaridade), seguido dosprogramas DFPlus (31,2%) e Dolphin (18,8%). A condição experimentalpermitiu concluir que o método de previsão manual teve maiorprecisão, embora a previsibilidade dos métodos digitais tenha sidorazoavelmente satisfatória.

The purpose of this research was to compare, by cephalometricanalysis (McNamara and Legan & Burstone) the predictivetracings (by methods manual, and by softwares Oentofacial Planner Plusand Oolphin Image) with the post surgical results. Were selected the preand post surgical lateral telerradiograph (six months after orthognaticsurgery) of the 25 long face patients treated with combined orthognaticsurgery. Weremade the prediction tracings for each method and comparingcephalometrically with the post surgical results. This protocol wasrepeated once more for the error method evaluation, and the statisticalwas made by variance analysis and Tuckey overtest. The results showmore frequency of the cephalometric values' aproximation of the postsurgical results when the manual method (50% of the similarity withthe post surgical result), followed of the DFPlus (31,2%) and Dolphin(18,8%) softwares. The experimental condition permits to concludethat the manual method had more precision, although the previsibilityof the digital methods was reasonable satisfactory.

Dental age as indicator of adolescence

AIM: The purpose of the present study was to analyze the relationship between root formation of the first premolars and skeletal maturation stages identified in hand-wrist radiographs. METHODS: A cross-sectional study was carried out involving the panoramic and hand-wrist radiographs obtained on the same date of 232 patients, 123 boys and 109 girls aged 4 years and 5 months to 17 years and 12 months. Root formation stages of the first premolars were related to the ossification stages of the sesamoid bone, epiphyseal stages of the phalanx of the thumb and epiphyseal stages of the radius. RESULTS: The studied variables demonstrated statistically significant correlations. CONCLUSION: Roots of the lower first premolars do not reach 2/3 of their complete length before adolescence.

Photographic assessment of nasal morphology following rapid maxillary expansion in children.

OBJECTIVE: The aim of the present study was to use facial analysis to determine the effects of rapid maxillary expansion (RME) on nasal morphology in children in the stages of primary and mixed dentition, with posterior cross-bite. MATERIAL AND METHODS: Facial photographs (front view and profile) of 60 patients in the pre-expansion period, immediate post-expansion period and one year following rapid maxillary expansion with a Haas appliance were evaluated on 2 occasions by 3 experienced orthodontists independently, with a 2-week interval between evaluations. The examiners were instructed to assess nasal morphology and had no knowledge regarding the content of the study. Intraexaminer and interexaminer agreement (assessed using the Kappa statistic) was acceptable. RESULTS: From the analysis of the mode of the examiners' findings, no alterations in nasal morphology occurred regarding the following aspects: dorsum of nose, alar base, nasal width of middle third and nasal base. Alterations were only detected in the nasolabial angle in 1.64% of the patients between the pre-expansion and immediate post-expansion photographs. In 4.92% of the patients between the immediate post-expansion period and 1 year following expansion; and in 6.56% of the patients between the pre-expansion period and one year following expansion. CONCLUSIONS: RME performed on children in stages of primary and mixed dentition did not have any impact on nasal morphology, as assessed using facial analysis.

Programa de extrações seriadas: variáveis relacionadas com a extração de pré-molares / Serial extraction: variables associated to the extraction of premolars

OBJETIVO: verificar o percentual de pacientes que necessitaram extração de dentes permanentes, pré-molares, dentre aqueles tratados com extração de dentes decíduos para correção do apinhamento primário na dentição mista, bem como analisar as possíveis variáveis relacionadas. MÉTODOS: a amostra foi composta por documentações ortodônticas de 70 pacientes na dentição permanente, cujo tratamento iniciou-se na dentição mista com planejamento de um programa de extrações seriadas (PES). Todos os prontuários foram analisados por um único examinador, no intuito de verificar se o PES havia sido cumprido com a extração de dentes permanentes ou se havia sido realizada apenas extração de dentes decíduos. Verificou-se a associação entre a extração de dentes permanentes e as variáveis padrão facial; relação sagital entre as arcadas dentárias; IMPA; proporção tamanho do segundo molar permanente inferior/espaço retromolar; mecânica de controle de espaço e discrepância de modelo (teste exato de Fisher para as variáveis categóricas e modelo de regressão logística para as variáveis numéricas). Os resultados foram considerados para p<0,05. RESULTADOS: dos pacientes que haviam sido tratados com extração de dentes decíduos para a correção do apinhamento na dentição mista, 70 por cento necessitaram de extração de dentes permanentes. A análise estatística não mostrou associação significativa entre as variáveis estudadas e a necessidade de extração de dentes permanentes, com exceção da variável discrepância de modelo. CONCLUSÃO: a discrepância de modelo representou a principal determinante de extração de pré-molares no PES.

OBJECTIVE: To determine the frequency of patients who require extraction of permanent premolars among those treated with extraction of deciduous teeth for the correction of incisor crowding in the mixed dentition and analyze possible associated variables.METHODS: The sample was composed of orthodontic records of 70 patients with permanent dentition whose treatment had begun in the mixed dentition phase and involved serial extraction. All records were analyzed by a single examiner to determine whether serial extraction had been performed with extraction of permanent teeth or only deciduous teeth. Associations were investigated between extraction of permanent teeth and lateral facial pattern, sagittal relationship of the dental arches, incisor-mandibular plane angle, size proportion of mandibular second molar/retromolar space, mechanics for space control and tooth-arch size discrepancy (Fisher's exact test for categorical variables and logistic regression for numeric variables, p<0.05).RESULTS: Among the patients who had been treated with extraction of deciduous teeth, 70% required the extraction of permanent teeth. The statistical analysis revealed no significant associations between the analyzed variables and the need for permanent tooth extraction, with the exception of tooth-arch size discrepancy.CONCLUSION: Tooth-arch size discrepancy was the main factor determining premolar extraction in a serial extraction program.

Photographic assessment of nasal morphology following rapid maxillary expansion in children

OBJECTIVE: The aim of the present study was to use facial analysis to determine the effects of rapid maxillary expansion (RME) on nasal morphology in children in the stages of primary and mixed dentition, with posterior cross-bite. MATERIAL AND METHODS: Facial photographs (front view and profile) of 60 patients in the pre-expansion period, immediate post-expansion period and one year following rapid maxillary expansion with a Haas appliance were evaluated on 2 occasions by 3 experienced orthodontists independently, with a 2-week interval between evaluations. The examiners were instructed to assess nasal morphology and had no knowledge regarding the content of the study. Intraexaminer and interexaminer agreement (assessed using the Kappa statistic) was acceptable. RESULTS: From the analysis of the mode of the examiners' findings, no alterations in nasal morphology occurred regarding the following aspects: dorsum of nose, alar base, nasal width of middle third and nasal base. Alterations were only detected in the nasolabial angle in 1.64 percent of the patients between the pre-expansion and immediate post-expansion photographs. In 4.92 percent of the patients between the immediate post-expansion period and 1 year following expansion; and in 6.56 percent of the patients between the pre-expansion period and one year following expansion. CONCLUSIONS: RME performed on children in stages of primary and mixed dentition did not have any impact on nasal morphology, as assessed using facial analysis.

Considerações acerca do preparo ortodôntico direcionado à cirurgia ortognática / Considerations concerning the orthodontic preparation addressed to the orthognathic surgery

Este trabalho tem a proposição de contribuir para que a comunicação entre ortodontista e cirurgiões bucomaxilofaciais seja aumentada e melhorada, revisando e discutindo os princípios de diagnóstico e movimentação ortodôntica específica para o paciente com indicação cirúrgica. Serão descritos os pontos eletivos na conduta do ortodontista para que suas decisões possam condizir a um planejamento individualizado e adequado, buscando a excelência em termos de resultados para o tratamento ortodôntico-cirúrgico das discrepâncias dentofaciais.

Considerações acerca do preparo ortodôntico direcionado à cirurgia ortognática / Considerations concerning of the orthodontic preparation addressed to the orthognatic surgery

Este trabalho tem a proposição de contribuir para que a comunicação entre ortodontistas e cirurgiões buco-maxilofaciais seja aumentada e melhorada, revisando e discutindo os princípios de diagnóstico e movimentação ortodôntica específicos para o paciente com indicação cirúrgica. Foram descritos os pontos eletivos na conduta do ortodontista para que suas decisões possam conduzir a um planejamento individualizado e adequado, buscando a excelência em termos de resultado para o tratamento ortodôntico-cirúrgico das discrepâncias dentofaciais.

This paper has the proposition of contributing so that the communication between orthodontist and maxillofacial surgeons is increased, revising and discussing the diagnosis beginnings and orthodontic movement for the patient with indication for orthognathic surgery. The elective points in the conduct of the orthodontist so that your decisions could lead her/ it an individualized planning and appropriate they had been described, looking for the excelence in terms of results for the surgical treatment of the dentofacial deformities.