Soft tissue profile changes in Angle class II patients treated with Twin Force or intermaxillary elastics-a comparison.

PROPOSITION: This study aimed to compare soft tissue profile changes in Angle class II malocclusion patients treated with a Twin Force appliance (Ortho Organizers, Inc., Carlsbad, CA, USA) or class II elastics. METHODS: The sample comprised 47 class II malocclusion patients treated orthodontically without extractions, divided into two groups. Group 1 (Twin Force): 25 patients were treated with the Twin Force, with initial and final mean ages of 17.91 and 20.45 years, respectively, and mean treatment time of 2.53 years. Group 2 (elastics): 22 patients were treated with class II elastics, with initial and final mean age of 15.87 and 18.63 years, respectively, and mean treatment time of 2.75 years. The lateral cephalograms were evaluated at the initial and final stages. Intragroup comparisons were performed with dependent t-tests and intergroup comparisons were performed with independent t-tests. RESULTS: Treatment-related changes in the Twin Force group included reduction of facial convexity, retrusion of the upper lip, increase of the H­Nose distance, and decrease in Sn­H distance, indicating improvement in facial profile. In the elastics group, treatment resulted in an increase in nasolabial angle, retrusion of the upper lip, increase of the H­Nose distance, and decrease in Sn­H distance, indicating improvement in facial profile. The Twin Force group showed a greater reduction of the facial convexity with treatment than the elastics group. CONCLUSIONS: Class II patients treated with the Twin Force appliance showed greater reduction in facial convexity than patients treated with class II elastics. The other soft tissue changes were similar for both groups.

Level of satisfaction in the use of the wraparound Hawley and thermoplastic maxillary retainers.

OBJECTIVE: To compare the level of satisfaction in the use of wraparound Hawley and thermoplastic maxillary retainers. MATERIALS AND METHODS: The study sample included 70 orthodontic patients (24 males and 46 females), who were in the retention stage (mean age = 20.80 years). All patients wore the two types of maxillary retainer for 1 month each, along with a 3×3 fixed mandibular retainer. After the use of each retainer, the patients responded to a questionnaire evaluating the level of satisfaction with their use of the maxillary retainer. Intergroup comparison was performed by independent t tests. Chi-square test was used to evaluate preference for the type of retainer by gender. RESULTS: The thermoplastic retainer was better for swallowing and the wraparound Hawley appliance was better for hygiene and durability. The other factors evaluated (adaptation, speech, comfort, esthetics, satisfaction, and fitting) did not show significant differences between the retainers. There was also no significant difference in preference for the appliances. CONCLUSIONS: Regarding the overall satisfaction and the preference, there was no difference between the wraparound Hawley and thermoplastic retainers. The wraparound Hawley appliance was better in hygiene and resistance than the thermoplastic retainer; and the thermoplastic appliance was better than the wraparound Hawley for swallowing fluids and saliva.

Influence of fixed appliances on two-phase orthopedic-orthodontic treatment

Aim: The purpose of this retrospective study was to investigate the effects of phase 2 with fixed appliances, after phase 1 Bionator treatment of Class II division 1 malocclusion, as compared to a matching control group. Methods: The experimental group consisted of 20 patients who were evaluated after orthodontic treatment with fixed appliances subsequently to functional therapy with the Bionator in phase 1. A control group consisting of 20 Class II, division 1 individuals. Results: During phase 1 there was significant forward growth restriction in the maxillary complex, improvement of the maxillomandibular relationship and decrease in facial convexity. There was also significant reduction of the maxillary incisor proclination and protrusion, protrusion of the mandibular incisors, and vertical development of the mandibular molars. The overjet was significantly reduced and the molar relationship was significantly improved. Treatment during phase 2, with fixed appliances, resulted in significant maxillary forward growth restriction and facial convexity reduction. Conclusion: Major Class II skeletal and dentoalveolar anteroposterior correction was obtained during phase 1, with the Bionator. Phase 2, with fixed appliances only produced a significant maxillary forward growth restriction and facial convexity reduction, without any significant dentoalveolar change

Anterior open-bite treatment with bonded vs conventional lingual spurs: A comparative study.

INTRODUCTION: The purpose of this study was to compare the isolated effects of bonded and conventional spurs on the craniofacial and dentoalveolar complexes of patients in the mixed dentition with anterior open bite. METHODS: The sample included 68 subjects with anterior open bite and Class I malocclusion. Group 1 comprised 20 patients treated with bonded lingual spurs with a mean initial age of 9.31 years (SD, 1.17). Group 2 consisted of 21 patients treated with conventional lingual spurs with a mean initial age of 9.22 years (SD, 1.62). The control group (group 3) consisted of 27 untreated subjects. One-way analysis of variance tests followed by Tukey tests were used for intergroup cephalometric comparisons. After 1 month of treatment, patient acceptance of the spurs was evaluated with a questionnaire. RESULTS: There were significantly greater overbite increases in the experimental groups than in the control group. The group with bonded lingual spurs showed significantly better acceptance than did the group with conventional lingual spurs during chewing and eating. CONCLUSIONS: The 2 appliances resulted in similar overbite increases during early open-bite treatment. After a week or less of treatment, 92.5% of the children had adjusted to the spurs.

Influence of treatment including second molars on final and postretention molar angulation.

OBJECTIVE: Evaluate axial mesiodistal inclinations of the mandibular molars in orthodontically treated cases, analyzing whether inclusion of second mandibular molars in treatment mechanics has any influence on final and postretention molars angulations. METHODS: The sample comprised 150 panoramic radiographs of 50 patients. Patients were treated with extraction of four first premolars and divided into 2 groups: Group 1 comprised 25 subjects without inclusion of mandibular second molars during orthodontic treatment, whereas Group 2 comprised 25 subjects with inclusion of mandibular second molars. Panoramic radiographs at three observation times were evaluated: pretreatment, posttreatment and postretention. The statistical analysis included one-way analysis of variance (ANOVA) for intragroup evaluation and independent t-tests for intergroup comparisons. RESULTS: Intragroup analysis demonstrated significant uprighting of mandibular first and second molars during treatment in Group 2, which remained stable during the postretention stage. Intergroup comparison demonstrated that Group 2 presented first and second molars significantly more uprighted in relation to Group 1 in both post-treatment and postretention stages. CONCLUSIONS: It was concluded that inclusion of mandibular second molars in the orthodontic mechanics is relevant not only to correct the angulation of these teeth, but also to aid mandibular first molars uprighting.

Long-term stability of maxillary anterior alignment in non-extraction cases.

OBJECTIVE: The purpose of this retrospective study was to evaluate long-term stability of maxillary incisors alignment in cases submitted to non-extraction orthodontic treatment. METHODS: The sample comprised 23 patients (13 female; 10 male) at a mean initial age of 13.36 years (SD = 1.81 years), treated with fixed appliances. Dental cast measurements were obtained at three different time points (T1 - pretreatment, T2 - posttreatment and T3 - long-term posttreatment). Variables assessed in maxillary arch were Little Irregularity Index, intercanine, interpremolar and intermolar widths, arch length and perimeter. The statistical analysis was performed by one-way ANOVA and Tukey tests when necessary. Pearson' correlation coefficients were used to investigate possible associations between the evaluated variables. RESULTS: There was no significant change in most arch dimension measurements during and after treatment, however, during the long-term posttreatment period, it was observed a significant maxillary incisors crowding relapse. CONCLUSIONS: The maxillary incisors irregularity increased significantly (1.52 mm) during long-term posttreatment. None of the studied clinical factors demonstrated to be predictive of the maxillary crowding relapse.

Influence of treatment including second molars on final and postretention molar angulation

OBJECTIVE: Evaluate axial mesiodistal inclinations of the mandibular molars in orthodontically treated cases, analyzing whether inclusion of second mandibular molars in treatment mechanics has any influence on final and postretention molars angulations. METHODS: The sample comprised 150 panoramic radiographs of 50 patients. Patients were treated with extraction of four first premolars and divided into 2 groups: Group 1 comprised 25 subjects without inclusion of mandibular second molars during orthodontic treatment, whereas Group 2 comprised 25 subjects with inclusion of mandibular second molars. Panoramic radiographs at three observation times were evaluated: pretreatment, posttreatment and postretention. The statistical analysis included one-way analysis of variance (ANOVA) for intragroup evaluation and independent t-tests for intergroup comparisons. RESULTS: Intragroup analysis demonstrated significant uprighting of mandibular first and second molars during treatment in Group 2, which remained stable during the postretention stage. Intergroup comparison demonstrated that Group 2 presented first and second molars significantly more uprighted in relation to Group 1 in both post-treatment and postretention stages. CONCLUSIONS: It was concluded that inclusion of mandibular second molars in the orthodontic mechanics is relevant not only to correct the angulation of these teeth, but also to aid mandibular first molars uprighting.

OBJETIVO: analisar a influência da inclusão dos segundos molares inferiores durante a mecânica ortodôntica nas angulações dos molares ao final do tratamento e na fase de pós-contenção. MÉTODOS: a amostra consistiu em 150 radiografias panorâmicas de 50 pacientes avaliados antes, após o tratamento e no período de pós-contenção. Os pacientes foram tratados com extrações dos quatro primeiros pré-molares, e divididos em dois grupos: grupo 1, composto por 25 pacientes com segundo molares incluídos na mecânica ortodôntica; grupo 2, 25 pacientes cujos segundos molares não foram incluídos na mecânica ortodôntica. As angulações dos primeiros e segundos molares inferiores foram comparadas nas fases estudadas utilizando-se a Análise de Variância (análise intragrupo) e o teste t independente (análise intergrupos). RESULTADOS: a análise intragrupo, realizada no grupo 2, demonstrou que ocorreu uma verticalização significativa dos primeiros e segundos molares inferiores durante o tratamento, que se manteve estável na fase de pós-contenção. Os resultados da análise intergrupos demonstraram diferenças significativas na angulação dos primeiros e segundos molares após o tratamento e na fase de pós-contenção. CONCLUSÃO: a inclusão dos segundos molares inferiores à mecânica ortodôntica apresenta-se relevante, não apenas para corrigir a angulação desses dentes, mas, também, para auxiliar a correção da angulação dos primeiros molares permanentes.

Extrações estratégicas de segundos pré-molares superiores na má-oclusão de Classe II / Strategic second pre-molar extraction in Class II malocclusion treatment

Introdução: o controle da ancoragem consiste em um fator de extrema importância para o sucesso dos tratamentos ortodônticos, e pode ser influenciado pelos diferentes protocolos de tratamento da Classe II por meio de extrações dentárias. A utilização dos mini-implantes para a ancoragem durante a fase de retração anterior trouxe maior praticidade e previsibilidade, principalmente no tratamento de casos em que a severidade oclusal permite pouca ou nenhuma perda de ancoragem superior. Objetivo: apresentar um caso clínico em que a eficiência do controle de ancoragem e o sucesso do protocolo de tratamento adotado foram derivados do emprego racional da ancoragem esquelética por meio de mini-implantes. Conclusão: o protocolo de tratamento adotado foi eficaz, possibilitou melhora da oclusão, da estética e, principalmente, alcançou as expectativas iniciais da paciente.

Introduction: the orthodontic anchorage control consists in a crucial factor for the orthodontic treatment success and may be influenced by different extractions protocols for Class II malocclusion patients. The use of miniscrew implants for skeletal anchorage during retraction phase provided more practical and predictable results, particularly during treatment of severe cases in which the occlusal characteristics allows little or no anchorage loss. Objective: the objective is to present a case in which the anchorage control efficiency and the success of the treatment protocol adopted were derived from the rational use of the skeletal anchorage with miniscrew implants. Conclusion: the treatment protocol was effective, provided an improvement in occlusion and aesthetics and, especially, reached initial expectations of the patient.

Long-term stability of maxillary anterior alignment in non-extraction cases

OBJECTIVE: The purpose of this retrospective study was to evaluate long-term stability of maxillary incisors alignment in cases submitted to non-extraction orthodontic treatment. METHODS: The sample comprised 23 patients (13 female; 10 male) at a mean initial age of 13.36 years (SD = 1.81 years), treated with fixed appliances. Dental cast measurements were obtained at three different time points (T1 - pretreatment, T2 - posttreatment and T3 - long-term posttreatment). Variables assessed in maxillary arch were Little Irregularity Index, intercanine, interpremolar and intermolar widths, arch length and perimeter. The statistical analysis was performed by one-way ANOVA and Tukey tests when necessary. Pearson' correlation coefficients were used to investigate possible associations between the evaluated variables. RESULTS: There was no significant change in most arch dimension measurements during and after treatment, however, during the long-term posttreatment period, it was observed a significant maxillary incisors crowding relapse. CONCLUSION: The maxillary incisors irregularity increased significantly (1.52 mm) during long-term posttreatment. None of the studied clinical factors demonstrated to be predictive of the maxillary crowding relapse.

OBJETIVO: o presente estudo avaliou, por meio de uma análise retrospectiva, a estabilidade pós-tratamento do alinhamento dos incisivos anterossuperiores de pacientes submetidos ao tratamento ortodôntico sem extrações. MÉTODOS: a amostra foi constituída de 23 pacientes (13 do sexo feminino e 10 do sexo masculino), com idade inicial de 13,36 ± 1,81 anos. Mediu-se nos modelos de estudo das fases inicial (T1), final (T2) e pós-tratamento (T3) de aproximadamente de 5 anos, a irregularidade dos incisivos superiores, as distâncias intercaninos e entre os primeiros e segundos pré-molares, a distância intermolares, o comprimento e o perímetro da arcada superior. Após a obtenção dos dados, realizou-se a análise estatística. Para a análise das alterações ao longo dos três tempos estudados, utilizou-se a análise de variância (ANOVA) a um critério de seleção e, em caso de resultado significativo, o teste de Tukey. Para verificar a presença de correlação entre a recidiva do apinhamento anterossuperior e a recidiva das variáveis distâncias intercaninos, interpré-molares, intermolares, comprimento e perímetro da arcada, utilizou-se o teste de correlação de Pearson. RESULTADOS: os resultados não evidenciaram alterações dimensionais significativas ao final do tratamento; entretanto, durante o período de pós-tratamento, foram observadas alterações significativas em relação à quantidade de irregularidade dos incisivos superiores. CONCLUSÃO: concluiu-se que houve recidiva estatisticamente significativa (+1,52mm) na irregularidade anterossuperior durante o período de pós-tratamento. Entretanto, nenhuma das variáveis aferidas nos modelos pôde ser clinicamente associada à recidiva anterossuperior.

Conhecimentos e meios necessários para a melhor correção de más-oclusões dentárias e dentoesqueléticas / Necessary knowledge and methods to improve dental and dentoskeletal malocclusion corrections

A correção das desarmonias dentoesqueléticas e neuromusculares mostra-se frequente em nossa especialidade. Sendo assim, cabe ao ortodontista propiciar a melhor forma, função e estabilidade dos seus casos. Embora exista apenas um único diagnóstico para cada caso, o tratamento da má-oclusão deverá ser planejado e executado de forma individualizada, selecionando dentre os vários meios e métodos corretivos a opção que melhor se aplica ao paciente. Neste artigo, pretende-se demonstrar, por meio da apresentação de quatro casos clínicos, alguns protocolos eficientes de tratamentos ortodônticos e ortopédicos que podem ser adotados atualmente para o tratamento de diferentes más-oclusões.

The correction of dentoskeletal and neuromuscular disharmonies occurs frequently in our specialty. In this situation, the orthodontists must provide the best form, function and stability of their cases. Although there is only one diagnosis for each patient, the individualized treatment of malocclusion will be planned and executed by selecting from among various protocols and corrective methods the best one for the patient. In this article, we intended to demonstrate, through the presentation of four clinical cases, some efficient protocols for orthopedic and orthodontic treatments that may be currently adopted for the treatment of different malocclusions.

Avaliação da influência da realização da expansão rápida da maxila sobre a recidiva do apinhamento anterossuperior, em casos tratados ortodonticamente sem extrações / Influence of rapid maxillary expansion on incisors alignment stability

O presente estudo objetivou comparar, por meio de umaanálise retrospectiva, a estabilidade pós-contenção do alinhamentodos incisivos anterossuperiores de pacientes submetidos ou não aoprocedimento de expansão rápida da maxila durante o tratamentoortodôntico. A amostra consistiu-se de 48 pacientes, de ambos osgêneros, apresentando más-oclusões de Classe I e II, tratados semextrações e mecânica Edgewise. A amostra total foi dividida em doisgrupos: Grupo 1 (com ERM), constituído de 25 pacientes com idadeinicialmédia de 13,53 anos (d.p. = ±1,63) e submetidos à expansãorápidada maxila durante o tratamento ortodôntico; Grupo 2 (sem ERM),apresentando 23 pacientes com idade inicial média de 13,36 anos(d.p. = ±1,81), cujo tratamento ortodôntico não priorizou a expansãotransversal maxilar. Foram medidos nos modelos de estudo dasfases pré (T1), pós-tratamento (T2) e pós-contenção (T3), o índice deirregularidade de Little, as distâncias intercaninos e, entre os primeirose segundos premolares, a distância intermolares, o comprimento e operímetro do arco superior. A comparação intergrupos foi realizadapor meio de testes t independentes. Os resultados evidenciaramincrementos transversais significantemente maiores no grupo tratadocom ERM, entretanto, durante o período pós-contenção, não foramobservadas diferenças significantes entre os grupos em relação àquantidade de aumento na irregularidade dos incisivos (+1,52 mmem ambos os grupos), bem como em relação à maioria das variáveisestudadas.Concluiu-se que a realização do procedimento de expansãorápidada maxila não apresentou influência na recidiva do apinhamentoanterossuperior em longo prazo.

The purpose of this retrospective study was to comparethe long-term stability of maxillary incisors alignment in cases treatedwith or without rapid maxillary expansion (RME) during orthodontictreatment. The sample comprised 48 subjects presenting Class Iand Class II malocclusions, treated nonextraction and Edgewise tixedappliances. The sample was divided into two groups according to thetreatment protocol: Group 1 (with RME) comprised 25 patients at amean initial age of 13.53 years (s.d.=±1.63), who underwent rapidmaxillary expansion during orthodontic treatment. Group 2 (withoutRME) comprised 23 patients at a mean initial age of 13.36 years(s.d.=±1.81), treated with tixed appliances and no rapid maxillaryexpansion. Dental casts measurements were obtained at three timesof evaluation (pretreatment, posttreatment and postretention) andthe variables assessed were Little Irregularity Index, intercanine,interpremolar and intermolar widths, and maxillary arch length andperimeter. Thestatistical analysis was performed by independent t-tests(Intergroup compenson). The results evidenced signiticant transversalincreases in group treated with RME (Group 1), however, during thepostretention period, no signiticant differences were observed betweenthe groups in the amount of maxillary incisors alignment relapse(+1,52mm in both groups), as well as in most of the variables evaluated.Therefore, it was concluded that the RME procedure did not influencethe long-term maxillary anterior crowding relapse.

Avaliação da utilização de anestésico tópico para instalação de mini-implantes ortodônticos / Evaluation of the use of tropical anesthetics for installation of orthodontic mini-implants

Objetivos: o objetivo deste trabalho foi avaliar a eficiência do uso de anestésico tópico para inserção de mini-implantes utilizados como meio de ancoragem esquelética em Ortodontia. Material e Métodos:o anestésico tópico a base de lidocaína 20% em gel foi utilizado para inserção de mini-implantes em 40 pacientes em tratamento com aparelhos fixos. A idade média dos pacientes era 23,58 anos. Os pacientes responderam a um questionário com quatro perguntas de múltipla escolha, avaliando a aceitabilidade e o desconforto durante a anestesia e a colocação do mini-implante. Os dados foram avaliados em porcentagem e pelo teste qui-quadrado para avaliação do dimorfismo sexual. Resultados: 92,5% dos pacientes relataram que não sentiram nenhum incômodo durante a aplicação do anestésico tópico e apenas7,5% sentiram uma leve dormência, o que mostra que o anestésico teve boa aceitação pelos pacientes. Em relação ao procedimento de instalação dos mini-implantes, somente 20% dos indivíduos da amostra relacionaram a dor (independente da intensidade) como a sensação mais desagradável durante todo o procedimento de colocação do mini-implante.Entretanto, 47,5% dos pacientes não sentiram dor alguma e apenas10% dos pacientes sentiram dor intensa. Houve diferença entre os gêneros apenas com relação à sensação mais desagradável durante todo o procedimento, sendo que a maioria das mulheres (55%) relatou não ter sentido nada desagradável, comparando com apenas 40% dos homens. Conclusão: a instalação de mini-implantes com anestésico tópico se mostrou viável e eficiente, podendo ser uma alternativa, mas são necessários mais estudos e comparações com outros métodos de anestesia.

Objectives: the objective of this study was to evaluate the efficiency of the use of topical anesthetics for insertion of miniimplants used as skeletal anchorage in orthodontics. Material and methods: the topical anesthetics based in lidocaine gel 20% was used to the insertion of mini-implants in 40 patients in treatment with fixed appliances. The mean age of the patients was 23.58 years. Patients answered to a questionnaire with 4 multiple choice questions, evaluating the acceptability and discomfort of the patients during anesthetics and placement of mini-implant. Data were evaluated by percentage and by the chi-square test to evaluate the sexual dimorphism. Results:92.5% of the patients reported that did not feel any discomfort during the application of the topical anesthetics, and only 7.5% felta slight dormancy, what shows that the anesthetics presented good acceptance by the patients. In relation to the procedure of installation of mini-implants, only 20% of the subjects related pain (regardless ofthe intensity) as the more unpleasant sensation during the procedure of placement of the mini-implant. However, 47.5% of the patients did not feel any pain and only 10% of the subjects felt intense pain. There was difference between sexes only regarding the more unpleasant sensation during the procedure, and the majority of the females (55%)reported not to feel any unpleasant sensation, comparing with only 40% of the males. Conclusion: the installation of mini-implants with topical anesthetics proved to be feasible and effective, it could bean altemative, but more studies and comparisons with other type of anesthesia are necessary.

Fatores clínicos associados com a estabilidade dos mini-implantes no tratamento ortodôntico / Clinical factors associated with the stability of miniscrews in orthodontic treatment

Objetivos: o objetivo deste trabalho foi avaliar a proporção de sucesso dosmini-implantes ortodônticos e identificar as principais variáveis clínicas que influenciam estaproporção. Material e Métodos: a amostra foi composta pela documentação ortodônticacompleta de 104 pacientes (79 feminino, 25 masculino; idade inicial média de 32,04 anos; DPde 18,59) que utilizaram 264 mini-implantes autoperfurantes para ancoragem durante algumafase do tratamento ortodôntico. Variáveis clínicas relacionadas a paciente, mini-implante, localde instalação e força aplicada foram investigadas para avaliar a sua influência com a proporçãode sucesso. Resultados: a proporção de sucesso total foi de 82,57%. As variáveis clínicasrelacionadas ao paciente (gênero, etnia e padrão facial) não influenciaram significantemente aproporção de sucesso. Na avaliação das características inerentes ao mini-implante (diâmetro,comprimento e marca), apenas o comprimento influenciaram significantemente a proporçãode sucesso. As variáveis clínicas relacionadas ao local de instalação mostraram quemini-implantes separados das raízes dentárias, instalados na maxila e na região anterior,apresentaram maior proporção de sucesso. Mini-implantes que receberam carga imediatamenteapós instalação apresentaram proporção de sucesso significantemente maior do queaqueles que permaneceram inativos. Conclusão: a idade inicial do paciente, o comprimentodo mini-implante, a base óssea, a região de instalação, a proximidade do mini-implante coma raiz dos dentes adjacentes e a aplicação de carga imediata são fatores que influenciamdiretamente a proporção de sucesso no uso dos mini-implantes como ancoragem ortodôntica.

Objectives: the aims of this study were to examine the success rates and findfactors affecting the clinical success of screw implants used as orthodontic anchorage. Materialand Methods: the sample comprised the complete records of 104 patients (79 female,25 male, mean age, 32.04 years; SD 18.59) that received 264 self drilled miniscrews usedas anchorage during any phase of their orthodontic treatment. Clinical variables related tothe patient, to the miniscrews, to the site of placement and to the force application wereinvestigated to evaluate their influence in the success rates. Results: the overall successrate was 82.57%. The clinical variables related to the patient (gender, ethnicity, and growthpattern) did not influence significantly the success rate. In assessing the inherent characteristicsof the miniscrews (diameter, length and commercial brand), only the length significantlyinfluence the success rate. The clinical variables related to the site of placement showed thatminiscrews placed separate from dental roots, in maxilla and in the anterior area showed agreater success rate. Miniscrews that received immediate force application after placementshowed a higher success rate than those that remain unload. Conclusions: initial age of thepatient, the length of the miniscrew, jaw, site of placement, proximity of miniscrews to dentalroots and immediate force application are factors that directly influence the success rate ofminiscrews used as orthodontic anchorage.

Recidiva do apinhamento anterossuperior nas más oclusões de Classe I e Classe II tratadas ortodonticamente sem extrações / Relapse of maxillary anterior crowding in Class I and Class II malocclusions orthodontically treated without extractions

OBJETIVO: o presente estudo objetivou comparar retrospectivamente a estabilidade pós-contenção do alinhamento dos incisivos anterossuperiores em pacientes com Classe I e Classe II. MÉTODOS: a amostra consistiu de 38 pacientes de ambos os sexos, tratados sem extrações e com mecânica Edgewise, divididos em dois grupos - Grupo 1, constituído por 19 pacientes, com idade inicial média de 13,06 anos, portadores da má oclusão de Classe I com apinhamento anterossuperior inicial maior que 3mm; Grupo 2, constituído por 19 pacientes, com idade inicial de 12,54 anos, portadores da má oclusão de Classe II e, também, com apinhamento anterossuperior inicial maior que 3mm. Foram medidos nos modelos de estudo, das fases pré- e pós-tratamento e pós-contenção, o índice de irregularidade de Little, as distâncias intercaninos e entre os primeiros e segundos pré-molares, a distância intermolares e o comprimento da arcada superior. Para a comparação intragrupo nos 3 tempos de avaliação, utilizou-se os testes ANOVA e Tukey. A comparação intergrupos foi realizada pelo teste t independente. Para verificação da presença de correlação, utilizou-se o teste de correlação de Pearson. RESULTADOS: os resultados evidenciaram maior estabilidade do tratamento no Grupo 2 (Classe II), pois, durante o período pós-contenção, foi observada recidiva do apinhamento dos dentes anterossuperiores menor no Grupo 2 (0,80mm) do que no Grupo 1 (1,67mm). CONCLUSÃO: concluiu-se que o tratamento do apinhamento dos dentes anterossuperiores é mais estável na má oclusão de Classe II do que na má oclusão de Classe I.

OBJECTIVE: The present study aimed to retrospectively compare the postretention stability of maxillary anterior incisors alignment in Class I and Class II patients. METHODS: The sample comprised 38 patients of both genders, treated with nonextraction and Edgewise mechanics, divided into two groups: Group 1, comprised of 19 patients, at a mean age of 13.06 years, with Class I malocclusion and initial maxillary anterior crowding greater than 3 mm; Group 2, comprised of 19 patients, at a mean age of 12.54 years, with Class II malocclusion, and also with a initial maxillary anterior crowding greater than 3 mm. In the dental casts of pretreatment, posttreatment and postretention phase, the Little's irregularity index, intercanine distance and distance between first and between second premolars, intermolar distance and maxillary arch length were measured. For intragroup comparison among the three times of evaluation, it was used the one-way ANOVA followed by Tukey test. Intergroup comparison was performed by independent t tests. To verify the presence of correlation, the Pearson correlation test was used. RESULTS: It was evidenced greater stability of treatment in Group 2 (Class II), because during the postretention period it was observed a softer relapse of maxillary anterior crowding in Group 2 (0.80mm) than in Group 1 (1.67mm). CONCLUSION: It can be concluded that the treatment of maxillary anterior crowding is more stable in Class II malocclusion than in Class I malocclusion.

Influence of rapid palatal expansion on maxillary incisor alignment stability.

INTRODUCTION: The purpose of this retrospective study was to compare the long-term stability of maxillary incisor alignment in patients treated with and without rapid maxillary expansion (RME). METHODS: The sample comprised 48 subjects with Class I and Class II malocclusions, treated without extractions with fixed edgewise appliances, divided into 2 groups according to the treatment protocol: group 1 comprised 25 patients (15 girls, 10 boys) at a mean initial age of 13.53 years (SD, 1.63), who had RME during orthodontic treatment. Group 2 comprised 23 patients (13 girls, 10 boys) at a mean initial age of 13.36 years (SD, 1.81 years), treated with fixed appliances without RME. Maxillary dental cast measurements were obtained at the pretreatment, posttreatment, and long-term posttreatment stages. Variables assessed were the irregularity index and maxillary arch dimensions. Intergroup comparisons were made with independent t tests. RESULTS: Greater transverse increases were found during treatment in the group treated with RME. However, during the long-term posttreatment period, no significant difference was observed in the amount of incisor crowding relapse between the groups. CONCLUSIONS: RME did not influence long-term maxillary anterior alignment stability.

Estudo comparativo cefalométrico das más oclusões de classe II, divisão 1, completas, com sobressaliências normal e acentuada / Comparative cephalometric evaluation of complete Class II division 1 malocclusions with normal and increased overjet

O presente estudo objetivou comparar, por meio de uma análise retrospectiva, as características cefalométricas de pacientes leucodermas portadores de má oclusão de Classe II, divisão 1, completa, bilateral, apresentando trespasse horizontal normal ou acentuado. A amostra consistiu-se da documentação ortodôntica inicial de 80 jovens brasileiros de ambos os gêneros, avaliados por meio de telerradiografias em norma lateral. A amostra total foi dividida em dois grupos de acordo com o a quantidade de sobressaliência inicial: Grupo 1 (sobressaliência normal) constituído por 40 pacientes (17 do gênero feminino e 23 do gênero masculino), com idade inicial média de 13,89 anos (d.p. = ±2,38), apresentando má oclusão de Classe II, divisão 1, de Angle, completa, e trespasse horizontal positivo menor que 3 mm. Grupo 2 (sobressaliência acentuada) apresentando 40 pacientes (21 do gênero feminino e do 19 gênero masculino), com idade inicial de 13,54 anos (d.p. = ±2,11 anos), apresentando má oclusão de Classe II, divisão 1 de Angle, completa e trespasse horizontal maior que 5mm. Os valores das variáveis cefalométricas obtidas para os dois grupos foram agrupados por componentes e comparados pelo teste t independente. Os resultados evidenciaram que, em relação ao componente dentário, observou-se uma menor quantidade de sobremordida no grupo 1. Em relação ao componente maxilar, notou-se que o comprimento efetivo da maxila (Co-A) foi significantemente menor no grupo 1. Não foram observadas diferenças significativas entre os grupos em relação ao componente mandibular. Entretanto, observou-se uma relação maxilomandibular significantemente melhor nos indivíduos Classe II com sobressaliência normal, baseando-se nos menores valores médios obtidos para as variáveis ANB e Wits. Em relação ao padrão de crescimento craniofacial dos grupos analisados, observou-se que o grupo 1 apresentou uma tendência de crescimento mais vertical quando comparado ao grupo 2, evidenciada pelos valores...

The purpose of this retrospective study was to compare the initial cephalometric characteristics of orthodontic patients presenting complete Class II division 1 malocclusions, with normal and increased overjet. The sample comprised 80 Brazilian subjects presenting bilateral complete Class II division 1 malocclusions, of both genders. The sample was divided into 2 groups according to the initial overjet: Group 1 (normal overjet) comprised 40 patients (17 female; 23 male) at a mean initial age of 13.89 years (s.d. = ±2.38) presenting positive overjet, smaller than 3 mm. Group 2 (increased overjet) comprised 40 complete Class II division 1 patients (21 female; 19 male), at a mean initial age of 13.54 years (s.d. = ±2.11 years), and overjet greater than 5 mm. The cephalometric measurements obtained for the two groups were analyzed by components and compared by independent t tests. The results showed that the overbite was significantly smaller in group 1 when analyzing the dental component. The effective length of the maxilla (Co-A) was significantly smaller in group 1, by the maxillary component evaluation. There were no significant differences between the groups in the mandibular component. However, there was a significantly better maxillomandibular relation in Class II subjects with normal overjet, based on the smaller mean values for the variables ANB and Wits obtained for the group 1. The craniofacial growth pattern presented a more vertical tendency in group 1, evidenced by significantly greater values for the variables SN.GoGn, FMA, PP.GoMe and SN.OP. The maxillary incisors in group 2 were buccally inclinated and protruded by the linear evaluation. The mandibular incisors showed more protrusion in group 1 when they were evaluated by the variable Li-AP. The facial soft tissue analysis showed that the lower lip was more prominent in subjects presenting Class II malocclusions with normal overjet.

Apinhamento ântero-superior: revisão e análise crítica da literatura / Maxillary crowding and long-term stability: a review of literature

INTRODUÇÃO: o tratamento do apinhamento dentário da região anterior superior e inferior é comumente acometido pela recidiva, entretanto a maior parte dos estudos aborda apenas a estabilidade do tratamento do arco dentário inferior. OBJETIVO: este artigo propõe uma revisão e análise crítica da literatura, enfatizando os fatores etiológicos do apinhamento dentário, as diversas formas de tratamento e a recidiva no arco superior, considerando o plano de tratamento, os fatores periodontais e a expansão rápida da maxila. CONCLUSÕES: a severidade inicial da má oclusão, as alterações dimensionais dos arcos dentários e as alterações na fisiologia do ligamento periodontal são os principais fatores etiológicos de recidiva. O estudo da etiologia da recidiva permite ao ortodontista o correto planejamento dos casos clínicos e a previsibilidade da estabilidade pós-contenção.

INTRODUCTION: The treatment of crowding of maxillary and mandibular anterior teeth commonly suffers relapse. Therefore, major studies focus only on stability of mandibular anterior segment. OBJECTIVE: This article propose a review and critical analysis of the literature, emphasizing the etiologic factors of incisors crowding, the various treatment plans and the relapse of the maxillary anterior segment, considering the treatment protocols, the periodontal factors and the rapid maxillary expansion. CONCLUSIONS: The main factors influencing the relapse are the severity of the initial malocclusion, the changes in arch dimensions and the changes in physiology of periodontal tissue. The study of the causes of relapse is important to help in achieving a correct treatment planning and to predict the postretention stability.