Smile attractiveness in patients treated with or without 4 premolar extractions: A 36-year follow-up.

INTRODUCTION: This study aimed to assess the smile attractiveness in patients treated with or without 4 premolar extractions at a 36-year follow-up. METHODS: The sample comprised 52 patients with Class I and II malocclusion divided into 2 groups. Group 1 consisted of 15 patients treated without extractions (10 females and 5 males), with a mean pretreatment, posttreatment, and long-term posttreatment (T3) age of 13.2, 15.1, and 49.8 years, respectively. The mean treatment time was 1.9 years, and the mean long-term follow-up period was 34.7 years. Group 2 consisted of 37 patients (25 females and 12 males) treated with 4 premolar extractions, with a mean pretreatment, posttreatment, and long-term posttreatment age of 13.3, 15.7, and 53.6 years, respectively. The mean treatment time was 2.3 years, and the mean long-term follow-up period was 37.9 years. The mean retention time was 2 years for both groups. Frontal smiling photographs were obtained at long-term follow-up. Smile attractiveness was evaluated in an online questionnaire in which the evaluator could rate the smiling photographs with a 10-point scale. The randomly selected evaluator sample consisted of 62 laypeople, 33 dentists, and 89 orthodontists. Independent t tests, 1-way analysis of variance, and Tukey tests were used for intergroup comparisons at P <0.05. RESULTS: The smile attractiveness on the long term was similar in the groups treated with 4 premolar extractions (4.70 ± 1.35) or without extractions (4.51 ± 1.46). Women and orthodontists were more critical in assessing smile attractiveness than men, dentists, and laypeople. CONCLUSIONS: After long-term posttreatment, the smile attractiveness was similar in patients treated with 4 premolar extractions or without extractions.

Assessment of patients' knowledge and preferences for the use of orthodontic aligners.

OBJECTIVE: To evaluate the knowledge and preference of patients treated at a Dental School in Jaraguá do Sul, Brazil, about using aligners and the reasons for choosing this device as a treatment option. DESIGN: A cross-sectional study. PARTICIPANTS: A total of 82 participants aged 18-45 years recruited at a screening clinic. METHODS: A questionnaire was completed in person using a tablet with digital forms. RESULTS: Almost half of the participants (49%) knew about aligners; 40% were aged 18-24 years, and 77% were female. When observing the images of the types of orthodontic appliances, the aligners had an acceptance rate of 80%. Among the reasons that led to the preference for choosing aligners, 68% cited aesthetics and 42% comfort. CONCLUSION: Recently, clear aligners have become a popular choice for orthodontic treatment, particularly among adults. Despite their popularity and effectiveness, many patients still need more information about aligner treatment. Over half of the respondents did not know what orthodontic aligners were. Younger participants had more knowledge about aligners than older participants. Patients still need more knowledge about the types of appliances available for orthodontic treatment. When presented with images of the kinds of devices available, almost 80% of participants showed greater satisfaction with aligners.

Comparison of the efficiency of initial dental alignment with Invisalign® aligners changed every 7 or 14 days in mature adults: Randomized clinical trial.

OBJECTIVE: To compare the anterior crowding correction after sequential use of the first 5 aligners between two aligner exchange protocols (7 and 14 days) in mature adult patients. MATERIALS AND METHODS: Thirty-six patients over 35 years who received orthodontic treatment with Invisalign® were randomly allocated to two different aligner replacement sequence protocols: Group 1: exchange every 7 days (n = 18); and Group 2: exchange every 14 days (n = 18). All patients were scanned with iTero Element 5D® (Align Technology) in two treatment times: at pre-treatment (T1) and after using the first five aligners (T2). Little's Irregularity Index (LII) and arch widths were evaluated with OrthoCAD software. Intra and intergroup comparisons were performed with the dependent and independent t-tests. The results were considered significant for P < .05. RESULTS: Thirty-five patients completed the study. Both groups' maxillary and mandibular Irregularity Indexesi were significantly lower at T2. There was no significant difference in inter-canine, inter-premolar, and intermolar distances. G2 (14 days) presented a greater decrease in mandibular irregularity than G1 (7 days). CONCLUSION: Both exchange protocols (7 and 14 days) effectively correct anterior crowding in the initial phase of orthodontic treatment with aligners in mature adult patients. However, the 14-day exchange protocol provided a greater correction in mandibular anterior crowding in the evaluated period than the 7-day exchange protocol.

Long-term profile attractiveness of patients with Class I and II malocclusion treated with and without extractions: A 35-year follow-up.

INTRODUCTION: The objective of this study was to compare the profile attractiveness in subjects treated with and without extractions after the long-term 35-year follow-up, according to laypeople, dentists, and orthodontists. METHODS: A total of 40 patients with Class I and II malocclusion were divided into 2 groups, according to the treatment protocol: extraction (E) group, extractions of 4 premolars (n = 24), with mean pretreatment (T1), posttreatment (T2), and long-term posttreatment (T3) ages of 13.13, 15.50 and 49.56 years, respectively. The mean treatment time (T2 - T1) was 2.37 years, and the long-term follow-up (T3 - T2) was 34.19. Nonextraction (NE) group (n = 16), with mean ages at T1, T2, and T3 of 13.21, 15.07, and 50.32 years, respectively. The mean (T2 - T1) was 1.86 years, and the (T3 - T2) was 35.25 years. Lateral cephalograms were used to perform profile facial silhouettes, and an online evaluation was performed by 72 laypeople, 63 dentists, and 65 orthodontists, rating the attractiveness from 1 (least attractive) to 10 (most attractive). The intragroup comparison was performed with the repeated measures analysis of variance and Tukey tests. Intergroup comparison was performed with t tests, 1-way analysis of variance, and Tukey tests. RESULTS: The E group had a longer treatment time than that of the NE group. In the pretreatment, posttreatment, and long-term posttreatment stages, the E and NE groups showed similar profile attractiveness. Laypersons and dentists were more critical than orthodontists. CONCLUSIONS: At long-term posttreatment follow-up, profile attractiveness was similar in patients treated with and without extractions.

Comparison of maxillary transversal changes between auxiliary beta-titanium expansion arch and miniscrew-assisted rapid palatal expansion.

OBJECTIVE(S): This study compared buccal bone thickness, dental inclinations and maxillary transverse width dimensions changes between auxiliary beta-titanium expansion arch (AEA) and miniscrew-assisted rapid palatal expansion (MARPE). MATERIALS AND METHODS: The sample consisted of 29 patients, aged between 18 and 40 years, with transverse maxillary deficiency and treated without extractions, divided into two groups: group AEA: comprised 13 individuals (initial mean age: 29.23 ± 9.13 years) treated using auxiliary beta-titanium expansion arch; group MARPE: comprised 16 patients (initial mean age: 24.92 ± 7.60 years) treated with miniscrew-assisted rapid palatal expansion. Buccal bone thickness, dental inclinations and transverse width dimensions (dental, nasal base and jugular) were measured in cone-bean computed tomographies at pre- and post-treatment stages. The variables were compared using the independent t-test. RESULTS: The buccal bone thickness was similar for both groups at the post-treatment stage. The second premolars were significantly more buccal inclined in the AEA group and the right maxillary first molars in the MARPE group. The intercanine and intermolar distances were statistically significantly greater in the MARPE group. Changes in dental arch transverse dimensions were significantly greater for the MARPE group. CONCLUSION: Both treatment protocols corrected the maxillary transverse discrepancy; however, MARPE provided greater correction.

Incisors' bone height and inclination changes after orthodontic treatment with a self-ligating passive system.

Background: This study aimed to evaluate changes in the alveolar buccal bone height of maxillary and mandibular incisors after orthodontic treatment with a self-ligating passive system and to assess the correlation between bone height and incisor inclination. Material and Methods: Pre (T1) and post-treatment (T2) cone-beam computed tomography images of patients treated with the Damon 3MX appliance system were measured to quantify the alveolar buccal bone height of the maxillary incisors. The incisor's inclination was measured in digital models. Paired t-test was used to evaluate the changes between T1 and T2, and Pearson's coefficient was used to test the correlation. Results: All teeth presented statistically significant alveolar buccal bone loss at T2. A statistically significant buccal inclination was observed only for the lower left lateral incisors. There was no correlation between bone height changes and incisor inclination. Conclusions: Orthodontic treatment with a self-ligating passive system showed changes in alveolar height, but these changes were not correlated with incisor inclination. Key words:Passive self-ligating brackets, orthodontics, corrective, treatment outcome, alveolar bone loss.

Correlation of age and skeletal effects after miniscrew assisted rapid palatal expansion.

Background: To evaluate the skeletal and dentoalveolar effects after miniscrew assisted rapid palatal expansion (MARPE) and their correlation with the age of the patients. Settings and sample population: Sample comprised 19 patients with maxillary atresia and posterior crossbite, treated with MARPE. Cone-beam computed tomographs (CBCT) were evaluated before and after expansion. Three patients were excluded since the midpalatal suture was not opened. Thus, 16 patients (11 female; 5 male) were evaluated, with a mean age of 24.92 years (s.d.=7.60). The time between the installation of MARPE and the second CBCT was, on average, 1.64 months (s.d.=1.12). Material and Methods: Linear and angular measurements were performed: bone thickness and level, tooth inclination, transverse dental widths, and nasal base and jugula widths. Comparison was performed with dependent t-test and correlations with Pearson coefficient. Results: MARPE was 84.2% successful. There was significant reduction in the buccal bone thickness of the first molars and an increase in the palatal bone thickness of all teeth. First molars showed significant buccal inclination. All transverse dimensions showed a significant increase. Older patients tended to show a less maxillary transverse skeletal increase. A greater maxillary transverse increase was accompanied by a greater intermolar width increase and also a greater buccal bone loss in the mesiobuccal roots of the maxillary first molars. Conclusions: MARPE corrected the maxillary atresia in adult patients, with significant transverse increases, a slight decrease in buccal bone thickness and buccal inclination of the first molars, combining skeletal and dental effects. Older patients presented less transverse skeletal increases. Key words:Palatal expansion technique, skeletal anchorage, cone-beam computed tomography.

Incisor irregularity and dental arch dimensions changes in subjects with different severity of anterior crowding: a 37-year follow-up.

BACKGROUND: Occlusal stability is one of the goals of orthodontic treatment, and keeping teeth aligned in the long term is a challenge for the orthodontist. This study aimed to compare the long-term incisors irregularity and dental arches dimensions changes in subjects treated with 4 premolar extractions with different pretreatment Little's irregularity index (LII). The knowledge of long-term outcomes is evidence-based information for the prognosis of future treatments. METHODS: In total, 41 treated subjects were divided into two groups according to mandibular Little irregularity value at pretreatment (mild or severe). The maxillary and mandibular LII, transversal, and longitudinal widths were assessed at pretreatment, posttreatment, and 37-year posttreatment. Chi-square and independent t tests were used for intergroup comparison. RESULTS: The groups presented similar behavior for all stages of maxillary and mandibular arch dimensions changes. Maxillary irregularity was corrected in both groups after treatment, and the alignment was acceptable in the long term. In the mild group, the mandibular incisor irregularity returned to pretreatment values in the long term. The mandibular LII increased in the severe group but did not return to pretreatment values in the long term. CONCLUSIONS: The mild crowding group presented proportionally more relapse of mandibular incisor irregularity than the severe crowding group in the long term. Even so, the correction of mild and severe crowding with the extraction of 4 premolars showed satisfactory results in the long term, even with the presence of maturational changes and relapse.

Evaluation of the attractiveness of lips with different volumes after filling with hyaluronic acid.

To compare the attractiveness of lips with different volumes after filling in the view of laypersons, dentists, and specialists. The sample comprised close-up frontal and lateral photographs of the lips of 16 women who underwent lip filling procedure with hyaluronic acid and was divided into 2 groups. Group 1: eight women with thinner lips at pretreatment. Group 2: eight female patients with thicker lips at pretreatment. Photographs from before and 10 days after lip filling were used to assess attractiveness randomly displayed in a Google Forms questionnaire and then sent via a messaging app to the evaluators. The evaluators' groups were general dentists, dentists with degrees in facial aesthetics, and laypersons. The attractiveness was evaluated with scores from 0 to 10 (0: least attractive and 10 the greatest). T-tests were used for the statistical comparisons. The group with thinner lips showed significantly improved attractiveness after filling. The group with thicker lips showed a worsening attractiveness after filling. The group with thicker lips had significantly higher attractiveness scores than those with thinner lips. There was no significant difference in the preference between men and women. The group of laypersons was more rigorous, giving significantly lower lip attractiveness scores. Thinner lips showed a significant improvement in attractiveness after filling. Thicker lips showed a worsening of the attractiveness score after filling. Before and after filling, thicker lips had significantly higher attractiveness scores than thinner lips.Clinical relevance: The amount of fillers applied to each patient must be individually evaluated.

Psychological and financial impact of the COVID-19 pandemic during the first stages of the pandemic: Brazilian orthodontists´ perspective.

INTRODUCTION: Brazil faced a catastrophic situation in the coronavirus pandemic. Due to the high risk of contamination and spread of COVID-19, dentist have been attending only urgency and emergency services in Brazil at the beginning of the pandemic. OBJECTIVE: This research aimed to evaluate the psychological and financial impacts caused by the coronavirus pandemic in Brazilian orthodontists. METHODS: This population-based cross-sectional study collected demographic data and mental health measurements from 404 orthodontists. Depression, anxiety, insomnia, and distress were evaluated through Brazilian versions of the 9-item Patient Health Questionnaire (9-PHQ), the 7-item Generalized Anxiety Disorder scale and Mini-Tracking (GAD), the 7-item Insomnia Severity Index (ISI), and the 22-item Impact of Event Scale-Revised (IES-R), respectively. The demographic data of the sample was described using descriptive statistics. The data was analyzed according to sex, professional status, and economic income. Comparisons were performed using Chi-square tests, Mann-Whitney U tests, and Kruskal-Wallis followed by post-hoc tests. RESULTS: Females, graduate students, and lower incomes subgroups showed higher levels of depression, anxiety, insomnia, and distress. Most orthodontists showed moderate to extreme financial and professional concerns during the pandemic. CONCLUSION: The coronavirus pandemic negatively affected the psychological health and increased the financial concerns of the Brazilian orthodontists, mainly female, graduate students, and with income below 10k participants.

Tratamento de uma má oclusão de Classe II com propulsor mandibular Forsus associado à tração de canino inferior impactado devido ao odontoma ­ relato de caso / Treatment of a Class II malocclusion with Forsus appliance associated with traction of an impacted mandibular canine due to odontoma ­ a case report

Resumo O objetivo deste caso clínico foi relatar o tratamento de uma paciente portadora de má oclusão de Classe II com aparelho de propulsão mandibular fixo Forsus associado à tração de canino inferior retido devido a um odontoma. Após exame clínico e radiográfico, foi detectada a retenção prolongada do canino inferior decíduo direito devido à presença desse odontoma. O exame clínico também mostrou que a paciente apresentava uma má oclusão de Classe II. Após a extração do dente decíduo e excisão do odontoma, foi colado um acessório no canino retido e instalado o aparelho fixo. Inicialmente, foi planejada a instalação de um APM devido ao seu baixo custo, no entanto, a paciente não se adaptou e foi instalado um Forsus. Ao final de 48 meses, o canino inferior direito alcançou o plano oclusal e a má oclusão de Classe II foi corrigida. Após 2 anos da finalização do tratamento, os resultados obtidos se mostraram estáveis. O objetivo foi avaliar os efeitos dentários e tecidos moles no tratamento da má oclusão de Classe II leve a moderada de uma paciente no final de crescimento puberal, analisando o antes e depois da face no desenvolvimento dentofacial e os efeitos do aparelho de protração. Concluiu-se que o propulsor mandibular associado ao aparelho fixo corrigiu a má oclusão de Classe II basicamente através da protrusão dentoalveolar do arco inferior. (AU)

Abstract The objective of this case report is to present the treatment of a patient with Class II malocclusion with a Forsus fixed appliance associated with the traction of an impacted mandibular canine due to an odontoma. After clinical and radiographic examination, prolonged right primary mandibular canine retention was detected. In addition, the mandibular canine was impacted due to the presence of this odontoma. Clinical analysis also showed that the patient had a Class II malocclusion. After the extraction of the primary canine and excision of the odontoma, an orthodontic accessory was bonded to the impacted canine, and the fixed appliance was placed. Initially, an APM (mandibular protractor appliance) was planned due to its low cost. However, the patient did not cooperate with its use, and a Forsus was placed. At the end of 48 months, the right mandibular canine reached the occlusal plane, and the Class II malocclusion was corrected. (AU)

Comparison of Gingival Recession of Mandibular Incisors of Class III Patients Immediately after Compensatory or Surgical Orthodontic Treatment.

OBJECTIVE: This study aimed to compare gingival recession in mandibular anterior teeth in patients with Class III malocclusion, immediately after compensatory or surgical orthodontic treatment. MATERIALS AND METHODS: The sample consisted of 40 patients with Class III malocclusion, divided into two groups: Group 1 (compensatory), 20 patients treated with compensatory orthodontics, with a mean initial age of 20.26 years (standard deviation [SD] . = 7.44), mean final age of 23.07 years (SD = 7.32), and mean treatment time of 2.81 years (SD =0.84). Group 2 (surgical), who undergone orthodontic-surgical treatment, with a mean initial age of 23.08 years (SD =5.48), mean final age of 25.43 years (SD =5.12), and mean treatment time of 2.35 years (SD =1.56). Intraoral photographs taken before and after removal of the fixed orthodontic appliance were used to measure the gingival recession, from the cervical of the mandibular incisors from the most cervical point of the gingival margin to the cementoenamel junction. In the initial and final cephalograms, the position of the mandibular incisors was measured. The intergroup comparison was performed using the independent t-test. RESULTS: The results showed that there was no statistically significant difference in the gingival recession at the beginning, at the end, and of changes with treatment between the compensatory and surgical groups. CONCLUSION: It was concluded that the compensatory and surgical orthodontic treatments for Class III malocclusion showed similar results regarding the gingival recession of the mandibular incisors.

Evaluation of enamel deproteinization in bond strength of orthodontic accessories: A split-mouth randomized clinical trial.

INTRODUCTION: This split-mouth randomized clinical trial aimed to evaluate the influence of dental enamel deproteinization with sodium hypochlorite on orthodontic accessories breakages using 2 orthodontic adhesives. METHODS: Forty patients with indications for orthodontic treatment with fixed appliances were randomly divided into 2 groups according to the orthodontic adhesive used: Transbond XT (3M Unitek, Monrovia, Calif) (n = 20) and Orthocem (FGM Dental Products, Joinville, Santa Catarina, Brazil) (n = 20). A split-mouth trial was conducted in the maxillary teeth; the deproteinization process with 5% sodium hypochlorite was performed on the experimental side. The opposite side served as a control without deproteinization. The primary outcome was the number of orthodontic accessories breakages. The randomization was performed using the BioStat software (AnalystSoft Inc, Walnut, Calif). Single-blind was applied for patients. Orthodontic accessories were bonded according to the manufacturer's instructions. The accessories breakages were followed during the first 6 months of treatment. Intergroup comparisons were performed with t tests and 1 and 2-way analysis of variance. RESULTS: Thirty-nine patients concluded the trial. The Transbond XT group comprised 20 patients (9 male, 11 female), with a mean age of 20.77 ± 6.44 years. The Orthocem group included 19 patients (9 male, 10 female), with a mean age of 23.14 ± 7.98 years. The application of sodium hypochlorite before bonding did not influence the number of orthodontic accessories breakages (P = 0.867). The type of adhesive used, associated or not with the deproteinization, did not affect the number of orthodontic accessories breakages (P = 0.929). CONCLUSIONS: Enamel deproteinization with 5% sodium hypochlorite did not impact the number of orthodontic accessories breakages. In addition, the 2 bonding adhesives used showed similar clinical results, with or without the enamel deproteinization. REGISTRATION: The trial was registered at ensaiosclinicos.gov.br, ReBEC (no. RBR-39ntmjk). PROTOCOL: The protocol was not published before trial commencement. FUNDING: This research did not receive any grant from funding agencies.

Ação clareadora e microbiológica do enxaguante bucal com peróxido de hidrogênio: ensaio clínico / Whitening and microbiological action of mouthwash with hydrogen peroxide: clinical trial

Introdução: os enxaguantes bucais clareadores tem sido muito utilizados, porém sua eficiência e efeitos colaterais trazem questionamentos. Objetivo: este ensaio clínico teve como objetivo avaliar se o enxaguante bucal clareador, contendo peróxido de hidrogênio a 1,5%, apresenta ação clareadora e se há algum efeito secundário na cavidade bucal. Metodologia: foram selecionados 10 voluntários com idade média de 21,5 anos, submetidos a avaliação da cor dos dentes com auxílio do espectrômetro em 3 momentos: inicial; com 15 e com 30 dias de uso do enxaguante. A avaliação dos efeitos colaterais foi realizada a partir da coleta de saliva estimulada em 4 momentos: antes e depois ao primeiro uso do produto, com 15 e com 30 dias, e realizadas as análises laboratoriais: fluxo salivar; pH; quantidade de Streptococcus mutans e de Lactobacillus. A normalidade dos dados foi verificada pelo teste de Shapiro-Wilk, comparação de cor pelo teste t dependente, comparação dos microrganismos pelos testes ANOVA de medidas repetida e Tukey. Resultados: as análises de cor dos dentes não evidenciaram nenhuma alteração significativa em nenhum dos tempos investigados. No fluxo salivar, pH e Lactobacillus não houveram alterações significativas. Na quantidade de Streptococcus mutans notou-se um aumento significativo quando comparado os valores após o primeiro uso e com 30 dias. Conclusão: a solução de enxague bucal contendo peróxido de hidrogênio a 1,5% não apresentou alteração significativa na coloração dos dentes e nenhum efeito colateral significativo na atividade cariogênica de acordo com os testes e períodos avaliados.

Introduction: whitening mouthwashes have been widely used, but their efficiency and side effects raise questions. Objective: this clinical trial aimed to assess whether the bleaching mouthwash, containing 1.5% hydrogen peroxide, has a bleaching action and whether there are any side effects in the oral cavity. Methods: 10 volunteers were selected, with a mean age of 21.5 years, who underwent tooth color evaluation with the aid of a spectrometer in 3 moments: initial; with 15 and 30 days of using the washes. The evaluation of side effects was performed from the collection of stimulated saliva in 4 moments: before and after the first use of the product, at 15 and 30 days, and laboratory analyzes were carried out: salivary flow; pH; the number of Streptococcus mutans and Lactobacillus. Normal distribution was verified with Shapiro-Wilk test, comparisons of color were performed with t-test, comparisons of the microorganisms were performed with repeated measures ANOVA and Tukey tests. Results: the analysis did not show any significant changes in any of the investigated times. There were no significant changes in the salivary flow, pH and Lactobacillus. The number of Streptococcus mutans, was noted a significant increase when comparing the values after the first use and with 30 days. Conclusion: the mouthwash containing 1.5% hydrogen peroxide was not shown any significant alterations in the color teeth. There were not significant collateral effects on the cariogenic activity according to the tests and periods evaluated.

Gingival recession in mandibular anterior teeth in patients with Class II malocclusion treated with elastics and Twin Force appliance.

INTRODUCTION: This study aimed to compare the early results of gingival recession in patients with Class II malocclusion treated with Class II intermaxillary elastics and the Twin Force appliance. METHODS: The sample comprised 55 patients with Class II malocclusion treated without extraction and divided into 2 groups. Group 1 consisted of 23 patients treated with fixed appliances and Class II elastics, with mean initial age of 15.41 ± 5.65 years and a mean treatment time of 3.11 ± 0.91 years. Group 2 consisted of 32 patients treated with fixed appliances and the Twin Force mandibular protraction appliance, with a mean initial age of 18.45 ± 6.63 years and a mean treatment time of 3.17 ± 1.59 years. Dolphin software measured gingival recession in initial and final intraoral photographs. Initial and final lateral cephalograms were used to measure the position of the mandibular incisors. Intragroup and intergroup comparisons were performed by dependent and independent t tests, respectively. RESULTS: In both groups, there was no significant increase in gingival recession with orthodontic treatment, and there was significant protrusion and buccal inclination of the mandibular incisors. When changes with treatment were compared between the groups, there was no statistically significant difference in gingival recession and mandibular incisor position. CONCLUSIONS: There was no significant increase in gingival recession immediately after orthodontic treatment performed with intermaxillary elastics and the Twin Force appliance.

Efficacy of Low-Level Laser Therapy in Reducing Pain in the Initial Stages of Orthodontic Treatment.

Purpose: There is no consensus about the mechanism and efficacy in alleviating pain of the lower-level laser therapy (LLLT) during orthodontic treatment. This study aimed to evaluate the LLLT effectiveness clinically in reducing pain caused by orthodontic movement that occurs in the early stages of treatment. Methods: The sample consisted of 54 patients in need of orthodontic treatment divided into two groups. A 28 experimental patients group (initial mean age: 26.84 years old) was undergone gallium-aluminum-arsenide infrared laser application on 12 points for each tooth immediately after the installation of the first alignment archwire, and a 26 patients control group (initial mean age: 29.13 years old) was undergone to no pain control intervention at all. Pain intensity was measured by using a visual analog scale, which was marked pain level (mm) reported in 06, 24, 48, and 72 hours. The perception of pain (beginning, peak, decline, and absence) was evaluated by filling up a questionnaire. To compare the intensity and perception of pain between groups, a nonparametric Mann-Whitney has been performed. Results: The experimental group showed levels (mm) at 6 (p < 0.001), 24 (p=0.004), and 48 hours (p=0.007) and perception of pain (hours) in the peak (p=0.026), decline (p=0.025), and absence (p=0.008) significantly lower compared to the group control. Conclusion: Low-level laser therapy is effective in reducing pain severity caused by orthodontic forces activation, and it promotes the analgesic action lasting effect during the most painful feeling time.

Evaluation of the botulinum toxin effects in the correction of gummy smile 32 weeks after application / Avaliação dos efeitos da toxina botulínica na correção do sorriso gengival 32 semanas pós-aplicação

INTRODUCTION: The use of botulinum toxin type A (BTX-A) to correct gummy smile has become popular in recent years. OBJECTIVE: To evaluate the effects of BTX-A application in the correction of gummy smile 2 and 32 weeks after application. METHODS: The sample comprised 35 patients (30 female, 5 male) at a mean age of 25.51 years (±5.59) with gummy smile due to muscular hyperfunction. In each patient, 2U of botulinum toxin was applied in the levator labii superioris alaeque nasi, 2 mm from the nasolabial fold. Photographs of spontaneous smiles were taken at 3 stages: before, 2 and 32 weeks after BTX application. Measurements of the gingival display were performed with the Radioface Studio 2 Software, and the calibration used the actual size of the right maxillary central incisor. Comparison of the three stages evaluated was performed with repeated measures ANOVA and Tukey tests. RESULTS: Gingival display decreased significantly 2 weeks after BTX-A application and increased after 32 weeks but did not return to the initial value. CONCLUSION: There was a significant improvement in gummy smile 2 weeks after botulinum toxin application, and a significant relapse in the gingival display after 32 weeks, however not returning to baseline values.

INTRODUÇÃO: A toxina botulínica tipo A (BTX-A) tem se tornado popular na correção do sorriso gengival nos últimos anos. OBJETIVO: Avaliar os efeitos da aplicação de BTX-A na correção do sorriso gengival 2 e 32 semanas após a aplicação. MÉTODOS: A amostra compreendeu 35 pacientes (30 mulheres, 5 homens) com uma idade inicial média 25,51 anos (±5,59) portadores de sorriso gengival devido à hiperfunção muscular. Em cada paciente foi aplicado 2U de BTX-A no músculo elevador superior da asa do nariz, 2 mm a partir da dobra nasolabial. Foram feitas fotografias dos sorrisos espontâneos dos pacientes em 3 fases: antes, 2 e 32 semanas após a aplicação de BTX-A. As medidas da exposição gengival foram feitas com o Software Radioface Studio 2, e a calibração utilizou o tamanho real do incisive central superior direito. A comparação das 3 fases foi feita com ANOVA de medidas repetidas e teste de Tukey. RESULTADOS: A exposição gengival diminuiu significantemente 2 semanas após a aplicação e aumentou novamente após 32 semanas, mas não retornando aos valores iniciais. CONCLUSÃO: Houve uma melhora significante no sorriso gengival 2 semanas após a aplicação de toxina Botulínica, e uma recidiva significante após 32 semanas, mas não retornando aos valores iniciais.

Psychological and financial impact of the COVID-19 pandemic during the first stages of the pandemic: Brazilian orthodontists´ perspective

ABSTRACT Introduction: Brazil faced a catastrophic situation in the coronavirus pandemic. Due to the high risk of contamination and spread of COVID-19, dentist have been attending only urgency and emergency services in Brazil at the beginning of the pandemic. Objective: This research aimed to evaluate the psychological and financial impacts caused by the coronavirus pandemic in Brazilian orthodontists. Methods: This population-based cross-sectional study collected demographic data and mental health measurements from 404 orthodontists. Depression, anxiety, insomnia, and distress were evaluated through Brazilian versions of the 9-item Patient Health Questionnaire (9-PHQ), the 7-item Generalized Anxiety Disorder scale and Mini-Tracking (GAD), the 7-item Insomnia Severity Index (ISI), and the 22-item Impact of Event Scale-Revised (IES-R), respectively. The demographic data of the sample was described using descriptive statistics. The data was analyzed according to sex, professional status, and economic income. Comparisons were performed using Chi-square tests, Mann-Whitney U tests, and Kruskal-Wallis followed by post-hoc tests. Results: Females, graduate students, and lower incomes subgroups showed higher levels of depression, anxiety, insomnia, and distress. Most orthodontists showed moderate to extreme financial and professional concerns during the pandemic. Conclusion: The coronavirus pandemic negatively affected the psychological health and increased the financial concerns of the Brazilian orthodontists, mainly female, graduate students, and with income below 10k participants.

RESUMO Introdução: O Brasil enfrentou uma situação catastrófica durante a pandemia do coronavírus. Devido ao alto risco de contaminação e disseminação do vírus da COVID-19, os cirurgiões-dentistas passaram a realizar apenas atendimentos de urgência ou emergência no início da pandemia. Objetivo: O presente estudo teve como objetivo avaliar o impacto financeiro e psicológico causado pela pandemia do coronavírus nos ortodontistas brasileiros. Métodos: Este estudo transversal de base populacional coletou os dados demográficos e o impacto da pandemia em 404 ortodontistas. Depressão, ansiedade, insônia e angústia foram avaliadas, respectivamente, por meio da versão em português do Questionário de Saúde do Paciente (PHQ-9), do módulo de transtorno de ansiedade generalizada (GAD) do Mini-Tracking (GAD/Mini-Tracking), do Índice de Severidade de Insônia (ISI) e o do Impact of Events Scale-Revised (IES-R). As características demográficas da amostra foram apresentadas por meio de estatística descritiva. Os dados foram analisados de acordo com o sexo, situação profissional e renda econômica. As comparações foram realizadas utilizando os testes de Qui-quadrado, Mann-Whitney U e Kruskal-Wallis, seguidos de testes post-hoc (p<0,05). Resultados: Mulheres, estudantes de pós-graduação e profissionais com menores rendas apresentaram níveis mais altos de depressão, ansiedade, insônia e angústia. A maioria dos ortodontistas mostrou preocupação financeira e profissional moderada a extrema durante a pandemia. Conclusão: A pandemia do coronavírus afetou negativamente a saúde psicológica dos ortodontistas brasileiros e aumentou as preocupações financeiras desses profissionais. As mulheres, os estudantes de pós-graduação e os participantes com renda mensal menor que R$10 mil foram os grupos mais afetados.

The influence of 3x3 bonded retainer on anterior crowding relapse in mandibular incisor extraction cases.

OBJECTIVE: To evaluate the 3x3 bonded retainer influence on the mandibular anterior crowding in cases treated with mandibular incisor extraction. METHODS: The sample comprised pretreatment, posttreatment and follow-up orthodontic records of 16 subjects (10 females and 6 males) with Class I malocclusion treated with extraction of a single mandibular incisor. The mean ages (± SD) at pretreatment, posttreatment and follow-up evaluation were 23.45 ± 9.14 years, 25.50 ± 8.95 years and 30.11 ± 8.59 years, respectively. The mean (± SD) treatment time and posttreatment evaluation time were 2.05 ± 0.45 years and 4.60 ± 1.85 years , respectively. Little irregularity index and interdental widths were evaluated using dental casts. The sample was divided into two subgroups, according to the presence of the 3x3 bonded retainer at follow-up. RESULTS: The subgroup without 3x3 bonded retainer presented a greater relapse at the follow-up, when compared to 3x3 bonded retainer subgroup. CONCLUSION: There was a significant relapse in cases treated with mandibular incisor extraction at follow-up. The subgroup without 3x3 bonded retainer showed a significant relapse at the follow-up when compared to the retainer group.