The impact of Metzembaum septoplasty on nasal and facial growth in children.

UNLABELLED: Several studies have investigated the effects of septoplasty on facial growth in children, with conflicting results. However, just handful of those employed objective measures or evaluated patients after facial growth completion. OBJECTIVE: This study assesses the effects of the Metzenbaum septoplasty, which preserves the perichondrium and growth-related areas on nasal and facial growth in children. METHOD: We included those children submitted to surgery before the age of 14 and who had 16 years or years of follow up. Sixteen patients were selected. We evaluated the following parameters: clinical satisfaction (nasal patency and aesthetics), anthropometric measurements and cephalometry. Scientific design: cross-sectional historical cohort. RESULTS: The mean age at surgery was 13 years, children were assessed on average 4.3 years after surgery. Only one patient had anthropometric and cephalometric values below normal, but no aesthetics or patency complaints. Four other patients complained about their nasal aesthetics and three had patency complaints. CONCLUSION: The Metzenbaum septoplasty appears to be a safe technique to correct caudal septum deviations. This technique had no significant impact on facial growth of the patients assessed.

O impacto da septoplastia Metzembaum sobre o crescimento nasal e facial em crianças / The impact of Metzembaum septoplasty on nasal and facial growth in children

Há vários estudos que investigaram os efeitos da septoplastia no crescimento facial em crianças, com resultados conflitantes. No entanto, poucos empregaram medidas objetivas ou avaliaram os pacientes após o término do crescimento facial. OBJETIVO: Este estudo avalia os efeitos da septoplastia Metzenbaum, que preserva o pericôndrio e áreas relacionadas com o crescimento, sobre o crescimento nasal e facial em crianças. MÉTODO: Crianças que foram operadas antes dos 14 anos e que apresentavam 16 anos ou mais na avaliação foram incluídas. Dezesseis pacientes foram selecionados. Os seguintes parâmetros foram avaliados: satisfação clínica (patência e estética nasal); medidas antropométricas; cefalometria. Desenho científico: estudo de coorte histórica com corte transversal. RESULTADOS: A idade média na cirurgia foi de 13 anos; as crianças foram avaliadas em média 4,3 anos após a cirurgia. Apenas um paciente apresentou medidas antropométricas e cefalométricas abaixo da normalidade, porém, sem queixas quanto à estética ou à patência. Outros quatro pacientes apresentaram queixa quanto à estética nasal e três quanto à patência nasal. CONCLUSÃO: A septoplastia Metzenbaum parece ser uma técnica segura na correção de desvios caudais. Esta técnica não apresentou impacto significativo no crescimento facial dos pacientes avaliados.

Several studies have investigated the effects of septoplasty on facial growth in children, with conflicting results. However, just handful of those employed objective measures or evaluated patients after facial growth completion. OBJECTIVE: This study assesses the effects of the Metzenbaum septoplasty, which preserves the perichondrium and growth-related areas on nasal and facial growth in children. METHOD: We included those children submitted to surgery before the age of 14 and who had 16 years or years of follow up. Sixteen patients were selected. We evaluated the following parameters: clinical satisfaction (nasal patency and aesthetics), anthropometric measurements and cephalometry. Scientific design: cross-sectional historical cohort. RESULTS: The mean age at surgery was 13 years, children were assessed on average 4.3 years after surgery. Only one patient had anthropometric and cephalometric values below normal, but no aesthetics or patency complaints. Four other patients complained about their nasal aesthetics and three had patency complaints. CONCLUSION: The Metzenbaum septoplasty appears to be a safe technique to correct caudal septum deviations. This technique had no significant impact on facial growth of the patients assessed.

Evaluation of home disinfection protocols for acrylic baseplates of removable orthodontic appliances: A randomized clinical investigation.

INTRODUCTION: In this randomized clinical trial, we investigated, using the microbial culture technique and scanning electron microscopy, the contamination of acrylic baseplates of removable orthodontic appliances by mutans streptococci (MS) and evaluated the efficacy of different home disinfection protocols with a 0.12% chlorhexidine gluconate spray (Periogard, Colgate-Palmolive, São Bernardo do Campo, Brazil). METHODS: Fifteen dental students were randomly enrolled in a 3-stage changeover system with a 1-week interval between each stage. The acrylic baseplates were worn full time except at meals to simulate the routine use of removable appliances under clinical conditions. Three 1-week home disinfection protocols were tested in all stages by a different group of students: protocol I, toothbrushing + baseplate brushing + sterile tap water spraying once a day; protocol II, toothbrushing + baseplate brushing + Periogard spraying on the seventh day after appliance placement; and protocol III, toothbrushing + baseplate brushing + Periogard spraying on the fourth and seventh days after appliance placement. After the first week, the volunteers received new baseplates, toothbrushes, and dentifrices, and the regimens were repeated 2 more times. At the end of each week, the baseplates had a randomized disinfection protocol and were sent for microbiologic analysis. A scanning electron microscope was used to examine 3 acrylic baseplates representing each home protocol. The Friedman test (α = 0.05) compared the home protocols for the formation of MS colonies or biofilms on the acrylic surfaces. RESULTS: MS colonies or biofilms were found on all acrylic baseplates after protocol I. Protocols II and III reduced significantly (P <0.05) the number of MS colonies and biofilms on the acrylic surfaces. No significant difference (P >0.05) was observed between protocols II and III. The scanning electron microscope analysis confirmed the results of the microbiologic cultures. CONCLUSIONS: Disinfection of baseplates of removable orthodontic appliances by using 0.12% chlorhexidine spray once or twice a week reduced the contamination by MS on the acrylic surface in vivo.

Dimensões nasofaringeanas e faciais em diferentes padrões morfológicos / Nasopharyngeal and facial dimensions of different morphological patterns

OBJETIVO: o presente estudo propõe-se a comparar as dimensões da nasofaringe e as características esqueléticas avaliadas por exame cefalométrico, em indivíduos com padrões morfológicos distintos. MÉTODOS: foram utilizadas 90 telerradiografias de pacientes de ambos os gêneros, de 12 a 16 anos de idade, as quais foram igualmente divididas em três grupos distintos, referentes aos padrões morfológicos - braquifacial, mesofacial e dolicofacial. Foram realizadas medições específicas da região nasofaringeana (ad1-Ptm, ad2-Ptm, ad1-Ba, ad2-S0, (ad1-ad2-S0-Ba-ad1/Ptm-S 0-Ba-Ptm) X 100, e Ptm-Ba) e relativas ao padrão esquelético da face. RESULTADOS: observou-se que os pacientes dolicofaciais apresentaram menor profundidade sagital óssea (Ptm-Ba) e da via aérea da nasofaringe (ad1-Ptm e ad2-Ptm). Sugere-se que essas diferenças estejam relacionadas a um posicionamento relativamente mais posterior da maxila, comum a esses pacientes. Todavia, não foram detectadas diferenças quanto à espessura de tecido mole na parede posterior nasofaringeana (ad1-Ba e ad2-S0), ou à sua proporção em relação a toda a área delimitada para a nasofaringe [(ad1-ad2-S0-Ba-ad1/Ptm-S 0-Ba-Ptm) X 100]. CONCLUSÃO: sugere-se, portanto, que as características faciais de excesso vertical encontradas em pacientes dolicofaciais podem ocorrer, dentre outros fatores, em virtude da obstrução da via aérea nasofaringeana, uma vez que tais dimensões se apresentaram menores para os dolicofaciais.

OBJECTIVE: The purpose of this study was to compare the dimensions of the nasopharynx and the skeletal features-evaluated by cephalometric examination-of individuals with different morphological patterns. METHODS: Were used cephalometric radiographs of 90 patients of both genders, aged 12 to 16 years, which were also divided into three distinct groups, according to their morphological patterns, i.e., brachyfacials, mesofacials and dolichofacials. Measurements were performed of specific nasopharyngeal regions (ad1-Ptm, ad2-Ptm, ad1-Ba, ad2-S0, (ad1-ad2-S0-Ba-ad1/Ptm-S 0-Ba-Ptm) X 100, and Ptm-Ba), and relative to the facial skeletal patterns. RESULTS: Dolichofacial patients were found to have lower than average bone depth sagittally (Ba-Ptm) and lower nasopharyngeal airway depth (ad1-Ptm and ad2-Ptm). Arguably, these differences are linked to a relatively more posterior position of the maxilla, typical of these patients. No differences were found, however, in the soft tissue thickness of the posterior nasopharyngeal wall (ad1-Ba and ad2-S0), or their proportion in the whole area bounded by the nasopharynx ((ad1-ad2-S0-Ba-ad1/Ptm-S 0-Ba-Ptm) X 100). CONCLUSIONS: We therefore suggest that the excessively vertical facial features found in dolichofacial patients may be the result, among other factors, of nasopharyngeal airway obstruction, since such dimensions were shown to be smaller in dolichofacials.

Dimensões do palato e características oclusais de crianças respiradoras nasais e bucais / Palatal dimensions and occlusal characteristics of nose and mouth-breathing children

Objetivo: Investigar as diferenças entre crianças respiradoras nasais e bucais quanto às características oclusais e dimensões do palato. Método: Foram empregados 60 modelos de estudo de crianças de 6 a 10 anos divididas em um grupo composto por respiradores nasais e outro por respiradores bucais, selecionados mediante diagnóstico otorrinolaringológico. Os modelos foram avaliados em relação à distância intermolares (DIM), intercaninos (DIC), profundidade de palato (PP), relação molar, e presença de mordida cruzada posterior. Resultados: Quanto às dimensões do palato, observou-se diferença significativa entre os dois grupos em relação à DIM, menor para respiradores bucais (p<0,05); quanto à PP, esta foi significativamente maior para o mesmo grupo em relação aos respiradores nasais (p<0,05). No entanto, em relação à DIC, nenhuma diferença foi observada (p>0,05). Na análise das características oclusais, não houve diferença significativa entre os dois grupos quanto ao posicionamento dos primeiros molares permanentes (p>0,05) ou em relação à presença de mordida cruzada posterior (p=0,184). Conclusão: A ausência de diferenças entre os grupos quanto à DIC, associada à diferença encontrada em relação à DIM sugere uma tendência de estreitamento maxilar em uma posição mais posterior em decorrência do padrão respiratório alterado. Os dados obtidos em relação às características oclusais sugerem que o respirador bucal não pode ser considerado como portador de um tipo de maloclusão específica. No entanto, a detecção da presença de uma maior PP e, principalmente, de uma menor DIM nos respiradores bucais pode indicar uma tendência de evolução de contração do arco maxilar e subseqüente instalação de mordida cruzada posterior que, eventualmente, pode se pronunciar com maior evidência com o passar da idade.

In-vivo evaluation of the contamination of Super Slick elastomeric rings by Streptococcus mutans in orthodontic patients.

INTRODUCTION: We investigated in vivo the contamination by Streptococcus mutans of Super Slick elastomeric rings (TP Orthodontics, LaPorte, Ind), manufactured with Metafasix technology (TP Orthodontics), using microbial culture and scanning electron microscopy (SEM). METHODS: Twenty patients undergoing fixed orthodontic appliance therapy were selected. Super Slick elastomeric rings (n = 160) were tied to brackets on the right maxillary premolars or molars and left mandibular premolars or molars. Conventional elastomeric rings (n = 160) were tied to brackets on the contralateral premolars or molars with the same split-mouth design. After a 15-day intraoral period, 75 elastomeric rings of each type were retrieved, submitted to microbiologic processing, and cultured in bacitracin sucrose broth-selective enrichment broth culture media. The number of S mutans colonies or biofilms on the surface of the electrometric rings was counted by using a stereomicroscope. Data were analyzed statistically with the Wilcoxon nonparametric test at the 5% significance level. Four representative rings of each type were chosen for SEM analysis. RESULTS: Statistical analysis by the Wilcoxon nonparametric test showed that the Super Slick elastomeric rings had statistically significant greater S mutans contamination than the conventional elastomeric rings (P <.0001). No formation of S mutans colonies or biofilms was observed in the elastomeric rings removed directly from their original packages. SEM micrographs showed fissures on the surface of Super Slick elastomeric rings. No fissures were found on conventional elastomeric rings. When the microbiologic culture was positive, S mutans bacterial biofilm was observed on both types of ligatures. CONCLUSIONS: There was no clinical evidence that Super Slick elastomeric rings are effective in reducing bacterial biofilm formation on their surfaces, and a recommendation for their use in orthodontic therapy for that purpose is not justifiable.

Streptococcus mutans counts in plaque adjacent to orthodontic brackets bonded with resin-modified glass ionomer cement or resin-based composite.

This study investigated the number of Streptococcus mutans CFU (colony forming units) in the saliva and plaque adjacent to orthodontic brackets bonded with a glass ionomer cement--GIC (Fuji Ortho) or a resin-based composite--RC (Concise). Twenty male and female patients, aged 12 to 20 years, participated in the study. Saliva was collected before and after placement of appliances. Plaque was collected from areas adjacent to brackets and saliva was again collected on the 15th, 30th, and 45th day after placement. On the 30th day, 0.4% stannous fluoride gel was applied for 4 minutes. No significant modification in the number of Streptococcus mutans CFU in saliva was observed after placement of the fixed orthodontic appliances. On the 15th day, the percentage of Streptococcus mutans CFU in plaque was statistically lower in sites adjacent to GIC-bonded brackets (mean = 0.365) than in those adjacent to RC-bonded brackets (mean = 0.935). No evidence was found of a contribution of GIC to the reduction of CFU in plaque after the 15th day. Topical application of stannous fluoride gel on the 30th day reduced the number of CFU in saliva, but not in plaque. This study suggests that the antimicrobial activity of GIC occurs only in the initial phase and is not responsible for a long-term anticariogenic property.

Streptococcus mutans counts in plaque adjacent to orthodontic brackets bonded with resin-modified glass ionomer cement or resin-based composite

This study investigated the number of Streptococcus mutans CFU (colony forming units) in the saliva and plaque adjacent to orthodontic brackets bonded with a glass ionomer cement - GIC (Fuji Ortho) or a resin-based composite - RC (Concise). Twenty male and female patients, aged 12 to 20 years, participated in the study. Saliva was collected before and after placement of appliances. Plaque was collected from areas adjacent to brackets and saliva was again collected on the 15th, 30th, and 45th day after placement. On the 30th day, 0.4 percent stannous fluoride gel was applied for 4 minutes. No significant modification in the number of Streptococcus mutans CFU in saliva was observed after placement of the fixed orthodontic appliances. On the 15th day, the percentage of Streptococcus mutans CFU in plaque was statistically lower in sites adjacent to GIC-bonded brackets (mean = 0.365) than in those adjacent to RC-bonded brackets (mean = 0.935). No evidence was found of a contribution of GIC to the reduction of CFU in plaque after the 15th day. Topical application of stannous fluoride gel on the 30th day reduced the number of CFU in saliva, but not in plaque. This study suggests that the antimicrobial activity of GIC occurs only in the initial phase and is not responsible for a long-term anticariogenic property.

Anticariogenic effect of fluoride-releasing elastomers in orthodontic patients.

This in vivo experimental study evaluated the efficacy of fluoride-releasing elastomers in the control of Streptococcus mutans levels in the oral cavity. Forty orthodontic patients were recruited and divided into two groups of 20. Fluoride-releasing elastomeric ligature ties (Fluor-I-Ties, Ortho Arch Co. Inc., USA) were used in the experimental group, and conventional elastomeric ligature ties (D. Morelli, Brazil), in the control group. Two initial samples of saliva were collected at a 14-day interval to determine the number of colony forming units (CFU) of Streptococcus mutans. Immediately after collecting the second sample, fluoride-releasing elastomeric ligature ties were placed in the patients of the experimental group, and conventional ligature ties, in the patients of the control group. Seven, 14 and 28 days after placement of the elastomeric ligature ties, saliva and plaque surrounding the orthodontic appliance were collected for microbiologic analysis. There were no significant differences in the number of Streptococcus mutans CFUs in saliva or plaque in the area surrounding the fluoride-releasing or conventional elastomeric ligature ties. Thus, fluoride-releasing elastomeric ligature ties should not be indicated to reduce the incidence of enamel decalcification in orthodontic patients. Since there was no significant reduction in S. mutans in saliva or plaque, other means of prevention against enamel decalcification should be indicated for these patients.

In-vivo evaluation of the bacterial contamination and disinfection of acrylic baseplates of removable orthodontic appliances.

INTRODUCTION: This randomized clinical trial assessed, by using microbial culture and scanning electron microscopy (SEM), the contamination by mutans streptococci (MS) colonies/biofilms on acrylic baseplates of removable orthodontic appliances and evaluated the efficacy of antimicrobial sprays (Periogard [Colgate-Palmolive Ind. Brasileira, Osasco, SP, Brazil], Cepacol [Merrell Lepetit Farmacêutica e Industrial Ltda, Santo Amaro, SP, Brazil], and sterile tap water [control]) on their disinfection. METHODS: Seventeen children were randomly enrolled in a 3-stage changeover system with a 1-week interval between each stage. All solutions were used in all stages by a different group of children. The acrylic baseplates were worn full time except at meals. At the end of each week of the trial, the baseplates were submitted to a randomized disinfection protocol and were sent for microbiologic analysis. New baseplates were constructed, and the same sequence of procedures was repeated 2 more times. Acrylic baseplates representing each test solution were examined by SEM. The Friedman test assessed differences at the 5% significance level among the solutions for MS biofilm formation on acrylic surface. RESULTS: Cepacol and Periogard reduced the formation of MS colonies/biofilms, and both solutions differed statistically from sterile tap water (P <.001). However, Periogard was significantly more effective against MS than Cepacol (P <.001). When MS colonies/biofilms were detected on acrylic surfaces under stereomicroscopy, this was confirmed with SEM. CONCLUSIONS: Acrylic baseplates of removable orthodontic appliances worn by children were contaminated by MS colonies/biofilms in all cases after 1 week. Although Cepacol had better results than sterile tap water, spraying with Periogard showed significantly greater efficacy in reducing MS colonies/biofilms on acrylic surfaces.

Anticariogenic effect of fluoride-releasing elastomers in orthodontic patients

This in vivo experimental study evaluated the efficacy of fluoride-releasing elastomers in the control of Streptococcus mutans levels in the oral cavity. Forty orthodontic patients were recruited and divided into two groups of 20. Fluoride-releasing elastomeric ligature ties (Fluor-I-Ties, Ortho Arch Co. Inc., USA) were used in the experimental group, and conventional elastomeric ligature ties (D. Morelli, Brazil), in the control group. Two initial samples of saliva were collected at a 14-day interval to determine the number of colony forming units (CFU) of Streptococcus mutans. Immediately after collecting the second sample, fluoride-releasing elastomeric ligature ties were placed in the patients of the experimental group, and conventional ligature ties, in the patients of the control group. Seven, 14 and 28 days after placement of the elastomeric ligature ties, saliva and plaque surrounding the orthodontic appliance were collected for microbiologic analysis. There were no significant differences in the number of Streptococcus mutans CFUs in saliva or plaque in the area surrounding the fluoride-releasing or conventional elastomeric ligature ties. Thus, fluoride-releasing elastomeric ligature ties should not be indicated to reduce the incidence of enamel decalcification in orthodontic patients. Since there was no significant reduction in S. mutans in saliva or plaque, other means of prevention against enamel decalcification should be indicated for these patients.

Esta pesquisa in vivo teve como objetivo avaliar a eficácia dos elastômeros liberadores de fluoreto estanoso no controle dos níveis de Streptococcus do grupo mutans na cavidade oral. Utilizou-se uma amostra de 40 pacientes ortodônticos, dividida em dois grupos de vinte indivíduos cada. No grupo experimental, foi utilizada ligadura elástica com liberação de fluoretos (Fluor-I-Ties, Ortho Arch Co. Inc., EUA) e, no grupo controle, foi utilizada ligadura elástica convencional (D. Morelli, Brasil). Para determinação do número de unidades formadoras de colônia (UFC) de Streptococcus do grupo mutans, foram realizadas duas coletas iniciais de saliva com intervalo de catorze dias. Logo após a segunda coleta de saliva, foram colocados os elastômeros liberadores de fluoretos nos pacientes do grupo experimental e, nos pacientes do grupo controle, foram inseridos os elastômeros convencionais. Nos 7°, 14° e 28° dias, saliva e biofilme ao redor do acessório ortodôntico foram coletados para análise microbiológica. Constatou-se que não houve diferenças estatisticamente significantes no número de UFC de Streptococcus do grupo mutans encontradas na saliva e no biofilme ao redor dos elastômeros com ou sem fluoretos. Dessa forma, os elastômeros liberadores de fluoreto não podem ser utilizados para reduzir a incidência de descalcificação do esmalte em pacientes ortodônticos. Como não houve redução significativa na quantidade de S. mutans na saliva e no biofilme, torna-se necessário indicar outros meios de prevenção da descalcificação do esmalte para esses pacientes.

Normal torque of the buccal surface of mandibular teeth and its relationship with bracket positioning: a study in normal occlusion.

This study evaluated the degree of buccolingual inclination of mandibular tooth crowns relative to torque. For such purpose, mandibular and maxillary stone casts from 31 Caucasian Brazilian adults with normal occlusion, pleasant facial aspect and no history of previous orthodontic treatment were examined. A custom device was developed for measuring the degree of inclination (torque) of bracket slots of orthodontic appliances relative to the occlusion plane, at three bonding height: standard (center of clinical crown), occlusal (0.5 mm occlusally from standard) and cervical (0.5 mm cervically from standard). Except for the mandibular incisors, which presented a small difference in torque from one another (lingual root torque for central incisors and buccal root torque for lateral incisors), the remaining average values are close to those found in the literature. Due to the convexity of the buccal surface, the 1-mm vertical shift of the brackets from occlusal to cervical affected the values corresponding to the normal torque, in approximately 2 degrees in central and lateral incisors, 3 degrees in canines and 8 degrees in premolars and molars.

Confiabilidade da predição da largura de caninos e pré-molares por métodos não radiográficos / Reliability of the prediction widths of unerupted canines and premolar in nonradiographic methods

A análise da dentição mista, mais precisamente a predição do espaço para erupção de caninos e pré-molares, é fundamental para que o Ortodontista possa realizar o diagnóstico e tratamentos criteriosos. O objetivo do estudo consiste em verificar a confiabilidade do método de predição das larguras mesiodistais de caninos e pré-molares propostos pelas análises de Moyers¹ e Tanaka & Johnston². Para a realização desta investigação, foram selecionados 37 pacientes dos arquivos da Faculdade de Odontologia de Ribeirão Preto - Universidade de São Paulo, em fase de dentição mista e permanente. Os procedimentos técnicos empregados para esta análise foram: 1 - Medição das larguras mesiodistais dos incisivos inferiores, 2 - previsão da soma dos diâmetros mesiodistais de caninos e pré-molares com auxílio da "Tabela de Probabilidades" proposta por Moyers¹ e, 3 - previsão da soma dos diâmetros mesiodistais de caninos e pré-molares proposta por Tanaka & Johnston². Os dados foram submetidos à análise estatística para verificar a correlação existente entre as medidas obtidas por meio dos referidos métodos de predição e as medidas reais de caninos e pré-molares. Pode-se constatar que não houve diferenças estatisticamente significantes no tamanho de canino e pré-molares (p>.05). O erro envolvendo o uso dos métodos de predição de Moyers¹ e Tanaka & Johnston², em relação ao tamanho real, é expresso como estimativa de erro padrão (EEP), indicando que o erro para a utilização do método de Moyers¹ foi de 1.28mm e para o de Tanaka & Johnston² de 1.07mm.

Effect of rapid maxillary expansion on the dimension of the nasal cavity and on nasal air resistance.

INTRODUCTION: Atresia of the maxilla is a transverse skeletal dysplasia, possibly associated with respiratory problems. For its correction, rapid maxillary expansion is a feasible orthodontic process. OBJECTIVE: To evaluate the effect of rapid maxillary expansion on the nasal cavity by acoustic rhinometry and computed rhinomanometry. MATERIAL AND METHODS: Twenty-nine children of both sexes with oral and/or mixed breathing, ranging in age from 7 to 10 years and with mixed dentition were selected. The children had uni- or bilateral posterior crossbite involving deciduous canines and the first permanent molars and were not being submitted to any otorhinolaryngologic or orthodontic treatment. All subjects were submitted to rhinologic exams and orthodontic documentation at three different times, i.e., before expansion and immediately and 90 days after expansion. RESULTS: There was no difference in the minimal cross-sectional area at the level of the valve and inferior nasal turbinate between the periods analyzed, but there was a statistically significant reduction in nasal resistance after expansion. CONCLUSION: On the basis of the present results, we may conclude that rapid maxillary expansion may lessen the nasal resistance. Although there was no difference in nasal geometry. Thus, this procedure may improve nasal respiration, but cannot be indicated for this purpose by itself.

Normal torque of the buccal surface of mandibular teeth and its relationship with bracket positioning: a study in normal occlusion

Este estudo avaliou o grau de inclinação vestíbulo-lingual de coroas dentais de dentes inferiores em relação ao torque. Foram obtidos modelos de gesso das arcadas superiores e inferiores de 31 adultos brasileiros, brancos com oclusão normal e estética facial agradável, que nunca haviam sido submetidos a tratamento ortodôntico. Foi desenvolvido um dispositivo capaz de medir o grau de inclinação do encaixe retangular do bráquete em relação ao plano oclusal, em três alturas de colagem: padrão (centro da coroa clínica); oclusal (deslocado 0.5 mm para oclusal em relação à posição padrão) e cervical (0.5 mm para cervical em relação à posição padrão). Com exceção dos incisivos inferiores, que apresentaram pequena diferença de torque entre si (centrais com torque lingual de raiz e laterais com torque vestibular de raiz), os demais valores médios estão próximos aos encontrados na literatura. A variação vertical dos bráquetes em 1.0 mm (de oclusal para cervical) determinou, devido à convexidade da face vestibular, pequenas variações de torque para incisivos e caninos e valores mais acentuados para pré-molares e molares (em média 2, 3 e 8 graus, respectivamente).

Influência do padrão respiratório na morfologia craniofacial / Breathing mode influence in craniofacial development

OBJETIVO: este estudo teve como objetivo avaliar por meio de análise cefalométrica as diferencas nas proporcões faciais de criancas respiradoras bucais e nasais. FORMA DE ESTUDO: coorte transversal. MATERIAL E MÉTODO: Foram selecionadas 60 criancas entre 6 e 10 anos que, após avaliacão otorrinolaringológica para o diagnóstico do tipo de respiracão, foram divididas em dois grupos: grupo I, constituído de criancas respiradoras bucais, com elevado grau de obstrucão das vias aéreas e grupo II, composto de criancas respiradoras nasais. Os pacientes foram submetidos à avaliacão ortodôntica por meio de radiografias cefalométricas em norma lateral, a fim de avaliar as proporcões faciais, através das seguintes medidas cefalométricas: SN.GoGn, ArGo.GoMe, N-Me, N-ENA, ENA-Me, S-Go, S-Ar, Ar-Go; e os seguintes índices: iAF=S-Go / N-Me, iAFA=ENA-Me / N-Me e iPFA=N-ENA / ENA-Me. RESULTADO: Foi constatada que a inclinacão do plano mandibular (SN.GoGn) nos pacientes respiradores bucais foi estatisticamente maior que nos respiradores nasais, enquanto que a proporcão da altura facial posterior e anterior (iAF), e da altura facial anterior superior e inferior (iPFA) foram estatisticamente menores nos pacientes bucais, indicando altura facial posterior menor que a anterior e altura facial anterior inferior aumentada nesses pacientes. CONCLUSAO: Pode-se concluir, então, que os respiradores bucais tendem a apresentar maior inclinacão mandibular e padrão de crescimento vertical, evidenciando a influência da funcão respiratória no desenvolvimento craniofacial.

Breathing mode influence in craniofacial development.

AIM: The aim of this study was to evaluate the differences in facial proportions of nose and mouth breathing children using cephalometric analysis. STUDY DESIGN: Transversal cohort. MATERIAL AND METHOD: Sixty cephalometric radiographs from pediatric patients aged 6 to 10 years were used. After otorhinolaryngological evaluation, patients were divided into two groups: Group I, with mouth breathing children and group II, with nose breathers. Standard lateral cephalometric radiographs were obtained to evaluate facial proportions using the following measures: SN.GoGn, ArGo.GoMe, N-Me, N-ANS, ANS-Me and S-Go; and the following indexes: PFH-AFH ratio: S-Go/N-Me; LFH-AFH ratio: ANS-Me/N-Me and UFH-LFH ratio: N-ANS/ANS-Me. RESULTS: It was observed that the measurements for the inclination of the mandibular plane (SN.GoGn) in mouth breathing children were statistically higher than those in nasal breathing children. The posterior facial height was statistically smaller than the anterior one in mouth breathing children (PFH-AFH ratio). Thus, the upper anterior facial height was statistically smaller than the lower facial height (UFH-LFH ratio). CONCLUSION: We concluded that mouth breathing children tend to have higher mandibular inclination and more vertical growth. These findings support the influence of the breathing mode in craniofacial development.

Dental-skeletal dimensions in growing individuals with variations in the lower facial height.

The dental and skeletal dimensions of individuals with Class I skeletal pattern in puberty were compared. Eighty patients with Class I malocclusion were selected, independent of the vertical relations (overbite) of the incisors. The sample was divided into 3 groups: normal, short and excessive lower anterior face height, based on facial proportions. The dental and skeletal measurements of the 3 groups were compared among themselves. In the angular measurements, the results showed no correlation in the mandibular plane angle. In the linear measurements, the mandibular length was significantly greater in the group of patients with short lower anterior face height, with a positive correlation among the three groups. The dentoalveolar heights of the incisors had a positive correlation among the three groups in relation to the lower anterior face height, showing that they are responsible for its variation.

Dental-skeletal dimensions in growing individuals with variations in the lower facial height

As dimensões dentoesqueléticas de indivíduos com padrão esquelético de Classe I foram comparadas na puberdade. Oitenta pacientes com maloclusão de Classe I foram selecionados, independente do trespasse vertical dos incisivos (sobremordida). A amostra foi dividida em 3 grupos: com altura facial inferior normal, diminuída e aumentada, baseados na proporção facial. As medidas dentoesqueléticas dos 3 grupos foram comparadas entre si. Nas medidas angulares os resultados mostraram que não houve diferenças na inclinação do plano mandibular. Nas medidas lineares o comprimento mandibular foi significantemente maior no grupo com terço facial diminuído, com correlação positiva nos 3 grupos. As alturas dentoalveolares dos incisivos apresentaram correlação positiva nos 3 grupos em relação ao terço facial inferior, mostrando serem responsáveis pela variação da altura facial inferior.

Estudo comparativo entre a análise de Moyers e a telerradiografia oblíqua em 45° na previsão do tamanho de caninos e pré-molares inferiores / Comparative study between Moyers and 45° oblique teleradiography's analysis on size prediction of the lower canines and premolars

A predição do diâmetro mésio-distal de caninos e pré-molares não erupcionados durante a fase da dentição mista é um diagnóstico importante nos pacientes que apresentam deficiência no comprimento do arco dentário. Inúmeros métodos têm sido propostos como o uso de tabelas de probabilidade, equação de proporção, radiográfias ou associação entre estes. O presente estudo tem o propósito de comparar dois métodos de predição do tamanho mésio-distal de caninos e pré-molares inferiores de 32 crianças (19 do sexo feminino e 13 do sexo masculino), na fase da dentição mista, utilizando-se do (1) método de Moyers e do (2)método de telerradiografia oblíqua em 45°, comparando-os com o tamanho real desses dentes. Os resultados mostraram haver diferenças significantes nos valores obtidos pelos dois métodos, sendo que somente os valores obtidos pela análise de Moyers foram estatisticamente diferentes do valor real dos dentes, indicando que a telerradiografia de 45° é um método mais preciso de predição do tamanho de caninos e pré-molares. O teste t Student mostrou não haver diferenças estatísticamente significantes no tamanho de caninos e pré-molares entre os sexos e entre os lados direito e esquerdo. Os valores de caninos e pré-molares não irrompidos obtidos a partir da radiografia cefalométrica de 45° foram estatisticamente maiores que os valores previstos pelo método de Moyers