Tratamento de mordida aberta causada por excessivo hábito de sucção de chupeta por meio de uma abordagem psico-pedagógica. acompanhamento por 11 anos: relato de caso / Treatment of open bite caused by excessive pacifier sucking through a psycho-pedagogical approach. follow-up for 11 years: case report

Objetivo: reportar o sucesso da utilização de uma abordagem psico-pedagógica precoce para resolução de uma mordida mordida aberta lateral causada por sucção de chupeta. Relato do caso: paciente com 3 anos de idade em dentadura decídua, sexo feminino, apresentando mordida aberta unilateral. Foi empregada uma técnica psico-pedagógica, utilizando terapia cognitivo-comportamental para ajudar a criança a lidar com questões, como estresse e ansiedade, por meio da contação de histórias por meio de livros infantis especializados. Resultado: após 2 anos de acompanhamento a mordida aberta foi completamente corrigida e não houve recorrência do hábito. Após 11 anos de acompanhamento, observou- se estabilidade da auto-correção, sem recorrência da mordida aberta lateral. Conclusão: uma vez que crianças em idade pré-escolar podem não apresentar maturidade suficiente para uso de aparelhos interceptativos, uma abordagem psico-pedagógica pode ser uma opção de tratamento viável.

Objective: the purpose of this article is to report a successful approach in an early psycho-pedagogical approach in a case of lateral open bite. Case report: a 3-year-old female patient in deciduous dentition presenting an unilateral open bite. A psycho-pedagogical technique was employed, using cognitive behavioral therapy to help the children to deal with issues, as stress and anxiety through the storytelling by means of specialized children´s books. No interceptive conduct was used. Results: after 2 years of follow-up, the open bite was completely corrected and there was no recurrence of the habit. After 11 years of follow-up, stability of self-correction was observed, with no recurrence of lateral open bite. Conclusion: since preschool-aged children may not be mature enough to use orthodontic interceptive devices, a psycho-pedagogical approach may be a viable treatment option.

Von Mises stresses on Mushroom-loop archwires for incisor retraction: a numerical study.

OBJECTIVE: To perform a numerical simulation using FEM to study the von Mises stresses on Mushroom archwires. METHODS: Mushroom archwires made of titanium-molybdenum alloy with 0.017 x 0.025-in cross-section were used in this study. A YS of 1240 MPa and a Young's modulus of 69 GPa were adopted. The archwire was modeled in Autodesk Inventor software and its behavior was simulated using the finite element code Ansys Workbench (Swanson Analysis Systems, Houston, Pennsylvania, USA). A large displacement simulation was used for non-linear analysis. The archwires were deformed in their extremities with 0° and 45°, and activated by their vertical extremities separated at 4.0 or 5.0 mm. RESULTS: Tensions revealed a maximum of 1158 MPa at the whole part of the loop at 5.0mm of activation, except in a very small area situated at the top of the loop, in which a maximum of 1324 Mpa was found. CONCLUSIONS: Mushroom loops are capable to produce tension levels in an elastic range and could be safely activated up to 5.0mm.

Von Mises stresses on Mushroom-loop archwires for incisor retraction: a numerical study

ABSTRACT Objective: To perform a numerical simulation using FEM to study the von Mises stresses on Mushroom archwires. Methods: Mushroom archwires made of titanium-molybdenum alloy with 0.017 x 0.025-in cross-section were used in this study. A YS of 1240 MPa and a Young's modulus of 69 GPa were adopted. The archwire was modeled in Autodesk Inventor software and its behavior was simulated using the finite element code Ansys Workbench (Swanson Analysis Systems, Houston, Pennsylvania, USA). A large displacement simulation was used for non-linear analysis. The archwires were deformed in their extremities with 0° and 45°, and activated by their vertical extremities separated at 4.0 or 5.0 mm. Results: Tensions revealed a maximum of 1158 MPa at the whole part of the loop at 5.0mm of activation, except in a very small area situated at the top of the loop, in which a maximum of 1324 Mpa was found. Conclusions: Mushroom loops are capable to produce tension levels in an elastic range and could be safely activated up to 5.0mm.

RESUMO Objetivo: Realizar uma simulação numérica, por meio do Método dos Elementos Finitos (MEF), para obter as tensões de von Mises em arcos Mushroom. Métodos: Foram usados arcos com geometria Mushroom de titânio-molibdênio, com secção transversal 0,017" x 0,025". Adotou-se valores de tensão de escoamento (σesc) de 1.240 MPa e módulo de elasticidade (E) de 69 GPa. O arco foi modelado por meio do software Autodesk Inventor, e seu desempenho foi simulado utilizando-se o software de elementos finitos Ansys Workbench (Swanson Analysis System, Houston, Pennsylvania, EUA). Para a simulação, foi considerada a análise para grandes deslocamentos. O arco foi conformado em suas extremidades considerando-se planos de 0° e 45°, pré-ativado em 2,5mm e ativado por meio de suas extremidades verticais, separadas 4,0 mm ou 5,0 mm. Resultados: As tensões revelaram um valor máximo de 1.158 MPa na maior parte da alça, aos 5,0 mm de ativação, com exceção de uma área muito pequena, com valor de 1.324 MPa, situada no topo da alça. Conclusões: Os arcos Mushroom são capazes de produzir níveis de tensão situados dentro da região elástica e poderiam ser ativados com segurança até os 5,0 mm de ativação.

Periodontal and orthodontic approach in periodontally compromised adults / Abordagem periodontal e ortodôntica em adultos com periodonto comprometido

Saúde bucal é uma condição para prevenir muitas doenças. Cirurgia combinada com boa higiene bucal e o uso de forças ortodônticas leves para o tratamento de pacientes adultos, os quais apresentam história de doença periodontal pode prevenir perda dentária e disseminação da infecção. O objetivo foi descrever a abordagem periodontal e ortodôntica em adultos com periodonto comprometido. Cirurgia periodontal é indicada quando há extensa perda óssea devido à periodontite, com objetivo de eliminar contaminações e tecido de granulação. Quando o status periodontal for saudável e controlado, um tratamento ortodôntico, em conjunto pode ser iniciado. Boa higiene bucal, profilaxia antibiótica e terapia periodontal-ortodôntica combinadas podem produzir bons resultados para formação de um novo suporte periodontal, após movimentos de intrusão, visto não haver mais nenhuma evidência de doença periodontal e aplicação de adequado sistema de forças. Além disso, a abordagem periodontal parece produzir um estímulo positivo para a neo-formação óssea(AU)

Oral health is a condition to prevent many diseases. Surgery combined with oral hygiene and the use of light orthodontic forces for the treatment of adult patients who have a history of periodontal disease can prevent teeth loss and infection dissemination. To describe periodontal and orthodontic approach in periodontal compromised adults. Periodontal surgery is indicated when there is extensive bone loss due to periodontitis. When periodontal status is healthy and under control, an adjunctive orthodontic treatment can be initiated. Good oral hygiene, antibiotic prophylaxis and a combined periodontal-orthodontic treatment can produce good results because the new attachment conditions may be formed after orthodontic intrusion provided there is no longer any evidence of periodontal disease and a proper force system was applied. The surgical approach produces a positive stimulus for a new bone formation(AU)

Three-dimensional analysis of an orthodontic delta spring

INTRODUCTION: The purpose of this study was to analyze the force system, moment-force ratios (M/F) and von Mises stresses in an orthodontic delta spring using a 3D finite element model. The M/F ratio produced by an orthodontic spring is related to the different types of tooth movement that are likely to occur in the sagittal and occlusal planes. METHODS: Analyses were performed using a 3D finite element model, and a data acquisition system was used to validate the numerical results. RESULTS: Reactive forces between 0.0 and 2.0 N were observed along the x-axis, while null values were observed along the y- and z-axes. The maximum activation that ensured geometric stability and mechanical stresses below the elastic limit of the material was 10.0 mm. CONCLUSION: The results indicate that a delta spring can provide (i) uncontrolled tipping for activation of less than 1.0 mm; (ii) controlled counterclockwise tipping for activation between 1.0 and 4.5 mm; (iii) translation for activation between 4.5 and 5.0 mm; and (iv) controlled clockwise tipping in the sagittal plane for activation between 5.0 and 10.0 mm. No tooth movement was observed in the occlusal plane for the M/F ratios observed.

Nickel-titanium alloys: a systematic review

OBJECTIVE: A systematic review on nickel-titanium wires was performed. The strategy was focused on Entrez-PubMed-OLDMEDLINE, Scopus and BioMed Central from 1963 to 2008. METHODS: Papers in English and French describing the behavior of these wires and laboratorial methods to identify crystalline transformation were considered. A total of 29 papers were selected. RESULTS: Nickel-titanium wires show exceptional features in terms of elasticity and shape memory effects. However, clinical applications request a deeper knowledge of these properties in order to allow the professional to use them in a rational manner. In addition, the necessary information regarding each alloy often does not correspond to the information given by the manufacturer. Many alloys called "superelastic" do not present this effect; they just behave as less stiff alloys, with a larger springback if compared to the stainless steel wires. CONCLUSIONS: Laboratory tests are the only means to observe the real behavior of these materials, including temperature transition range (TTR) and applied tensions. However, it is also possible to determine in which TTR these alloys change the crystalline structure.

Alguns aspectos da mecânica das alças de retração ortodôntica / Some aspects of the mechanics of the orthodontic retraction springs

As alças de retração ortodôntica são comumente empregadas em sistema Edgewise por meio de uma abordagem seccional (ex.: retração de caninos) ou por meio de uma abordagem segmentada (ex.: retração dos dentes anteriores em conjunto). Estas alças podem modular a demanda de ancoragem, dependendo dos objetivos impostos pelo plano de tratamento. Neste trabalho são discutidas as propriedades mecânicas relacionadas ao projeto de alças de retração ortodôntica, o sistema de forças decorrente de sua conformação geométrica e ativação, e os métodos empregados para testá-las. Dentre as técnicas utilizadas na análise de uma alça, o Método dos Elementos Finitos (MEF) merece destaque. Embora seja baseado em modelos matemáticos, é uma ferramenta eficaz e não onerosa para a simulação computacional de um protótipo, podendo-se assim avaliá-lo antes de sua construção física. Já os métodos experimentais se aproximam mais da condição real, porém com custo mais elevado. A utilização em diferentes estágios de ambos os métodos é aconselhável para um melhor desenvolvimento e caracterização dos protótipos.

Retraction springs are commonly used in Edgewise mechanics in a sectional (e.g. canine retraction) or in a segmental approach (e.g. "en masse" anterior retraction). These springs can modulate the anchorage needs depending on the treatment plan objectives. In this work it is discussed the mechanical properties related to the spring's design, the force system originated by their geometric shape and activation, and the methods used to test them. Among the techniques used to analyze a retraction spring, it can be pointed out the Finite Element Method (FEM). Nevertheless the FEM is based on mathematical models, it is an efficient non-onerous way for computational simulation of a prototype, so it can be evaluated before its physical construction. On the other hand, the experimental methods are closer to real conditions, but they are more costly. The use of both methods in different stages is recommended for a better development and characterization of prototypes.

Treatment of a Class I deep bite malocclusion in a periodontally compromised adult.

BACKGROUND: Light forces and an appropriate force system should be used to treat adult patients with periodontal disease. AIMS: To describe the orthodontic treatment of an adult patient with a Class I deep bite malocclusion, horizontal and vertical bone loss and root resorption. METHODS: After periodontal surgery and initial alignment of the maxillary incisors with a fixed orthodontic appliance the maxillary incisors were splinted together as a single unit. A double palatal arch and sectional buccal archwires were used for anchorage. The palatal arch and splint were joined by a NiTi coil spring (100 g). The incisor segment was then intruded and retracted with a force acting just below the centre of resistance of the splinted incisor teeth. The force system avoided extruding the maxillary molars. The maxillary teeth were then rebonded to close the spaces between maxillary lateral incisors and canines. A Hawley appliance was used for retention. Treatment was completed in 22 months. CONCLUSIONS: Surgical treatment and intrusion with light forces encouraged the development of periodontal attachment to the teeth affected by severe horizontal and vertical bone loss. Retraction of the proclined incisors improved the facial aesthetics.

A biomecânica das alças de retração ortodôntica / The biomechanics of retraction springs

Neste artigo são discutidas as características biomecânicas relacionadas ao sistema de forças decorrentes da ativação de alças de retração ortodôntica, de sua geometria e do tipo de liga metálica utilizada. As alças são capazes de produzir movimento ortodôntico, controlado por meio de inclinações em suas extremidades, as quais geram momentos de força. Estes dispositivos devem apresentar constante elástica de baixa magnitude, relação momento-força (M/F) capaz de produzir movimentação dentária controlada relativamente constante ao longo do deslocamento e limite de escoamento suficientemente alto para evitar deformação plástica durante sua utilização em clínica.

Experimental force definition system for a new orthodontic retraction spring.

A new geometry of orthodontic retraction spring was experimentally studied through an electronic device (platform for measuring forces), using strain gauges that were adapted to cantilever beams. The sample consisted of 36 titanium-molybdenum springs, divided into three groups of 12 springs each. The springs were produced with different cross sections of 0.016 x 0.022 inch and 0.017 x 0.025 inch and with different angles between the extremities (120 degrees and 130 degrees). The springs were adapted to the platform in three different positions so that the force system developed by them could be known (horizontal forces, vertical forces, alpha-beta moments, and moment-to-force ratio M:F). The analysis of factorial variance and the Tukey honestly significant difference test were applied to verify the differences between the averages caused by three possible variation sources and the interactions between them. Regression analysis was also performed to obtain the spring rate. The results show the interactions between the three geometric variables, force magnitudes, and also the spring rates, which are compatible with the ones mentioned in the literature related to the subject. The spring rate was within the levels that are appropriate for clinical use (varying from beta = 33.1 gf/mm to beta = 43.9 gf/mm).

Aspectos metalúrgicos das ligas utilizadas em ortodontia / Metallurgical aspects of orthodontic wires

O presente trabalho enfoca aspectos metalúrgicos das ligas utilizadas em fios ortodônticos

Propriedades elásticas básicas das ligas usadas em fios ortodônticos / Basic elastic properties of alloys used in orthodontic wires

O presente trabalho enfoca conceitos básicos das propriedades mecânicas elásticas das ligas utilizadas em Ortodontia, tais como: resistência à deflexäo, força elástica máxima e recuperaçäo elástica

Hábitos bucais no contexto da maturaçäo / Oral habits in the context of the maturation

Este trabalho apresenta uma breve revisäo da literatura no que se refere aos hábitos bucais mais comumente associados à má-oclusäo