Arcos pré-contornados de Nitinol e sua correlação com a morfologia da arcada dentária inferior: estudo longitudinal / Pre-contoured Niti archwires and its correlation with the morphology of the lower dental arch: a longitudinal study

O presente estudo tem como objetivo analisar as dimensões dos arcos pré-contornados de Nitinol e sua correlação com a morfologia da arcada dentária inferior. Foram utilizados trinta e dois modelos em gesso de indivíduos com má oclusão Classe II, divisão 1, cuja morfologia da arcada inferior foi comparada à forma de arcos pré-contornados de NiTi de três marcas. Foram obtidas imagens digitais dos modelos e dos arcos, e com o auxílio do programa Cef X (CDT Software, versão 2.3.20), foi mensurada a distância transversal entre o arco analisado e as pontas de cúspide dos dentes 34, 35, 44, 45. Observou-se que todos os arcos pré-contornados avaliados apresentam uma tendência a expandir a morfologia da arcada dentária normal. Porém, os arcos da marca TP Orthodontics apresentam uma morfologia mais próxima à forma da arcada em oclusão normal, quando comparados aos arcos das marcas 3M Uniteck e G&H Wire (p>0,05). Visto que todos os arcos pré-contornados avaliados possuem a tendência de expandir a morfologia normal da arcada dentária, é prudente individualizar os arcos utilizados para cada paciente, com o objetivo de alcançar resultados mais estáveis.(AU)

The present study aims to analyze the dimensions of pre-contoured Nitinolarches and its correlation with the morphology of the lower dental arch. Thirty-two plaster casts of individuals with Class II malocclusion were used in this study to compare the morphology of lower dental arch with the shape of NiTi pre-contoured archwire. Digital images were obtained from plaster casts and from the archwires, and after the superposition of the images, the computer software Cef X (CDT Software, version 2.3.20) was used to measure the lateral distance between the archwire analyzed and the cusp tips of teeth 34, 35, 44, 45. It was observed that all pre-contoured archwires evaluated have tendency to expand the morphology of lower dental arch. However, the TP Orthodontics archwires presented a more similar shape to the morfology of lower dental arch, when compared to the 3M Uniteck and G&H Wire archwires (p>0.05). Since all pre-contoured archwires studied have a tendency to expand the normal morphology of the dental arches, it is prudent to individualize the arches used for each patient in order to achieve more stable results.(AU)

Effectiveness of fluoride sealant in the prevention of carious lesions around orthodontic brackets: an OCT evaluation.

OBJECTIVE: This article aimed to evaluate in vitro the efficiency of Pro Seal fluoride sealant application in the prevention of white spot lesions around orthodontic brackets. MATERIAL AND METHODS: Brackets were bonded to the buccal surface of bovine incisors, and five groups were formed (n = 15) according to the exposure of teeth to oral hygiene substances and the application of enamel sealant: G1 (control), only brushing was performed with 1.450 ppm fluoride; G2 (control) brushing associated with the use of mouthwash with 225 ppm fluoride; G3, only Pro Seal sealant application was performed with 1.000 ppm fluoride; G4 Pro Seal associated with brushing; G5 Pro Seal associated with brushing and mouthwash. Experimental groups alternated between pH cycling and the procedures described. All specimens were kept at a temperature of 37 °C throughout the entire experiment. Both brushing and immersion in solutions were performed within a time interval of one minute, followed by washing in deionized water three times a day for 28 days. Afterwards, an evaluation by Optical Coherence Tomography (OCT) of the spectral type was performed. In each group, a scanning exam of the white spot lesion area (around the sites where brackets were bonded) and depth measurement of carious lesions were performed. Analysis of variance (ANOVA) was applied to determine whether there were significant differences among groups. For post hoc analysis, Tukey test was used. RESULTS: There was statistically significant difference between groups 1 and 2 (p = 0.003), 1 and 3 (p = 0.008), 1 and 4 (p = 0.000) and 1 and 5 (p = 0.000). The group in which only brushing was performed (Group 1) showed deeper enamel lesion. CONCLUSION: Pro Seal sealant alone or combined with brushing and/or brushing and the use of a mouthwash with fluoride was more effective in protecting enamel, in comparison to brushing alone.

Effectiveness of fluoride sealant in the prevention of carious lesions around orthodontic brackets: an OCT evaluation

Abstract Objective: This article aimed to evaluate in vitro the efficiency of Pro Seal fluoride sealant application in the prevention of white spot lesions around orthodontic brackets. Material and Methods: Brackets were bonded to the buccal surface of bovine incisors, and five groups were formed (n = 15) according to the exposure of teeth to oral hygiene substances and the application of enamel sealant: G1 (control), only brushing was performed with 1.450 ppm fluoride; G2 (control) brushing associated with the use of mouthwash with 225 ppm fluoride; G3, only Pro Seal sealant application was performed with 1.000 ppm fluoride; G4 Pro Seal associated with brushing; G5 Pro Seal associated with brushing and mouthwash. Experimental groups alternated between pH cycling and the procedures described. All specimens were kept at a temperature of 37 °C throughout the entire experiment. Both brushing and immersion in solutions were performed within a time interval of one minute, followed by washing in deionized water three times a day for 28 days. Afterwards, an evaluation by Optical Coherence Tomography (OCT) of the spectral type was performed. In each group, a scanning exam of the white spot lesion area (around the sites where brackets were bonded) and depth measurement of carious lesions were performed. Analysis of variance (ANOVA) was applied to determine whether there were significant differences among groups. For post hoc analysis, Tukey test was used. Results: There was statistically significant difference between groups 1 and 2 (p = 0.003), 1 and 3 (p = 0.008), 1 and 4 (p = 0.000) and 1 and 5 (p = 0.000). The group in which only brushing was performed (Group 1) showed deeper enamel lesion. Conclusion: Pro Seal sealant alone or combined with brushing and/or brushing and the use of a mouthwash with fluoride was more effective in protecting enamel, in comparison to brushing alone.

Resumo Objetivo: avaliar in vitro a eficiência da aplicação de selante fluoretado Pro Seal na prevenção de lesões de mancha branca ao redor de braquetes ortodônticos. Métodos: braquetes foram fixados na face vestibular de incisivos bovinos, formando os seguintes cinco grupos (n = 15) de acordo com a exposição a substâncias de higiene bucal e a aplicação do selante de esmalte: 1) controle - realizada apenas escovação; 2) controle - escovação + utilização de enxaguante bucal com flúor; 3) apenas aplicação de selante Pro Seal (Reliance Orthodontic Products, Itasca, Ill); 4) Pro Seal + escovação; 5) Pro Seal + escovação + bochecho. Os grupos experimentais alternaram entre ciclagem de pH e os procedimentos descritos. Todos os espécimes foram mantidos, durante todo o experimento, à temperatura de 37°C. Tanto a escovação quanto a imersão nas soluções foram realizadas em um intervalo de tempo de 1 minuto, seguidas por lavagem em água deionizada, três vezes por dia, durante 28 dias. Após isso, realizou-se avaliação utilizando Tomografia por Coerência Óptica (OCT) do tipo espectral (Ganymede OCT/Thorlabs, Newton, EUA). Em cada grupo, foi realizado um exame em varredura da área de mancha branca (em torno da região onde foram colados os braquetes), assim como a aferição da profundidade das lesões de cárie. A análise de variância (ANOVA) foi aplicada para determinar se houve diferenças significativas entre os grupos. Para o testepost hoc, foi utilizado o teste de Tukey. Resultados: houve diferença estatisticamente significativa entre os grupos 1 e 2 (p = 0,003), 1 e 3 (p = 0,008), 1 e 4 (p = 0,000) e 1 e 5 (p = 0,000). O grupo onde apenas escovação foi feita (Grupo 1) mostrou lesão do esmalte mais profunda. Conclusão: o selante ProSeal sozinho ou combinado com escovação e/ou escovação e uso de bochechos com flúor foi eficaz em proteger mais do que apenas escovar esmalte.

Enamel Quality after Debonding: Evaluation by Optical Coherence Tomography.

The aims of this study were to evaluate quantitatively the enamel fractures, adhesive remnants and bracket fragments on enamel after debonding of metal and ceramic brackets, and to quantify the layer of adhesive remnants in depth after two different cleanup procedures. Metal and ceramic brackets were bonded on 120 human incisors and then debonded using two different techniques with Side Cutter (SC) and Anterior Bracket Removal plier (ABR). After this, a high-speed tungsten carbide finishing bur or a low-speed tungsten carbide finishing bur was used. The debonded samples were submitted to enamel assessment with optical coherence tomography (OCT). In sequence, two different methods of removing the remaining adhesive (tungsten carbide burs at high and low speed) were performed and at the end of these procedures, the remaining adhesive layer was measured with OCT. The results demonstrated that enamel fractures were observed only in the samples bonded with ceramic brackets, and the type of pliers did not influence the incidence and extent of enamel damage. Moreover, the type of debonding technique (with side-cutting pliers or anterior bracket removal pliers) and the type of bracket did not influence the amount of adhesive remaining after debonding. The burs at low speed removed the remaining adhesive more effectively during cleanup procedures.

Enamel Quality after Debonding: Evaluation by Optical Coherence Tomography

The aims of this study were to evaluate quantitatively the enamel fractures, adhesive remnants and bracket fragments on enamel after debonding of metal and ceramic brackets, and to quantify the layer of adhesive remnants in depth after two different cleanup procedures. Metal and ceramic brackets were bonded on 120 human incisors and then debonded using two different techniques with Side Cutter (SC) and Anterior Bracket Removal plier (ABR). After this, a high-speed tungsten carbide finishing bur or a low-speed tungsten carbide finishing bur was used. The debonded samples were submitted to enamel assessment with optical coherence tomography (OCT). In sequence, two different methods of removing the remaining adhesive (tungsten carbide burs at high and low speed) were performed and at the end of these procedures, the remaining adhesive layer was measured with OCT. The results demonstrated that enamel fractures were observed only in the samples bonded with ceramic brackets, and the type of pliers did not influence the incidence and extent of enamel damage. Moreover, the type of debonding technique (with side-cutting pliers or anterior bracket removal pliers) and the type of bracket did not influence the amount of adhesive remaining after debonding. The burs at low speed removed the remaining adhesive more effectively during cleanup procedures.

Os objetivos deste artigo foram avaliar quantitativamente a presença de fraturas de esmalte, adesivo remanescente e fragmentos de bráquetes no esmalte após a descolagem de bráquetes metálicos e cerâmicos e quantificar a camada de adesivo remanescente após a realização de diferentes procedimentos de limpeza. Bráquetes metálicos e cerâmicos foram colados em 120 incisivos humanos e descolados usando duas técnicas diferentes: com alicate de corte (SC) e alicate removedor de bráquete (ABR). Após isso, brocas de carboneto de tungstênio em alta ou baixa velocidade foram utilizadas. As amostras de esmalte foram então submetidas à avaliação com tomografia de coerência óptica (OCT). Na sequência, foram realizados dois métodos diferentes de remoção do adesivo remanescente (brocas de carboneto de tungsténio em alta e baixa velocidade), e no final destes procedimentos, a camada de adesivo remanescente foi medida com OCT. Os resultados demonstraram que as fraturas de esmalte foram observadas apenas nas amostras coladas com bráquetes cerâmicos e o tipo de alicate não influenciou a incidência nem a extensão dos danos ao esmalte. Além disso, o tipo de técnica de descolamento com alicate de corte ou alicate de remoção de bráquetes e o tipo de bráquete não influenciaram a quantidade de adesivo remanescente após a descolagem. O uso de brocas em baixa velocidade mostrou-se mais efetivo na remoção do adesivo remanescente durante os procedimentos de limpeza.

Influence of different beverages on the force degradation of intermaxillary elastics: an in vitro study.

OBJECTIVE: The aim of this study was to evaluate in vitro the effects of frequently ingested beverages on force degradation of intermaxillary elastics. MATERIAL AND METHODS: One hundred and eighty 1/4-inch intermaxillary elastics (TP Orthodontics) were immersed into six different beverages: (1) Coca-Cola®; (2) Beer; (3) Orange juice; (4) Red wine; (5) Coffee and (6) artificial saliva (control). The period of immersion was 15 min for the first and second cycles and 30 min for the third to fifth cycles. Tensile forces were read in a tensile testing machine before and after the five immersion cycles. One-way repeated measures ANOVA was used to identify significant differences. RESULTS: Force degradation was seen in all evaluated groups and at all observation periods (p<0.05). A greater degree of degradation was present at the initial periods, decreasing gradually over time. However, no statistically significant differences were seen among groups at the same periods, showing that different groups behaved similarly. CONCLUSION: The chemical nature of the evaluated beverages was not able to influence the degree of force degradation at all observation periods.

Influence of different beverages on the force degradation of intermaxillary elastics: an in vitro study

Objective: The aim of this study was to evaluate in vitro the effects of frequently ingested beverages on force degradation of intermaxillary elastics. Material and Methods: One hundred and eighty 1/4-inch intermaxillary elastics (TP Orthodontics) were immersed into six different beverages: (1) Coca-Cola®; (2) Beer; (3) Orange juice; (4) Red wine; (5) Coffee and (6) artificial saliva (control). The period of immersion was 15 min for the first and second cycles and 30 min for the third to fifth cycles. Tensile forces were read in a tensile testing machine before and after the five immersion cycles. One-way repeated measures ANOVA was used to identify significant differences. Results: Force degradation was seen in all evaluated groups and at all observation periods (p<0.05). A greater degree of degradation was present at the initial periods, decreasing gradually over time. However, no statistically significant differences were seen among groups at the same periods, showing that different groups behaved similarly. Conclusion: The chemical nature of the evaluated beverages was not able to influence the degree of force degradation at all observation periods.

Optical coherence tomography for debonding evaluation: an in-vitro qualitative study.

INTRODUCTION: The purpose of this research was to demonstrate the potential of the optical coherence tomography technique on the evaluation of changes and damages in the enamel structure caused by debonding and cleanup procedures. METHODS: Twin metal and ceramic brackets were bonded to the labial enamel surfaces of 120 incisors; the brackets were debonded 24 hours later. The anterior surfaces of the teeth were scanned, and optical coherence tomography images were captured in 2-dimensional and 3-dimensional modes before and after debonding and cleanup. A commercial spectral domain optical coherence tomography system with a 5-µm axial spatial resolution was used. The system is based on the Michelson interferometer setup. It is connected to a preconfigured personal computer, and the images are captured with a scanner probe that controls the light beam position at the sample. A total of 960 images were evaluated. RESULTS: The analysis of the 2-dimensional and 3-dimensional images obtained with optical coherence tomography allows observation and evaluation of adhesive remnants, enamel damage, and superficial aspects of enamel from different methods of adhesive remnant removal. The 2-dimensional optical coherence tomography analysis allows in-depth observation of the adhesive remnant layer. CONCLUSIONS: Optical coherence tomography can be a powerful tool for academic and clinical applications for the evaluation of debonding procedures.

Arco duplo helicoide palatino fixo: O arco indesejável para o hábito de sucção do polegar / Double helicoidal palatal arch. The undesirable arch for thumb sucking habit

A mordida aberta anterior é a má oclusão mais freqüente dentre as consequências do hábito de sucção do polegar. No presente relato de caso clínico, na fase de dentição mista com má oclusão Classe II divisão 1 subdivisão direita, mordida aberta anterior e palato profundo, preconizou-se um aparelho fixo com uma configuração diferenciada na região da curvatura anterior do palato constituída de duplo helicoide para impedir, de forma mecânica, o hábito de sucção do polegar da mão direita e interceptar a mordida aberta anterior. Após três meses de tratamento ocorreu a eliminação do hábito, correção da mordida aberta anterior e normalização do overjet. A estabilidade da conduta clínica empregada foi constatada após três anos de remoção do hábito de sucção.

Anterior open bite is the most frequent malocclusion among the consequences for thumb sucking habit. In this Angle Class II, 1 malocclusion, in mixed dentition and na open bite, it was used a fixed appliance with a differentiated configuration in the anterior curvature of the palate. This device consisted in a allow double helix to prevent sucking the thumb and the anterior open bite to close. After three months of treatment it was observed the correction of anterior open bite and normalization of overjet. The stability of treatment was found after three years of removing the sucking habit. The main reason was the elimination of the thumb sucking habit.

O hábito de sucção do dedo anelar direito: relato de caso / A ring finger sucking habit: case report

Na primeira infância, a sucção de dedo ou dedos pode ser considerada normal, porém, se o hábito persistir na segunda infância, o mesmo pode tornar-se prejudicial. Os hábitos bucais deletérios dependem de fatores como duração, frequência, intensidade, bem como do padrão facial, podendo interferir no crescimento e desenvolvimento dentoalveolar, favorecendo o aparecimento de más oclusões e alterações nos padrões normais de deglutição e fonação. Para a eliminação do hábito de sucção de dedo, a participação familiar, interação profissional multidisciplinar e, principalmente, a vontade do paciente, são relevantes e devem ser consideradas. O presente trabalho ilustra o caso clínico de um paciente com má oclusão Classe II, divisão 1, com hábito de sucção do dedo médio da mão direita de maneira intensa e com as consequências minimizadas pelo padrão facial braquifacial. A obtenção de estética e função foram decorrentes do binômio de cooperação em remover o hábito e domínio da biomecânica ortodôntica.

The thumb-sucking habit in childhood is very common and can develop malocclusion and modify the normal patterns of swallowing and speech, depending on some factors as dura-tion, frequency, intensity and facial pattern. The parents, compliance, multidisciplinary in-teraction and patient’s willingness should be also considered. The article illustrates a case of an Angle Class II ,1 malocclusion with a thumb-sucking habit and consequences minimized by brachyfacial pattern. The esthetics and function were achieved mainly because the patient compliance in stopping with the habit and the management of orthodontic biomechanics.

Métodos de detecção de cárie: do tradicional às novas tecnologias de emprego clínico / Methods for detection of dental caries: from traditional to new technologies for clinical use

O desenvolvimento de novos métodos de detecção de cárie tem o objetivo de facilitar o diagnóstico de lesões incipientes de cárie, suprindo a deficiência dos métodos convencionais. Pretende-se avaliar os métodos de detecção de cárie citados na literatura e compará-los segundo sua especificidade e sensibilidade, desde os mais tradicionais até os mais recentes. Durante o século 20, critérios tátil-visuais foram usados para o diagnóstico de cárie dental; estes detectavam apenas a presença de cavitação. Com compreensão crescente do processo da cárie dental, a criação de sistemas diagnósticos sensíveis e específicos é necessária para permitir a detecção precoce de desmineralização. Para tanto, o avanço da tecnologia tem auxiliado na criação de novos métodos para a detecção de cárie. Esses novos métodos são baseados na mensuração da diferença de condutividade elétrica entre tecido sadio e tecido lesado, em imagens obtidas através de radiação X e na dispersão da luz visível nos tecidos dentais

The development of new methods of caries detection aims to facilitate the diagnosis of incipient caries lesions, supplying the deficiency of conventional methods. The purpose of this review is to evaluate methods of detect¬ing caries in literature and compare them according to their specificity and sensitivity, from the most traditional to the most recent. During the 20th century, visual-tactile criteria were used for the diagnosis of dental caries; they detected only the presence of cavitation. With growing understanding of the process of dental caries, the creation of sensitive and specific diagnostic systems is needed to allow early detection of demineralization. Thus, the advancement of technology has helped in creating new methods for detection of caries. These new methods are based on the measurement of electrical conductivity difference between healthy tissue and injured tissue, in images obtained by X-rays and visible light scattering in dental tissues

Anatomia do forame palatino maior aplicada à anestesia dos nervos palatino maior e maxilar: estudo em crânios secos / Anatomy of the greater palatine foramen applied to the greater palatine nerve and maxillary nerve anesthesia: a study on dry skulls

A localização precisa do Forame Palatino Maior (FPM) é importante na prática clínica quando é necessário o bloqueio do nervo Maxilar, ou quando é requerida a anestesia dos tecidos moles da porção posterior do palato. Este estudo visa conhecer a anatomia do FPM e Canal Palatino (CP), buscando identificar marcos anatômicos que possam nortear a localização do FPM, com o objetivo de facilitar e padronizar as técnicas de bloqueio do nervo Palatino Maior e do nervo Maxilar. Para este fim, foi utilizada uma amostra de 55 crânios, na qual se analisou qual elemento dental é interceptado por uma linha que atravessa o FPM formando 45° com a Sutura Palatina Mediana (SPM), a relação do FPM com os molares superiores, comprimento do Canal Palatino, entre outras mensurações. Os resultados demonstraram que a maioria dos FPM estava ao nível do terceiro molar (60,SOJo). O comprimento médio do CP encontrado foi 30,1 mm (±3,7S). Durante a realização da técnica anestésica, a seringa deve ser posicionada formando 45° com a SPM sendo apoiada sobre o primeiro pré-molar superior, pois se observou que na maioria dos casos em que uma reta foi traçada em 45° com a SPM atravessando o FPM, o primeiro pré-molar foi interceptado pela extensão de tal reta. Os dados apresentados no presente estudo tornam mais fáceis e mais seguras as técnicas de bloqueio do Nervo Palatino Maior e Nervo Maxilar, na medida em que proporcionam mais precisão na localização do FPM.

The exact location of Greater Palatine Foramen (GPF) is important in clinical practice in many aspects when is needed to the maxillary nerve block, or when is required the anesthesia of the soft tissue in posterior portion of the palate. This study aims to investigate the anatomy of (GPF) and Palatine Canal (PC) in order to identify anatomical structures that could guide pre- cisely the GPF localization, aiming to facilitate and standardize the technical of greater palatine and maxillary nerve block. A sample of fifty five human skulls were used and analyzed to know what teeth was intercepted bya line that pass for GPF and forming 450 with Midsagittal Suture (MS) of the hard palate. As was also observed the relationship of GPF with maxillary molars, their morphology, the length of PC. The results indicate that during the anesthetic technique the syringe should be positioned forming 450 with MSS on the first premolar, because in this position was statistically significant be on GPF. The investigations showed too that the most GPF appered as an a oval opened (60.6 0J0) and was situated in most of cases at third maxillary molar in the palatal aspect (60.S0J0).The GPC mean length was 30.1 mm (±3.7Smm). Our findings may make easier and safer the techniques of nerve block of greater palatine and maxillary nerve that provide more precision in the location of the GPF.