Prevalence of malocclusion in public school students in the mixed dentition phase and its association with early loss of deciduous teeth.

OBJECTIVE: To determine the prevalence of malocclusion and its association with the early loss of deciduous teeth and other factors in children in the mixed dentition phase, aged six to eight years, enrolled in public schools in southern Brazil. METHODS: A cross-sectional study was conducted with a representative sample of 528 children from municipal public schools in 2009. Data collection involved a clinical examination for the determination of early tooth loss, dental caries, tongue pressure and malocclusion (outcome), as well as the administration of a questionnaire. Poisson regression analysis with robust variance was used to model the association between malocclusion and the independent variables. RESULTS: The prevalence of malocclusion and early tooth loss was 69.1% and 21.8%, respectively. In the raw data analysis, malocclusion was associated with age, early tooth loss, dental caries and tongue pressure. After the adjustment, the likelihood of malocclusion was greater among children older than eight years, those who exerted tongue pressure on the teeth and those with early tooth loss. The likelihood of malocclusion was 24% greater among children with early tooth loss, compared to those without tooth loss. CONCLUSION: The early loss of deciduous teeth was associated with the occurrence of malocclusion in the children studied.

Prevalence of malocclusion in public school students in the mixed dentition phase and its association with early loss of deciduous teeth

ABSTRACT Objective: To determine the prevalence of malocclusion and its association with the early loss of deciduous teeth and other factors in children in the mixed dentition phase, aged six to eight years, enrolled in public schools in southern Brazil. Methods: A cross-sectional study was conducted with a representative sample of 528 children from municipal public schools in 2009. Data collection involved a clinical examination for the determination of early tooth loss, dental caries, tongue pressure and malocclusion (outcome), as well as the administration of a questionnaire. Poisson regression analysis with robust variance was used to model the association between malocclusion and the independent variables. Results: The prevalence of malocclusion and early tooth loss was 69.1% and 21.8%, respectively. In the raw data analysis, malocclusion was associated with age, early tooth loss, dental caries and tongue pressure. After the adjustment, the likelihood of malocclusion was greater among children older than eight years, those who exerted tongue pressure on the teeth and those with early tooth loss. The likelihood of malocclusion was 24% greater among children with early tooth loss, compared to those without tooth loss. Conclusion: The early loss of deciduous teeth was associated with the occurrence of malocclusion in the children studied.

RESUMO Objetivo: Determinar a prevalência de má oclusão em crianças de seis a oito anos de idade no município de Florianópolis (Santa Catarina, Brasil), e a sua associação com a perda precoce de dentes decíduos. Métodos: Esse estudo transversal avaliou uma amostra representativa de 528 crianças de escolas públicas municipais de Florianópolis, no ano de 2009. Os dados foram coletados por meio de exame clínico (perda dentária precoce, cárie dentária, interposição lingual e má oclusão - que foi o desfecho do estudo) e de um questionário. A regressão de Poisson com variância robusta foi utilizada para modelar a associação entre má oclusão e as variáveis independentes. Resultados: A prevalência de má oclusão e de perda dentária precoce foi, respectivamente, de 66,7% e 21,8%. Na análise dos dados brutos, a má oclusão foi associada com a idade, perda dentária precoce e cárie dentária. Após ser feito o ajuste, crianças com mais de 7 anos, com interposição lingual e perda dentária precoce apresentaram maior probabilidade de ter má oclusão. Crianças com perda dentária precoce apresentaram probabilidade 24% maior de ter má oclusão do que aquelas sem perda dentária. Conclusões: A perda precoce de dentes decíduos foi associada à ocorrência de má oclusão nas crianças estudadas.

Evaluation of the rapid and slow maxillary expansion using cone-beam computed tomography: a randomized clinical trial.

OBJECTIVE:: The aim of this randomized clinical trial was to evaluate the dental, dentoalveolar, and skeletal changes occurring right after the rapid maxillary expansion (RME) and slow maxillary expansion (SME) treatment using Haas-type expander. METHODS:: All subjects performed cone-beam computed tomography (CBCT) before installation of expanders (T1) and right after screw stabilization (T2). Patients who did not follow the research parameters were excluded. The final sample resulted in 21 patients in RME group (mean age of 8.43 years) and 16 patients in SME group (mean age of 8.70 years). Based on the skewness and kurtosis statistics, the variables were judged to be normally distributed and paired t-test and student t-test were performed at significance level of 5%. RESULTS:: Intermolar angle changed significantly due to treatment and RME showed greater buccal tipping than SME. RME showed significant changes in other four measurements due to treatment: maxilla moved forward and mandible showed backward rotation and, at transversal level both skeletal and dentoalveolar showed significant changes due to maxillary expansion. SME showed significant dentoalveolar changes due to maxillary expansion. CONCLUSIONS:: Only intermolar angle showed significant difference between the two modalities of maxillary expansion with greater buccal tipping for RME. Also, RME produced skeletal maxillary expansion and SME did not. Both maxillary expansion modalities were efficient to promote transversal gain at dentoalveolar level. Sagittal and vertical measurements did not show differences between groups, but RME promoted a forward movement of the maxilla and backward rotation of the mandible.

Evaluation of the rapid and slow maxillary expansion using cone-beam computed tomography: a randomized clinical trial

ABSTRACT OBJECTIVE: The aim of this randomized clinical trial was to evaluate the dental, dentoalveolar, and skeletal changes occurring right after the rapid maxillary expansion (RME) and slow maxillary expansion (SME) treatment using Haas-type expander. METHODS: All subjects performed cone-beam computed tomography (CBCT) before installation of expanders (T1) and right after screw stabilization (T2). Patients who did not follow the research parameters were excluded. The final sample resulted in 21 patients in RME group (mean age of 8.43 years) and 16 patients in SME group (mean age of 8.70 years). Based on the skewness and kurtosis statistics, the variables were judged to be normally distributed and paired t-test and student t-test were performed at significance level of 5%. RESULTS: Intermolar angle changed significantly due to treatment and RME showed greater buccal tipping than SME. RME showed significant changes in other four measurements due to treatment: maxilla moved forward and mandible showed backward rotation and, at transversal level both skeletal and dentoalveolar showed significant changes due to maxillary expansion. SME showed significant dentoalveolar changes due to maxillary expansion. CONCLUSIONS: Only intermolar angle showed significant difference between the two modalities of maxillary expansion with greater buccal tipping for RME. Also, RME produced skeletal maxillary expansion and SME did not. Both maxillary expansion modalities were efficient to promote transversal gain at dentoalveolar level. Sagittal and vertical measurements did not show differences between groups, but RME promoted a forward movement of the maxilla and backward rotation of the mandible.

RESUMO OBJETIVO: o objetivo do presente ensaio clínico randomizado foi avaliar as transformações dentárias, dentoalveolares e ósseas que ocorrem imediatamente após o tratamento com expansão rápida da maxila (ERM) e lenta (ELM) usando expansores do tipo Haas. MÉTODOS: todos os indivíduos foram submetidos a tomografias computadorizadas de feixe cônico (TCFC) antes da colocação dos expansores (T1) e imediatamente após a estabilização do parafuso (T2). Os pacientes que não seguiram os parâmetros da pesquisa foram excluídos. A amostra final constou de 21 pacientes no grupo ERM (idade média de 8,43 anos) e 16 no grupo ELM (idade média de 8,7 anos). Com base em estatística de assimetria e curtose, as variáveis foram consideradas de distribuição normal, e os testes t pareado e t de Student foram realizados, com nível de significância de 5%. RESULTADOS: o ângulo intermolares mudou significativamente devido ao tratamento, e o grupo ERM apresentou maior inclinação vestibular do que o grupo ELM. O grupo ERM mostrou alterações significativas em outras quatro medidas devido ao tratamento: a maxila apresentou deslocamento anterior e a mandíbula, rotação posterior; no nível transversal, houve tanto alterações ósseas quanto dentoalveolares significativas, devido à expansão maxilar. O grupo ELM apresentou alterações significativas devido à expansão maxilar. CONCLUSÕES: apenas o ângulo intermolares apresentou diferença significativa entre as duas modalidades de expansão maxilar, com maior inclinação vestibular no grupo ERM. A ERM resultou, também, em expansão maxilar óssea, ao contrário da ELM. As duas modalidades de expansão maxilar promoveram, de forma eficiente, um ganho transversal em nível dentoalveolar. As medidas sagitais e verticais não apresentaram diferenças entre os grupos, mas a ERM promoveu o deslocamento anterior da maxila e a rotação posterior da mandíbula.

Avaliação longitudinal em pacientes com má oclusão de Classe II Divisão 1 submetidos ao tratamento ortodôntico sem extrações – análise de modelos / Long-term evaluation in Class II Division 1 patients after nonextraction orthodontic treatment – Dental cast analysis

O objetivo deste estudo longitudinal foi avaliar as alterações dentárias pós-tratamento e em longo prazo em pacientes Classe II Divisão 1 de Angle tratados com aparelho extrabucal cervical e aparelho ortodôntico fixo sem extrações dentárias. Os modelos dentários de 33 pacientes foram avaliados no pré-tratamento (T1), pós-tratamento (T2) e pós-contenção (T3). Os pacientes apresentavam em média 10,7 anos em T1, 15,1 anos em T2, e 26,2 anos no T3. As larguras intermolares e intercaninos, comprimento do arco, perímetro do arco, overjet, overbite e irregularidade dos incisivos inferiores foram avaliados nos modelos do arco maxilar e mandibular. Para identificar mudanças estatisticamente significativas em curto prazo (T1-T2) e longo prazo (T2-T3) foi utilizado o teste t de Student. Os resultados mostraram que, durante o tratamento, as larguras do arco maxilar e mandibular foram significativamente aumentadas, tanto nas regiões de molares quanto de caninos, e reduzidas no período pós-contenção. Durante o tratamento apenas o comprimento do arco mandibular reduziu, no entanto, em T3, o perímetro e o comprimento diminuíram em ambos os arcos. Overjet e overbite diminuíram em média 5,5 mm e 2,1 mm, respectivamente, no pós-tratamento e ambos aumentaram (média de 0,5 mm e 0,4 mm) na avaliação pós-contenção. A irregularidade dos incisivos inferiores diminuiu em média de 1,9 mm durante o tratamento e aumentou em média 1,1 mm depois do tratamento. Concluiu-se que a terapia utilizada foi eficaz para a correção da má oclusão de Classe II Divisão 1. Após o período de contenção, mínimas alterações dentárias podem ser esperadas na largura intercanino e intermolar, perímetro e comprimento dos arcos, irregularidade dos incisivos e overjet.

The aim of this longitudinal study was to evaluate the post-treatment and long-term dental changes in Class II Division 1 malocclusion patients treated with cervical headgear in conjunction with full-fixed appliance in nonextraction therapy. Dental casts of 33 patients were evaluated at: pretreatment (T1), post-treatment (T2), and postretention (T3). The mean ages were 10.7 years at T1, 15.1 years at T2, and 26.2 years at T3. Molars and canines transversal widths, arch length, arch perimeter, overjet, overbite and lower incisor irregularity were assessed on maxillary and mandibular dental casts. To identify statistically significant changes in short term (T1-T2) and long-term (T2-T3) was used the Student paired t test. The results showed that, during treatment, maxillary and mandibular widths have increased significantly, at both, molar and canine regions and reduced in postretention period. During treatment only mandibular arch length showed reduction, however at T3 perimeter and length, decreased for maxillary and mandibular arches. Overjet and overbite had a mean decreased, during treatment of 5.5 mm and 2.1 mm, respectively, and both increased (mean of 0.5 mm and 0.4mm) in postretention evaluation. Lower incisor irregularity decreased mean was 1.9 mm during treatment and increased mean of 1.1 mm after. The therapy used was effective for Class II Division 1 malocclusion correction. After the retention period small dental changes can be expected in intercanine and intermolar width, arch perimeter and length, incisor irregularity and overjet.

Considerações sobre recessão gengival e sua resolução através da Ortodontia e Periodontia / Considerations about gingival recession and its resolution through Orthodontics and Periodontics

A recessão gengival pode ser definida como a perda de inserção do periodonto de proteção, com consequente aumento de coroa clínica e exposição radicular. Na grande maioria dos casos, fatores como acúmulo de placa bacteriana, seguido de inflamação gengival, trauma, deficiência de espessura de gengiva queratinizada e o tipo de mecânica ortodôntica empregada podem, de maneira isolada ou conjuntamente, causar ou agravar o problema. Uma vez estabelecido este quadro, resta ao ortodontista recorrer ao auxílio da terapia periodontal. Contudo, alguns detalhes, como o momento oportuno para a interação entre as terapias ortodôntica e periodontal, ainda geram dúvidas ao clínico. Desta forma, o presente artigo tem por objetivo promover a discussão sobre os fatores etiológicos da recessão gengival, bem como a validade científica, viabilidade, necessidade e o momento oportuno para emprego da terapia periodontal cirúrgica em pacientes submetidos ao tratamento ortodôntico.

Loss of insertion of periodontium followed by increased display of clinical crown and exposition of the root defines gingival recession. Factors as gingivitis, trauma, thin keratinized gingiva and the type of orthodontic mechanics, aisolated or combined may cause or increase gingival recession. Once established, the problem demands attention of orthodontists and probably requires assistance of periodontal surgical therapy. However, some details such as the timing for interaction between orthodontic and periodontal therapies still raise questions to the clinician. Thus, the purpose of this study is to discuss the etiological factors of gingival recession and the scientific value, feasibility, necessity and the convenient time for periodontal surgical therapy in orthodontic patients.

Orthodontic traction in a patient with cleidocranial dysplasia: 3 years of follow-up.

This case report describes the treatment and long-term follow-up care of a patient diagnosed with cleidocranial dysplasia who had multiple impacted permanent and supernumerary teeth. The aim of the treatment was to provide an adequate esthetic and functional reconstruction of the occlusion with good periodontal care. The patient was treated with a multidisciplinary therapeutic protocol including orthodontic and surgical procedures, and traction of 11 permanent teeth. The proposed objectives of good occlusion, normal function, healthy periodontium, and balanced profile were achieved, and the 3-year follow-up records showed stable results.

A escola na promoção da saúde de crianças com fissura labiopalatal / School in health promotion for children with cleft lips and palates / La escola en la promoción de salud para los niños con fisura labiopalatina

O objetivo foi conhecer a influência da escola na vida e nos cuidados com a saúde de crianças e adolescentes com fissura labiopalatal atendidas em um centro de referência do Sul do Brasil. A pesquisa foi do tipo exploratório-descritiva, com abordagem qualitativa. Foram realizadas entrevistas semiestruturadas com 15 mães de crianças e adolescentes com fissura labiopalatal participantes de um programa de acompanhamento da saúde bucal. A análise dos dados foi fundamentada na técnica de análise temática, pertencente à análise de conteúdo, originando duas categorias temáticas centrais: enfrentando e superando o preconceito relacionado à má formação; e a escola influenciando a saúde bucal da criança e adolescente e o seu desenvolvimento. A escola traz à criança e adolescente com fissura labiopalatal possibilidades de cuidados e inclusão social, mas também pode trazer conflitos pelo preconceito gerado pela sua aparência física. O apoio da comunidade escolar é essencial para que possam ter um desenvolvimento adequado com qualidade de vida.

The aim of this study was to understand the influence of school in the life and care of the health of children with cleft lips and palates, treated at a reference center in southern Brazil. This qualitative descriptive-exploratory study was performed using semi-structured interviews, conducted with 15 mothers of children and teenagers with cleft lips and palates of an oral health surveillance program. The data analysis was based on the thematic analysis, which highlights two central themes: facing and overcoming the stigma associated with the physical appearance, and the school as an influence on the oral health of children and teenagers and their development. The school provides children and teenagers with cleft lips and palates with opportunities of social integration, but it also contributes to conflicts generated by the prejudice against their physical appearance. The support of the school community is essential for proper development of quality of life.

El objetivo fue estudiar la influencia de la escuela en la vida e en el cuidado de de niños y adolescentes con fisura labiopalatina atendidos en un centro de referencia en el sur de Brasil. Investigación cualitativa de tipo descriptivo-exploratorio que realizó entrevistas semiestructuradas con 15 madres de niños y adolescentes con fisura labiopalatina de un programa de vigilancia de la salud bucal. El análisis de los datos se fundamentó en el análisis temático, destacando dos temas centrales: Enfrentando y superando los prejuicios relacionados con la malformación, y La escuela como influencia en la salud bucal de los niños y su desarrollo. La escuela trae a los niños y adolescentes con fisura labiopalatina posibilidades de cuidados e inserción social, pero también trae conflictos generados por los prejuicios de su apariencia física. El apoyo de la comunidad escolar es esencial para el desarrollo adecuado con calidad de vida.

In vitro evaluation of force degradation of elastomeric chains used in orthodontics.

OBJECTIVE: To analyze the in vitro force degradation of four different brands of elastomeric chains: American Orthodontics, Morelli, Ormco and TP Orthodontics. METHODS: The sample consisted of 80 gray elastomeric chains that were divided into four groups according to their respective manufacturers. Chain stretching was standardized at 21 mm with initial force release ranging from 300 g to 370 g. The samples were kept in artificial saliva at a constant temperature of 37°C and the degradation force was recorded at the following time intervals: initial, 1, 3, 5, 7 and 9 hours, and 1, 7, 14, 21, 28, and 35 days. RESULTS: There was a statistically significant difference between the groups regarding the force degradation, mainly within the first day, as a force loss of 50-55% was observed during that time in relation to the initial force. The force delivered at 35 days ranged from 122 g to 148 g. CONCLUSIONS: All groups showed force degradation over time, regardless of their trademarks, a force loss of 59-69% was observed in the first hour compared to baseline. However, because the variation in force degradation depends on the trademark, studies such as the present one are important for guiding the clinical use of these materials.

Three-dimensional assessment of buccal alveolar bone after rapid and slow maxillary expansion: a clinical trial study.

INTRODUCTION: The purposes of this study were to analyze and compare the immediate effects of rapid and slow maxillary expansion protocols, accomplished by Haas-type palatal expanders activated in different frequencies of activation on the positioning of the maxillary first permanent molars and on the buccal alveolar bones of these teeth with cone-beam computerized tomography. METHODS: The sample consisted of 33 children (18 girls, 15 boys; mean age, 9 years) randomly distributed into 2 groups: rapid maxillary expansion (n = 17) and slow maxillary expansion (n = 16). Patients in the rapid maxillary expansion group received 2 turns of activation (0.4 mm) per day, and those in the slow maxillary expansion group received 2 turns of activation (0.4 mm) per week until 8 mm of expansion was achieved in both groups. Cone-beam computerized tomography images were taken before treatment and after stabilization of the jackscrews. Data were gathered through a standardized analysis of cone-beam computerized tomography images. Intragroup statistical analysis was accomplished with the Wilcoxon matched-pairs test, and intergroup statistical analysis was accomplished with analysis of variance. Linear relationships, among all variables, were determined by Spearman correlation. RESULTS AND CONCLUSIONS: Both protocols caused buccal displacement of the maxillary first permanent molars, which had more bodily displacement in the slow maxillary expansion group, whereas more inclination was observed in the rapid maxillary expansion group. Vertical and horizontal bone losses were found in both groups; however, the slow maxillary expansion group had major bone loss. Periodontal modifications in both groups should be carefully considered because of the reduction of spatial resolution in the cone-beam computerized tomography examinations after stabilization of the jackscrews. Modifications in the frequency of activation of the palatal expander might influence the dental and periodontal effects of palatal expansion.

Evaluation of mechanical properties of five cements for orthodontic band cementation

The aim of this in vitro study was to compare the flexural, compressive and diametral tensile strengths of five cements used in orthodontics for band cementation. Twelve specimens of each cement were tested: 1 - GC Fuji Ortho Band (FJ), GC America Inc.; 2 - Meron (MR), Voco; 3 - Multi-Cure Glass Ionomer Band Cement (MC), 3M Unitek; 4 - Band-Lok (BL), Reliance Orthodontic Products; and 5 - Ketac Cem (KC), 3M ESPE. The results (mean) for diametral tensile strength were: 10.51 MPa (FJ), 9.60 MPa (MR), 20.04 MPa (MC), 42.80 MPa (BL), and 4.08 MPa (KC). The results for compressive strength were (in the same order): 64.50 MPa, 77.71 MPa, 94.21 MPa, 193.88 MPa, and 81.93 MPa. The results for flexural strength were (in the same order): 20.72 MPa, 25.84 MPa, 53.41 MPa, 137.41 MPa, and 20.50 MPa. The statistical analysis was performed by two-way ANOVA and Tukey tests with p-value £ 0.05. In terms of diametral tensile strength, BL showed the highest strength statistically, and MC, the second highest. In terms of compressive tensile strength, BL showed the highest strength statistically, and FJ did not attain the minimum recommended strength. In terms of flexural tensile strength, BL cement was superior to MC, and MR, FJ and KC were equivalent and inferior to BL and MC.

Combining traditional techniques to correct anterior open bite and posterior crossbite.

The treatment of anterior open bite often requires the use of skeletal anchorage to prevent excessive eruption of the posterior teeth and consequent downward rotation of the mandible. However, this procedure might not always be accomplished. This article reports the successful treatment of an anterior open bite and a posterior crossbite in a young boy, combining traditional techniques and involving high-pull maxillary traction to help growth to correct the skeletal Class II malocclusion without skeletal anchorage. The vertical dentoalveolar contribution of maxillary growth was also favorable to close the bite, whereas cross-elastics corrected the axial inclination of the mandibular posterior teeth, eliminating the inverted posterior crossbite. The open bite was completely closed with edgewise appliances, which also achieved normal overjet, intercuspation, and incisor exposure on smiling. Traditional mechanics for the treatment of open bite and crossbite remain a useful alternative when patients do not accept skeletal anchorage.

Evaluation of mechanical properties of five cements for orthodontic band cementation.

The aim of this in vitro study was to compare the flexural, compressive and diametral tensile strengths of five cements used in orthodontics for band cementation. Twelve specimens of each cement were tested: 1 - GC Fuji Ortho Band (FJ), GC America Inc.; 2 - Meron (MR), Voco; 3 - Multi-Cure Glass Ionomer Band Cement (MC), 3M Unitek; 4 - Band-Lok (BL), Reliance Orthodontic Products; and 5 - Ketac Cem (KC), 3M ESPE. The results (mean) for diametral tensile strength were: 10.51 MPa (FJ), 9.60 MPa (MR), 20.04 MPa (MC), 42.80 MPa (BL), and 4.08 MPa (KC). The results for compressive strength were (in the same order): 64.50 MPa, 77.71 MPa, 94.21 MPa, 193.88 MPa, and 81.93 MPa. The results for flexural strength were (in the same order): 20.72 MPa, 25.84 MPa, 53.41 MPa, 137.41 MPa, and 20.50 MPa. The statistical analysis was performed by two-way ANOVA and Tukey tests with p-value £ 0.05. In terms of diametral tensile strength, BL showed the highest strength statistically, and MC, the second highest. In terms of compressive tensile strength, BL showed the highest strength statistically, and FJ did not attain the minimum recommended strength. In terms of flexural tensile strength, BL cement was superior to MC, and MR, FJ and KC were equivalent and inferior to BL and MC.

In vitro evaluation of force degradation of elastomeric chains used in Orthodontics

OBJECTIVE: To analyze the in vitro force degradation of four different brands of elastomeric chains: American Orthodontics, Morelli, Ormco and TP Orthodontics. METHODS: The sample consisted of 80 gray elastomeric chains that were divided into four groups according to their respective manufacturers. Chain stretching was standardized at 21 mm with initial force release ranging from 300 g to 370 g. The samples were kept in artificial saliva at a constant temperature of 37°C and the degradation force was recorded at the following time intervals: initial, 1, 3, 5, 7 and 9 hours, and 1, 7, 14, 21, 28, and 35 days. RESULTS: There was a statistically significant difference between the groups regarding the force degradation, mainly within the first day, as a force loss of 50-55% was observed during that time in relation to the initial force. The force delivered at 35 days ranged from 122 g to 148 g. CONCLUSION: All groups showed force degradation over time, regardless of their trademarks, a force loss of 59-69% was observed in the first hour compared to baseline. However, because the variation in force degradation depends on the trademark, studies such as the present one are important for guiding the clinical use of these materials.

OBJETIVO: analisar, in vitro, a degradação de força, ao longo do tempo, de elastômeros das marcas comerciais American Orthodontics, Morelli, Ormco e TP Orthodontics. MÉTODOS: a amostra constituiu-se de 80 segmentos de elastômeros em cadeia fechada na cor cinza, divididos em quatro grupos, conforme o fabricante. A distensão foi padronizada em 21mm, com liberação de força inicial variando de 300 a 370g de força. As amostras foram mantidas em saliva artificial em temperatura constante de 37ºC, e a força avaliada nos seguintes intervalos: inicial, 1h, 3h, 5h, 7h, 9h, 1 dia, 7 dias, 14 dias, 21 dias, 28 dias e 35 dias. RESULTADOS: houve diferença estatisticamente significativa na degradação de força entre os grupos avaliados, sendo que no primeiro dia houve perda de 50 a 55% em relação à força inicial. Os valores médios de força em 35 dias variaram de 122 a 148g. CONCLUSÃO: todas as marcas comerciais apresentaram degradação de força ao longo do tempo, sendo que na primeira hora a perda de força esteve entre 59 e 69% da força inicial. Porém, como existe variação dessa degradação dependendo da marca comercial, estudos como esses são importantes para orientação do uso desses elastômeros.

Angle Class II, division 2 malocclusion with pronounced overbite

Angle Class II, division 2, malocclusion is characterized by a Class II molar relation associated with retroclined or vertical positioning of the upper incisors and in general an overbite. This clinical case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as part of the requirements for becoming a BBO Diplomate .

A má oclusão de Classe II divisão 2 de Angle é caracterizada pela relação molar de Classe II associada a um posicionamento vertical ou retroinclinado dos incisivos superiores e, geralmente, a uma sobremordida exagerada. O presente caso clínico foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO) como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

Ideal treatment protocol for cleft lip and palate patient from mixed to permanent dentition.

A girl with an Angle Class III malocclusion, anterior and posterior crossbites, a concave profile, and cleft lip and palate sought orthodontic treatment. She was treated with a multidisciplinary therapeutic protocol including orthodontic and surgical procedures. The proposed objectives of occlusion, normal function, and balanced profile were achieved, and these results remained stable 4 years after the treatment.

Avaliação dos efeitos de três métodos de remoção da resina remanescente do braquete na superfície do esmalte / Effects evaluation of remaining resin removal (three modes) on enamel surface after bracket debonding

INTRODUÇÃO: é fundamental, para alcançar a correta técnica de descolagem, a seleção adequada do instrumental para remover o braquete e a resina remanescente. OBJETIVO: avaliar a superfície do esmalte com Microscópio Eletrônico de Varredura (MEV) após a utilização de três métodos de remoção da resina remanescente da descolagem do braquete. MÉTODOS: foram selecionados 18 incisivos bovinos, divididos em três grupos (A, B e C), contendo 6 dentes cada. Previamente à colagem do braquete, os dentes foram moldados com silicone de adição e preenchidos com resina epóxi, para o registro das características do esmalte, assim formando o Grupo Controle. Os métodos de remoção da resina remanescente utilizados foram: Grupo A - Soflex granulações grossa e média; Grupo B - broca Carbide em baixa rotação; Grupo C - broca Carbide em alta rotação. Polimento com Soflex granulações fina e ultrafina no Grupo A, pontas de borracha nos grupos B e C, e pasta de polimento para esmalte nos três grupos. Após cada etapa de remoção da resina remanescente e polimento, os dentes foram novamente moldados, duplicados e as réplicas analisadas em MEV. Foram, então, comparadas as características do esmalte inicial (Grupo Controle) com o aspecto do esmalte após as etapas de remoção de resina, assim possibilitando avaliar o método que gerou menor abrasão ao esmalte. RESULTADOS E CONCLUSÃO: a remoção do remanescente adesivo com broca Carbide multilaminada em baixa rotação, polimento com pontas de borracha, e polimento final com pasta de polimento é o procedimento que ocasiona menor dano ao esmalte.

INTRODUCTION: An appropriate selection of instruments is essential to perform a correct debonding technique, by properly removing orthodontic brackets and the remaining resin.OBJECTIVE: The aim of this study was to evaluate three methods of remaining resin removal on enamel surface after bracket debonding, by means of Scanning Electron Microscopy (SEM).METHODS: Eighteen bovine incisors were selected and divided into three groups (A, B and C) of six teeth each. Before bracket bonding, epoxy resin casts were obtained by impression of the teeth with addition silicon, in order to register baseline enamel characteristics and representing the control group. The methods for remaining resin removal were: Group A - gross and medium granulation Soflex discs; Group B - carbide bur in low-speed; Group C - carbide bur in high-speed. Soflex polishing system fine and ultrafine granulation discs were used for Group A, rubber tips for Groups B and C, and polishing paste for all groups. After polishing, impression of teeth were taken and casts were analyzed by means of SEM. The baseline enamel characteristics (Control Group) were compared to the final aspect of enamel to determine the method that generated less enamel abrasion.RESULTS AND CONCLUSION: The remaining resin removal by carbide bur in low-rotation, and enamel polished with rubber tips followed by polishing paste produced the smaller damage to the enamel.

Expansão maxilar rápida X expansão maxilar lenta: considerações clínicas / Rapid maxillary expansion X Slow maxillary: clinical considerations

A recuperação da discrepância transversal da maxila mostra-se indispensável para o tratamento adequado de diversos tipos de má oclusão. Diferentes aparelhos expansores têm sido descritos na literatura com a finalidade de expandir a maxila, sendo que esses podem resultar em expansão maxilar lenta (EML) ou rápida (EMR). O objetivo deste trabalho é discutir as considerações clínicas da EML e da EMR. Os dois pacientes avaliados utilizaram expansor fixo como preconizado por Haas, porém, foram submetidos a diferentes protocolos de ativação. Apesar das diferenças clínicas apresentadas, tanto a EMR quanto a EML mostraram-se eficientes na correção da mordida cruzada posterior na dentição mista.

Análise da expansão rápida da maxila por meio da tomografia computadorizada Cone-Beam / Analysis of rapid maxillary expansion using Cone-Beam computed tomography

Diante do diagnóstico de uma arcada maxilar esqueleticamente atrésica, o tratamento de escolha geralmente é a expansão ortopédica da maxila, envolvendo a separação da sutura palatina mediana. A avaliação dessa sutura era basicamente realizada por meio da radiografia oclusal superior, limitando sua análise em norma frontal. Da mesma forma, quantificar essa atresia radiograficamente nas telerradiografias cefalométricas sempre foi um obstáculo para o clínico, devido à grande sobreposição das estruturas faciais. O advento da tomografia computadorizada na Odontologia tem transformado a forma de diagnóstico devido à alta precisão na avaliação das dimensões das estruturas faciais, possibilitando quantificar de maneira fiel o comportamento das hemimaxilas, a inclinação dentária, a formação óssea na sutura nos três planos do espaço, assim como a reabsorção óssea alveolar e demais consequências da expansão palatina.

Whenever a maxillary arch is diagnosed as skeletally atresic the treatment of choice is usually maxillary orthopedic expansion, involving separation of the midpalatal suture. Basically, this suture used to be assessed with the aid of a maxillary occlusal radiograph, which limited its posteroanterior evaluation. Similarly, quantifying this atresia in cephalometric x-rays always posed an obstacle for clinicians owing to considerable superimposition of facial structures. With the advent of computed tomography, this technology has revolutionized diagnostic methods in dentistry because it provides high dimensional accuracy of the facial structures and a reliable method for quantifying the behavior of the maxillary halves, tooth inclination, bone formation at the suture in the three planes of space, as well as alveolar bone resorption and other consequences of palatal expansion.

Alimentação na primeira infância: abordagempara a promoção da saúde bucal / Feeding in infancy: approach for oral healthpromotion

Introdução e objetivo: Apresentar ao cirurgião-dentista informaçõesatualizadas pertinentes a uma dieta saudável na primeira infância,já que os hábitos alimentares podem ter influência direta na saúdebucal dos pacientes, correlacionada por sua vez com a saúde geral.Revisão de literatura: Diante do paradigma de promoção da saúde eda necessidade de interação entre a Odontologia e as demais áreas dasaúde e visando ao bem-estar e à qualidade de vida, o artigo discorre arespeito da alimentação do paciente pediátrico de acordo com a épocaideal para a introdução de novos alimentos, ou seja, a alimentaçãocomplementar. Conclusão: Desse modo, o profissional terá condiçõesde oferecer opções de alimentos no aconselhamento dietético a paise/ou responsáveis por pacientes na faixa etária de 0 a 3 anos.

Introduction and objective: The purpose of this article is to presentupdated information on healthy diet in infancy to dentists, since feedinghabits may directly affect patients? oral and general health. Literaturereview: Considering the health promotion paradigm and the needof interaction between dentistry and other health s, aiming tolife quality and welfare, the article reports on the pediatric patientfeeding according to the ideal time for introducing new foods, thatis, complementary feeding. Conclusion: Therefore, clinicians will beable to provide food options when performing nutrition counseling forparents and/or guardians of 0- to 3-year-old patients.