Abordagem ortodôntica na correção da classe III com mordida aberta anterior com osteotomia sagital mandibular e mentoplastia – caso clínico / Orthodontic approach in class III correction associated to open bite with sagittal mandibular osteotomy and mentoplasty – case report

O presente trabalho tem a finalidade de relatar um caso orto-cirúrgico de uma paciente com má oclusão do tipo Classe III associada a uma mordida aberta anterior. O plano de tratamento foi estabelecido em quatro fases, a pré-cirúrgica, a transcirúrgica, a pós-cirúrgica e a fase de contenção. Após o diagnóstico, todas as metas do tratamento foram estabelecidas e discutidas de maneira conjunta entre o ortodontista e o cirurgião bucomaxilofacial. Na fase pré-cirúrgica foram feitos todos os procedimentos para a descompensação dentária em ambos os maxilares. O procedimento cirúrgico consistiu na rotação anti-horária da mandíbula por meio da osteotomia sagital do ramo mandibular juntamente com mentoplastia. Na fase transoperatória foi conseguida a intercuspidação dentária com obtenção de um trespasse vertical e horizontal adequados pelo ato cirúrgico e por procedimentos fisioterápicos até que fosse retomada a função ideal do sistema estomatognático. Após esta fase, a paciente retornou à clínica ortodôntica para que fosse submetida aos procedimentos de finalização. Foi colocada uma contenção superior e inferior.

The present study aims to report an ortho-surgical case of a patient with Class III malocclusion associated with an anterior open bite. The treatment plan was established in four phases, the pre-surgical, trans-surgical, post-surgical and the retention phase. After the diagnosis, all treatment goals were established and discussed jointly between the orthodontist and maxillofacial surgeon. At pre-surgical phase all procedures for dental decompensation were performed in both jaws. The surgical procedure consisted on a counterclockwise rotation of the mandible by sagittal osteotomy of the mandibular ramus with mentoplasty. At transoperative dental intercuspation was achieved through vertical and horizontal overlap suitable for surgery and physiotherapy procedures until this resume optimal function of the stomatognathic system. After this phase, the patient returned to the clinic to complete the procedure. An upper and lower retainer was placed.

Alterações nas dimensões dos arcos dentários em pacientes com classe II, primeira divisão, tratados com AEB / Changes in dental arch dimensions in patients with class II, division 1, malocclusion treated with headgear

O objetivo deste estudo foi avaliar as possíveis alterações nas larguras intercaninos e intermolares, e no comprimento dos arcos dentários, em modelos de gesso, de pacientes submetidos ao tratamento ortodôntico com aparelho extrabucal (AEB). Para isso, foram selecionados 12 pares de modelos em gesso de pacientes com classe II, primeira divisão, antes e após o tratamento com AEB, totalizando 24 pares de modelos. As medidas da distância intermolares e intercaninos foram obtidas por meio de um paquímetro digital com precisão de 0,000 mm. Os resultados demonstraram aumento estatisticamente significante nas distâncias intermolares superiores. Não ocorreram diferenças estatisticamente significantes nas distâncias intercaninos e nos comprimentos dos arcos dentários. Concluiu-se que no tratamento ortodôntico com AEB em pacientes classe II, primeira divisão, na dentição mista, pode-se esperar um aumento significativo nas distâncias intermolares superiores...

The aim of this study was to evaluate possible changes in the intermolar distance, intercanine distance and arch length, through dental casts, of patients undergoing orthodontic treatment with headgear. To that end, we selected 12 pairs of dental casts of patients with class II, division 1 before and after treatment with headgear, totaling 24 pairs of dental casts. The measures of intermolar and intercanine distances were performed on casts with digital calipers accurate to 0.000 mm. The results showed a statistically significant increase in the upper intermolar distances. There were no statistically significant differences in the intercanine distances and dental arches lengths. It was concluded that orthodontic treatment with headgear in class II, division 1 patients, in mixed dentition we can expect a significant increase in the upper intermolar distances...

Comparação in vitro da resistência ao cisalhamento na interface "PAD" de resina/esmalte dentário / Shear strength in vitro comparison in the "PAD" interface of dental resin/enamel

Objetivo: o presente estudo comparou a resistência ao cisalhamento na interface ?pad? de resina/esmalte dentário em três materiais comumente utilizados para a colagem de bráquetes linguais. Materiais e método: foram elaborados 45 corpos de prova com incisivos bovinos inclusos em resina composta Transbond XT (3M Unitek, Monrovia, USA) para simulação dos ?pads?, os quais foram divididos em três grupos: Grupo I ? a colagem com a resina Sondhi Rapid Set (3M Unitek, Monrovia, USA); Grupo II - a colagem com o selante Maximum Cure (Reliance Orthodontics Products, Itasca, USA); Grupo III ? a colagem com a resina Natural Flow (Dfl, Ind e Com., Rio de Janeiro, Brasil). Após a colagem, os corpos de prova foram armazenados em água destilada em uma temperatura média de 37 °C por 24 horas. Em seguida, foram submetidos a ensaio de resistência ao cisalhamento em máquina universal de ensaios a uma velocidade de 0,5mm/minuto. Os dados foram submetidos à Análise de Variância, e as médias ao teste de Tukey (5%). Resultados: os valores médios de resistência ao cisalhamento foram 17,28 Mpa para o Grupo I, 18,63 Mpa para o Grupo II e 24,33 Mpa para o grupo III. Os resultados encontrados para o Grupo III foram estatisticamente superiores aos grupos I e II, que não apresentaram diferenças estatísticas entre si. Conclusões: a resina Natural Flow apresentou a maior resistência ao cisalhamento entre os três materiais testados, seguida pelo selante Maximum Cure e a resina Sondhi Rapid Set respectivamente; todos os materiais testados apresentaram resistência ao cisalhamento adequada para suprir as necessidades clínicas.

Tratamento da mordida aberta anterior com a utilização do gancho J / Treatment of open bite using J hook

O presente artigo tem a finalidade de relatar um caso clínico de uma paciente afro-brasileira, dolicofacial, 18 anos de idade, com mordida aberta anterior (MAA) dentoalveolar associada ao hábito de sucção digital. O tratamento ortodôntico consistiu na colocação de um aparelho ortodôntico fixo com bráquetes Edgewise e controle vertical com o uso do Gancho J com puxada alta somente na arcada inferior, com a finalidade de rotação anti-horária da mandíbula e o consequente fechamento da mordida. Simultaneamente, a paciente foi encaminhada para tratamento fonoaudiológico. O tratamento foi finalizado com êxito ao final de 36 meses com a correção da MAA havendo melhora das relações vertical e sagital entre a maxila e a mandíbula, obtenção de estética, equilíbrio e harmonia facial, além das características oclusais e funcionais. Assim, foi possível concluir que após a remoção do hábito de sucção digital é necessário que seja feita uma intervenção multidisciplinar que, neste caso, consistiu numa intervenção ortodôntica associada a um acompanhamento fonoaudiológico. Além disto, o uso de um extrabucal, colocado diretamente no aparelho ortodôntico na arcada inferior (Gancho J) foi primordial no fechamento da mordida, pois houve um controle vertical, o que proporcionou uma rotação mandibular no sentido anti-horário e o consequente fechamento da mordida.

This article aims to report a case of an Afro-Brazilian patient, dolicofacial, 18 years of age, with open bite dentoalveolar associated with digit sucking habit. Orthodontic treatment consisted on a fixed orthodontic appliance with edgewise brackets and vertical control using the J hook with high pull only in the lower jaw for the purpose of anti-clockwise rotation of the mandible and the consequent closing of the bite. Simultaneously, the patient was referred for speech therapy. The treatment was completed successfully at the end of 36 months with the correction of open bite with an improvement of vertical and sagittal relations between the maxilla and the mandible obtaining facial aesthetics and harmony besides the occlusal and functional characteristics. Thus, it was concluded that after breaking digit habit, a multidisciplinary intervention is required.In this case it consisted on an orthodontic intervention associated with a speech therapist. In addition, the use of a headgear placed directly on the archwire, the lower arch in the case was the J hook, was paramount in closing the bite because there was a vertical control which provided a mandibular rotation in a counterclockwise direction and the consequent closing of the bite

Aplicações do “gancho J” durante o tratamento ortodôntico / Use of “J-hook” during orthodontic treatment

O gancho “J” auxilia no redirecionamento das forças resultantes em sentido anti-horário, geradas durante o tratamento ortodôntico e pode ser aplicado diretamente sobre os dentes ou sobre ganchos soldados nos arcos metálicos, conforme a indicação ou a fase do tratamento ortodôntico. O objetivo do aparelho extrabucal gancho “J” é controlar rotações dos planos palatino, oclusal e mandibular que podem ocorrer durante o tratamento ortodôntico corretivo. O gancho “J” possui também aplicações clínicas específicas, tais como controle e correção do trespasse vertical, distalização de molares e caninos, retração em massa dos incisivos superiores e/ou inferiores, fechamento de mordida e/ou manutenção da posição dos incisivos mandibulares. Dentro deste contexto, o presente trabalho mostrará as possibilidades ortodônticas da utilização do gancho “J”, bem como as etapas para a sua elaboração.

The “J-hook” assists the redirection in anti-clockwise direction of resultant forces generated during orthodontic treatment, and can be applied directly on the teeth or hooks welded on the metal arches according to prescription or stage of the orthodontic treatment. The goal of the “J-hook” headgear is to control rotations of palatal occlusal and mandibular plans that may occur during orthodontic treatment. The “J-hook” also has specific clinical applications, such as control and correction of overbite, distalization of molars and canines, mass retraction of the upper/lower incisors, closing bite, maintenance of the position of mandibular incisors. Within this context, this work will present orthodontic possibilities of using “J-hook” and the steps for its preparation.

Expectations of orthodontic treatment in adults: the conduct in orthodontist/patient relationship.

INTRODUCTION: The high demand for orthodontic treatment, evidenced over the last few decades, has been justified mainly by the greater importance given to facial esthetics, influencing individual's self esteem. However, the professional frequently does not meet all the patient's expectations, for not establishing good communication and not knowing about the critical points during orthodontic treatment. OBJECTIVE: The aim of this study was to elucidate patients' desires and doubts regarding orthodontic treatment, by means of a survey applied to 60 adult patients. RESULTS: The analysis of results revealed that most individuals (38.3%) noticed treatment success after its conclusion. Occlusion deviation was pointed out by 66.7% as the main reason for seeking treatment, and esthetics ranked as second (with 48.3%). Treatment time was considered within the prediction by 46.7% of the interviewees and the results were judged as very good by 43.3%. The social relations of most participants were not affected by treatment (73.3%). Also, 58.3% of the interviewees reported pain as the main complaint and 53.3% found it difficult to use dental floss. Most participants saw the orthodontist as a professional who was concerned about their health (76.7%), and believed that he/she was more able to treat them (96.6%) when compared with the general practitioner. CONCLUSIONS: The orthodontist/patient relationship enables an understanding of the expectations regarding orthodontic treatment, resulting in greater motivation and cooperation, leading to a successful outcome.

Expectations of orthodontic treatment in adults: the conduct in orthodontist/patient relationship

INTRODUCTION: The high demand for orthodontic treatment, evidenced over the last few decades, has been justified mainly by the greater importance given to facial esthetics, influencing individual's self esteem. However, the professional frequently does not meet all the patient's expectations, for not establishing good communication and not knowing about the critical points during orthodontic treatment. OBJECTIVE: The aim of this study was to elucidate patients' desires and doubts regarding orthodontic treatment, by means of a survey applied to 60 adult patients. RESULTS: The analysis of results revealed that most individuals (38.3 %) noticed treatment success after its conclusion. Occlusion deviation was pointed out by 66.7 % as the main reason for seeking treatment, and esthetics ranked as second (with 48.3 %). Treatment time was considered within the prediction by 46.7% of the interviewees and the results were judged as very good by 43.3 %. The social relations of most participants were not affected by treatment (73.3 %). Also, 58.3 % of the interviewees reported pain as the main complaint and 53.3 % found it difficult to use dental floss. Most participants saw the orthodontist as a professional who was concerned about their health (76.7 %), and believed that he/she was more able to treat them (96.6 %) when compared with the general practitioner. CONCLUSION: The orthodontist/ patient relationship enables an understanding of the expectations regarding orthodontic treatment, resulting in greater motivation and cooperation, leading to a successful outcome.

INTRODUÇÃO: a elevada procura por tratamentos ortodônticos, evidenciada nas últimas décadas, justifica-se principalmente pela maior importância à estética facial, influenciando a autoestima do indivíduo. Entretanto, muitas vezes o profissional não atinge todas as expectativas esperadas pelo paciente, por não estabelecer uma correta comunicação e conhecer os pontos críticos durante o tratamento ortodôntico. OBJETIVO: esse estudo objetivou elucidar os anseios e dúvidas de pacientes em relação ao tratamento ortodôntico por meio da aplicação de questionário a 60 pacientes adultos. RESULTADOS: a análise dos resultados revelou que a maioria dos indivíduos (38,3%) percebeu êxito após a finalização da terapêutica. O desvio da oclusão foi apontado por 66,7% como principal motivo de procura pelo tratamento, e, em segundo lugar, 48,3% pela estética. O tempo de tratamento foi considerado dentro do previsto por 46,7% dos entrevistados e os resultados foram julgados como muito bons para 43,3%. As relações sociais da maioria dos participantes não foram afetadas pelo tratamento (73,3%), sendo que 58,3% dos entrevistados relataram a dor como queixa principal, e 53,3% encontraram dificuldades no uso do fio dental. A maioria dos participantes vê o ortodontista como um profissional preocupado com sua saúde (76,7%), e acredita que é mais apto em relação ao clínico-geral para tratá-los (96,6%). CONCLUSÃO: o vínculo entre profissional e paciente possibilita compreender as expectativas em relação ao tratamento ortodôntico, resultando em maior motivação, cooperação e sucesso do tratamento.

Clinical evaluation of the failure rates of metallic brackets.

OBJECTIVES: The aim of this study was to evaluate in vivo the bonding of metallic orthodontic brackets with different adhesive systems. MATERIAL AND METHODS: Twenty patients (10.5-15.1 years old) who had sought corrective orthodontic treatment at a University Orthodontic Clinic were evaluated. Brackets were bonded from the right second premolar to the left second premolar in the upper and lower arches using: Orthodontic Concise, conventional Transbond XT, Transbond XT without primer, and Transbond XT associated with Transbond Plus Self-etching Primer (TPSEP). The 4 adhesive systems were used in all patients using a split-mouth design; each adhesive system was used in one quadrant of each dental arch, so that each group of 5 patients received the same bonding sequence. Initial archwires were inserted 1 week after bracket bonding. The number of bracket failures for each adhesive system was quantified over a 6-month period. RESULTS: The number of debonded brackets was: 8--Orthodontic Concise, 2--conventional Transbond XT, 9--Transbond XT without primer, and 1--Transbond XT + TPSEP. By using the Kaplan-Meier methods, statistically significant differences were found between the materials (p=0.0198), and the Logrank test identified these differences. Conventional Transbond XT and Transbond XT + TPSEP adhesive systems were statistically superior to Orthodontic Concise and Transbond XT without primer (p<0.05). There was no statistically significant difference between the dental arches (upper and lower), between the dental arch sides (right and left), and among the quadrants. CONCLUSIONS: The largest number of bracket failures occurred with Orthodontic Concise and Transbond XT without primer systems and few bracket failures occurred with conventional Transbond XT and Transbond XT+TPSEP. More bracket failures were observed in the posterior region compared with the anterior region.

Clinical evaluation of the failure rates of metallic brackets

OBJECTIVES: The aim of this study was to evaluate in vivo the bonding of metallic orthodontic brackets with different adhesive systems. MATERIAL AND METHODS: Twenty patients (10.5-15.1 years old) who had sought corrective orthodontic treatment at a University Orthodontic Clinic were evaluated. Brackets were bonded from the right second premolar to the left second premolar in the upper and lower arches using: Orthodontic Concise, conventional Transbond XT, Transbond XT without primer, and Transbond XT associated with Transbond Plus Self-etching Primer (TPSEP). The 4 adhesive systems were used in all patients using a split-mouth design; each adhesive system was used in one quadrant of each dental arch, so that each group of 5 patients received the same bonding sequence. Initial archwires were inserted 1 week after bracket bonding. The number of bracket failures for each adhesive system was quantified over a 6-month period. RESULTS: The number of debonded brackets was: 8- Orthodontic Concise, 2- conventional Transbond XT, 9- Transbond XT without primer, and 1- Transbond XT + TPSEP. By using the Kaplan-Meier methods, statistically significant differences were found between the materials (p=0.0198), and the Logrank test identified these differences. Conventional Transbond XT and Transbond XT + TPSEP adhesive systems were statistically superior to Orthodontic Concise and Transbond XT without primer (p<0.05). There was no statistically significant difference between the dental arches (upper and lower), between the dental arch sides (right and left), and among the quadrants. CONCLUSIONS: The largest number of bracket failures occurred with Orthodontic Concise and Transbond XT without primer systems and few bracket failures occurred with conventional Transbond XT and Transbond XT+TPSEP. More bracket failures were observed in the posterior region compared with the anterior region.

Resistência ao cisalhamento da colagem com compósitos utilizando potencializador de adesão / Shear bond strength of composites using an adhesion booster

OBJETIVO: avaliar a resistência ao cisalhamento dos compósitos Transbond XT e Concise Ortodôntico utilizando o potencializador de adesão Ortho Primer. MÉTODOS: a amostra consistiu de 90 incisivos bovinos divididos em seis grupos (n=15). Todos os dentes receberam profilaxia com pedra-pomes e condicionamento do esmalte com ácido fosfórico. No Grupo I, utilizou-se Transbond XT de maneira convencional. O Grupo II foi semelhante ao I, porém, aplicou-se o Ortho Primer ao invés do XT Primer. No Grupo III, após condicionamento, o esmalte foi contaminado com saliva, aplicou-se o Ortho Primer e colagem com Transbond XT. No Grupo IV, utilizou-se o Concise Ortodôntico de maneira convencional. O Grupo V foi semelhante ao IV, porém, utilizou-se o Ortho Primer ao invés da resina fluida. No Grupo VI, após condicionamento, o esmalte foi contaminado com saliva, aplicou-se o Ortho Primer e colagem com Concise. Os corpos de prova foram armazenados em água destilada em estufa a 37ºC por 24h e submetidos ao ensaio de resistência ao cisalhamento. Os dados foram submetidos à ANOVA e ao teste de Tukey (5 por cento). RESULTADOS: a resistência da colagem no Grupo IV foi estatisticamente superior à dos Grupos II, III e VI (p<0,05). Entre os Grupos I, IV e V; e entre os Grupos I, II, III e VI não foram encontradas diferenças estatísticas significativas (p>0,05). O Transbond XT e o Concise utilizados convencionalmente obtiveram os maiores valores adesivos. O Ortho Primer em esmalte seco atuou efetivamente como agente de união dos compósitos avaliados. Em esmalte contaminado, a colagem com Concise obteve baixa resistência adesiva.

OBJECTIVE: To evaluate the shear strength of two composites (Transbond XT and Concise) using an adhesion booster (Ortho Primer).METHODS: The sample consisted of 90 bovine incisors divided into six groups (n=15). All teeth were subjected to prophylaxis with pumice and enamel etching with phosphoric acid. Transbond XT was used conventionally in Group I. Group II was handled similarly to Group I, except that Ortho Primer was applied instead of XT Primer. After etching, the enamel in Group III was contaminated with saliva, Ortho Primer was then applied and bonding performed using Transbond XT. In Group IV, Concise was used conventionally. Group V was handled similarly to Group IV, except that Ortho Primer was applied instead of the fluid resin. After etching, the enamel in Group VI was contaminated with saliva, Ortho Primer was then applied and bonding performed using Concise. The specimens were stored in distilled water at 37 ºC for 24 hours and subjected to shear strength testing. Data were analyzed with ANOVA and Tukey's test (5%).RESULTS: Bond strength in Group IV was statistically higher than in Groups II, III and VI (p<0.05). No statistically significant differences were found among Groups I, IV and V, and between I, II, III and VI (p>0.05). When used conventionally, both Transbond XT and Concise yielded the highest bond strength values. When applied to dry enamel, Ortho Primer acted effectively as a bonding agent for the composites under evaluation. When applied to contaminated enamel, Concise yielded low bond strength.

Correlação entre a análise de Carrea e as dimensões intra-arcos de Nouer em crianças com dentição decídua clinicamente normal / Correlation between morphological analyses and intra-arch dimensions in child with deciduous dentition clinically normal

O objetivo deste estudo foi avaliar a forma do arco dentário decíduo, verificando a correlação com as dimensões intra-arcos. Foram avaliados modelos de gesso de 30 crianças leucodermas de três a cinco anos, com dentição decídua completa, hígida, oclusão clinicamente normal e ausência de hábitos bucais deletérios, sendo que as crianças foram divididas por gênero. Foram utilizadas a análise de Carrea (1920) e as medidas intra-arcosde Nouer (1982): perímetro, comprimento total do arco e dos segmentos anterior e posteriore distâncias intermolares e intercaninos. Os dados demonstraram que o triângulo equilátero (ABC) descrito por Carrea foi observado em apenas 80% e 53,3% dos modelos superiores e em 40% e 20% dos modelos inferiores, nos meninos e meninas, respectivamente. Nosdemais casos foram encontrados triângulos isósceles. A coincidência entre a medida do perímetro do segundo molar inferior e a distância entre os segundos molares superiores, como Carrea afirmou existir, foi observada em apenas 30% da amostra. As correlaçõesentre as medidas dos triângulos e as dimensões intra-arcos foram analisadas por meio da correlação de Pearson (p < 0,05) e foram significativas entre a base dos triângulos (BC) e as distâncias intermolares (superior r = 0,90 e inferior r = 0,72) e entre BC e as distâncias intercaninos (superior r = 0,75 e inferior r = 0,64). Além disso, também houve correlaçãosignificativa entre os lados dos triângulos (AB e AC) e o perímetro dos arcos (superior r =0,70 e inferior r = 0,80). Concluiu-se que a análise de Carrea deve ser utilizada criteriosamente, associando-a com mensurações intra-arcos, como as de Nouer, para uma correta avaliação da dentição decídua.

The aim of this study was to evaluate the deciduous dental arch form, verifyingthe correlation with the intra-arch dimensions. It was evaluated dental casts of the 30 Caucasian children, aged between 3 and 5 years with complete deciduous dentition, without caries,normal occlusion and absence of deleterious oral habit, they were divided by gender. It was used the Garrea (1920) analyses and the intra-arch measurements by Nouer (1982): perimeter, arch total, anterior and posterior length, and the inter-molar and inter-canine distances. The data showed that the equilateral triangle (ABG) was observed in just 80% and 53.3% of theupper casts, and in 40% and 20% of the lower cast, on boys and girls, respectively. In the other cases, it was observed isosceles triangles. The coincidence between the second lowermolar perimeter and the second upper molar distances, according to Garrea affirmative, was observed injust 30% of this data. The correlation between the measurements of the trianglesand the intra-arch dimensions were analyzed by Pearson correlation (p < 0.05) and they were significant between the triangle bases (BG) and the inter-molar distances (upper r = 0.90 andlower r = 0.72), and between BG and the inter-canines distances (upper r = 0.75 and lower r = 0.64). Besides that, it was found significant correlation between the triangles sides (AB and AG) and the arch perimeters (upper r = 0.70 and lower r = 0.80). It was conclude thatthe Garrea analyses must be used with criteria and associated with intra-arch measurements, as Nouer's one, for a correct evaluation of the deciduous dentition.

Avaliação do espaço na dentição mista por meio da análise de Moyers e de Tanaka-Johnston / Evaluation of the space in the mixing dentition based on the analysis of Moyers and Tanaka-Johnston

A análise do espaço na dentição mista é um aspecto importante no diagnóstico e planejamento ortodôntico, permitindo determinar se o tratamento irá envolver extrações seriadas, orientação quanto à sequência de erupção, manutenção de espaço, recuperação de espaço, ou apenas observação periódica do paciente. Em vista, disto inúmeros métodos têm sido propostos visando à previsão da largura mesiodistal de caninos e pré-molares não irrompidos, dentre eles, e talvez os mais utilizados recentemente, estão os métodos de Moyers e de Tanaka-Johnston. Esta pesquisa teve a finalidade de avaliar a aplicabilidade destes dois métodos em uma população de adolescentes brasileiros da região de Piracicaba (SP) verificando qual seria a melhor maneira de previsão nesse caso. Foram realizadas mensurações diretas dos incisivos centrais e laterais inferiores, caninos e pré-molares de ambas as arcadas em modelos de gesso de 40 pacientes com idade média de 12 anos, provenientes de arquivos da área de Ortodontia da FOP/Unicamp. Tendo-se em mãos tais medidas, foram calculadas as respectivas diferenças entre a largura mesiodistal real dos caninos permanentes e pré-molares e a prevista segundo as análises de Moyers e de Tanaka-Jhonston. A análise de Tanaka-Johnston mostrou que essa pode ser utilizada nessa população, exceto para a arcada inferior do gênero feminino onde superestimou os resultados em cerca de 0,8mm; além disso, a análise de Moyers demonstrou que os níveis de probabilidade a serem utilizados para essa população são os de 75% para a arcada inferior e 95% para a arcada superior, em ambos os gêneros.

The analysis of the space in the mixing dentition is an important aspect in the diagnosis and orthodontic planning, allowing to determine if the treatment will go to involve serial extractions, orientation of eruption, maintenance of space, recovery of space, or only periodic comment of the patient. In sight of this innumerable method they have been considered aiming at the forecast of the mesiodistal width of tooth’s and premolars not burst, amongst them, and perhaps the most used recently, they are the methods of Moyers and Tanaka- Johnston. This research had as purpose to evaluate the applicability of these two methods in a population of Brazilian adolescents of the region of Piracicaba (SP) and to determine which would be better way of forecast in this case. Direct measurements of the incisors had been carried through inferior, canine and premolars of both the arches in plaster models of 40 patients with average age of 12 years, proceeding from archives of the Orthodontics Department of the FOP/Unicamp. Having in hands these measures, the respective differences between real the mesiodistal width of the permanent and daily pay-molar teeth according to the analyses of Moyers and Tanaka-Johnston had been calculated. The analysis of Tanaka-Johnston showed that this can be used in this population, except for the lower arches of the female group where it overestimated the results in about 0,8mm; moreover, the analyses of Moyers had demonstrated that the probability levels that must be used for this population are of 75% for inferior arches and 95% for the superior arches, in both sexes.

Shear bond strength of metallic brackets bonded with a new orthodontic composite

Aim: The aim of this study was to assess the shear bond strength of orthodontic brackets in different enamel surfaces using the Transbond Plus Color Change composite (TPCC-3M Unitek), and to analyze the Adhesive Remnant Index (ARI). Methods: Seventy-two human premolars were divided into six groups (n = 12), as follows: Group 1(control) - Transbond XT conventional; in Groups 2 to 6, TPCC was used under the following enamel treatment conditions: phosphoric acid and XT-primer; Transbond Plus Self-Etching Primer (TPSEP); phosphoric acid only; phosphoric acid, XT-primer and saliva; and TPSEP and saliva, respectively. Twenty-four hours after bonding, the brackets were debonded with an Instron machine at a crosshead speed of 0.5 mm/min, and ARI was evaluated by using a stereoscopic magnifying glass. Results: The mean shear strength values (MPa) for Groups 1 to 6 were 24.6, 18.7, 17.5, 19.7, 17.5 and 14.8, respectively. Data were submitted to ANOVA and Tukey's test (α = 0.05). Group 1 had significantly higher shear bond strength values than Groups 3, 5, and 6 (p < 0.05), but did not differ significantly from Groups 2 and 4 (p > 0.05). No statistically significant differences (p > 0.05) were found between Groups 2, 3, 4, 5 and 6. Conclusions: Bracket bonding using TPCC showed adequate adhesion for clinical use, and the type of enamel preparation had no influence.

The effect of repeated bracket recycling on the shear bond strength of different orthodontic adhesives

Aim: The aim of this study was to evaluate the effect of two consecutive recycling procedures on the shear bond strength of different orthodontic adhesives. Methods: Edgewise brackets were bonded to the buccal surfaces of 40 bovine incisors using the following bonding materials: Concise (group I), Transbond XT (group II), Smart Bond (group III) and Fuji Ortho (group IV). The teeth were stored in water at 37°C for 24 h, thermocycled between 5 and 55°C, and debonded using an Instron machine at a crosshead speed of 0.5 mm/min. In all groups, the bonded brackets were detached and rebonded after recycling by 50-µm particle aluminum oxide blasting. After the second recording of retentive strengths, the recycling procedure, the rebonding and the shear bond strength test were repeated. Data were analyzed statistically by ANOVA and Tukey’s test at 5% significance level. Results: The results showed that repeated recycling did not interfere in retention of brackets, regardless of the adhesive used. The highest shear bond strength values were obtained after bonding with Transbond XT, independent of the recycling procedure. Conclusion: Repeated bracket recycling using 50-µm aluminum oxide particle air abrasion did not affect the shear bond strength of metallic brackets bonded with different orthodontic adhesives.

Reabilitação protética após verticalização de terceiro molar com severa inclinação / Prosthodontic rehabilitation after uprighting of third molar with severe inclination: a clinical report

Molares com inclinações severas geram situações desafiadoras para reabilitação oral e, portanto, requerem planejamento multidisciplinar. Este relato de caso apresenta um paciente adulto com histórico de desordem temporomandibular proveniente de extensa migração mesial de terceiro molar inferior associado a utilização de prótese inadequada. Uma alça simplificada, confeccionada com segmento de fio .018"x.025" TMA foi utilizada para verticalização de molar inferior, que permitiu a aplicação de forças suaves e evitando a extrusão dentária. Após seis meses, foi observada a correção do eixo de inserção para prótese fixa, garantindo uma oclusão satisfatória ao paciente.

A severe inclination of molars is generally a challenge to oral rehabilitation, which required a multidisciplinary planning. An adult patient with temporomandibular disorder history due mesial tipping of third inferior molar associated with inadequate prosthesis is presented. A tipback apparatus of uprighting inferior molar was used by applying low forces and to avoid tooth extrusion. This six-month molar uprighting was observed to improve the prosthesis insertion a is, providing the patient with an adequate occlusion.

Prevalence of malocclusion in a Brazilian schoolchildren population and its relationship with early tooth loss

The purpose of this study was to evaluate the prevalence of malocclusion in a Brazilian schoolchildren population in the mixed dentition, assessing its relationship with early tooth loss. The study population consisted of 1,014 7-11-year-old children of both genders, with low socioeconomic backgrounds and multiracial characteristics, living in the city of Jequié, in the Northeast region of Brazil. The clinical examination was carried out by an adequately calibrated orthodontist in the children’s classrooms. Data were analyzed statistically by either chi-square or Fisher’s exact test (a=0.05). Angle’s classification revealed that 22.3% of the population had normal occlusion. Class I malocclusion was observed in 47.6%, Class II division 1 in 21%, Class II division 2 in 0.9% and Class III in 8.2% of the children. Excluding the subjects (n=199) with early tooth loss, which is a condition that can modify malocclusion status, the distribution was as follows: Class I (36.2%), Class II division 1 (17.5%), Class II division 2 (0.7%) and Class III (3.7%). Early tooth loss was more commonly observed in boys (Class I, Class III left side, and both sides simultaneously). Anterior crossbite was observed in 5.7% of the subjects, posterior crossbite in 8.4%, anterior and posterior crossbite simultaneously in 2.6%, open bite in 13% and crowding in 49.6%. In conclusion, Class I malocclusion was the most prevalent alteration. The occlusal pattern of Class III was more common than Class II division 2, among the examined individuals.

Alterações periodontais e microbiológicas após instalação de aparelho ortodôntico fixo / Periodontal and microbiologic changes after the placement of fixed orthodontic appliance

Áreas de retenção do aparelho ortodôntico fixo permitem um maior acúmulo de biofilme dental, principal agente etiológico das doenças periodontais. Este estudo, através de revisão da literatura, pretende avaliar possíveis alterações periodontais e microbiológicas de pacientes com aparelho ortodôntico fixo. Os parâmetros clínicos, como índice de placa, índice de sangramento gengival e profundidade de sondagem foram analisados em diversos estudos, e a maior parte deles mostra resultados significativos de acúmulo de biofilme e inflamação gengival associado ao aparelho ortodôntico fixo. Há um grande aumento de microrganismos cariogênicos em pacientes ortodônticos, como S. mutans e Lactobacillus, principalmente nos casos de deficiência na higiene bucal. Quanto ao biofilme subgengival, pode-se afirmar que A. actinomycetemcomitans e T. forsythia, envolvidos com a doença periodontal, são os principais componentes do biofilme subgengival de bandas ortodônticas. Esta revisão mostrou a necessidade de mais estudos sobre a relação entre patógenos periodontais e aparelhos ortodônticos e ressaltou a importância da interação entre Periodontia e Ortodontia durante os tratamentos ortodônticos, principalmente nos pacientes com maiores riscos.

Shear bond strength of metallic brackets bonded with four different composite resins

The objective of this study was to assess the shear bond strength of metallic brackets with different types of Concise composites and the Adhesive Remnant Index (ARI). Sixty bovine permanent lower incisors were inserted into PVC tubes and divided into four groups (n = 15): Group 1 û Transbond XT (control) composite; Group 2 û Concise restorative composite; Group 3 û Concise diluted restorative composite (Artun and ZachrissonÆs technique); and Group 4 û Concise Orthodontic composite. After bonding the brackets, the samples were stored in distilled water at 37oC for 24 hours and then submitted to shear strength tests (Instron) at a crosshead speed of 0.5 mm/min. Analysis of variance and TukeyÆs test (5%) were used for statistically analysing the data regarding the shear bond strength results, whereas Kruskal-Wallis test was used for analysing the ARI scores. The shear bond strength mean values (MPa) for Group 1 (12.13) and Group 2 (12.20) were found to be statistically higher (p < .05) than that for Group 3 (8.20). No statistically significant differences were observed (p > .05) between Groups 1, 2, and 4 (9.86) as well as between Groups 3 and 4. Regarding the ARI evaluation, the majority of the fractures involved the bracket/ composite interface.

Jarabak 's cephalometric analysis of Brazilian black patients.

The treatment of skeletal disharmonies presents better results when performed during the growth period. The physical changes that occur in every individual express growth, which is ruled by genetic, general and environmental factors. In order to identify such disharmonies and hence concentrate the clinical actions during treatment and influence facial growth, cephalometrics appears as a useful a diagnostic tool for identifying facial growth patterns or growth direction. Jarabak's cephalometric analysis is used to assess facial growth pattern of subjects with normal occlusion or malocclusions. The purpose of this study was to obtain mean values for cephalometric measurements from Jarabak's cephalometric analyses of black Brazilian subjects resident in the city of Piracicaba, São Paulo state, Brazil and vicinities, who presented Class I molar relationship with normal overjet and overbite, mild or no tooth crowding or spacing, and no history of orthodontic treatment. A sample of 37 stone plaster casts and 37 lateral teleradiographs from both male and female individuals aged 10 to 14 years was evaluated. Data were analyzed statistically by Student's t-test at 5% significance level. There was no significant differences between genders. The cephalometric measurements obtained in this study were similar to the Jarabak's standards, except for S-N mean value in females (66.50 mm +/- 3.16), which was significantly lower than the standard.