Impact of body and orofacial appearance on life satisfaction among Brazilian adults.

AIMS: 1. to elaborate a general model of physical appearance taking into account body image (BI) and orofacial appearance (OA) components; and 2. to evaluate the impact of BI and OA on life satisfaction among Brazilian adults. METHODS: This is a cross-sectional observational study. The cognitive, behavioral, affective, and satisfaction/dissatisfaction aspects of BI, the satisfaction and psychosocial impact of OA, and life satisfaction were evaluated by self-reported psychometric scales. Principal Component Analysis and Parallel Analysis were performed. Structural equation models were elaborated to estimate the impact of BI and OA on life satisfaction. The fit of the models was verified and the significance of the path estimates (ß) was evaluated using z-tests (α = 5%). RESULTS: A total of 1,940 individuals participated in the study (age: mean = 24.8, standard deviation = 5.7 years; females = 70.1%). In the male sample, three physical appearance factors were retained (OA, cognitive and behavioral components of BI, and affective and satisfaction/dissatisfaction components of BI). In the female sample, two factors were retained (OA and all components of BI). All factors had significant impact on life satisfaction (ß = |0.26|-|0.48|, p<0.001) in both samples. Individuals dissatisfied with BI and OA had lower levels of life satisfaction. For men, the affective and satisfaction components of BI had a greater impact on life satisfaction (ß = 0.48, p<0.001) than the other factors (ß =] -0.30;-0.25[, p<0.001). For women, both BI and OA had a similar impact (BI: ß = -0.30, p<0.001; OA: ß = -0.32, p<0.001). CONCLUSION: BI and OA formed distinct clusters in the physical appearance evaluation. Physical appearance was perceived differently by men and women, fostering discussion about the sociocultural construction of the body. BI and OA had a significant impact on life satisfaction and should be considered in assessment and treatment protocols.

Hyoid Bone Position and Head Posture in Patients With Richieri-Costa Pereira Syndrome (EIF4A3 Mutations).

Robin sequence with cleft mandible and limb anomalies, known as Richieri-Costa-Pereira syndrome (RCPS), is an autosomal recessive acrofacial dysostosis characterized by mandibular cleft and other craniofacial anomalies and respiratory complications. The aim of this cross-sectional study was to describe the hyoid and head posture of 9 individuals with RCPS using cephalometric measurements and provide a discussion about its implications in obstructive sleep apnea syndrome (OSAS). The study was conducted on lateral cephalograms of patients with RCPS and 9 selected age-matched controls in tertiary cleft center in Brazil. The cephalograms were digitized and analyzed on a software to obtain the vertical and horizontal hyoid position, its relationship with the mandible and the relation of the cranial base and postvertebral line. The t test was used for analysis of means and Levene's test for equality of variances.Cephalometric measurements H-S (vertical distance between hyoid bone and sella) (Supplemental Digital Content, Figure 1, http://links.lww.com/SCS/B247) and H-C4lp (horizontal position of the hyoid in relation to the post-pharyngeal space) showed statistically significant difference compared to controls (P < 0.05). Therefore, the hyoid bone was more inferiorly and posteriorly positioned in the study group compared with the control group. The vertebrae measurements did not present differences compared to controls. The described position of hyoid bone could be involved in the severe OSAS of RCPS patients.

Comparison of anterior retraction and anchorage control between en masse retraction and two-step retraction: A randomized prospective clinical trial.

OBJECTIVES: The purpose of this two-arm parallel trial was to compare en masse (ER) and two-step retraction (TSR) during space closure. MATERIALS AND METHODS: Forty-eight adult patients with bimaxillary protrusion who were planned for treatment with extraction of four first premolars were enrolled. All patients were randomly allocated in a 1:1 ratio to either the ER (n = 24) group or the TSR (n = 24) group. The main outcome was the amount of posterior anchorage loss in the molars and the retraction of the incisors between ER and TSR; the difference in incisor and molar inclination was a secondary outcome. Lateral cephalometric radiographs and oblique cephalometric radiographs at 45° were taken before retraction (T1) and after space closure (T2). Cephalograms were digitized and superimposed on the anatomic best fit of the maxilla and mandible by one operator who was blinded to the treatment group. RESULTS: Neither incisor nor molar crown movements showed any significant differences between the ER and TSR. There were no significant differences in the tipping of incisors and molars between the two groups. CONCLUSIONS: No significant differences existed in the amount of retraction of incisors and anchorage loss of molars between ER and TSR. Changes in incisor and molar tipping were similar, with the crowns showing more movement than the apex.

Efeito da escovação e das bebidas na rugosidade superficial de bráquetes cerâmicos / Effect of brushing and beverages on surface roughness of ceramic brackets

Introdução: Quando introduzidos no meio bucal, os bráquetes cerâmicos podem sofrer alterações em sua estrutura provocadas pelo processo de degradação química e mecânica do material. Objetivo: Este estudo avaliou a rugosidade superficial de bráquetes cerâmicos e se eles sofreram alteração com a escovação dentária e a imersão em bebidas com diferentes pH. Material e método: Foram testados sete bráquetes cerâmicos de incisivo central superior direito de quatro marcas comerciais (duas marcas de bráquete monocristalino e duas de policristalino). Os bráquetes foram imersos em soluções de café, vinho tinto, Coca-Cola, chá preto e saliva artificial durante 21 dias. Outros sete bráquetes de cada marca comercial foram imersos nas mesmas soluções e no mesmo tempo, porém com intervalos de escovação diários realizados por uma máquina de escovação. A rugosidade (Ra) foi obtida por meio de um rugosímetro (Surftest SJ-400, Mitutoyo®) antes e após 24 horas, 7, 14 e 21 dias. Os dados foram avaliados pela análise de perfis multivariados, análise de variância (ANOVA) e teste de comparação múltipla de médias. Resultado: Os resultados da rugosidade e de sua alteração após 21 dias foram: média Ra do Allure = 0,277 μm (alteração = 0,002 μm), Inspire Ice = 0,262 μm (alteração = 0,013 μm), Radiance = 0,177 μm (alteração = 0,009 μm) e Transcend = 0,367 μm (alteração = 0,019 μm). Conclusão: A rugosidade superficial dos bráquetes cerâmicos aumentou após 21 dias de imersão nas soluções, sendo o tempo de imersão um fator significante. No entanto, essa alteração da rugosidade no tempo é semelhante nos bráquetes monocristalinos e policristalinos, assim como nas diferentes soluções. A escovação dentária não produziu alteração na rugosidade superficial de bráquetes cerâmicos.

Introduction: When introduced into the oral environment, the ceramic brackets may undergo change their structure caused by the process of chemical and mechanical degradation of the material. Objective: This study evaluated the surface roughness of ceramic brackets and whether it is altered by toothbrushing process and diet solutions. Material and method: Seven ceramic brackets of four commercial brands were tested: two monocrystalline and two polycrystalline. The brackets were immersed in solutions of coffee, red wine, Coke, black tea and artificial saliva for 21 days. Another group of brackets of each brand were also immersed in the same solutions and for an equal time, but with daily brushing performed by a toothbrushing machine. The surface roughness (Ra) was analyzed by a Roughness Tester (Surftest SJ-400,Mitutoyo®) before and after 24 hours, 7, 14 and 21 days. The data were evaluated by the Analysis of Multivariate Profiles, Analysis of Variance (ANOVA), multiple comparison test of means. Result: The results of Ra and its change after 21 days were: Ra mean of Allure = 0.277μm (change = 0.002μm), Inspire Ice = 0.262μm (change = 0.013μm), Radiance = 0.177μm change = 0.009μm), Transcend = 0.367μm (change = 0.019μm). Conclusion: the surface roughness of the ceramic brackets increased after 21 days of immersion in the solutions, and the immersion time was a significant factor. However, this change in the surface roughness was similar for the monocrystalline and polycrystalline brackets, as well as for the different solutions. Brushing did not change the surface roughness of ceramic brackets.

Cephalometric Findings in Nine Individuals With Richieri-Costa-Pereira Syndrome.

The Richieri-Costa-Pereira syndrome (RCPS) is an autosomal-recessive acrofacial dysostosis caused by mutations in EIF4A3, characterized by mandibular cleft comprising other craniofacial anomalies and limb defects such as cleft palate/Robin Sequence, microstomia, absence of mandibular central incisors, minor ear anomalies, clubfeet and first and 5 ray defects. The findings from this study are useful for better understanding the morphological consequences of disorders of EIF4A3, and having a better picture of the anatomic characteristics of the syndrome for a better therapeutic planning. Twenty-four angular and linear variables were measured to assess anteroposterior and vertical (superior-inferior) position of the cranial base, maxilla, mandible, and facial profile. The cephalometric radiographic analysis was performed on 9 individuals with RCPS, obtained at a mean age of 10.3 years, and compared with randomly selected age-matched 9 controls, without clefts and with well-balanced faces, with mean age of 10.6 years (both groups range 8.1 to 13.7 years). t test was used for analysis of means and Levene test for equality of variances. The syndrome group presented severe mandibular hypoplasia and retrognathism (P = 0.009, P = 0.001), greater facial convexity (N'PnPog and N'SnPog, P < 0.05) in syndrome group compared with the control group (P = 0.003, P = 0.004). In conclusion, in the RCPS group, most craniofacial defects affect the lower facial third, considering the severely affected mandible.

Molar Uprighting: A Considerable and Safe Decision to Avoid Prosthetic Treatment.

BACKGROUND: Tipped lower molar over edentulous space is very common in orthodontics practice when adults seek treatment. The segmented arch technique features a predictable force system that provides a controlled release of force that can produce light and continuous tooth movement. CASE DESCRIPTION: A female adult patient, who lost a permanent lower first molar, needed correction of the position of her permanent first molar place. Instead of making space for rehabilitation, it was closed after second molar uprighting and a balanced interdigitation was created without prosthetics. The patient was successfully treated with segmented arch technique using root correction spring activated with geometry VI to promote uprighting of a tipped molar and Niti spring coil to promote space closure. PRACTICAL IMPLICATIONS: Segmented arch technique is known to provide predictable light and continuous forces, which is very much indicated in adult treatment. There are several things to consider when orthodontically treating adult patients. Their periodontal conditions might not be ideal, less bone apposition may occur, and side effects of orthodontic tooth movement are expected. Thus, a predictable and controlled orthodontic treatment is needed.

Effect of temporomandibular joint articular disc repositioning on anterior open-bite malocclusion: An orthodontic-surgical approach.

An anterior open bite is a challenge to orthodontic treatment; it has a multifactorial etiology and a wide range of intervention options. Temporomandibular joint (TMJ) disorders are a risk factor for the development of malocclusions such as the anterior open bite, especially in patients who have TMJ osteoarthritis with disc displacement. Articular disc repositioning surgery is an available option for treating this pathology, and it contributes to maintaining the condyles in a more stable position. The aim of this article was to report the case of a 20-year-old woman diagnosed with anterior open bite and TMJ osteoarthritis with bilateral disc displacement. The patient received both orthodontic treatment and TMJ disc repositioning surgery. Cone-beam computed tomography was used to create 3-dimensional models of the condyles with regional superposition, and assessment of bone remodeling was performed at different time intervals. Complete orthodontic and surgical treatment time was approximately 12 months. The results provided a stable correction of the patient's anterior open bite with a 2-year follow-up and favorable bone remodeling of the condyles due to functional improvement of the TMJ.

Differences in bite force between dolichofacial and brachyfacial individuals: Side of mastication, gender, weight and height.

PURPOSE: Due to the bite force importance in functionality of the masticatory system, this study aimed to characterize it in dolichofacial and brachyfacial individuals. METHODS: A sample comprised by 190 patients was divided into two groups: 90 severe dolichofacial, and 100 severe brachyfacial individuals classified according to the VERT index and the face height ratio (Jarabak quotient). Bite force was measured by using an adjusted digital dynamometer and proper methodology. RESULTS: The sample met the parametric assumptions and presented statistical significance when right and left sides of dolichofacial and brachyfacial individuals were compared. However, within the same group, no differences between the left and right sides were found. Generally, bite force was higher for male, left masticator, age between 41-50 years, weighing over 100kg and between 1.81 and 1.90m tall. CONCLUSIONS: Based on the results of this cross-sectional study, it was possible to conclude that the bite force in severe brachyfacial individuals was significantly higher than in severe dolichofacial individuals, being influenced by gender, weight and height.

Expansão rápida da maxila osseossuportada: um relato de caso e passo a passo laboratorial / Rapid bone-borne maxillary expansion: a case report and laboratorial step-by-step

A expansão rápida da maxila osseossuportada tem sido amplamente utilizada na clínica ortodôntica, entretanto ainda existem dúvidas em relação ao planejamento e efeitos do tratamento. É objetivo do presente artigo relatar um caso clínico descrevendo passo a passo as etapas de planejamento, confecção e instalação do aparelho. Paciente com mordida cruzada posterior, 11 anos de idade foi indicada para tratamento com aparelho. Inicialmente, foi realizada tomografia computadorizada de feixe cônico a fim de planejar o local ideal de instalação de 4 mini-implantes considerando a disponibilidade óssea no palato. Imediatamente após a instalação dos mini-implantes foi realizada moldagem, adaptação de mini-implantes de latão no alginato e confeccionado modelo de trabalho. O disjuntor em acrílico, apoiado apenas nos mini-implantes, foi adaptado em boca e a paciente instruída a ativar o torno expansor » de volta pela manhã e a noite durante 14 dias. Após esse período nova tomografia foi realizada, assim como após o tempo de contenção de 4 meses. Mensurações nas tomografias mostraram expansão maxilar sem efeitos de vestibularização de molares. Após 4 meses foi observada leve redução da expansão esquelética e inclinação lingual dos dentes posteriores. Pode ser concluído que o tratamento foi bem sucedido, resultando em correção da mordida cruzada posterior sem efeitos colaterais nos dentes posteriores.(AU)

Rapid bone-borne maxillary expansion has been widely used in orthodontic clinic, however there are still some doubts about its planning and treatment effects. The aim of this paper is to report a case describing step-by-step planning, manufacturing and installation of the appliance. Patient with posterior crossbite, 11 years-old was indicated to treatment with this appliance. A cone bean computed tomography was achieved to plan the ideal site for installing 4 miniscrews, considering bone availability of the palatal area. Immediately after miniscrews insertion, an impression was taken and miniscrews were inserted in the alginate to obtain the cast model. The acrylic appliance, supported exclusively on miniscrews, was adapted and the patient instructed to activate » turn twice a day for 14 days. After this period a new tomography was obtained and also after a 4-month retention period. Tomography measurements showed maxillary expansion with no molars vestibularization. After 4 months there was a slight decrease on maxillary expansion and molars lingual tipping. It can be concluded that the treatment was successful with correction of the crossbite and no deleterious effects in the posterior teeth.(AU)

Skeletal and dental changes induced by bionator in early treatment of class II / Alterações esqueléticas e dentárias induzidas pelo bionator no tratamento precoce da classe II

The purpose was to investigate the amount of skeletal and dentoalveolar changes after early treatment of Class II, Division 1 malocclusion with bionator appliance in prepubertal growing patients. Forty Class II patients were divided in two groups. Treated group consisted of 20 subjects treated consecutively with bionator. Mean age at the start of treatment (T0) was 9.1 years, while it was 10.6 years at the end of treatment (T1). Mean treatment time was 17.7 months. Pretreatment and post-treatment cephalometric records of treated group were evaluated and compared with a control group consisted of 20 patients with untreated Class II malocclusion. Intergroup comparisons were performed using Student's t-tests and chi-square test with Yates' correction at a significance level of 5 per cent. Bionator appliance was effective in generating differential growth between the jaws. Cephalometric skeletal measurements ANB, WITS, Lafh, Co-A and dental L6-Mp, U1.Pp, IsIi, OB, OJ showed statistically significantly different from the control. Bionator induced more dentoalveolar changes than skeletal during treatment in prepubertal stage.

Este estudo quantificou as alterações esqueléticas e dentoalveolares no período pré-puberal de crescimento após o tratamento da má oclusão de classe II, divisão 1 com bionator. Quarenta pacientes classe II foram divididos em dois grupos. Um grupo com 20 pacientes tratados consecutivamente com bionator. A média de idade no início do tratamento (T0) foi de 9,1 anos, enquanto ao final (T1) foi de 10,6 anos. O tempo médio de tratamento foi de 17,7 meses. Os dados cefalométricos antes e após o tratamento foram avaliados e comparados com um grupo controle de 20 pacientes com má oclusão de classe II, divisão 1 não tratada. A comparação intergrupo foi realizada pelo teste t de Student e teste qui-quadrado com correção de Yates para um nível de significância de 5 por cento. O aparelho foi efetivo em gerar diferencial de crescimento entre os arcos dentários. As medidas cefalométricas esqueléticas ANB, WITS, Lafh, Co-A e as dentárias L6-Mp, U1.Pp, IsIi, OB, OJ demonstraram diferença estatística significante entre os grupos. O bionator induziu maiores alterações dentoalveolares que esqueléticas no tratamento da classe II, divisão 1 durante o período pré-puberal.

Abordagem cirúrgica e ortodôntica de incisivos superiores impactados / Surgical and orthodontic approach of impacted maxillary incisors

Embora incomum, a impacção de incisivos centrais superiores é geralmente diagnosticada precocemente, devido à importância destes dentes na função mastigatória e na aparência do indivíduo. O objetivo deste trabalho foi relatar dois casos clínicos nos quais uma abordagem cirúrgica e ortodôntica foi realizada para tratar incisivos centrais impactados. Em ambos os casos, foi realizada a expansão rápida da maxila com o auxílio de um aparelho disjuntor de Haas. Da mesma forma, foi efetuada a exposição cirúrgica e o tracionamento ortodôntico do incisivo central superior impactado. Forças ortodônticas leves foram utilizadas durante todo o tracionamento ortodôntico, as quais foram aplicadas em arcos rígidos. Ao final do tratamento, os dentes apresentavam uma altura de coroa clínica adequada, contornos gengivais satisfatórios e vitalidade pulpar. De acordo com o desfecho clínico dos dois casos apresentados, pôde-se concluir que a exposição cirúrgica bem planejada, associada ao tracionamento ortodôntico dos dentes impactados contribuiu para os resultados positivos observados neste estudo...

Although uncommon, the impaction of maxillary central incisors is usually early diagnosed, due to the importance of these teeth in masticatory function and appearance of the individual. The aim of this paper was to report two clinical cases, in which surgical and orthodontic approach were performed, in order to treat impacted central incisors. In both cases, we have done the rapid disjunction of the midpalatal suture, as well as exposure and orthodontic traction of the impacted maxillary central incisor. Light forces were used during the all the orthodontic traction, which were applied on rigid archs. It was noted that the teeth presented adequate clinical crown height, satisfactory gingival contours and pulp vitality. It can be concluded that a well-planned surgical exposure of the impacted teeth in association with orthodontic traction contributed to periodontal and aesthetic optimal treatment outcomes...

Alterações cefalométricas dentárias induzidas pelo aparelho de Herbst com dois tipos de ancoragem para maxila / Cephalometric changes induced by the Herbst appliance with two types of maxillary Anchorage

O presente estudo avaliou se o tipo de ancoragem maxilar utilizada no aparelho de Herbst tem influência nos efeitos dentários induzidos pelo seu uso no tratamento da Classe II. Neste estudo retrospectivo, foram avaliadas telerradiografias de 44 pacientes em fase de crescimento com má oclusão Classe II Divisão 1ª e deficiência mandibular, submetidos ao tratamento com aparelho de Herbst. A amostra foi dividida em dois grupos de acordo com a ancoragem maxilar utilizada: dentossuportada (Grupo 1) e dentomucossuportada (Grupo 2). Em ambos os grupos, para cada indivíduo, foram obtidas duas telerradiografias: T1 ao início do tratamento e T2 ao final da fase ortopédica de tratamento. Para avaliação dos resultados foram usadas as abordagens descritiva e dedutiva. A análise exploratória dos dados foi feita através do cálculo de medidas e a análise inferencial através do teste não paramétrico de Mann-Whitney com nível de significância de 5%. Os resultados evidenciaram diferenças estatisticamente significantes para as medidas 1.NB, 1-NB, 1/.Pp, IMPA, linha vertical de referência – molar superior (LVR-M6s), linha horizontal de referência – molar superior (LHR-M6s) e linha vertical de referência – incisal do incisivo inferior (LVR-Iii). O Grupo 1, com ancoragem maxilar reduzida, apresentou distalização e intrusão dos molares superiores, menor efeito de verticalização dos incisivos superiores e menor efeito de vestibularização dos incisivos inferiores, enquanto que o Grupo 2, com ancoragem maxilar total, apresentou extrusão do molar superior, maior verticalização dos incisivos superiores e maior vestibularização dos incisivos inferiores. Os dois grupos apresentaram efeito similar de mesialização dos molares inferiores...

This study aimed at verifying if the type of jaw anchorage used in Herbst appliance interferes over dental effects induced by the use of the device in the treatment of Class II. The presennt retrospective study analyzed lateral cephalograms of 44 prepubertal Caucasian patients, both genders, with Class II division 1 and mandibular deficiency, submitted to orthodontic treatment using Herbst appliance. The sample was divided into two groups according to the type of jaw anchorage: tooth-supported (Group 1) and tooth-tissue-supported (Group 2). In both groups, for each subject, two lateral cephalograms at maximum intercuspation were obtained: T1 at the beginning of treatment and T2 at the end of treatment. To evaluate the results descriptive and deductive approaches were utilized. Exploratory analysis of data was performed by calculating summary statistics and inferential analysis using the nonparametric Mann-Whitney test with significance level of 5%. The results showed statistically significant differences for measures 1.NB, 1-NB, 1/.Pp, IMPA, vertical reference line – upper-molar (LVR-M6s), horizontal reference line – upper-molar (LHR-M6s), and vertical reference line – lower incisor incisal (LVR - Iii). Group 1, with low jaw anchorage, presented distalization and intrusion of upper molars, lower effect of verticalization of the upper incisors and lower effect of proclination of the lower incisors. The second group, with total jaw anchorage, presented extrusion of upper molars, and showed higher verticalization of the upper incisors and higher proclination of the lower incisors. Both groups showed similar effect of mesial movement of mandibular molars...

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion

INTRODUCTION: This study assessed the three-dimensional changes in the dental arch of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusions at three different periods. METHODS: Landmarks previously identified on upper and lower dental casts were digitized on a three-dimensional digitizer MicroScribe-3DX and stored in Excel worksheets in order to assess the width, length and depth of patient's dental arches. RESULTS: During orthodontic preparation, the maxillary and mandibular transverse dimensions measured at the premolar regions were increased and maintained throughout the follow-up period. Intercanine width was increased only in the upper arch during orthodontic preparation. Maxillary arch length was reduced during orthodontic finalization, only. Upper and lower arch depths were stable in the study periods. Differences between centroid and gingival changes suggested that upper and lower arch premolars buccaly proclined during the pre-surgical period. CONCLUSIONS: Maxillary and mandibular dental arches presented transverse expansion at premolar regions during preoperative orthodontic preparation, with a tendency towards buccal tipping. The transverse dimensions were not altered after surgery. No sagittal or vertical changes were observed during the follow-up periods. .

INTRODUÇÃO: esse estudo avaliou as alterações tridimensionais ocorridas na morfologia das arcadas dentárias de pacientes submetidos ao tratamento ortodôntico-cirúrgico para a correção da má oclusão de Classe II, em três períodos distintos: (T1) modelos iniciais, (T2) modelos pré-cirúrgicos imediatos (de 1 a 15 dias antes da cirurgia) e (T3) modelos pós-cirúrgicos (mínimo de 6 meses após a remoção do aparelho ortodôntico). MÉTODOS: pontos previamente demarcados em cada modelo foram digitalizados por meio do digitalizador tridimensional MicroScribe-3DX, cujas coordenadas, armazenadas em planilhas do programa Excel, deram origem a valores que possibilitaram a avaliação da largura, comprimento e profundidade das arcadas dentárias. RESULTADOS: durante o preparo ortodôntico, houve aumentos nas distâncias transversais superiores e inferiores medidas na região de pré-molares que se mantiveram no período total de acompanhamento. Apenas a distância intercaninos superior apresentou alterações de aumento durante o preparo ortodôntico, assim como a largura da arcada superior, que diminuiu durante a fase de finalização. A profundidade de ambas as arcadas manteve-se estável nas fases avaliadas. Diferenças entre as mudanças dos pontos centroide e gengival sugerem que os pré-molares superiores e inferiores inclinaram para vestibular durante o preparo ortodôntico pré-cirúrgico. CONCLUSÇÕES: conclui-se que as arcadas dentárias superiores e inferiores sofreram expansão transversal na região de pré-molares durante o preparo ortodôntico pré-cirúrgico, com tendência à inclinação vestibular de todos os dentes posteriores. Após a cirurgia, as dimensões transversais ...

Dimensões do corredor bucal e sua relação com a distância inter pré-molar e intercomissural / Dimensions of buccal corridor and relationship, with inter premolar distance and inter commissure width

O objetivo desse estudo foi analisar o tamanho do corredor bucal durante o sorriso de indivíduos, de dez a 19 anos de idade, e determinar se há uma relação entre o corredor bucal, a distância inter pré-molar e a largura intercomissural. Fotografias padronizadas digitais frontais de sorriso posado e modelos de gesso foram realizados em uma amostra de 150 indivíduos divididos em cinco grupos de 30 indivíduos: 10-11 anos (G1), 12-13 anos (G2), 14-15 anos (G3), 16-17 anos (G4), 18-19 anos (G5). As distâncias entre as cúspides dos primeiros pré-molares superiores e o corredor bucal foram medidas para subsequente comparação, utilizando o software Image Tool. Os dados foram analisados utilizando Anova, e os testes SNK e Tamhane foram aplicados. Os valores médios do corredor bucal variam de 4,00 a 10,69 mm do lado direito, e de 4,06 a 11,43 mm do lado esquerdo. Em percentagem variou de 7,46 a 16,47% do lado direito, e de 7,58% a 17,61% do lado esquerdo. O corredor bucal foi diferente entre os gêneros e aumentou com a idade. Não houve diferença entre os gêneros, quando calculado em percentagem. A distância inter pré-molar está correlacionada com a largura intercomissural no gênero feminino de 14-15 anos e 18-19 anos, e com o corredor bucal linear em ambos os gêneros de 14-15 anos...

The objective of the study was to analyze the size of buccal corridor during the smile of individuals from 10 to 19 years of age and to determine whether there is a relationship among buccal corridor, inter premolar distance, inter commissure width. Standard digital frontal photographs in posed broad smiles and dental casts were taken of a sample of 150 individuals divided into 5 age groups of 30 individuals: 10-11 years old (G1), 12-13 years old (G2), 14-15 years old (G3), 16-17 years old (G4), 18-19 years old (G5). Distances among the cusps of superior first premolars and buccal corridors were measured for subsequent comparisons using the Image Tool 3.0 program. Data was analyzed using Anova. The SNK test and Tamhane test were applied. The mean values of the buccal corridor ranged from 4.00-to 10.69 mm on the right side and from 4.06 to 11.43 mm on the left side. In percentage related with intercomissure width each side of the buccal corridor ranged from 7.46 to 16.47% on the right side and from 7.58% to 17.61% on the left side. Buccal corridors were different between genders and increased with age. Males have bigger buccal corridors than females, but there is no difference between gender when calculated as a percentage related with the inter commissure width. The inter premolar width is significantly correlated with inter commissure widths of female individuals 14-15 years old and 18-19 years old, and with the right linear buccal corridor of males and females aged 14-15 years old...

Estabilidade oclusal a longo prazo de Classe II, divisão 1, após tratamento com extração de pré-molares / Long-term occlusal stability of Class II division 1 after treatment with premolars extraction

Pacientes buscam mudanças estéticas e funcionais quando procuram tratamento ortodôntico e esperam que a oclusão permaneça estável. A estabilidade da oclusão é um dos objetivos do ortodontista, entretanto, mudanças das relações dentárias a longo prazo podem ocorrer, levando a uma recidiva do tratamento. Os dentes e a forma dos arcos tendem a voltar para a forma original, sendo a fase de contenção importante após a remoção do aparelho, mesmo depois de alguns anos de pós-tratamento. Este artigo aborda a apresentação de um caso clínico de Classe II, divisão 1, tratado com extração de pré-molares, analisando sua estabilidade a longo prazo...

Patients are looking for esthetic and functional changes when seeking orthodontic treatment and expect the remaining of a stable occlusion. Occlusion stability is one of the goals of the orthodontist; however, dental relationships changes in long-term can occur leading to a relapse of the treatment. Teeth and shape of arches tend to return to the original form, been the retention phase important after the appliance removal, even after several years of post-treatment. This article approaches a submission of a clinical case of Class II division 1 treated with extraction of premolars analyzing its long-term stability...

Comparison of linear measurements and analyses taken from plaster models and three-dimensional images.

Digital models are an alternative for carrying out analyses and devising treatment plans in orthodontics. The objective of this study was to evaluate the accuracy and the reproducibility of measurements of tooth sizes, interdental distances and analyses of occlusion using plaster models and their digital images. Thirty pairs of plaster models were chosen at random, and the digital images of each plaster model were obtained using a laser scanner (3Shape R-700, 3Shape A/S). With the plaster models, the measurements were taken using a caliper (Mitutoyo Digimatic(®), Mitutoyo (UK) Ltd) and the MicroScribe (MS) 3DX (Immersion, San Jose, Calif). For the digital images, the measurement tools used were those from the O3d software (Widialabs, Brazil). The data obtained were compared statistically using the Dahlberg formula, analysis of variance and the Tukey test (p < 0.05). The majority of the measurements, obtained using the caliper and O3d were identical, and both were significantly different from those obtained using the MS. Intra-examiner agreement was lowest when using the MS. The results demonstrated that the accuracy and reproducibility of the tooth measurements and analyses from the plaster models using the caliper and from the digital models using O3d software were identical.

Transverse maxillary and mandibular growth during and after bionator therapy: study with metallic implants.

INTRODUCTION: This study evaluated posteroanterior cephalograms before and after treatment and long term follow-up of Class II division 1 patients treated with bionator. OBJECTIVE: The objective was to demonstrate the transverse growth of maxilla and mandible during and after bionator therapy. METHODS: Measurement of transverse dimensions between posterior maxillary and mandibular implants, as well as the distances between the buccal, gonial and antegonial points were recorded. Measurements were analyzed at three periods: T1 - before bionator therapy, T2 - after bionator therapy and T3 - 5.74 years after T2. RESULTS: There was statistically significant transverse increase due to growth and/or treatment for all variables, except for the distance between the anterior maxillary implants. CONCLUSIONS: During the study period only the anterior maxillary area did not show transverse growth.

Aparelho extrabucal como recurso auxiliar para alinhamento e nivelamento no tratamento orto-cirúrgico de má oclusão Classe III esquelética / Headgear as an aid of alignment and leveling for skeletal Class III orthodontic surgical approach

Quando bem indicado, o tratamento ortodôntico cirúrgico consiste na abordagem ideal para adultos portadores de má oclusão Classe III esquelética. Para potencializar os resultados estéticos decorrentes da cirurgia ortognática, a fase de alinhamento e nivelamento do arco superior deve ser realizada com o mínimo de inclinação e projeção, ou até mesmo, retroinclinação dos incisivos superiores. No período pré-cirúrgico, a força extrabucal bilateral de 150 gF foi aplicada por 12 meses aos primeiros molares superiores de um paciente colaborador, do gênero masculino, 22 anos de idade, portador de má oclusão Classe III esquelética, para promover controle da inclinação mesial e da projeção dos dentes superiores. Os parâmetros oclusais requeridos para a translação cirúrgica das bases ósseas foram obtidos sem a necessidade de extrações, permitindo que o tempo total de tratamento fosse de 37 meses, tendo o paciente mostrado estabilidade no acompanhamento por 3 anos após remoção do aparelho. Esses achados mostram que apesar de depender grandemente da colaboração dos pacientes, quando bem indicado, o aparelho extrabucal consiste em uma alternativa para promover as descompensações dentárias no período pré-cirúrgico, a fim de possibilitar a correção cirúrgica das más oclusões Classe III esqueléticas

When well indicated, the orthodontic surgical approach is the ideal treatment mean for Skeletal Class III adult patients. To improve facial esthetic results from orthognatic surgery, the leveling and alignment of maxillary dental arch must be achieved with minimal inclination and projection or even retro-inclination of anterior upper teeth. During a pre-surgical phase of 12 months, headgear bilateral force of 150 g/F was applied to the upper molars of a 22 years old male compliant patient with Class III skeletal malocclusion, to provide an upper teeth control of mesial tipping and projection during alignment and leveling. The ideal occlusal parameters required for surgical procedure were achieved without dental extractions permitting a total treatment period of 37 months. The outcomes remained stable over 3 years follow up after the removal of the appliance. The results indicate that, although headgear use depends greatly on patient compliance, when well indicated it is an interesting alternativetopromote dentaldecompensationon pre-surgical period, in order to allow surgical correction of skeletal Class III malocclusion

Alterações dentoesqueléticas verticais e horizontais induzidas pelo Ativador Elástico Aberto de Klammt / Vertical and horizontal dentoskeletal changes induced by the Klammt Open Elastic Activator

O objetivo deste estudo foi avaliar as alterações dentoesqueléticas verticais ehorizontais induzidas pelo Ativador Elástico Aberto de Klammt no tratamento das rnás-oclusôesde Classe II, divisão 1. A amostra de 34 crianças foi dividida em dois grupos de 17 indivíduoscada (dez meninas, sete meninos), pareados por idade e gênero, com idade inicial média de8,5 anos. Os dados foram analisados usando o teste t Student para comparações intragrupoe intergrupos. Os resultados do trabalho mostraram que o aparelho promoveu restriçãodentoalveolar do crescimento maxilar; incremento no deslocamento vertical da sínfise mandibularassociado ao crescimento horizontal normal da mandíbula; verticalização dos incisivossuperiores; restrição da migração anterior dos molares superiores; maior padrão de erupçãoe deslocamento anterior normal dos incisivos e dos molares inferiores. Foi concluído que oaparelho Klammt produz alterações predominantemente dentoalveolares horizontais no arcosuperior e verticais no arco inferior e alterações esqueléticas verticais na mandíbula.

The aim of this study was to evaluate the vertical and horizontal dentoskeletalchanges induced by the Klammt Open Elastic Activator in the treatment of the Class II Division1 malocclusion. The sample of 34 children was divided into two groups of 1 7 subjects each(ten girls, seven boys), matched by age and gender and with an initial mean age of 8. 5 years.The data was analyzed using a Student's t-test for intragroup and intergroup comparison. Theresults showed that the appliance promoted dentoalveolar restriction of the maxilar growthwithin normal anteroposterior and vertical growth of the maxillary apical base; increment in thevertical displacement the mandibular symphysis associated with normal horizontal growth ofthe mandible; palatal tipping of the upper incisors; restriction of the anterior migration of theupper molars; greater eruption pattern and normal anterior displacement of the lower incisorsand molars. It was concluded that Klammt appliance induce changes that are predominantlyhorizontal dentoalveolar in upper arch and vertical dentoalveolar in lower arch and verticalskeletal changes in the mandible.

Occurrence of skeletal malocclusions in Brazilian patients with dentofacial deformities.

In this study, a survey was conducted on the occurrence of skeletal malocclusions presented by patients of the Center for Research and Treatment of Buccofacial Deformities (CEDEFACE) in the city of Araraquara, SP, Brazil. The clinical charts of 381 patients with dentoskeletal deformities, who underwent combined orthodontic-surgical treatment in the period between 2000 and 2006, were reviewed. After sample selection (convenience method), based on the data of the pre- and post-surgical documentation, the number of patients was reduced to 171. For classification of the survey, the anteroposterior discrepancy (Class I, II and III), race, age, gender, absence or presence of asymmetry, vertical maxillary excess and maxillary biprotrusion were considered, in addition to determining in which bony base the surgical procedure was performed. Patients' documentations were analyzed by one examiner previously calibrated by repetition of the process until the method was considered adequate (intraclass correlation coefficient > 0.94). Patients' mean age was 23.59 (SD 6.93) years, the majority (102 patients) were women, and Caucasians (160 patients). Class III malocclusion was the most prevalent (81 patients). Asymmetry, vertical maxillary excess and biprotrusion were present in 54, 33, and 7 patients, respectively. The majority of surgeries for correction of dentoskeletal deformities were combined, involving the maxilla and mandible. In conclusion, Class III was the most prevalent skeletal deformity and Class I was the least prevalent; in general, the prevalence of skeletal deformities was higher in women; in the majority of patients with skeletal malocclusions there was a combination of maxillary and mandibular problems, which interferes directly in the decision regarding the most adequate treatment plan, and a higher incidence of asymmetry was observed in skeletal Class III; vertical excess occurred in a similar manner in Class II and III and there was a low incidence of biprotrusion among the malocclusions evaluated.