Occlusion development after premature loss of deciduous anterior teeth: preliminary results of a 24-month prospective cohort study.

OBJECTIVE: This study aimed to evaluate occlusion development after premature loss or extraction of deciduous anterior teeth, by means of a prospective cohort study. METHODS: Fifteen infants and children aged 1 to 5 years old were longitudinally assessed (with loss or extraction of deciduous anterior teeth [n = 9], and without tooth losses [n = 6]). Photographs and dental casts at the baseline and after 24 months of follow-up were performed. Dental casts were scanned, and linear measurements were made on the digitalized models (missing tooth space, arch perimeter, arch length, arch width, intercanine length and intercanine width). The t-test was used for groups comparisons (α = 0.05). RESULTS: Individuals' mean age at baseline was 2.93 (± 1.18) years. No statistically significant differences were observed in the missing tooth space in the group with tooth loss during the 24 months of follow-up (p > 0.05). Arch perimeter, arch length, arch width, intercanine length and intercanine width did not show differences between the groups (p > 0.05). Qualitative photographic evaluation revealed other changes in the dental arches and occlusion, such as exfoliation and eruption of deciduous teeth, eruption of permanent teeth, self-correction or establishment of malocclusion, among others. CONCLUSION: The results suggest that the premature loss of deciduous anterior teeth does not affect the perimeter, length and width of the dental arches; however, other alterations that lead to malocclusion could be established.

Changes in biomarkers levels from gingival crevicular fluid in pre- and postmenopausal women undergoing orthodontic treatment : A systematic review.

PURPOSE: This study aimed to verify whether there is a difference in biomarker levels in the gingival crevicular fluid between premenopausal and postmenopausal women undergoing orthodontic treatment. METHODS: As eligibility criteria, prospective or retrospective observational studies evaluating women undergoing orthodontic treatment (P), comparing postmenopausal (E) and premenopausal (C) women, and analyzing differences in gingival crevicular fluid biomarkers (O) were included. An electronic search was conducted in seven databases (PubMed, Scopus, Web of Science, LILACS, The Cochrane Library, Embase, and EBSCO: Dentistry & Oral Science) and one grey literature source (Google Scholar). All databases were searched from September 2022 to March 2023. After duplicate exclusion and data extraction, the Newcastle-Ottawa scale was applied to assess the quality and risk of bias, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool was used to verify the certainty of evidence. RESULTS: Three case-control studies that analyzed receptor activator of nuclear factor kappa­B ligand (RANKL), osteopontin (OPN), and interleukin (IL)-17A levels were included. One study reported a significant difference for RANKL and another for OPN levels. A third study reported that there was a higher expression of IL17­A in the postmenopausal group. However, the small number of articles limits our systematic review. The heterogeneity and imprecision in the study results cast doubt on the findings' internal validity. CONCLUSION: The studies reported alterations in biomarker levels but differed in their conclusions. Therefore, further studies must include other types of bone and inflammatory biomarkers in female patients who are pre- or postmenopausal and undergoing orthodontic treatment. REGISTRATION: The review was registered at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/Q9YZ8 ).

In-vitro effect of a single application of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets.

OBJECTIVE: To assess the in-vitro effect of single applications of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets. MATERIAL AND METHODS: Tooth/bracket sets (n=65) were immersed in artificial saliva (1h at 37ºC) and randomly subjected to single applications (100µL; 1min) of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP emulsion), CPP-ACP with fluoride (CPP-ACPF emulsion), solutions of titanium tetrafluoride (TiF4) or sodium fluoride (NaF), or no treatment (CG). Multispecies biofilm (5 x 105 CFU/mL) was formed in the presence of 2% sucrose. After 24 h, the pH and the concentration of total soluble fluoride (TSF) were analyzed by culture medium. The presence of active white spot lesions (WSL) evaluated by macroscopic examination and the percent surface mineral loss (%SML) were analyzed. Also, the topography of enamel was detected by analysis of scanning electron microscopy (SEM). The data was assessed by chi-square, Kruskal-Wallis, and Mann-Whitney tests (p < 0.05). RESULTS: Fluoride-containing compounds led to a smaller pH reduction than did CPP-ACP and CG (p<0.05). There was difference in TSF between the groups (p<0.05), denoted as TiF4> NaF > CPP-ACPF > CPP-ACP > CG. Regarding the presence of WSL and %SML, the NaF group obtained lower values (p<0.05), while TiF4 and CPP-ACPF were similar (p>0.05). SEM demonstrated that fluoride-free groups had a larger surface dissolution. CONCLUSION: Fluoridated groups including solutions and CPP-ACPF were more effective than CPP-ACP in reducing enamel demineralization around orthodontic brackets after a single application.

Evaluation of the impact of orthodontists' smile with malocclusions on social media and professional credibility.

OBJECTIVES: This study assessed laypeople's perceptions of orthodontist credibility based on malocclusions and whether these views affect their choice to seek treatment. Eye-tracking technology and questionnaires were utilized. MATERIALS AND METHODS: Ninety-five lay raters, through eye tracking and a questionnaire, assessed 12 images of orthodontists with malocclusions. Malocclusions were categorized by the Index Of Treatment Need (IOTN) as grade 1 (near ideal), 3 (anterior crowding), and 5 (with diastemas). Fixation points were recorded, and credibility was gauged via questionnaires. A Mentimeter word cloud was generated. RESULTS: IOTN 1 orthodontists were viewed as more credible than IOTN 3 (p < 0.001) and 5 (p < 0.001). Raters were more willing to receive treatment from IOTN 1 orthodontists. The focus for IOTN 1 was between eyes and mouth, while IOTN 3 and 5 were on the mouth. "Crooked teeth" and "spacing" were predominant in word clouds for IOTN 3 and 5. CONCLUSION: Orthodontists with an IOTN grade 1 rating were perceived as more competent, reliable, and professional, thus making it more likely for laypeople to choose them as their preferred providers. CLINICAL RELEVANCE: The smiles of professionals play a significant role in laypeople's decision to choose them as their orthodontist, and strategic utilization of social media can effectively deliver health information to a larger audience in a faster and more direct manner.

Peeling with retinoic acid in microemulsion for treatment of melasma: A double-blind randomized controlled clinical study.

OBJECTIVE: To evaluate the clinical efficacy of peeling with a microemulsion formulation containing 1% retinoic acid. MATERIALS AND METHODS: After development of the product, 60 patients with melasma were randomly divided into three groups (n = 20): Group 1-application of conventional 1% retinoic acid peeling (RA 1%). Group 2-application of 1% retinoic acid peeling in microemulsion (RA 1%M). Group 3-Application of placebo. The groups were submitted to four peeling sessions, fortnightly on Days 0, 15, 30, and 45, and analyzed at the time intervals of 0, 15, 30, 45, and 60 days. Evaluation was made by using the Melasma Area and Severity Index (MASI) and Melasma Quality of Life (MelasquoL) instrument. Hemato-biochemical parameters were also evaluated at Days 0 and 60. After obtaining the results, normality was evaluated by means of the Kolmogorov-Smirnov test and afterwards, the following tests were applied: Friedman statistical (to test the effect of the treatments on the MASI index); Wilcoxon, (for comparison between pairs to test the effect of treatments on the MelasQoL index); Kruskal-Wallis, (to test the differences between the groups); and Mann-Whitney, (comparisons between treatments). The level of significance adopted was 5% (α = 0.05). RESULTS: The three groups presented a significant reduction in the MASI index, indicating the effect of all the treatments on reducing the melasma (p < 0.001). A significant reduction in the stains was observed with the use of retinoic acid peeling delivered in microemulsion (62%) when compared with the conventional peeling with 1% retinoic acid in a conventional vehicle (26%) and the placebo (12%). There was also a significant reduction in the MelasQoL index (sum of all the aspects) in the three groups, indicating the effect of all the treatments, including the placebo, on the overall quality of life of those with melasma. However, RA 1%M the treatment that promoted the greatest effect on the quality of life of individuals. In percentage terms, the RA 1%M provided a mean reduction of 30% in the MelasQoL index, against 13% of the conventional treatment and only 4% of the placebo. When the hemato-biochemical parameters were compared on Days 0 and 60, there were no significant changes in the results. CONCLUSION: The chemical peeling performed with RA 1%M was effective for the treatment of melasma, and was shown to be superior to the peeling performed with retinoic acid in a conventional vehicle, in reducing the stains and improving the quality of life of patients.

Can rapid maxillary expansion affect speech sound production in growing patients? A systematic review.

Rapid maxillary expansion (RME) may change speech sound parameters due to the enlargement of oral and nasal cavities. This study aimed to systematically review the current evidence on speech changes as a side effect of RME. An electronic search was conducted in nine databases, and two of them accessed the 'grey literature'. The eligibility criteria included clinical studies assessing orthodontic patients with maxillary transverse deficiency and the relationship with speech alterations without restricting publication year or language. Only interventional studies were included. The JBI Critical Appraisal Tool assessed the risk of bias. The initial search provided 4853 studies. Seven articles (n = 200 patients) met the inclusion criteria and were analysed. The primary source of bias was the absence of a control group in four studies. RME altered speech production by changing vowel fundamental frequency and fricative phoneme formant frequency. Shimmer and jitter rates changed in one and two studies, respectively. Two studies presented deterioration during orthodontic treatment, but speech improved after appliance removal. Despite the limited evidence, RME affects speech during and after treatment.

Occlusion development after premature loss of deciduous anterior teeth: preliminary results of a 24-month prospective cohort study

ABSTRACT Objective: This study aimed to evaluate occlusion development after premature loss or extraction of deciduous anterior teeth, by means of a prospective cohort study. Methods: Fifteen infants and children aged 1 to 5 years old were longitudinally assessed (with loss or extraction of deciduous anterior teeth [n = 9], and without tooth losses [n = 6]). Photographs and dental casts at the baseline and after 24 months of follow-up were performed. Dental casts were scanned, and linear measurements were made on the digitalized models (missing tooth space, arch perimeter, arch length, arch width, intercanine length and intercanine width). The t-test was used for groups comparisons (α = 0.05). Results: Individuals' mean age at baseline was 2.93 (± 1.18) years. No statistically significant differences were observed in the missing tooth space in the group with tooth loss during the 24 months of follow-up (p > 0.05). Arch perimeter, arch length, arch width, intercanine length and intercanine width did not show differences between the groups (p > 0.05). Qualitative photographic evaluation revealed other changes in the dental arches and occlusion, such as exfoliation and eruption of deciduous teeth, eruption of permanent teeth, self-correction or establishment of malocclusion, among others. Conclusion: The results suggest that the premature loss of deciduous anterior teeth does not affect the perimeter, length and width of the dental arches; however, other alterations that lead to malocclusion could be established.

RESUMO Objetivo: Este estudo teve como objetivo avaliar o desenvolvimento da oclusão após perda prematura ou extração de dentes decíduos anteriores, por meio de um estudo de coorte prospectivo. Métodos: Quinze bebês e crianças de 1 a 5 anos foram avaliados longitudinalmente (com perda ou extração de dentes anteriores decíduos [n = 9] e sem perdas dentárias [n = 6]). Foram realizadas fotografias e modelos dentais no início e após 24 meses de acompanhamento. Os modelos dentários foram escaneados e medidas lineares foram feitas nos modelos digitalizados (espaço dentário perdido, perímetro da arcada, comprimento da arcada, largura da arcada, comprimento intercaninos e largura intercaninos). O teste t foi utilizado para comparações entre grupos (α = 0,05). Resultados: A média de idade dos indivíduos no início do estudo foi de 2,93 (± 1,18) anos. Não foram observadas diferenças estatisticamente significativas no espaço dentário perdido no grupo com perda dentária durante os 24 meses de acompanhamento (p > 0,05). O perímetro da arcada, comprimento da arcada, largura da arcada, comprimento intercaninos e largura intercaninos não apresentaram diferenças entre os grupos (p> 0,05). A avaliação fotográfica qualitativa revelou alterações nas arcadas dentárias e na oclusão, como: esfoliação e erupção de dentes decíduos, erupção de dentes permanentes, autocorreção ou estabelecimento de má oclusão, entre outras. Conclusão: Os resultados sugerem que a perda prematura de dentes anteriores decíduos não afeta o perímetro, comprimento e largura das arcadas dentárias; entretanto, outras alterações que levam à má oclusão poderiam ser estabelecidas.

Aesthetic perception of black spaces between lower incisors by laypeople of different ethnicities and age groups

Objective: To evaluate the degree of perception among lay people of different age groups about black spaces between lower incisors. Methodology: digital changes were performed in a frontal photograph of a smiling 30 year-old patient, simulating different dimensions of black spaces. The images were printed on photographic paper and applied with a questionnaire in order to evaluate the attractiveness using as tool a visual analogue scale (VAS). The participants were divided into 6 groups, considering race (Caucasian and Negroid) and age (15-19 years, 35-44 years and 65-74 years old). The differences between the examiners were checked by the Mann-Whitney test and the significance level was 5% (α = 0.05) for all analyzes. Results: The photographs that did not have black spaces were better graded and the ones that had larger black spaces scored worse. The older age group and the Negroid race group graded better the photograph with the largest black spaces, compared to the younger age groups and the group of Caucasians. Conclusion: black spaces between lower incisors are esthetically unattractive and their perception decreases with aging, besides being less relevant to older and Negroid people.

Assessing the reliability of ChatGPT: a content analysis of self-generated and self-answered questions on clear aligners, TADs and digital imaging.

INTRODUCTION: Artificial Intelligence (AI) is a tool that is already part of our reality, and this is an opportunity to understand how it can be useful in interacting with patients and providing valuable information about orthodontics. OBJECTIVE: This study evaluated the accuracy of ChatGPT in providing accurate and quality information to answer questions on Clear aligners, Temporary anchorage devices and Digital imaging in orthodontics. METHODS: forty-five questions and answers were generated by the ChatGPT 4.0, and analyzed separately by five orthodontists. The evaluators independently rated the quality of information provided on a Likert scale, in which higher scores indicated greater quality of information (1 = very poor; 2 = poor; 3 = acceptable; 4 = good; 5 = very good). The Kruskal-Wallis H test (p< 0.05) and post-hoc pairwise comparisons with the Bonferroni correction were performed. RESULTS: From the 225 evaluations of the five different evaluators, 11 (4.9%) were considered as very poor, 4 (1.8%) as poor, and 15 (6.7%) as acceptable. The majority were considered as good [34 (15,1%)] and very good [161 (71.6%)]. Regarding evaluators' scores, a slight agreement was perceived, with Fleiss's Kappa equal to 0.004. CONCLUSIONS: ChatGPT has proven effective in providing quality answers related to clear aligners, temporary anchorage devices, and digital imaging within the context of interest of orthodontics.

Development and psychometric properties of a questionnaire about knowledge of lay people about traumatic dental injury.

BACKGROUND/AIMS: The level of knowledge about traumatic dental injuries (TDI) of lay people from a national point of view has never been studied and there is currently a lack of validated research instruments on this issue. The present study aims to develop and validate a questionnaire (TDI-Q) to assess the knowledge of lay people about TDI, including participants from the five regions of Brazil. MATERIAL AND METHODS: TDI-Q was drafted, in Brazilian Portuguese, based on the recommendations of the International Association of Dental Traumatology (IADT). Before its application, TDI-Q was evaluated by dentists, lay people, linguists, and psychometrists. The questionnaire was applied to measure temporal stability at two distinct times, with an interval of 15-20 days between the two applications: test (n = 110) and retest (n = 50). The presence of floor and ceiling effects were investigated by analyzing the frequency of responses of the questionnaire; convergent construct validity was tested through Spearman's correlation; the Mann-Whitney test was applied to discriminant construct validity. Temporal stability and internal consistency were evaluated through intraclass correlation coefficient and Cronbach's alpha, respectively. RESULTS: The floor and ceiling effects were not observed (0.9% and 2.7%, respectively); convergent validity analysis indicated a positive and strong correlation (r = 0.50; p < .001). Significant discriminant construct validity (p < .05) was observed. Satisfactory internal consistency (α = 0.7) and temporal stability (ICC = 0.82, p < .001) were also achieved. CONCLUSION: TDI-Q proved to have good psychometric properties and to be a reliable tool for evaluating the knowledge of lay people regarding TDI in the Brazilian population.

Development and validation of the Brazilian Version of Lay Persons' Social Judgements about Cleft-lip Scale (B-LSojCleft-S).

The aim of this study was to develop and analyze the psychometric properties of the Brazilian Version of Lay Person's Social Judgement about Cleft-lip Scale (B-LSojCleft-S). A standardized photograph of a 16-year-old girl was manipulated by using photo editing software, to simulate different cleft-lip situations. The cleft-free image was used as a control. The researchers structured an initial questionnaire that was evaluated by experts and a sample of the target population to evaluate the construct. After analysis by the researchers, a final version of the B-LSojCleft-S containing 14 items was generated. Each answer was awarded score from 1 to 3 points, yielding a total score of 14 to 42 points. Higher scores represented better social judgements. The B-LSojCleft-S was applied online to 103 test participants and 73 retest participants with an interval of 20 days between application. Aspects of acceptability, discriminant property, internal consistency, reliability and construct validity were evaluated. Construct validity was assessed using the Friedman test (p < 0.05). Reliability was determined using an intraclass correlation coefficient > 0.70, and internal consistency using Cronbach's alpha > 0.81. The B-LSojCleft-S showed high acceptability, strong discriminant property, excellent internal consistency and reliability, but had a floor and ceiling effect. The instrument reached valid and reliable scores and had acceptable psychometric properties to evaluate the social judgments of lay persons about different cleft lip situations in a Brazilian population.

Orthodontics social media, perceptions of science- and non-science-based posts among orthodontists, dentists, students and laypeople.

Worldwide, social media is gaining popularity year after year. In Brazil, by 2027, there will be more than 188 million users of social media sites, against 165 million in 2022, therefore, the usage of general population and health care professionals, including orthodontists, is increasing. Differently from scientific journals that undergo a rigorous peer review process prior to publication, the same level of demand is not found on social media. Hence, this study aimed to assess whether orthodontists can recognize scientifically based and non-science-based posts and if their perceptions are different from general opinion (laypeople), dentistry students, and dentists (non-orthodontists). The posts were created using the search tool on Instagram with the hashtags #clearaligners #acceledent #selfligatingbraces and #propelorthodontics, four scientific based posts and four without or with low scientific evidence were selected and evaluated through a virtual questionnaire in the QUALTRICS platform by 385 people, (175 laypeople, 102 dentists, 58 dentistry students, and 50 orthodontists) using a visual analogue scale (VAS). In addition, four questions were asked. ANOVA (Adjusted Bonferroni correction) and Pearson's chi-squared, and Student T tests were applied to identify statistical differences. Significant difference was found only for posts with no scientific evidence between orthodontist's group when comparing with laypeople (p < 0.001) for the #selfligatingbraces, and the #propelorthodontics for the group orthodontists when compared with laypeople (p = 0.031) and dentists (p = 0.033). Instagram was the favorite social media where most of the participants spend more than 3 h. Of the participants, 97% used social media to keep informed and read the news. Almost half of the respondents search for orthodontics services on social media. Orthodontists were able to perceive differences in only two posts from the general perception (laypeople) regarding non- or low-scientific-evidence posts.

Effect of an aqueous 4% titanium tetrafluoride solution on preventing caries in orthodontic patients: a controlled clinical trial.

INTRODUCTION: Titanium tetrafluoride (TiF4) is a fluoride compound that, when is applied over enamel, promotes a protection against demineralization through a titanium dioxide (TiO2) acid-resistant coat. OBJECTIVES: This study sought to verify the hypothesis that a single application of 4% TiF4 increases the resistance of enamel to dental demineralization in orthodontic patients. MATERIALS AND METHODS: This controlled clinical trial followed CONSORT guidelines and investigated the prevention of enamel demineralization, fluoride retention, and the presence of a Ti layer after TiF4 application on banded teeth exposed to clinical cariogenic biofilm. Forty premolars were divided into a control group (CG; n = 20) and a test group (TG; n = 20). Teeth from both groups received prophylaxis and orthodontic bands with a cariogenic locus. In the TG, all teeth additionally underwent aqueous 4% TiF4 solution application after prophylaxis before being banded. After one month, teeth from both groups were extracted and prepared to assess the microhardness, fluoride retention, and evaluation of the Ti coating over the enamel surface. All data were analyzed with a paired Student's t-test (p<0.05). RESULTS: Enamel microhardness and fluoride uptake were higher in TG than in CG, while the Ti layer could be seen over TG teeth that received TiF4 application. CONCLUSION: Under clinical circumstances, the 4% aqueous TiF4 solution was effective in preventing enamel mineral loss through increasing the enamel resistance to dental demineralization, enhancing its microhardness and fluoride uptake, and forming a Ti coat.

Alterações dimensionais em marcas de mordidas humanas simuladas em alimentos: estudo in vitro / Dimensional changes in simulated human bite marks on food: in vitro study

Objetivo: avaliar alterações dimensionais em marcas de mordidas simuladas em um tipo de queijo e de goiabada com o decorrer do tempo. Materiais e Métodos: mordidas foram simuladas em 20 amostras-padrão formato retangular nas medidas 30 x 60 mm e espessura de 20 mm de queijo tipo muçarela (n=10) e goiabada (n=10) com a utilização de um manequim odontológico montado em oclusão normal e acoplado à máquina universal de ensaios mecânicos. Amostras foram mantidas em superfície de vidro em ambiente com temperatura e umidade controladas seguida da aferição das distâncias intercaninas das marcas a cada hora com auxílio de paquímetro digital, durante 120 horas de experimentação. A temperatura e umidade mantiveram-se constantes durante todo período. As medidas obtidas foram estatisticamente analisadas por meio dos testes de Friedman, de Wilcoxon, coeficiente de correlação de Spearman e a partir da análise de regressão linear simples. O nível de significância adotado foi de 5%. Resultados: os alimentos testados mantiveram o padrão das medidas lineares nas primeiras quatro horas (p>0,05). Após esse período, ocorreu uma deformação progressiva, levando ao aumento significativo das medidas (p<0,05). Conclusão: a marca de mordida em queijo tipo muçarela e goiabada apresentou-se dimensionalmente estável nas primeiras quatro horas, pós mordida. Após esse período, as marcas já não apresentaram características favoráveis para serem utilizadas como registro para fins de comparação.

Objective: to evaluate dimensional changes in simulated bite marks in a type of cheese and guava paste over time. Materials and Methods: Bites were simulated on 20 standard rectangular samples. in the measures 30 x 60 mm and thickness of 20 mm of mozzarella cheese (n=10) and guava paste (n=10) using a dental manikin mounted on normal occlusion and coupled to the universal mechanical testing machine. The samples were kept on a glass surface in an environment with controlled temperature and humidity , followed by the measurement of intercanine distances of the marks, every hour, with the aid of a caliper digital, during 120 hours of experimentation. The temperature and humidity remained constant throughout the period. The measurements obtained were statistically analyzed using the Friedman, Wilcoxon, Spearman's correlation coefficient and from the linear regression analysis simple (IBM SPSS. 21.0, 2012, Armonk, NY: IBM Corp.). The level of significance adopted was 5%. Results: the foods tested maintained the pattern of linear measurements in the first four hours (p>0.05). After this period, a progressive deformation occurred, leading to the significant increase in measurements (p<0.05). Conclusion: the bite mark in mozzarella cheese and guava paste it was dimensionally stable in the first four hours, post-bite. After this period, brands no longer have favorable characteristics to be used as a record for comparison purposes.

Cone-beam computed tomography study of mandibular morphology and tooth compensation in asymmetrical patients.

INTRODUCTION: This study evaluated mandibular morphology and transverse dental compensation between symmetrical and asymmetrical subjects, allocated according to sagittal skeletal patterns. In addition, the hypothesis that mandibular morphology and dental compensations differed between symmetrical/asymmetrical groups and also among the different types of sagittal skeletal patterns was tested. METHODS: Cone-beam computed tomography images of 96 patients were included in this study and were divided into 2 groups according to the degree of menton deviation: a symmetrical group with deviation up to 2.0 mm (n = 48; mean age, 15 ± 6 years), and an asymmetrical group with deviation from 3.5 mm (n = 48; mean age, 16 ± 8 years). The 2 groups were divided in accordance with the ANB angle: Class I, II, and III. Skeletal and dental measurements were performed. Intergroup and intragroup analyses were carried out, using a 2-way analysis of variance to assess the interaction of factors: symmetry and sagittal skeletal pattern; and the Student t test for differences between deviated (Dv) and nondeviated (NDv) sides. RESULTS: Symmetrical/asymmetrical groups and Class I, II, and III groups were similar in relation to demographic aspects (P = 0.412 and P = 0.357 for sex and age, respectively). Asymmetrical patients had higher values for body length and mandibular ramus and condyle height on the NDv side (P = 0.011, P = 0.024, and P = 0.001, respectively). When comparing the different skeletal patterns, patients with a Class III relationship demonstrated higher values for mandibular ramus height. Intergroup analysis showed no differences in dental parameters. In the comparison between the sides, the asymmetrical group showed a significant difference in canine inclination (P = 0.008), mandibular ramus height (P = 0.004), condyle height (P = 0.010) and gonion to midsagittal plane distance (P = 0.018). CONCLUSIONS: Asymmetrical subjects showed higher values for canine inclination and mandibular body, ramus and condylar height on the NDv side. The hypothesis was partially confirmed that mandibular morphology and dental compensations are different between symmetrical/asymmetrical groups and among different sagittal skeletal patterns.

Patient perception of orthodontists with different stereotypes: development, psychometric properties, and application of an assessment instrument.

INTRODUCTION: This research aimed to develop and validate a questionnaire that considers social judgments and, through its application, assesses whether the presence of piercings, tattoos, beards, and loose hair visible in the face and neck region reflect on the patient perception regarding characteristics of the orthodontist's professional scope. METHODS: The developed questionnaire had its psychometric properties evaluated and was applied to 220 young people and adults, aged 18-70 years, who responded according to their perception of 12 manipulated images of orthodontists with different stereotypes, considering the following items: hygiene, care, punctuality, experience and knowledge in orthodontics. RESULTS: The developed questionnaire showed high acceptability, confirmed reliability and validity of the construct, and satisfactory internal consistency. The stereotype interfered with the perception of professionalism (P <0.01), in which the orthodontist with combined characteristics (beard/loose hair, piercing, earrings, and tattoo) obtained the lowest mean scores, both for each item of the questionnaire individually (P <0.01) and in total (P <0.01). Health professional (P = 0.427) and educational level (P = 0.285) status did not influence the perception; however, there was a significant difference for the age groups (P = 0.041). CONCLUSIONS: The developed questionnaire proved to be valid and reliable for application. Orthodontists with piercings and tattoos on the face and neck were considered less professional. Being a health professional and educational level status did not influence the perception. However, older subjects (aged 51-70 years) were more critical in judging stereotypes than younger subjects (aged 18-30 years).

Did the Use of Minimum Interventions for Caries Management Change during the COVID-19 Pandemic? A Cross-Sectional Study.

The aim of this study was to evaluate changes in the frequency of use of minimum intervention (MI) techniques for caries management during the COVID-19 pandemic. A questionnaire was applied through the SurveyMonkeyTM platform to evaluate changes in the dentist's frequency of use of noninvasive, microinvasive, minimally invasive, and mixed interventions, nonaerosol or aerosol productive, to manage dental caries before and during COVID-19 pandemic. Differences in the use of MI techniques were analyzed by Wilcoxon test, and the effect size (ES) was calculated. An α = 0.05 was adopted. A total of 781 dentists answered the questionnaire; most of them were female (76.4%), with 30s (76.4%), graduated over 10-24 years ago (38%) in public dental schools (62%), graduated in southwest of Brazil (38%), that work in clinical environment (66.8%) and in private jobs (53.4%). During COVID-19, among the sample, 91 respondents were not working. In relation to the noninvasive techniques, only the use of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) decreased during the COVID-19 pandemic (p < 0.01; ES = 0.11). The frequency of sealants to repair defective restorations was the only microinvasive technique that increased during the pandemic (p < 0.01; ES = 0.03). Among the minimally invasive techniques, the use of atraumatic restorative treatment increased significantly (p < 0.01; ES = 0.06), while the use of air abrasion decreased (p = 0.02; ES = 0.04) during COVID-19 pandemic. Moreover, nonrestorative cavity control (mixed intervention) increased during pandemic period (p < 0.001; ES = 0.11). Although the results demonstrated differences in the use of some procedures, a very small magnitude of the effect was perceived, demonstrating that the influence of COVID-19 pandemic was very little, if any, in the use of MI techniques for caries management. Moreover, the use of MI strategies was already well established between Brazilian dentists before the pandemic period.

Treatment of Class II malocclusion with anterior open bite and posterior crossbite with the aid of mini-implants in a patient with Down syndrome: Clinical case report.

OBJECTIVE: We report the orthodontic treatment of a class II malocclusion with anterior open bite and posterior crossbite in a patient with Down syndrome (DS) treated with mini-implants. METHODS: Treatment began with rapid maxillary expansion with a Haas appliance, followed by dental alignment and leveling with a fixed appliance and the correction of class II dental relationships with the use of orthodontic mini-implants associated with a sliding jig. RESULTS: The results obtained at the end of the treatment were satisfactory, with improvements in occlusion, including bite closure; maxillary expansion; and the correction of dental relationships. CONCLUSION: When well-planned, orthodontic treatment in a patient with DS achieves satisfactory results from a skeletal, occlusal, and facial perspective.