Fatores biopsicossociais do Eixo II dos Critérios de Diagnóstico para Pesquisa das Desordens Temporomandibulares em indivíduos com disfunção temporomandibular muscular e migrânea / Biopsychosocial factors of Axis II of the Research Diagnostic Criteria for Temporomandibular Disorders in individuals with muscular temporomandibular disorder and migraine

RESUMO JUSTIFICATIVA E OBJETIVOS: Relacionar as variáveis biopsicossociais do Research Diagnostic Criteria for Temporomandibular Disorders com os grupos de pacientes com disfunção temporomandibular, com disfunção temporomandibular e migrânea e grupo controle. MÉTODOS: Estudo do tipo observacional transversal onde foram avaliados 280 pacientes consecutivos, divididos em 3 grupos: grupo I (140 indivíduos controle); grupo II (65 indivíduos com disfunção temporomandibular muscular) e grupo III (75 indivíduos com migrânea e disfunção temporomandibular muscular). Os critérios de exclusão foram indivíduos que apresentaram histórico clínico de processos inflamatórios musculares, espasmos musculares, contraturas e injúria traumática aguda na articulação temporomandibular. RESULTADOS: Os indivíduos do grupo III apresentaram associação com depressão grave (p<0,0001), grau 4 na variável intensidade da dor (p=0,004), sintomas físicos não específicos sem dor intensa (p<0,0001) e sintomas físicos não específicos com dor intensa (p<0,0001). Houve diferença significativa entre os gêneros feminino e masculino no grupo III (Z=2,59; p=0,001), evidenciando maior tempo de dor no gênero feminino. A porcentagem de mulheres no grupo III foi significativamente maior em relação aos homens (p=0,004). CONCLUSÃO: A relação entre as variáveis e os três grupos mostrou maior número de indivíduos acometidos com maior intensidade de sintomas no grupo III. Dessa forma, entende-se que a migrânea é uma condição mórbida frequentemente associada à disfunção temporomandibular, potencializando os sintomas descritos pelos pacientes. Há necessidade de avaliações clínicas multidisciplinares nesses indivíduos para que o tratamento seja otimizado, minimizando a morbidade e diminuindo os custos e o número de consultas prestadas aos pacientes.

ABSTRACT BACKGROUND AND OBJECTIVES: To relate biopsychosocial variables of Research Diagnostic Criteria for Temporomandibular Disorders to groups of patients with temporomandibular disorders, temporomandibular disorders and migraine and a control group. METHODS: This is a cross-sectional observational study where 280 consecutive patients were evaluated and distributed in three groups: group I (140 control individuals); group II (65 individuals with muscle temporomandibular disorders) and group III (75 individuals with migraine and muscle temporomandibular disorders). Exclusion criteria were individuals with clinical history of muscle inflammatory processes, muscle spasms, contractures and acute temporomandibular joint traumatic injury. RESULTS: Group III individuals had association with severe depression (p<0.001), level 4 in pain severity (p=0.004), unspecific physical symptoms without severe pain (p<0.0001) and unspecific symptoms with severe pain (p<0.00001). There has been significant difference between females and males in group III (Z=2.59; p=0.001), with longer pain duration among females. The percentage of females in group III was significantly higher as compared to males (p=0.004). CONCLUSION: The relationship between variables and the three groups has shown a higher number of individuals with more severe symptoms in group III. So, it is understood that migraine is a morbid condition often associated to temporo mandibular disorders, worsening symptoms referred by patients. There is the need for multidisciplinary evaluation of these individuals to optimize treatment and minimize morbidity, costs and the number of medical visits.

Maxillary anterior alignment stability in Class I and Class II malocclusions treated with or without extraction.

OBJECTIVE: To compare the postretention stability of maxillary incisors alignment in subjects with Class I and II malocclusion treated with or without extractions. MATERIALS AND METHODS: The sample comprised 103 subjects with initial maxillary anterior irregularity greater than 3 mm and was divided into four groups: group 1 comprised 19 patients with Class I malocclusion treated with nonextraction (mean initial age = 13.06 years); group 2 comprised 19 patients with Class II malocclusion treated with nonextraction (mean initial age = 12.54 years); group 3 comprised 30 patients with Class I malocclusion treated with extractions (mean initial age = 13.16 years); group 4 comprised 35 patients with Class II malocclusion treated with extractions (mean initial age = 12.99 years). Dental casts were obtained at three different stages: pretreatment (T1), posttreatment (T2), and long-term posttreatment (T3). Maxillary incisor irregularity and arch dimensions were evaluated. Intergroup comparisons were performed by one-way analysis of variance followed by Tukey tests. RESULTS: In the long-term posttreatment period, relapse of maxillary crowding and arch dimensions was similar in all groups. CONCLUSION: Changes in maxillary anterior alignment in Class I and Class II malocclusions treated with nonextractions and with extractions were similar in the long-term posttreatment period.

Stability of maxillary anterior crowding treatment / Estabilidade do tratamento de apinhamento anterossuperior

OBJECTIVE: To evaluate the stability and the relapse of maxillary anterior crowding treatment on cases with premolar extraction and evaluate the tendency of the teeth to return to their pretreatment position. METHODS: The experimental sample consisted of 70 patients of both sex with an initial Class I and Class II maloclusion and treated with first premolar extractions. The initial mean age was 13,08 years. Dental casts' measurements were obtained at three stages (pretreatment, posttreatment and posttreatment of 9 years on average) and the variables assessed were Little Irregularity Index, maxillary arch length and intercanine. Pearson correlation coefficient was used to know if some studied variable would have influence on the crowding in the three stages (LII1, LII2, LII3) and in each linear displacement of the Little irregularity index (A, B, C, D, E) in the initial and post-retention phases. RESULTS: The maxillary crowding relapse ( LII3-2) is influenced by the initial ( LII1), and the teeth tend to return to their pretreatment position. CONCLUSION: The results underline the attention that the orthodontist should be given to the maxillary anterior relapse, primarily on those teeth that are crowded before the treatment.

OBJETIVO: avaliar a estabilidade e recidiva do tratamento de apinhamento dos dentes anterossuperiores em casos com extrações de pré-molares e avaliar a tendência dos dentes apinhados, no início do tratamento, a retornar à sua posição original. MÉTODOS: a amostra consistiu de 70 pacientes de ambos os sexos, com má oclusão inicial de Classe I e Classe II de Angle, tratados com extrações dos primeiros pré-molares. A idade média inicial foi de 13,08 anos. Foram avaliados os modelos de estudo nas fases inicial (T1), final (T2) e, em média, 9 anos pós-tratamento (T3) de cada paciente. As variáveis da arcada superior avaliadas e comparadas estatisticamente pela Análise de Variância (ANOVA) foram: índice de irregularidade de Little Superior (IRLS), comprimento da arcada (CAS) e distância intercaninos (DICS). O Teste de Correlação de Pearson foi utilizado para verificar se alguma variável estudada teria influência sobre o apinhamento nas três fases (IRLS1, IRLS2, IRLS3) e em cada deslocamento de Little (A, B, C, D, E), na fase inicial e pós-tratamento. RESULTADOS: a recidiva do apinhamento superior (IRLS3-2) é influenciada pelo apinhamento inicial (IRLS1), e os dentes tendem a voltar à posição original. CCONCLUSÃO: os resultados ressaltam a atenção que o ortodontista deve dar à recidiva anterossuperior, principalmente àqueles dentes que estavam apinhados antes do tratamento.

Análise da relação carga/deflexão de fios ortodônticos retangulares de beta-titânio e aço inoxidável / Analysis of load/deflection rate of rectangular beta-titanium and stainless steel archwires

Visando comparar a relação carga/deflexão de fios ortodônticos retangulares de beta-titânio e aço inoxidável, de diferentes marcas, foram selecionados cinco arcos pré-contornados de cada uma das ligas das seguintes marcas: Abzil Lancer, Morelli, 3M Unitek e Ormco. A metodologia consistiu em posicionar os fios em um manequim ortodôntico com aparelho fixo colado e desprovido de incisivo central superior direito. O conjunto foi fixado a uma máquina universal de ensaios, Emic 10000, munida de uma ponteira de aço que transmitia cargas no centro do segmento do fio selecionado, correspondente ao incisivo extraído. Conforme o equipamento aplicava as forças, um software mensurava a deflexão do fio e gerava, automaticamente, gráficos e tabelas da relação carga/deflexão. Os fios de beta-titânio que apresentaram a menor relação carga/deflexão foram da marca Ormco, seguidos pela 3M Unitek e Abzil Lancer, que não apresentaram diferenças estatisticamente significantes. Analisando comparativamente os dois tipos de fios, notou-se que a liga de beta-titânio demonstrou uma relação carga/deflexão bem menor que a do aço inoxidável, independente da marca comercial do fio.

Comparing the load/deflection rate of beta-titanium and stainless steel rectangular orthodontic wire from different companies makers available in Brazil, they were selected by five archwires from each alloys of: Abzil Lancer, Morelli, 3M Unitek and Ormco. The methodology of replace the archwires in an orthodontic mannequin with fixed appliance and without right central incisor superior. The team was fixed in a Universal Testing Machine - Emic 10000 - that has a stainless pointer which takes the load in the center of the selected section of wire, in the area of the extracted incisor. While the equipment pressing the wire, a software was measuring the deflection of the wire and providing graphics and charts of load/deflection relate. The arches of beta-titanium alloy that had the lowest load/deflection rate was Ormco followed by 3M Unitek and Abzil Lancer, those didn't show significant statistic differences. Comparing both types of wires, concluded that the beta-titanium alloy showed a lower load/deflection rate than stainless steel, independent of brand wires.

Stability and relapse of maxillary anterior crowding treatment in class I and class II Division 1 malocclusions.

INTRODUCTION: The maxillary anterior teeth are the most important to facial esthetics because they are the first to show on a smile. Therefore, stability of the maxillary anterior teeth alignment is an important issue. The objective of this study was to compare the stability of maxillary anterior tooth alignment in Class I and Class II Division 1 malocclusions. METHODS: The sample comprised dental casts of 70 patients with Class I and Class II Division 1 malocclusions and a minimum of 3 mm of maxillary anterior crowding measured by an irregularity index. The patients were treated with extractions and evaluated at pretreatment and posttreatment and at least 5 years after treatment. The sample was divided into 3 groups: group 1, Class I malocclusion treated with 4 first premolar extractions comprising 30 subjects, with an initial age of 13.16 years and 8.59 mm of initial maxillary irregularity; group 2, Class II malocclusion treated with 4 first premolar extractions comprising 20 subjects, with an initial age of 12.95 years and 11.10 mm of maxillary irregularity; and group 3, Class II malocclusion treated with 2 first maxillary premolar extractions comprising 20 subjects, with an initial age of 13.09 years and 9.68 mm of maxillary irregularity. RESULTS: The decrease in the maxillary irregularity index was significantly greater in group 2 than in group 1 during treatment. The stability of maxillary anterior alignment was 88.12% over the long term; 77% of the linear displacement of the anatomic contact points tended to return to their original positions. CONCLUSIONS: Stability of maxillary anterior alignment between the 3 groups was similar. The stability of maxillary anterior alignment was high over the long term, but a high percentage of teeth tended to return to their original positions.

Craniofacial characteristics of Caucasian and Afro-Caucasian Brazilian subjects with normal occlusion.

OBJECTIVE: The objective of this study was to compare the skeletal, dental and soft tissue characteristics of Caucasian and Afro-Caucasian Brazilian subjects with normal occlusion and to evaluate sexual dimorphism within the groups. MATERIAL AND METHODS: The sample comprised lateral cephalograms of untreated normal occlusion subjects, divided into 2 groups. Group 1 included 40 Caucasian subjects (20 of each sex), with a mean age of 13.02 years; group 2 included 40 Afro-Caucasian subjects (20 of each sex), with a mean age of 13.02 years. Groups 1 and 2 and males and females within each group were compared with t tests. RESULTS: Afro-Caucasian subjects presented greater maxillary protrusion, smaller upper anterior face height and lower posterior face height, larger upper posterior face height, greater maxillary and mandibular dentoalveolar protrusion as well as soft tissue protrusion than Caucasian subjects. The Afro-Caucasian female subjects had less mandibular protrusion and smaller total posterior facial height and upper posterior facial height than males. CONCLUSIONS: Brazilian Afro-Caucasian subjects have greater dentoalveolar and soft tissue protrusion than Brazilian Caucasian subjects, with slight sexual dimorphism in some variables.

Craniofacial characteristics of Caucasian and Afro-Caucasian Brazilian subjects with normal occlusion

OBJECTIVE: The objective of this study was to compare the skeletal, dental and soft tissue characteristics of Caucasian and Afro-Caucasian Brazilian subjects with normal occlusion and to evaluate sexual dimorphism within the groups. MATERIAL AND METHODS: The sample comprised lateral cephalograms of untreated normal occlusion subjects, divided into 2 groups. Group 1 included 40 Caucasian subjects (20 of each sex), with a mean age of 13.02 years; group 2 included 40 Afro-Caucasian subjects (20 of each sex), with a mean age of 13.02 years. Groups 1 and 2 and males and females within each group were compared with t tests. RESULTS: Afro-Caucasian subjects presented greater maxillary protrusion, smaller upper anterior face height and lower posterior face height, larger upper posterior face height, greater maxillary and mandibular dentoalveolar protrusion as well as soft tissue protrusion than Caucasian subjects. The Afro-Caucasian female subjects had less mandibular protrusion and smaller total posterior facial height and upper posterior facial height than males. CONCLUSIONS: Brazilian Afro-Caucasian subjects have greater dentoalveolar and soft tissue protrusion than Brazilian Caucasian subjects, with slight sexual dimorphism in some variables.

Metallographic analysis of the internal microstructure of orthodontic mini-implants.

Effective orthodontic anchorage may be obtained by miniimplants inserted into the maxillary bones. However, the risk of miniimplant failure is one of the most important issues, especially the rupture of its structure referred to as fracture, mainly due to metal deficiencies. This study analyzed the internal microstructure of orthodontic mini-implants, ascertaining the composition of the metal to detect possible discontinuities from the surface to the core of the screws. Eighteen samples of mini-implants, of 3 different brands, were obtained. The samples were cold-embedded in methyl methacrylate polymer, and were sectioned both longitudinally (3 samples of each brand) and transversely (the other 3 screws of each brand). After preparation, the samples were observed using a light microscope at up to 2,000 x magnification. The results showed that the mini-implants thus analyzed were composed of an Alpha-Beta globular phase of titanium alloy, patterns A1 and A9 (in accordance with the "Technical Committee of European Titanium Producers"). The miniimplants did not present any defects such as bubbles, imperfections or fissures, in either longitudinal or transverse sections, in their internal microstructure. All samples met the requirements of international norms. Orthodontists must be aware of the metal composition and internal microstructure of mini-implants, to decrease the risk of fractures.

Metallographic analysis of the internal microstructure of orthodontic mini-implants

Effective orthodontic anchorage may be obtained by miniimplants inserted into the maxillary bones. However, the risk of miniimplant failure is one of the most important issues, especially the rupture of its structure referred to as fracture, mainly due to metal deficiencies. This study analyzed the internal microstructure of orthodontic mini-implants, ascertaining the composition of the metal to detect possible discontinuities from the surface to the core of the screws. Eighteen samples of mini-implants, of 3 different brands, were obtained. The samples were cold-embedded in methyl methacrylate polymer, and were sectioned both longitudinally (3 samples of each brand) and transversely (the other 3 screws of each brand). After preparation, the samples were observed using a light microscope at up to 2,000 x magnification. The results showed that the mini-implants thus analyzed were composed of an Alpha-Beta globular phase of titanium alloy, patterns A1 and A9 (in accordance with the "Technical Committee of European Titanium Producers"). The miniimplants did not present any defects such as bubbles, imperfections or fissures, in either longitudinal or transverse sections, in their internal microstructure. All samples met the requirements of international norms. Orthodontists must be aware of the metal composition and internal microstructure of mini-implants, to decrease the risk of fractures.

Tooth-wear patterns in adolescents with normal occlusion and Class II Division 2 malocclusion.

INTRODUCTION: In this study, we investigated tooth-wear patterns in adolescents with either normal occlusion or Class II Division 2 malocclusion. METHODS: The sample consisted of dental casts from 165 subjects that were divided into 2 groups: 115 normal occlusion subjects (mean age, 14.3 years) and 50 complete Class II Division 2 subjects (mean age, 13.9 years). Dental wear was assessed by using a modified version of the tooth wear index. The 2 groups were compared with the Mann-Whitney test for the frequency and severity of wear on each surface of each group of teeth. The level of statistical significance was set at 5%. RESULTS: The normal occlusion group statistically had greater tooth wear on the incisal surfaces of the maxillary lateral incisors and the incisal surfaces of the maxillary canines than did the Class II Division 2 malocclusion group. The malocclusion group showed statistically greater tooth wear on the labial surfaces of the mandibular lateral incisors, the occlusal surfaces of the maxillary premolars and first molars, the occlusal surfaces of the mandibular premolars, the palatal surfaces of the maxillary second premolars, and the buccal surfaces of the mandibular premolars and first molars than did the normal occlusion group. CONCLUSIONS: Subjects with normal occlusion and those with complete Class II Division 2 malocclusions have different tooth-wear patterns. Tooth wear on the malocclusion subjects should not be considered pathologic but, rather, the consequence of different interocclusal arrangements.

Tooth-wear patterns in subjects with Class II Division 1 malocclusion and normal occlusion.

INTRODUCTION: The aim of this study was to investigate the prevalence of tooth wear in adolescents with Class II malocclusion, compared with those with normal occlusion. METHODS: The sample consisted of dental casts obtained from 310 subjects, divided into 3 groups: group 1, 110 subjects with normal occlusion (mean age, 13.51 years); group 2, 100 complete Class II Division 1 patients (mean age, 13.44 years); and group 3, 100 half-cusp Class II Division 1 patients (mean age, 13.17 years). Dental wear was assessed by using a modified version of the tooth-wear index. The 3 groups were compared by means of the Kruskal-Wallis and Dunn tests, considering the frequency and the severity of wear on each surface of each group of teeth. The level of statistical significance was set at 5%. RESULTS: The normal occlusion group had statistically greater tooth wear on the palatal surfaces of the maxillary central incisors and the incisal surfaces of the maxillary canines than the corresponding surfaces in both Class II malocclusion groups. The complete and half-cusp Class II Division 1 malocclusion groups had statistically greater tooth wear on the occlusal surfaces of the maxillary second premolar and first molar, the occlusal surfaces of the mandibular premolars, and the buccal surfaces of the mandibular posterior teeth compared with the normal occlusion group. The half-cusp Class II Division 1 malocclusion group had significantly greater tooth wear on the incisal surfaces of the mandibular incisors compared with the complete Class II Division 1 malocclusion group. CONCLUSIONS: Subjects with normal occlusion and complete or half-cusp Class II Division 1 malocclusions have different tooth-wear patterns. Tooth wear on the malocclusion subjects should not be considered pathologic but rather consequent to the different interocclusal tooth arrangement.

Método para avaliação da mastigação unilateral na dentadura mista / Method for evaluating unilateral mastication in mixed dentition

A mastigação unilateral é, muitas vezes, o resultado da adaptação funcional a alterações que impedem movimentos suaves durante as excursões laterais da mandíbula. A literatura apresenta inúmeros trabalhos relatando consequências negativas nas estruturas faciais, tais como nos músculos mastigatórios, nas superfícies oclusais e na articulação temporomandibular, decorrente da mastigaçãounilateral.O método mais conhecido para a avaliação da mastigação unilateral é o método clínico. Com o advento de softwares para confecção de modelos computadorizados, uma nova realidade na avaliação da mastigação unilateral pode estar surgindo. O objetivo deste estudo foi comparar o método computadorizado (OrthoCAD) ao método clínico de avaliação da mastigaçãounilateral.A amostra foi composta de 15 indivíduos na fase de dentadura mista, sem cáries ou restaurações anteriores. O ângulo funcional mastigatório planas (AFMP) foi avaliado a partir de imagens fotográficas dos pacientes e modelos computadorizados produzido pelo programa OrthoCAD, em máxima íntercuspidação (MIC), excursão lateral direita (LD) e esquerda (LE). Comos resultados da comparação entre estes métodos pelo one-sample t-test, concluiu-se que o método clínico se mostra mais preciso para a avaliação da mordida unilateral.

Unilateral mastication is often the result of adaptation to disturbances which hinder smooth jaw movements during excursion. The literature presents several negative effects of unilateral mastication on facial structures such as masticatory muscles, occlusal surfaces and temporomandibular joint. The clinical Method is the most known to evaluate the unilateral mastication. A new reality for this evaluation could be emerging with the raise of softwares that creates computerized models. The purpose of this study was to compare the OrthoCAD method to the clinical method to evaluate the unilateral mastication. Fifteen subjects in the mixed dentition stage with no caries or previous restorations were used to compare these two techniques. measurements of the planas functional masticatory angle (PFMA) were made from patient photographs as well as computerized models produced by OrthoCAD in maximum lntercuspation, right and left lateral excursion. Resulting values were compared by one-sample t-test and it was concluded that the clinical method seen to be more accurate to evaluate the unilateral mastication.

Classe II divisão 1 associada à deficiência transversal maxilar. Tratamento com disjuntor tipo Hyrax e aparelho de Herbst: relato de caso clínico / Class II division 1 associated with maxillary transverse deficiency treated by Hyrax expander and Herbst appliance: clinical case report

A má oclusão de Classe II divisão 1 de Angle é, frequentemente, acompanhada da atresia maxilar. Esse problema transversal da maxila deve ser corrigido, sempre que possível, antes da correção anteroposterior, sendo que os aparelhos de expansão rápida são os mais utilizados para isso. Para a correção da Classe II, atualmente, os aparelhos funcionais fixos são os mais estudados e empregados, por serem aparelhos intrabucais e necessitarem de menor colaboração do paciente. O objetivo deste estudo é demonstrar a estabilidade dos resultados obtidos após seis anos de tratamento com expansor tipo Hyrax, seguido do aparelho funcional fixo de Herbst e aparelho fixo. Após uma revisão da literatura, será apresentado um caso clínico, com atresia maxilar e má oclusão de Classe II divisão 1, tratado com essa terapia. O tratamento foi realizado em um curto período de tempo, com resultados funcionais e estéticos satisfatórios e mantidos ao longo dos anos.

The Angle Class II division 1 malocclusion is often accompanied by maxillary transverse deficiency. When ever is possible, this maxillary transverse problem must be corrected before the anteroposterior correction. The rapid maxillary expanders is the appliance more used to correct the transverse deficiency. For the Class II malocclusion correction the fixed functional appliances are more studied and used. They are a kind of intraoral appliance that almost don't need patient's collaboration. The aim of this study is to show the results' stability after six years of the orthodontic treatment with Hyrax expander, followed by Herbst and straight wire appliances. After a literature review, a clinical case with maxillary transverse deficiency and Class II division 1 malocclusion treated with this therapy is reported. The treatment duration was very brief and the results were functionally and esthetically satisfactory with a long-term stability.

Bionator de Balters: componentes, efeitos e indicações - apresentação de um caso clínico / Balter's Bionator: components, effects and application - case report

A má oclusão de Classe II tem o retrognatismo mandibular como sua principal etiologia. Existem algumas possíveis terapias para o tratamento desta má oclusão. Para que o ortodontista decida por uma delas é imprescindível um diagnóstico preciso, uma estimativa da fase de crescimento em que se encontra o paciente e a motivação dele e dos pais para o tratamento. Os aparelhos ortopédicos funcionais costumam ser efetivos para a correção de discrepâncias esqueléticas, enquanto há crescimento ósseo, diminuindo ou eliminando o uso do aparelho fixo e a necessidade de extrações de dentes permanentes para esta correção. Os aparelhos utilizados nesta fase melhoram a estética facial do paciente, elevando sua auto-estima, diminuindo os riscos de traumas nos incisivos superiores - decorrentes de quedas ou batidas no rosto - e retomando o curso correto do crescimento e desenvolvimento facial. Um tratamento bem sucedido depende não só dos fatores acima, mas também do conhecimento do aparelho escolhido, assim como, seu correto manuseio pelo ortodontista. O trabalho descrito demonstra, por meio de um caso clínico, um tratamento ortopédico com o aparelho Bionator de Balters. Serão detalhados os componentes do aparelho, a importância de cada um deles e demonstrado como o ortodontista deve conduzir o tratamento para obter o melhor resultado.

Incidência dos tipos faciais de Ricketts (dolicofacial, mesofacial e braquifacial) nas maloclusões de classe I e classe II divisão 1ª / Incidence of ricketts facial types (dolicofacial, mesofacial and brachyfacial) on individuals with Angle class I or class II, division 1 malocclusions

Este estudo visa a determinar a incidência dos tipos faciais de Ricketts (braquifacial, mesofacial e dolicofacial) em portadores de maloclusão de Classe I e Classe II divisão 1ª, segundo a classificação de Angle, visto que a definição dos tipos faciais é de suma importância para o diagnóstico e planejamento ortodôntico. A amostra foi composta por telerradiografias em norma lateral de pacientes leucodermas, filhos ou netos de brasileiros descendentes de portugueses, espanhóis e/ou italianos, com 12 anos e 4 meses de idade, em média, sendo 40 pacientes portadores de maloclusão de Classe I (20 do gênero masculino e 20 do gênero feminino) e 40 pacientes portadores de maloclusão de Classe II divisão 1ª de Angle (20 do gênero masculino e 20 do gênero feminino). De acordo com a metodologia empregada neste trabalho, verificou-se uma tendência à maior distribuição de mesofaciais, seguido de braquifaciais e em menor número os dolicofaciais, segundo os tipos faciais de Ricketts. Analisando-se os resultados obtidos, observou-se que não ocorreram diferenças estatisticamente significantes na distribuição dos tipos faciais tanto no gênero masculino quanto no gênero feminino e a incidência dos tipos faciais nos grupos de maloclusão de Classe I e Classe II divisão 1ª se comportou de maneira semelhante, ou seja, os grupos tenderam à igualdade e as diferenças existentes nas comparações devem ser atribuídas a flutuações estatísticas. Na verdade, esses resultados tendem a indicar uma independência dos tipos faciais em relação às maloclusões dentais.

Idade ideal para correção ortodôntica / The perfect age for orthodontic correction

Há várias considerações a serem analisadas quando se discute o momento ideal para a intervenção ortodôntica. Alguns profissionais defendem a intervenção precoce, outros atuam durante a dentadura permanente. O que deve ser considerado é o tipo de má oclusão, o crescimento crânio-facial e o desejo do paciente. Este artigo vem elucidar quando e por que o profissional pode ou deve intervir para o melhor desenvolvimento dentário e facial do paciente

Tratamento interceptador de má oclusão de Classe II de Angle, 1ª divisão, utilizando o AEB conjugado (Splint Maxilar Modificado): apresentação de um caso clínico / Interceptor treatment of a Class II division 1 malocclusion (Angle) using the modified maxillary splint: a clinical case report

A má oclusão de Classe II, 1ª divisão, de Angle é encontrada com frequência na clínica ortodôntica. Quando diagnosticada e tratada adequadamente durante o surto de crescimento, os resultados são bastante satisfatórios e somente um alinhamento na posição dentária pode ser necessário na dentadura permanente. Um dos aparelhos mais utilizados e estudados para a correção desta má relação ântero-posterior na fase de dentadura mista é o AEB Conjugado (Splint Maxilar Modificado). Este aparelho visa conter ortopedicamente a maxila e o complexo dentoalveolar, não interferindo no crescimento e desenvolvimento mandibular. A apresentação do caso clínico demonstra a eficácia do aparelho na correção de má oclusão de Classe II, 1ª divisão, com protrusão maxilar

Estudo da prevalência do trespasse vertical interincisivos na dentadura décidua dos dois aos seis anos de idade em: Nipo-Brasileiros / Prevalence study of the anterior overbite at the deciduous dentition in Japanese-Brazilian from two to six years of age

Introdução: Medidas do perfil facial obtidas diretamente sobre imagens fotográficas podem ser valiosos auxiliares no diagnóstico e no planejamento ortodôntico. Este trabalho tem como objetivo padronizar e testar a reprodutibilidade de um método computadorizado de avaliação fotográfica do perfil facial tegumentar. Método - A amostra utilizada neste estudo constituiu-se de 324 fotografias do perfil facial de 36 adultos jovens leucodermas, na faixa etária dos 18 aos 30 anos de idade, não importando o tipo de oclusão ou características faciais que possuíam. Todas as fotografias foram obtidas de modo padronizado, por três operadores distintos, utilizando-se como referência uma vertical verdadeira, com os jovens em pé e em posição natural da cabeça. Posteriormente, as fotografias foram digitalizadas e inseridas no programa de informática "Radiocef2. O" e procedeu-se à demarcação dos pontos tegumentares de referência e às medições de grandezas antropométricas anterionnente descritas na literatura. Resultados e Conclusões - De acordo com os resultados estatísticos, os valores mensurados na análise facial apresentaram confiabilidade, tanto quando obtidos por um mesmo operador, como quando conseguidos por operadores distintos. Essa confiabilidade foi confirmada avaliando-se o teste t, que na grande maioria dos casos não indicou diferença significante entre os valores mensurados. O método descrito neste trabalho mostrou-se eficiente e de fácil reprodução.

lntroduction: The aim of the present study was to determine the prevalence of anterior overbite in the deciduous dentition in Japanese-Brazilian children, as well as to evaluate the variations regarding gender and age range. Method - A total of31 O children ofboth genders, 2 to 6 years of age, were selected from 19 schools in Sao Paulo state. The children were Brazilian and had at least 50% Japanese ancestry. Clinical examination was performed by three examiners while the children were biting with the jaws in maximal intercuspidation. The sample was assigned to two graups, according to the age range: from 2 to 4 and from 5 to 6 years old. The collected data were submitted to descriptive statistics and analyzed by the chi-square testo The levei of statistical significance was set at 5%. Resu/ts and Conc/usions - Due to the absence of gender dimorphism, the prevalence rates were associated in a unique graup comprising the total sample, fram 2 to 6 years of age. The results revealed the following prevalence indices: 60% for normal overbite, 27.1 % for deep bite, 8.39 % for edge to edge relationship and 4.51 % for open bite. The results also revealed statistically significant gender dimorphism only for normal overbite in Graup 1, showing a prevalence of 50% for females and 64.49% for males. In addition to that, there was lack of statistically significant variations in the prevalence indices between the two groups.