Comparison of the efficiency of initial dental alignment with Invisalign® aligners changed every 7 or 14 days in mature adults: Randomized clinical trial.

OBJECTIVE: To compare the anterior crowding correction after sequential use of the first 5 aligners between two aligner exchange protocols (7 and 14 days) in mature adult patients. MATERIALS AND METHODS: Thirty-six patients over 35 years who received orthodontic treatment with Invisalign® were randomly allocated to two different aligner replacement sequence protocols: Group 1: exchange every 7 days (n = 18); and Group 2: exchange every 14 days (n = 18). All patients were scanned with iTero Element 5D® (Align Technology) in two treatment times: at pre-treatment (T1) and after using the first five aligners (T2). Little's Irregularity Index (LII) and arch widths were evaluated with OrthoCAD software. Intra and intergroup comparisons were performed with the dependent and independent t-tests. The results were considered significant for P < .05. RESULTS: Thirty-five patients completed the study. Both groups' maxillary and mandibular Irregularity Indexesi were significantly lower at T2. There was no significant difference in inter-canine, inter-premolar, and intermolar distances. G2 (14 days) presented a greater decrease in mandibular irregularity than G1 (7 days). CONCLUSION: Both exchange protocols (7 and 14 days) effectively correct anterior crowding in the initial phase of orthodontic treatment with aligners in mature adult patients. However, the 14-day exchange protocol provided a greater correction in mandibular anterior crowding in the evaluated period than the 7-day exchange protocol.

Comparison of maxillary transversal changes between auxiliary beta-titanium expansion arch and miniscrew-assisted rapid palatal expansion.

OBJECTIVE(S): This study compared buccal bone thickness, dental inclinations and maxillary transverse width dimensions changes between auxiliary beta-titanium expansion arch (AEA) and miniscrew-assisted rapid palatal expansion (MARPE). MATERIALS AND METHODS: The sample consisted of 29 patients, aged between 18 and 40 years, with transverse maxillary deficiency and treated without extractions, divided into two groups: group AEA: comprised 13 individuals (initial mean age: 29.23 ± 9.13 years) treated using auxiliary beta-titanium expansion arch; group MARPE: comprised 16 patients (initial mean age: 24.92 ± 7.60 years) treated with miniscrew-assisted rapid palatal expansion. Buccal bone thickness, dental inclinations and transverse width dimensions (dental, nasal base and jugular) were measured in cone-bean computed tomographies at pre- and post-treatment stages. The variables were compared using the independent t-test. RESULTS: The buccal bone thickness was similar for both groups at the post-treatment stage. The second premolars were significantly more buccal inclined in the AEA group and the right maxillary first molars in the MARPE group. The intercanine and intermolar distances were statistically significantly greater in the MARPE group. Changes in dental arch transverse dimensions were significantly greater for the MARPE group. CONCLUSION: Both treatment protocols corrected the maxillary transverse discrepancy; however, MARPE provided greater correction.

Incisors' bone height and inclination changes after orthodontic treatment with a self-ligating passive system.

Background: This study aimed to evaluate changes in the alveolar buccal bone height of maxillary and mandibular incisors after orthodontic treatment with a self-ligating passive system and to assess the correlation between bone height and incisor inclination. Material and Methods: Pre (T1) and post-treatment (T2) cone-beam computed tomography images of patients treated with the Damon 3MX appliance system were measured to quantify the alveolar buccal bone height of the maxillary incisors. The incisor's inclination was measured in digital models. Paired t-test was used to evaluate the changes between T1 and T2, and Pearson's coefficient was used to test the correlation. Results: All teeth presented statistically significant alveolar buccal bone loss at T2. A statistically significant buccal inclination was observed only for the lower left lateral incisors. There was no correlation between bone height changes and incisor inclination. Conclusions: Orthodontic treatment with a self-ligating passive system showed changes in alveolar height, but these changes were not correlated with incisor inclination. Key words:Passive self-ligating brackets, orthodontics, corrective, treatment outcome, alveolar bone loss.

Correlation of age and skeletal effects after miniscrew assisted rapid palatal expansion.

Background: To evaluate the skeletal and dentoalveolar effects after miniscrew assisted rapid palatal expansion (MARPE) and their correlation with the age of the patients. Settings and sample population: Sample comprised 19 patients with maxillary atresia and posterior crossbite, treated with MARPE. Cone-beam computed tomographs (CBCT) were evaluated before and after expansion. Three patients were excluded since the midpalatal suture was not opened. Thus, 16 patients (11 female; 5 male) were evaluated, with a mean age of 24.92 years (s.d.=7.60). The time between the installation of MARPE and the second CBCT was, on average, 1.64 months (s.d.=1.12). Material and Methods: Linear and angular measurements were performed: bone thickness and level, tooth inclination, transverse dental widths, and nasal base and jugula widths. Comparison was performed with dependent t-test and correlations with Pearson coefficient. Results: MARPE was 84.2% successful. There was significant reduction in the buccal bone thickness of the first molars and an increase in the palatal bone thickness of all teeth. First molars showed significant buccal inclination. All transverse dimensions showed a significant increase. Older patients tended to show a less maxillary transverse skeletal increase. A greater maxillary transverse increase was accompanied by a greater intermolar width increase and also a greater buccal bone loss in the mesiobuccal roots of the maxillary first molars. Conclusions: MARPE corrected the maxillary atresia in adult patients, with significant transverse increases, a slight decrease in buccal bone thickness and buccal inclination of the first molars, combining skeletal and dental effects. Older patients presented less transverse skeletal increases. Key words:Palatal expansion technique, skeletal anchorage, cone-beam computed tomography.

Evaluation of the attractiveness of lips with different volumes after filling with hyaluronic acid.

To compare the attractiveness of lips with different volumes after filling in the view of laypersons, dentists, and specialists. The sample comprised close-up frontal and lateral photographs of the lips of 16 women who underwent lip filling procedure with hyaluronic acid and was divided into 2 groups. Group 1: eight women with thinner lips at pretreatment. Group 2: eight female patients with thicker lips at pretreatment. Photographs from before and 10 days after lip filling were used to assess attractiveness randomly displayed in a Google Forms questionnaire and then sent via a messaging app to the evaluators. The evaluators' groups were general dentists, dentists with degrees in facial aesthetics, and laypersons. The attractiveness was evaluated with scores from 0 to 10 (0: least attractive and 10 the greatest). T-tests were used for the statistical comparisons. The group with thinner lips showed significantly improved attractiveness after filling. The group with thicker lips showed a worsening attractiveness after filling. The group with thicker lips had significantly higher attractiveness scores than those with thinner lips. There was no significant difference in the preference between men and women. The group of laypersons was more rigorous, giving significantly lower lip attractiveness scores. Thinner lips showed a significant improvement in attractiveness after filling. Thicker lips showed a worsening of the attractiveness score after filling. Before and after filling, thicker lips had significantly higher attractiveness scores than thinner lips.Clinical relevance: The amount of fillers applied to each patient must be individually evaluated.

Stability of Class II malocclusion treatment with Class II elastics.

INTRODUCTION: The objective of this study was to compare the long-term cephalometric stability after successful therapy of nonextraction Class II malocclusion with elastics and with headgear. METHODS: The sample comprised 43 patients with Class II malocclusion and was divided into 2 groups. The elastic group (EG) consisted of 20 patients treated with fixed appliances associated with Class II elastics, and the headgear group (HG) consisted of 23 patients treated with fixed appliances and extraoral headgear. Pretreatment, posttreatment, and long-term posttreatment lateral radiographs were evaluated; t tests were used to compare the long-term posttreatment changes between the groups. RESULTS: The groups were matched regarding initial age, time of long-term posttreatment evaluation, initial malocclusion severity, quality of treatment result, and all pretreatment cephalometric variables. Intergroup comparisons of long-term posttreatment changes showed that the HG group presented significantly greater mandibular protrusion, occlusal plane angle decrease, and maxillary molar mesialization. However, long-term posttreatment stability was similar in overjet, overbite, and molar relationships. CONCLUSIONS: Nonextraction Class II malocclusion treatment with elastics or extraoral headgear have similar long-term posttreatment stability.

Correção da inclinação frontal do plano oclusal com utilização de mini-implantes / Correction of frontal inclination of the occlusal plane with the use of mini-implants

Resumo O objetivo deste trabalho é relatar o caso clínico de uma paciente de 21 anos, dolicofacial, classe II com impacção de incisivo lateral superior esquerdo e queixa de inclinação do plano oclusal em vista frontal do sorriso. O tratamento ortodôntico foi realizado com aparelho fixo da prescrição Roth e alinhamento e nivelamento com fios de NiTi. Ao chegar no fio retangular, um mini-implante interradicular foi instalado entre incisivo lateral e canino superior direito (dentes 12 e 13) como ancoragem para mecânica intrusiva nessa região. Ainda durante essa fase, foi realizada a extrusão do dente 23 para nivelamento da margem gengival em relação aos incisivos. Após 11 meses, a inclinação do plano oclusal em vista frontal sorrindo foi corrigida e iniciada a fase de finalização. Ao final do tratamento, foi realizada a reanatomização do dente 23 transformando-o em incisivo lateral, o que resultou em um sorriso estético e harmônico. Por meio desse caso clínico, conclui-se que a inclinação frontal do plano oclusal de origem dentoalveolar pode ser corrigida com a ajuda da ancoragem esquelética em casos onde haja boa exposição gengival na região anterior (AU)

Abstract The objective of this study is to report a clinical case of 21-year-old female, hyperdivergent Class II patient with impaction of the maxillary left lateral incisor and a complaint of inclination of the occlusal plane in a frontal view of the smile. Orthodontic treatment was performed with a Roth prescription fixed appliance and alignment and leveling with NiTi wires. Upon reaching the rectangular wire, an interradicular mini-implant was inserted between the maxillary right lateral incisor and the maxillary right canine (teeth 12 and 13) as an anchorage for intrusive mechanics in this region. Also, during this phase, the extrusion of tooth 23 was performed to level the gingival margin in relation to the incisors. After 11 months, the inclination of the occlusal plane in a smiling frontal view was corrected and the finishing phase began. At the end of the treatment, tooth 23 was re-anatomized, transforming it into a lateral incisor, which resulted in an aesthetic and harmonious smile. Through this clinical case, it is concluded that the frontal inclination of the occlusal plane of dentoalveolar origin can be corrected with the help of skeletal anchorage in cases where there is good gingival exposure in the anterior region. (AU)

Tratamento de uma má oclusão de Classe II com propulsor mandibular Forsus associado à tração de canino inferior impactado devido ao odontoma ­ relato de caso / Treatment of a Class II malocclusion with Forsus appliance associated with traction of an impacted mandibular canine due to odontoma ­ a case report

Resumo O objetivo deste caso clínico foi relatar o tratamento de uma paciente portadora de má oclusão de Classe II com aparelho de propulsão mandibular fixo Forsus associado à tração de canino inferior retido devido a um odontoma. Após exame clínico e radiográfico, foi detectada a retenção prolongada do canino inferior decíduo direito devido à presença desse odontoma. O exame clínico também mostrou que a paciente apresentava uma má oclusão de Classe II. Após a extração do dente decíduo e excisão do odontoma, foi colado um acessório no canino retido e instalado o aparelho fixo. Inicialmente, foi planejada a instalação de um APM devido ao seu baixo custo, no entanto, a paciente não se adaptou e foi instalado um Forsus. Ao final de 48 meses, o canino inferior direito alcançou o plano oclusal e a má oclusão de Classe II foi corrigida. Após 2 anos da finalização do tratamento, os resultados obtidos se mostraram estáveis. O objetivo foi avaliar os efeitos dentários e tecidos moles no tratamento da má oclusão de Classe II leve a moderada de uma paciente no final de crescimento puberal, analisando o antes e depois da face no desenvolvimento dentofacial e os efeitos do aparelho de protração. Concluiu-se que o propulsor mandibular associado ao aparelho fixo corrigiu a má oclusão de Classe II basicamente através da protrusão dentoalveolar do arco inferior. (AU)

Abstract The objective of this case report is to present the treatment of a patient with Class II malocclusion with a Forsus fixed appliance associated with the traction of an impacted mandibular canine due to an odontoma. After clinical and radiographic examination, prolonged right primary mandibular canine retention was detected. In addition, the mandibular canine was impacted due to the presence of this odontoma. Clinical analysis also showed that the patient had a Class II malocclusion. After the extraction of the primary canine and excision of the odontoma, an orthodontic accessory was bonded to the impacted canine, and the fixed appliance was placed. Initially, an APM (mandibular protractor appliance) was planned due to its low cost. However, the patient did not cooperate with its use, and a Forsus was placed. At the end of 48 months, the right mandibular canine reached the occlusal plane, and the Class II malocclusion was corrected. (AU)

Comparison of Gingival Recession of Mandibular Incisors of Class III Patients Immediately after Compensatory or Surgical Orthodontic Treatment.

OBJECTIVE: This study aimed to compare gingival recession in mandibular anterior teeth in patients with Class III malocclusion, immediately after compensatory or surgical orthodontic treatment. MATERIALS AND METHODS: The sample consisted of 40 patients with Class III malocclusion, divided into two groups: Group 1 (compensatory), 20 patients treated with compensatory orthodontics, with a mean initial age of 20.26 years (standard deviation [SD] . = 7.44), mean final age of 23.07 years (SD = 7.32), and mean treatment time of 2.81 years (SD =0.84). Group 2 (surgical), who undergone orthodontic-surgical treatment, with a mean initial age of 23.08 years (SD =5.48), mean final age of 25.43 years (SD =5.12), and mean treatment time of 2.35 years (SD =1.56). Intraoral photographs taken before and after removal of the fixed orthodontic appliance were used to measure the gingival recession, from the cervical of the mandibular incisors from the most cervical point of the gingival margin to the cementoenamel junction. In the initial and final cephalograms, the position of the mandibular incisors was measured. The intergroup comparison was performed using the independent t-test. RESULTS: The results showed that there was no statistically significant difference in the gingival recession at the beginning, at the end, and of changes with treatment between the compensatory and surgical groups. CONCLUSION: It was concluded that the compensatory and surgical orthodontic treatments for Class III malocclusion showed similar results regarding the gingival recession of the mandibular incisors.

Surgical effects of rehabilitation protocols on dental arch occlusion of children with cleft lip and palate

Aim: to evaluate the surgical effects of two rehabilitation protocols on dental arch occlusion of 5-year-old children with or without cleft lip and palate. Methods: this is a retrospective longitudinal study the sample comprised 45 digitized dental casts divided into followed groups: Group 1 (G1) ­ children who underwent to cheiloplasty (Millard technique) at 3 months and to one-stage palatoplasty (von Langenbeck technique) at 12 months; Group 2 (G2) ­ children who underwent to cheiloplasty (Millard technique) and two-stage palatoplasty (Hans Pichler technique for hard palate closure) at 3 months and at 12 months to soft palate closure (Sommerlad technique); and Group 3 (G3) ­ children without craniofacial anomalies. Linear measurements, area, and occlusion were evaluated by stereophotogrammetry software. Shapiro-Wilk test was used to verify normality. ANOVA followed by posthoc Tukey test and Kruskal-Wallis followed by posthoc Dunn tests were used to compared groups. Results: For the measures intercanine distance (C-C'), anterior length of dental arch (I-CC'), and total length of the dental arch (I­MM'), there were statistical differences between G1x G3 and G2xG3, the mean was smaller for G1 and G2. No statistically significant differences occurred in the intermolar distance and in the dental arch area among groups. The occlusion analysis revealed significant difference in the comparison of the three groups (p=0.0004). Conclusion: The surgical effects of two rehabilitation protocols affected the occlusion and the development of the anterior region of the maxilla of children with oral clefts when compared to children without oral clefts.

Evaluation of enamel deproteinization in bond strength of orthodontic accessories: A split-mouth randomized clinical trial.

INTRODUCTION: This split-mouth randomized clinical trial aimed to evaluate the influence of dental enamel deproteinization with sodium hypochlorite on orthodontic accessories breakages using 2 orthodontic adhesives. METHODS: Forty patients with indications for orthodontic treatment with fixed appliances were randomly divided into 2 groups according to the orthodontic adhesive used: Transbond XT (3M Unitek, Monrovia, Calif) (n = 20) and Orthocem (FGM Dental Products, Joinville, Santa Catarina, Brazil) (n = 20). A split-mouth trial was conducted in the maxillary teeth; the deproteinization process with 5% sodium hypochlorite was performed on the experimental side. The opposite side served as a control without deproteinization. The primary outcome was the number of orthodontic accessories breakages. The randomization was performed using the BioStat software (AnalystSoft Inc, Walnut, Calif). Single-blind was applied for patients. Orthodontic accessories were bonded according to the manufacturer's instructions. The accessories breakages were followed during the first 6 months of treatment. Intergroup comparisons were performed with t tests and 1 and 2-way analysis of variance. RESULTS: Thirty-nine patients concluded the trial. The Transbond XT group comprised 20 patients (9 male, 11 female), with a mean age of 20.77 ± 6.44 years. The Orthocem group included 19 patients (9 male, 10 female), with a mean age of 23.14 ± 7.98 years. The application of sodium hypochlorite before bonding did not influence the number of orthodontic accessories breakages (P = 0.867). The type of adhesive used, associated or not with the deproteinization, did not affect the number of orthodontic accessories breakages (P = 0.929). CONCLUSIONS: Enamel deproteinization with 5% sodium hypochlorite did not impact the number of orthodontic accessories breakages. In addition, the 2 bonding adhesives used showed similar clinical results, with or without the enamel deproteinization. REGISTRATION: The trial was registered at ensaiosclinicos.gov.br, ReBEC (no. RBR-39ntmjk). PROTOCOL: The protocol was not published before trial commencement. FUNDING: This research did not receive any grant from funding agencies.

Ação clareadora e microbiológica do enxaguante bucal com peróxido de hidrogênio: ensaio clínico / Whitening and microbiological action of mouthwash with hydrogen peroxide: clinical trial

Introdução: os enxaguantes bucais clareadores tem sido muito utilizados, porém sua eficiência e efeitos colaterais trazem questionamentos. Objetivo: este ensaio clínico teve como objetivo avaliar se o enxaguante bucal clareador, contendo peróxido de hidrogênio a 1,5%, apresenta ação clareadora e se há algum efeito secundário na cavidade bucal. Metodologia: foram selecionados 10 voluntários com idade média de 21,5 anos, submetidos a avaliação da cor dos dentes com auxílio do espectrômetro em 3 momentos: inicial; com 15 e com 30 dias de uso do enxaguante. A avaliação dos efeitos colaterais foi realizada a partir da coleta de saliva estimulada em 4 momentos: antes e depois ao primeiro uso do produto, com 15 e com 30 dias, e realizadas as análises laboratoriais: fluxo salivar; pH; quantidade de Streptococcus mutans e de Lactobacillus. A normalidade dos dados foi verificada pelo teste de Shapiro-Wilk, comparação de cor pelo teste t dependente, comparação dos microrganismos pelos testes ANOVA de medidas repetida e Tukey. Resultados: as análises de cor dos dentes não evidenciaram nenhuma alteração significativa em nenhum dos tempos investigados. No fluxo salivar, pH e Lactobacillus não houveram alterações significativas. Na quantidade de Streptococcus mutans notou-se um aumento significativo quando comparado os valores após o primeiro uso e com 30 dias. Conclusão: a solução de enxague bucal contendo peróxido de hidrogênio a 1,5% não apresentou alteração significativa na coloração dos dentes e nenhum efeito colateral significativo na atividade cariogênica de acordo com os testes e períodos avaliados.

Introduction: whitening mouthwashes have been widely used, but their efficiency and side effects raise questions. Objective: this clinical trial aimed to assess whether the bleaching mouthwash, containing 1.5% hydrogen peroxide, has a bleaching action and whether there are any side effects in the oral cavity. Methods: 10 volunteers were selected, with a mean age of 21.5 years, who underwent tooth color evaluation with the aid of a spectrometer in 3 moments: initial; with 15 and 30 days of using the washes. The evaluation of side effects was performed from the collection of stimulated saliva in 4 moments: before and after the first use of the product, at 15 and 30 days, and laboratory analyzes were carried out: salivary flow; pH; the number of Streptococcus mutans and Lactobacillus. Normal distribution was verified with Shapiro-Wilk test, comparisons of color were performed with t-test, comparisons of the microorganisms were performed with repeated measures ANOVA and Tukey tests. Results: the analysis did not show any significant changes in any of the investigated times. There were no significant changes in the salivary flow, pH and Lactobacillus. The number of Streptococcus mutans, was noted a significant increase when comparing the values after the first use and with 30 days. Conclusion: the mouthwash containing 1.5% hydrogen peroxide was not shown any significant alterations in the color teeth. There were not significant collateral effects on the cariogenic activity according to the tests and periods evaluated.

Six-year post-surgical evaluation in the treatment protocols in the dental arches of children with oral cleft: longitudinal study.

OBJECTIVE: Oral cleft surgical repairs are performed using different techniques worldwide. To evaluate and compare the development of the dental arches of children with unilateral cleft lip and palate before and after the primary surgeries performed with different techniques at the first months and six years of life. METHODOLOGY: This is a retrospective longitudinal study. The sample comprised 56 dental casts divided int the following groups: Group 1 (G1) - cheiloplasty (Millard technique) at three months and one-step palatoplasty (von Langenbeck technique) at 12 months; and Group 2 (G2) - cheiloplasty (Millard technique) and two-step palatoplasty: anterior hard palate closure (Hans Pichler technique) at three months and posterior soft palate closure (Sommerlad technique) at 12 months. The digitized dental casts were evaluated at three months - pre-surgical (T1) and six years of life- post-surgical (T2). The following linear measurements were analyzed: intercanine (C-C'), intertuberosity (T-T') distances; anterior dental arch (I-CC'), anterior intersegment (I-C'), and total arch (I-TT') lengths. The palate area was also measured. Parametric and non-parametric tests were applied (p<0.05). RESULTS: In G1, the intragroup comparison showed statistically significant smaller I-CC' and I-C' at T2 (p=0.001 and p<0.001, respectively), while T-T', I-TT', and area comparisons were significantly greater (p<0.001, p=0.002, and p<0.001, respectively). In G2, the intragroup comparison exhibited statistically significant smaller C-C' and I-C' at T2 (p=0.004, for both), whereas T-T', I-TT' and area comparisons were significantly greater (p<0.001, p=0.004, and p<0.001, respectively). At T2, the intergroup analysis revealed that G1 had a statistically significant smaller I-CC' (p=0.014). The analysis of the intergroup differences (∆=T2-T1) showed that G1 had a statistically smaller I-CC' (p=0.043). CONCLUSION: The two-step palatoplasty showed a more favorable prognosis for the maxillary growth than one-step palatoplasty in children with oral clefts.

Gingival recession in mandibular anterior teeth in patients with Class II malocclusion treated with elastics and Twin Force appliance.

INTRODUCTION: This study aimed to compare the early results of gingival recession in patients with Class II malocclusion treated with Class II intermaxillary elastics and the Twin Force appliance. METHODS: The sample comprised 55 patients with Class II malocclusion treated without extraction and divided into 2 groups. Group 1 consisted of 23 patients treated with fixed appliances and Class II elastics, with mean initial age of 15.41 ± 5.65 years and a mean treatment time of 3.11 ± 0.91 years. Group 2 consisted of 32 patients treated with fixed appliances and the Twin Force mandibular protraction appliance, with a mean initial age of 18.45 ± 6.63 years and a mean treatment time of 3.17 ± 1.59 years. Dolphin software measured gingival recession in initial and final intraoral photographs. Initial and final lateral cephalograms were used to measure the position of the mandibular incisors. Intragroup and intergroup comparisons were performed by dependent and independent t tests, respectively. RESULTS: In both groups, there was no significant increase in gingival recession with orthodontic treatment, and there was significant protrusion and buccal inclination of the mandibular incisors. When changes with treatment were compared between the groups, there was no statistically significant difference in gingival recession and mandibular incisor position. CONCLUSIONS: There was no significant increase in gingival recession immediately after orthodontic treatment performed with intermaxillary elastics and the Twin Force appliance.

Efficacy of Low-Level Laser Therapy in Reducing Pain in the Initial Stages of Orthodontic Treatment.

Purpose: There is no consensus about the mechanism and efficacy in alleviating pain of the lower-level laser therapy (LLLT) during orthodontic treatment. This study aimed to evaluate the LLLT effectiveness clinically in reducing pain caused by orthodontic movement that occurs in the early stages of treatment. Methods: The sample consisted of 54 patients in need of orthodontic treatment divided into two groups. A 28 experimental patients group (initial mean age: 26.84 years old) was undergone gallium-aluminum-arsenide infrared laser application on 12 points for each tooth immediately after the installation of the first alignment archwire, and a 26 patients control group (initial mean age: 29.13 years old) was undergone to no pain control intervention at all. Pain intensity was measured by using a visual analog scale, which was marked pain level (mm) reported in 06, 24, 48, and 72 hours. The perception of pain (beginning, peak, decline, and absence) was evaluated by filling up a questionnaire. To compare the intensity and perception of pain between groups, a nonparametric Mann-Whitney has been performed. Results: The experimental group showed levels (mm) at 6 (p < 0.001), 24 (p=0.004), and 48 hours (p=0.007) and perception of pain (hours) in the peak (p=0.026), decline (p=0.025), and absence (p=0.008) significantly lower compared to the group control. Conclusion: Low-level laser therapy is effective in reducing pain severity caused by orthodontic forces activation, and it promotes the analgesic action lasting effect during the most painful feeling time.

Evaluation of the botulinum toxin effects in the correction of gummy smile 32 weeks after application / Avaliação dos efeitos da toxina botulínica na correção do sorriso gengival 32 semanas pós-aplicação

INTRODUCTION: The use of botulinum toxin type A (BTX-A) to correct gummy smile has become popular in recent years. OBJECTIVE: To evaluate the effects of BTX-A application in the correction of gummy smile 2 and 32 weeks after application. METHODS: The sample comprised 35 patients (30 female, 5 male) at a mean age of 25.51 years (±5.59) with gummy smile due to muscular hyperfunction. In each patient, 2U of botulinum toxin was applied in the levator labii superioris alaeque nasi, 2 mm from the nasolabial fold. Photographs of spontaneous smiles were taken at 3 stages: before, 2 and 32 weeks after BTX application. Measurements of the gingival display were performed with the Radioface Studio 2 Software, and the calibration used the actual size of the right maxillary central incisor. Comparison of the three stages evaluated was performed with repeated measures ANOVA and Tukey tests. RESULTS: Gingival display decreased significantly 2 weeks after BTX-A application and increased after 32 weeks but did not return to the initial value. CONCLUSION: There was a significant improvement in gummy smile 2 weeks after botulinum toxin application, and a significant relapse in the gingival display after 32 weeks, however not returning to baseline values.

INTRODUÇÃO: A toxina botulínica tipo A (BTX-A) tem se tornado popular na correção do sorriso gengival nos últimos anos. OBJETIVO: Avaliar os efeitos da aplicação de BTX-A na correção do sorriso gengival 2 e 32 semanas após a aplicação. MÉTODOS: A amostra compreendeu 35 pacientes (30 mulheres, 5 homens) com uma idade inicial média 25,51 anos (±5,59) portadores de sorriso gengival devido à hiperfunção muscular. Em cada paciente foi aplicado 2U de BTX-A no músculo elevador superior da asa do nariz, 2 mm a partir da dobra nasolabial. Foram feitas fotografias dos sorrisos espontâneos dos pacientes em 3 fases: antes, 2 e 32 semanas após a aplicação de BTX-A. As medidas da exposição gengival foram feitas com o Software Radioface Studio 2, e a calibração utilizou o tamanho real do incisive central superior direito. A comparação das 3 fases foi feita com ANOVA de medidas repetidas e teste de Tukey. RESULTADOS: A exposição gengival diminuiu significantemente 2 semanas após a aplicação e aumentou novamente após 32 semanas, mas não retornando aos valores iniciais. CONCLUSÃO: Houve uma melhora significante no sorriso gengival 2 semanas após a aplicação de toxina Botulínica, e uma recidiva significante após 32 semanas, mas não retornando aos valores iniciais.

Evaluation of cheiloplasty and palatoplasty on palate surface area in children with oral clefts: longitudinal study.

This study evaluated the palatal surface area in children with different oral clefts after primary surgeries and at five years of age. This longitudinal study was composed by 216 digital models: unilateral complete cleft lip (UCL), unilateral complete cleft lip and palate (UCLP), and complete cleft palate (CP). The models were analysed at four time periods: T1 (before cheiloplasty), T2 (before palatoplasty), T3 (after palatoplasty); and T4 - (at five years of age). Area of the dental arches was measured through stereophotogrammetry software. Measurements evaluated with Student's test and ANOVA followed by the Tukey test (p<0.05) (AQ 1). In the UCL group, the palatal surface area significantly increased among phases. In the primary surgery periods, UCLP and CP significantly decreased (p<0.001). Palatal area in the UCLP group was significantly greater than the CP group. Overall, no statistically significant differences occurred among groups. At T4, the area of the palate in the UCL group was significantly greater than the UCLP group and no significant differences occurred between UCLP and CP groups. This study suggests that cheiloplasty did not inhibit the growth of the palatal surface area in children with UCL and UCLP. Palatoplasty significantly decreased the palatal area in children with UCLP and CP, demonstrating a significant negative effect of palatal repair on maxillary growth. At five years, children with UCLP and CP had a significantly smaller palate area than those with UCL.

3D morphometric evaluation of the dental arches in children with cleft lip and palate submitted to different surgical techniques.

OBJECTIVES: This study aimed to compare dimensional alterations of dental arches in children with unilateral complete cleft lip and palate before and after different techniques of primary plastic surgeries. MATERIALS AND METHODS: The sample was divided into two groups: group 1-cheiloplasty by Millard's technique and one-stage palatoplasty by von Langenbeck's technique; group 2-cheiloplasty by Millard's technique and two-stage palatoplasty: anterior palatoplasty by Hans Pichler's technique and posterior palatoplasty by Sommerlad's technique. Dental arches were evaluated before (T1), after the first phase (T2), and 1 year after the second phase (T3) of primary surgeries. Linear measurements and palatal area were assessed. To analyze the method's error, interclass correlation coefficient was applied. ANOVA (followed by Tukey test), dependent, and independent t-test were used (p < 0.05). RESULTS: At T1, the intertuberosity distance was statistically greater in G2 (p = 0.004). At T2, the anterior length of the dental arch was statistically greater in G2 (p = 0.025), while the area of the smaller palatal segment (p = 0.001), cleft area (p = 0.014), and total area (p = 0.002) were statistically smaller in G2. At T3, the intertuberosity distance was statistically greater in G2 (p = 0.017). CONCLUSION: This study suggests that cheiloplasty and one-stage palatoplasty resulted in smaller growth of maxilla than cheiloplasty and two-stage palatoplasty in the linear measurements (T-T' and I-CC') and total area of the dental arches. CLINICAL RELEVANCE: Surgical protocols need to be evaluated to verify their effects aiming at improving the clinical practice of the interdisciplinary team, determining new parameters for the rehabilitation of individuals with cleft lip and palate.