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1.
J. health sci. (Londrina) ; 24(1): 02-05, 20220322.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1362796

RESUMO

Rapid maxillary expansion (RME) is the protocol of choice for early treatment of transverse malocclusions and it is achieved with fixed expanders that produce heavy forces to achieve midpalatal suture opening. One third of patients with maxillary constriction have a greater transversal deficiency at the intercanine width than at the intermolar. The aim of this article is to present a protocol for early treatment of posterior crossbite with the use of the expander with differential opening (EDO) for RME. It is a new appliance to perform RME and its main advantage would be to allow the expansion individualization. EDO was proposed aiming to promote greater expansion on the anterior rather than on the posterior region. A 9 year-old female sought treatment. The interceptive treatment plan was based on using EDO for RME. The post-expansion orthopedic response showed an opening of 7.5 mm between the maxillary central incisors, at the level of the incisal edge. It was observed an opening of 4.8mm in the midpalatal suture. The opening at a distance of 10 mm and 20 mm from the crest to posterior at the midpalatal suture were 3.9mm and 2.8mm. The upper intercanine distance showed an increase of 9.31 mm. The upper intermolar distance had increased 8.04 mm. The upper arch perimeter showed a difference from 74.02 mm to 80.11 mm . And the upper arch length, from 29.83 mm to 31.56 mm. The posterior crossbite was 2 mm overcorrected. Early diagnosis and treatment of posterior crossbite has a very favorable prognosis. (AU)


A expansão rápida da maxila (ERM) é a técnica de escolha para o tratamento precoce das más oclusões transversais e é ativada com expansores fixos que produzem forças pesadas para possibilitar a abertura da sutura palatina mediana. Um terço dos pacientes com atresia maxilar apresenta uma maior deficiência transversal na região intercaninos do que na região intermolares. O objetivo desse artigo é apresentar um protocolo de tratamento precoce para a mordida cruzada posterior utilizando o expansor maxilar Diferencial (EMD) para realizar a ERM. EMD é um novo dispositivo que pode ser empregado para realização da ERM e sua principal vantagem seria permitir a individualização da expansão. EMD foi proposto para proporcionar maior expansão na região anterior do que na região posterior da maxila. Uma menina de 9 anos de idade buscou tratamento. O plano de tratamento interceptativo proposto foi ERM utilizando o dispositivo EMD. A resposta ortopédica pós expansão mostrou uma abertura de 7,5 mm entre os incisivos centrais superiores, ao nível da borda incisal. Foi observada uma abertura de 4,8 mm na sutura palatina mediana. A abertura a uma distância de 10 mm e 20 mm da crista para posterior na sutura palatina mediana foi de 3,9 mm e 2,8 mm. A distância intercaninos superior apresentou aumento de 9,31 mm. A distância intermolares superiores aumentou 8,04 mm. O perímetro do arco superior apresentou diferença de 74,02 mm para 80,11 mm. E o comprimento do arco superior, de 29,83 mm para 31,56 mm. A mordida cruzada posterior foi sobrecorrigida em 2 mm. O diagnóstico precoce e o tratamento da mordida cruzada posterior tem um prognóstico muito favorável. (AU)

2.
J. health sci. (Londrina) ; 23(4): 257-263, 20211206.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1353556

RESUMO

Abstract Orthodontic-surgical treatment with the "Surgery First Approach" provides immediate facial aesthetic improvements and significantly reduces the patient's orthodontic treatment time, avoiding the transient worsening of the facial profile due to dental decompensation that occurs in surgical cases. Thus, this clinical case describes the retreatment of a 22-year-old female leukoderma patient, whose main complaint was related to the proclination of upper and lower incisors. The patient used a mio-relaxing plate for 30 days, which evidenced the skeletal mandibular deficiency and the ½ bilateral Class II malocclusion. Orthognathic surgery first approach associated with the extraction of the 4 premolars was chosen considering the patient's aesthetic demand. The use of a mio-relaxing plate in the diagnostic stage was essential for the real diagnosis of mandibular deficiency and the technique employed made it possible to conclude the treatment avoiding aesthetic commitment, with excellent results. (AU)


Resumo O tratamento ortodôntico-cirúrgico por meio do benefício antecipado proporciona melhorias estéticas faciais imediatas e reduz de maneira significativa o tempo de tratamento ortodôntico do paciente, evitando a piora transitória do perfil facial devido à descompensação dentária que ocorre em casos cirúrgicos. Assim, este caso clínico descreve o retratamento de uma paciente com 22 anos de idade, leucoderma, sexo feminino, que apresentava queixa principal relacionada à inclinação vestibular dos dentes anteriores. Após uso de placa miorrelaxante por 30 dias, verificou-se a presença de Classe II esquelética com deficiência mandibular e ½ Classe II dentária bilateral. Considerando a demanda estética da paciente, optou-se pela abordagem ortodôntico-cirúrgica com Benefício Antecipado associada à extração de 4 pré-molares para correção da inclinação dentária anterior. O uso da placa miorrelaxante foi fundamental para o diagnóstico real da deficiência mandibular e a técnica empregada possibilitou concluir o tratamento evitando o comprometimento estético pré-cirúrgico, com obtenção de excelentes resultados. (AU)

3.
Braz Dent J ; 32(3): 116-126, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34755786

RESUMO

This 2-year-follow up study compared and evaluated the stability of early anterior open bite (AOB) treatment based on different appliances. Children from 7 to 10 years with Angle Class I, AOB larger than 1.0 mm and fully erupted maxillary and mandibular permanent central incisors were eligible. The initial sample was 99 patients distributed, by simple randomization, into four groups: BS (bonded spurs), CC (chincup), FPC (fixed palatal crib) and RPC (removable palatal crib). Cephalometric analysis was performed at baseline (T1), final (T2) and 2-year post-treatment (T3) by taking the overbite measurements as the main outcome. Blinding was possible to cephalometric analysis. At T3, with dropouts, there were 63 individuals, being BS (n=15; overbite 0.19 mm; 11.54 years; 10 female (F)/5 male (M)); CC (n=11; overbite -0.19 mm; 11.41 years; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 years; 15 F/6 M) and; RPC (n=16; overbite 0.73 mm; 11.67 years; 6 F/10 M). Changes in dentoskeletal variables and breaking deleterious oral habits during the follow up were statically analyzed with p<.05. Mandibular skeletal linear measurements and vertical dental components have gradually increased with age, manly at pubertal growth spurt and at the establishment of permanent dentition after treatment. Incisor teeth extrusion had impact on AOB correction and stability in 4 groups, which recorded a 1.15 mm-improvement of overbite after treatment (T3-T2). The experimental appliances were effective with stable results, being FPC the device recorded the highest AOB correction and the lowest patient withdrawal rate.


Assuntos
Má Oclusão Classe II de Angle , Mordida Aberta , Cefalometria , Criança , Feminino , Seguimentos , Humanos , Masculino , Mandíbula , Mordida Aberta/terapia
4.
J Clin Exp Dent ; 13(11): e1131-e1139, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34824700

RESUMO

BACKGROUND: The selection of temporary anchorage device (TAD) site can be a challenging task since one should not only consider the 2-D distances between roots, but also the entire 3-D space. Thus, the aim of this study was to evaluate the posterior maxillary region areas available for the insertion of temporary anchorage devices in reconstructed images from cone beam computed tomography (CBCT). MATERIAL AND METHODS: Sample consisted of 72 patients with indication for orthodontic treatment, grouped into three distinct age groups: 11 to 14 years (age group 1), 15 to 19 years (age group 2) and aged 20 years or older (age group 3), which were further subdivided as to the type of malocclusion (Angle Class I, II and III). Orthopantomographic reconstructions and cross sections were obtained with the Dolphin Imaging software. The distance between the roots of maxillary teeth (canines, premolars and first molars) was determined at 5 mm of the cementoenamel junction, as well as the depth of bone availability at different insertion angles (90°, 75°, 60°, 45°). The influence of different angulations, age, and malocclusion on bone availability was evaluated by ANOVA, followed by the Bonferroni post-test. For the evaluation of the interaction of these factors, 2-way ANOVA was used. RESULTS: Bone availability was found to be poor between roots in the molar region. There was a reduction in bone availability with increasing age. With regard to angulations, greater bone availability was found in depth for 45° angulation in the canine and first premolar regions and for angulation of 75° or 90° in the molar region. However, there was no difference between bone availability in the region of the second premolars. CONCLUSIONS: According to applied methodology it can be concluded that the region between canines and premolars accepts better vertical angular variations for TADs insertion. Key words:Cone-Beam Computed Tomography, Orthodontic Anchorage Procedures.

5.
Korean J Orthod ; 51(5): 329-336, 2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34556587

RESUMO

OBJECTIVE: To compare the magnitude of external apical root resorption (EARR) 6 months after starting orthodontic treatment using orthodontic aligners (OAs) and fixed appliances (FAs). METHODS: This parallel randomized clinical trial included 40 patients randomized into two groups: OA group (n = 20, 160 incisors) and FA group (n = 20, 160 incisors). For evaluation of the tooth length, periapical radiographs and standardized linear measurements of the maxillary and mandibular incisors were acquired before (T0) and 6 months after treatment initiation (T1). EARR was calculated through the difference in length between the two time points (T1-T0). Statistical comparisons were performed by means of using t-tests, chi-squared test and covariance analysis (a = 5%). RESULTS: Rounding of the root apex was observed in both groups; the resorption involved 2.88% of the root length, so 97.12% of the tooth length remained intact. Intragroup comparisons between the two time points revealed a significant difference, with (T1-T0) ranging from -0.52 to -0.88 mm in the FA group and from -0.52 to -0.85 mm in the OA group. In the intergroup comparisons, only tooth #21 presented a statistically significant difference (OA: -0.52 ± 0.57 mm, FA: -0.86 ± 0.60 mm); however, the overall differences between groups were not clinically relevant, ranging from 0.03 to 0.35 mm. CONCLUSIONS: OA and FA treatment resulted in a similar degree of EARR in the maxillary and mandibular incisors at 6 months after treatment initiation. However, the amount of resorption was small and does not impair tooth longevity.

6.
J. health sci. (Londrina) ; 23(3): 167-172, 20210920.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1292746

RESUMO

Extrusive tooth movements are an important resource in orthodontic treatment and allow the manipulation of teeth and periodontal tissues. They can be performed quickly or slowly, depending on the patient's need. Rapid extrusion is indicated for cases in need of prosthetic preparation or restoration, where the bone and gingival tissues are intact, such as horizontal and oblique fractures, coronary or external root resorption, iatrogenic perforations (trepanations) and the presence of subgingival caries. The aim of this study is to describe the treatment of a patient who had a coronary fracture of the right upper central incisor, with a limit located 1 mm above the level of the bone crest. Rapid orthodontic extrusion was performed, to restore biologic distances and allow the preparation for prosthesis. It started with partial differentiated bonding of a fixed orthodontic appliance to the upper arch, to allow for a 3mm orthodontic extrusion. At the end of the extrusion, periodontal surgery was performed to increase the clinical crown and endodontic treatment. After these procedures, the case was concluded with the fixed prosthesis installation. The realization of an integrated planning allowed the restoration of aesthetics, with preservation of the functional periodontal limits for the patient.(Au)


Os movimentos dentários extrusivos constituem um recurso importante no tratamento ortodôntico e permitem a manipulação dos dentes e dos tecidos periodontais. Eles podem ser realizados de forma rápida ou lenta, dependendo da necessidade do paciente. A extrusão rápida está indicada para casos com necessidade de preparo protético ou restauração, onde os tecidos ósseo e gengival encontram-se íntegros, tais como fraturas horizontais e oblíquas, reabsorções coronárias ou radiculares externas, perfurações iatrogências (trepanações) e presença de cárie subgengival. O objetivo deste trabalho é descrever o tratamento de uma paciente que apresentava fratura coronária do incisivo central superior direito, com limite localizado 1mm acima do nível da crista óssea. Realizou se extrusão ortodôntica rápida, com a finalidade de restabelecer as distâncias biológicas e permitir o preparo para prótese. Iniciou-se com colagem diferenciada parcial de aparelho ortodôntico fixo no arco superior, para permitir a extrusão ortodôntica de 3mm. Ao término da extrusão, realizou-se cirurgia periodontal para aumento da coroa clínica e tratamento endodôntico. Após esses procedimentos, o caso foi finalizado com a instalação da prótese fixa. A realização de um planejamento integrado permitiu o restabelecimento da estética, com preservação dos limites periodontais funcionais para a paciente. (Au)

7.
Braz Oral Res ; 35: e081, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34231768

RESUMO

The object of this study was to compare the clinical complications of 4 different appliances used in the early treatment of anterior open bite (AOB), and to test the null hypothesis that there is no difference in the number of complications among the appliances. Records from 99 Class I malocclusion patients with AOB treated using bonded spurs, BS, n = 25; chin cup, CC, n = 25; fixed palatal crib, FPC, n = 25; and removable palatal crib, RPC, n = 24) were examined. The total number and frequency of clinical complications that occurred over 12 months were described and compared by using chi-square and Kruskal-Wallis tests (Dunn's post-test) (α = 5%, CI = 95%). The incidence of clinical complications was 66.7%, comprising: breakage, bond failure, maladjustment, allergy, soft-tissue lesion, loss of removable appliance and abandonment. Eighteen patients gave up treatment; this occurred more frequently in the groups with removable appliances. Regarding the total number of complications per patient, Group BS exhibited a significantly higher number than the other groups (p < 0.0001). A low frequency of complications (1 to 3) was found in the groups, except for Group BS, in which 8% of the patients presented moderate frequency (4 to 6). In terms of appliance types (fixed or removable), there was no difference in the incidence of complications (p > 0.094). The null hypothesis was rejected, since the BS group exhibited the highest total number and frequency of complications. There was no difference between fixed and removable appliances in terms of incidence of clinical complications, although more patients using removable appliances abandoned their treatment.


Assuntos
Mordida Aberta , Aparelhos Ortodônticos Removíveis , Humanos , Mordida Aberta/epidemiologia , Mordida Aberta/etiologia , Mordida Aberta/terapia , Palato
8.
Braz. dent. j ; 32(3): 116-126, May-June 2021. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1345509

RESUMO

Abstract This 2-year-follow up study compared and evaluated the stability of early anterior open bite (AOB) treatment based on different appliances. Children from 7 to 10 years with Angle Class I, AOB larger than 1.0 mm and fully erupted maxillary and mandibular permanent central incisors were eligible. The initial sample was 99 patients distributed, by simple randomization, into four groups: BS (bonded spurs), CC (chincup), FPC (fixed palatal crib) and RPC (removable palatal crib). Cephalometric analysis was performed at baseline (T1), final (T2) and 2-year post-treatment (T3) by taking the overbite measurements as the main outcome. Blinding was possible to cephalometric analysis. At T3, with dropouts, there were 63 individuals, being BS (n=15; overbite 0.19 mm; 11.54 years; 10 female (F)/5 male (M)); CC (n=11; overbite -0.19 mm; 11.41 years; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 years; 15 F/6 M) and; RPC (n=16; overbite 0.73 mm; 11.67 years; 6 F/10 M). Changes in dentoskeletal variables and breaking deleterious oral habits during the follow up were statically analyzed with p<.05. Mandibular skeletal linear measurements and vertical dental components have gradually increased with age, manly at pubertal growth spurt and at the establishment of permanent dentition after treatment. Incisor teeth extrusion had impact on AOB correction and stability in 4 groups, which recorded a 1.15 mm-improvement of overbite after treatment (T3-T2). The experimental appliances were effective with stable results, being FPC the device recorded the highest AOB correction and the lowest patient withdrawal rate.


Resumo Os objetivos do presente estudo foram comparar e avaliar a estabilidade do tratamento precoce da mordida aberta anterior (MAA) com diferentes dispositivos. A amostra inicial foi composta por 99 pacientes randomizados em quatro grupos experimentais: BS - esporões colados; CC - mentoneira; FPC - grade palatina fixa; RPC - grade palatina removível. Análise cefalométrica foi realizada para avaliar os dados do período inicial (T1), final do tratamento (T2) e 2 anos após tratamento (T3), sendo a variável overbite o desfecho principal. Em T3, após perdas de seguimento, haviam 63 indivíduos, sendo BS (n=15; overbite 0.19 mm; 11.54 anos; 10 Feminino (F)/5 Masculino (M)); CC (n=11; overbite -0.19 mm; 11.41 anos; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 anos; 15 F/6 M) e; RPC (n=16; overbite 0.73 mm; 11.67 anos; 6 F/10 M). Comparações das alterações nas variáveis dentoesqueléticas e abandono de hábitos bucais deletérios durante o tempo de acompanhamento foram estatisticamente analisados com p<.05. Medidas esqueléticas lineares mandibulares e componentes verticais aumentaram gradualmente com a idade, principalmente com o surto de crescimento puberal e estabelecimento da dentição permanente no pós-tratamento. O overbite foi significantemente melhorado durante o tratamento, permanecendo estável com alterações positivas. A extrusão dos incisivos impactou na correção da MAA e estabilidade nos 4 grupos, que registraram uma melhora de 1.15 mm no pós-tratamento (T3-T2). Com suas limitações, todos dispositivos experimentais foram efetivos e mostraram resultados estáveis no tratamento precoce da MAA, sendo que a FPC apresentou a maior correção da MAA e o menor índice de desistência.


Assuntos
Humanos , Masculino , Feminino , Criança , Mordida Aberta/terapia , Má Oclusão Classe II de Angle , Cefalometria , Seguimentos , Mandíbula
9.
J. health sci. (Londrina) ; 23(1): https://revista.pgsskroton.com/index.php/JHealthSci/article/view/8382, 20210330.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1179418

RESUMO

Amelogenesis imperfecta (AI) is an inherited disease that expresses a disorder in the development of enamel structure. In its mildest form, it promotes tooth color change; and in more severe cases, it presents a loss of enamel structure initiated during the eruption phase. Different AI manifestations can coexist in the same patient or in the same tooth, both in the primary and permanent dentures. In addition, several subtypes are described, characterized according to the variety of phenotype and genotype. Successful treatment requires early diagnosis and therapeutic solutions involving different dental specialties. Although some professionals prefer to postpone permanent rehabilitation until the development of complete permanent dentures, the aesthetic and functional impact of this disease in childhood and adolescence requires that restorative treatment be started as soon as possible. The proposed therapies demonstrate numerous challenges such as extreme dentinal sensitivity, difficulties installing and maintaining the orthodontic appliance and the need for restorative and prosthetic intervention in malformed teeth. This work aims to demonstrate the interaction between Orthodontics, Restorative Dentistry and Prosthesis in the treatment of a patient with AI, reporting the success of treatment involving aesthetics, function and well-being and the long-term benefit of this interdisciplinary approach for patients with this disease. (AU)


A amelogênese imperfeita (AI) é uma doença hereditária que expressa uma desordem no desenvolvimento da estrutura do esmalte. Na sua forma mais branda, promove alteração na cor dos dentes; e em casos mais severos, apresenta perda de estrutura do esmalte iniciada durante a fase de irrupção. Diferentes manifestações da AI podem coexistir no mesmo paciente ou no mesmo dente, tanto na dentadura decídua quanto na permanente. Além disso, são descritos diversos subtipos, caracterizados de acordo com a variedade do fenótipo e genótipo. O sucesso do tratamento requer diagnóstico precoce e soluções terapêuticas que envolvam diversas especialidades odontológicas. Embora alguns profissionais prefiram adiar a reabilitação definitiva até o desenvolvimento da dentadura permanente completa, o impacto estético e funcional desta doença na infância e adolescência exige que o tratamento restaurador seja iniciado o mais cedo possível. As terapias propostas demonstram inúmeros desafios como a sensibilidade dentinária extrema, as dificuldades para instalação e manutenção do aparelho ortodôntico e a necessidade de intervenção restauradora e protética em dentes com má formação. O presente trabalho tem como finalidade demonstrar a interação entre a Ortodontia, a Dentística Restauradora e a Prótese no tratamento de um paciente com AI, relatando o sucesso do tratamento envolvendo estética, função, bem estar e o benefício em longo prazo desta abordagem interdisciplinar para os portadores desta doença. (AU)

10.
Braz. oral res. (Online) ; 35: e081, 2021. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1278597

RESUMO

Abstract The object of this study was to compare the clinical complications of 4 different appliances used in the early treatment of anterior open bite (AOB), and to test the null hypothesis that there is no difference in the number of complications among the appliances. Records from 99 Class I malocclusion patients with AOB treated using bonded spurs, BS, n = 25; chin cup, CC, n = 25; fixed palatal crib, FPC, n = 25; and removable palatal crib, RPC, n = 24) were examined. The total number and frequency of clinical complications that occurred over 12 months were described and compared by using chi-square and Kruskal-Wallis tests (Dunn's post-test) (α = 5%, CI = 95%). The incidence of clinical complications was 66.7%, comprising: breakage, bond failure, maladjustment, allergy, soft-tissue lesion, loss of removable appliance and abandonment. Eighteen patients gave up treatment; this occurred more frequently in the groups with removable appliances. Regarding the total number of complications per patient, Group BS exhibited a significantly higher number than the other groups (p < 0.0001). A low frequency of complications (1 to 3) was found in the groups, except for Group BS, in which 8% of the patients presented moderate frequency (4 to 6). In terms of appliance types (fixed or removable), there was no difference in the incidence of complications (p > 0.094). The null hypothesis was rejected, since the BS group exhibited the highest total number and frequency of complications. There was no difference between fixed and removable appliances in terms of incidence of clinical complications, although more patients using removable appliances abandoned their treatment.


Assuntos
Humanos , Aparelhos Ortodônticos Removíveis , Mordida Aberta/etiologia , Mordida Aberta/terapia , Mordida Aberta/epidemiologia , Palato
11.
Ortho Sci., Orthod. sci. pract ; 14(56): 106-112, 2021. tab, graf
Artigo em Português | BBO - Odontologia | ID: biblio-1352814

RESUMO

Resumo O objetivo da pesquisa foi avaliar a eficácia do pacote Invisalign Lite no tratamento de apinhamentos anteriores suaves e moderados sob a perspectiva de ortodontistas e leigos. Dez indivíduos tratados com Invisalign Lite foram selecionados consecutivamente e divididos em dois grupos: menos de 2mm de apinhamento (suave) e mais que 2mm e menos que 5mm de apinhamento (moderado). Imagens do modelo digital pré e pós-tratamento de cada paciente foram obtidas e organizadas randomicamente em uma apresentação Power Point. A avaliação foi realizada por 109 indivíduos divididos em dois grupos: ortodontistas e leigos. A eles foi solicitado que atribuíssem uma nota de 1 (pobre) a 5 (excelente) para o alinhamento dos dentes em cada imagem. Ainda os avaliadores tinham que responder para cada uma das imagens, se na opinião deles o tratamento ortodôntico era necessário. Em todos os grupos foi realizado o teste de normalidade Kolmogorov-Smirnov. O teste-t pareado e o teste não paramétrico Wilcoxon foram utilizados para comparações pareadas. O teste-t independente e o não-paramétrico Mann-Whitney foram utilizados para comparar os grupos de avaliadores e de quantidade de apinhamento. O nível de significância de 5% (P<0,05) foi adotado para todos os testes. Para os ortodontistas, a avaliação do alinhamento dentário subiu de 2,85 para 4,13 após o tratamento ortodôntico. Já para os leigos, a nota subiu de 2,54 para 3,69. De acordo com os ortodontistas, 11,15% das imagens pós-tratamento necessitava de tratamento ortodôntico. Já de acordo com os leigos, essa porcentagem foi de 35,63%. (AU)


Abstract The aim of the research was to evaluate the efficacy of Invisalign Lite package in mild and moderate anterior crowding treatment from the perspective of orthodontists and lay people. Ten subjects treated with Invisalign Lite were consecutively selected and divided into 2 groups: less than 2mm crowding (mild) and more than from 2mm to 5mm crowding (moderate). Images pre-and post-treatment of each subject were obtained from digital cast and randomly arranged in a Power Point presentation. The evaluation was performed by 109 individuals divided into 2 groups: orthodontists and lay people. They were asked to assign a score for teeth alignment from 1 (poor) to 5 (excellent). Also, the evaluators had to answer for each of the images, if in their opinion orthodontic treatment was necessary. In all groups the Kolmogorov-Smirnov normality test was performed. Paired t-test and non-parametric Wilcoxon test were used for paired comparison. The independent t-test and non-parametric Mann-Whintney were used for comparing evaluators groups and the amount of crowding. In all tests a 5% (p<0,05) significance level was adopted. For the orthodontists, alignment evaluation increased from 2,85 to 4,13 after orthodontic treatment. The scores assigned by lay people increased from 2,54 to 3,69. Orthodontists pointed out that they would indicate orthodontic treatment for 11,15% of the post-treatment images. For lay people, orthodontic treatment would be necessary for 35,63% of post-treatment images.(AU)


Assuntos
Humanos , Aparelhos Ortodônticos Removíveis , Técnicas de Movimentação Dentária , Desenho Assistido por Computador
12.
J World Fed Orthod ; 9(4): 155-158, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33183991

RESUMO

BACKGROUND: The purpose of this study was to evaluate patients' and orthodontists' perspectives on knowledge of techniques for reducing orthodontic treatment time and acceptance of these techniques. METHODS: A total of 200 individuals were interviewed and equally divided into two groups: orthodontist group (62 female and 38 male; mean age, 38.07 years) and patient group (52 female and 48 male; mean age, 22.61 years; in the active stage of fixed orthodontic treatment). One questionnaire for each group was administered, including questions about the duration of orthodontic treatment and techniques used for treatment optimization, such as corticotomy, distraction osteogenesis, vibration, and laser therapy. The associations between variables were analyzed by the χ2 test at a significance level of 5%. RESULTS: Among orthodontists, 76% knew at least one technique to reduce the treatment duration, with corticotomy being the most frequently cited (66%); however, only 12% used one or more of these techniques. Laser therapy was the most frequently implemented technique (7%). Regarding the duration of orthodontic treatment, the mean time reported by orthodontists was 19 to 24 months, regardless of the technique or the experience of the orthodontist. Furthermore, 39% of patients expected their treatment to last for more than 24 months, with 50% accepting to undergo further procedures to reduce this duration. CONCLUSIONS: Patients are willing to undergo additional procedures to reduce the treatment duration and to bear additional costs. However, despite their knowledge, orthodontists do not apply or offer these techniques to the patients.


Assuntos
Duração da Terapia , Ortodontistas , Adulto , Assistência Odontológica , Feminino , Humanos , Masculino , Percepção , Inquéritos e Questionários , Adulto Jovem
13.
Dental Press J Orthod ; 25(5): 30-37, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33206826

RESUMO

OBJECTIVE: This prospective study aimed at assessing the effects of anxiety and a follow-up text message on pain perception after the installation of fixed orthodontic appliances and its impact on the patients' routine. METHODS: The sample of this study consisted of 103 orthodontic patients, 40 males and 63 females (mean age 20.5 years), distributed in two groups: G1 (n=51), including control patients that did not receive any post-procedure communication; and G2 (n=52), including patients that received a structured text message. In baseline phase, the patients completed a questionnaire to assess their level of anxiety prior to treatment. Pain was assessed by using 100-mm visual analog scale (VAS) in baseline and ten times prospectively in predetermined time points. VAS was also applied to assess the patient's routine alterations caused by the pain. All data were analyzed using ANOVA, Tukey, Mann-Whitney, t-test, chi-square and Spearman's correlation tests. All statistical tests were performed with significance level of 5%. RESULTS: Low-level and high-level anxiety was observed in 42.7% and 7.8% of the patients, respectively. Statistically significant correlation was observed between anxiety and pain (p< 0.05). Maximum mean pain intensity was detected in the second treatment day (G1=36.9mm and G2=26.2mm) and was significantly higher in G1. Nearly 53% of the patients in G1 reported alterations in the routine (18.8mm), while in G2 the percentage rate reached 28.8% (9.9mm) (p=0.013). CONCLUSIONS: Anxious patients report more pain after the installation of orthodontic appliances. Text messages were effective to reduce pain levels and to decrease the negative effects on patients' daily routine.


Assuntos
Envio de Mensagens de Texto , Adulto , Ansiedade/etiologia , Feminino , Humanos , Masculino , Medição da Dor , Percepção da Dor , Estudos Prospectivos , Adulto Jovem
14.
J Clin Exp Dent ; 12(10): e922-e930, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33154793

RESUMO

BACKGROUND: Rapid maxillary expansion (RME) is a usual procedure for correcting the transversal maxillary deficiency. Among the most used appliances are the Haas type (tooth-tissue-borne) and Hyrax (tooth-borne) whose main difference is the design. This study aimed to evaluate the dentoskeletal effects of RME using two different expanders in children. MATERIAL AND METHODS: The sample was composed of 42 children of both gender presenting unilateral or bilateral posterior crossbite with mean age 9.49 (SD± 1.35). Patients were randomized into two groups according to the type of expander: Hyrax (n= 21, 9 boys and 12 girls) and Haas (n= 21, 11 boys and 10 girls). Multiplanar coronal and axial slices obtained from cone-beam computed tomography images (i-Cat, Hartsfield, PA, USA) were used at pretreatment (T1) and after 6 months when the expander was removed (T2). Measurements were performed on Dolphin Imaging Systems 11.7 software (Chatsworth, California, USA). The following variables were evaluated: inclinations of the posterior teeth, transverse skeletal widths, length of maxillary dental arch, buccal bone thickness and level of buccal alveolar crest. Statistical analysis performed using chi-squared test to compare the sex ratios between groups and independent t test with the Bonferroni correction for multiple tests. RESULTS: RME increased all maxillary transverse dimensions, regardless of the type of expanders used. Subjects in the Hyrax group experienced significantly increase in the lingual bone thickness (0.94 mm) compare to Haas group (0.21 mm). CONCLUSIONS: The Hyrax-type expander produced greater increase in the lingual bone thickness than did the Haas-type expander, but this effect might not be clinically significant. Both appliances presented similar transversal gain and tended to produce similar orthopedic and orthodontic effects. Key words:Cone-beam computed tomography, palatal expansion technique, palate.

15.
Dental press j. orthod. (Impr.) ; 25(5): 30-37, Sept.-Oct. 2020. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1133685

RESUMO

ABSTRACT Objective: This prospective study aimed at assessing the effects of anxiety and a follow-up text message on pain perception after the installation of fixed orthodontic appliances and its impact on the patients' routine. Methods: The sample of this study consisted of 103 orthodontic patients, 40 males and 63 females (mean age 20.5 years), distributed in two groups: G1 (n=51), including control patients that did not receive any post-procedure communication; and G2 (n=52), including patients that received a structured text message. In baseline phase, the patients completed a questionnaire to assess their level of anxiety prior to treatment. Pain was assessed by using 100-mm visual analog scale (VAS) in baseline and ten times prospectively in predetermined time points. VAS was also applied to assess the patient's routine alterations caused by the pain. All data were analyzed using ANOVA, Tukey, Mann-Whitney, t-test, chi-square and Spearman's correlation tests. All statistical tests were performed with significance level of 5%. Results: Low-level and high-level anxiety was observed in 42.7% and 7.8% of the patients, respectively. Statistically significant correlation was observed between anxiety and pain (p< 0.05). Maximum mean pain intensity was detected in the second treatment day (G1=36.9mm and G2=26.2mm) and was significantly higher in G1. Nearly 53% of the patients in G1 reported alterations in the routine (18.8mm), while in G2 the percentage rate reached 28.8% (9.9mm) (p=0.013). Conclusions: Anxious patients report more pain after the installation of orthodontic appliances. Text messages were effective to reduce pain levels and to decrease the negative effects on patients' daily routine.


RESUMO Objetivo: O presente estudo prospectivo teve como objetivo avaliar os efeitos da ansiedade e de mensagens de texto de acompanhamento na percepção da dor após a instalação de aparelhos ortodônticos fixos e seu impacto na rotina dos pacientes. Métodos: A amostra deste estudo foi composta por 103 pacientes ortodônticos, 40 homens e 63 mulheres (idade média de 20,5 anos), distribuídos em dois grupos: G1 (n = 51), que incluiu pacientes controle, que não receberam comunicação pós-procedimento; e G2 (n = 52), incluindo os pacientes que receberam mensagem de texto estruturada. Na fase inicial, os pacientes responderam a um questionário para avaliar seu nível de ansiedade antes do tratamento. A dor foi avaliada por meio de escala visual analógica (EVA) de 100 mm antes da instalação dos aparelhos e em 10 períodos consecutivos predeterminados. A EVA também foi aplicada para avaliar as alterações de rotina do paciente causadas pela dor. Os resultados foram analisados usando ANOVA, Tukey, Mann-Whitney, teste t, Qui-quadrado e testes de correlação de Spearman. Todos os testes estatísticos foram realizados com nível de significância de 5%. Resultados: Níveis baixos e altos de ansiedade foram observados em 42,7% e 7,8% dos pacientes, respectivamente. Foi observada correlação estatisticamente significativa entre ansiedade e dor (p< 0,05). A intensidade média máxima da dor foi detectada no segundo dia de tratamento (G1 = 36,9mm e G2 = 26,2mm) e foi significativamente maior no G1. Quase 53% dos pacientes do G1 relataram alterações na rotina (18,8mm), enquanto no G2 o percentual atingiu 28,8% (9,9mm) (p= 0,013). Conclusões: Pacientes ansiosos relatam mais dor após a instalação de aparelhos ortodônticos. As mensagens de texto foram eficazes para reduzir os níveis de dor e diminuir os efeitos negativos na rotina diária dos pacientes.


Assuntos
Humanos , Masculino , Feminino , Adulto , Ansiedade/etiologia , Envio de Mensagens de Texto , Medição da Dor , Estudos Prospectivos , Percepção da Dor
16.
J. health sci. (Londrina) ; 21(5): https://seer.pgsskroton.com/index.php/JHealthSci/article/view/6776, 20/12/2019.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1051619

RESUMO

Anterior open bite affects the child population by approximately 20%, with great aesthetic-functional impairment due to dental-skeletal changes, which may involve the presence of posterior crossbite. The objective was to present the anterior open bite correction associated with posterior crossbite with the use of a removable palatal crib. Patient during the mixed dentition phase presented an anterior open bite caused by a pacifier sucking habit and secondary lingual interposition. The treatment protocol consisted of the use of removable expander with palatal crib and nocturnal use of the chincup. The anterior open bite was corrected, and the best transverse relation of the arches was obtained. The precocious treatment using the palatal crib associated to the chincup allows to achieve favorable results in the resolution of the anterior open bite. (AU)


A mordida aberta anterior acomete a população infantil em aproximadamente 20%, com grande comprometimento estético-funcional em decorrência das alterações dentoesqueléticas, podendo envolver a presença de mordida cruzada posterior. O objetivo do estudo foi apresentara correção da mordida aberta anterior associada à mordida cruzada posterior com a utilização de grade palatina removível. Paciente em fasede dentadura mista, apresentava mordida aberta anterior ocasionada por um hábito de sucção de chupeta e interposição lingual secundária.O protocolo de tratamento consistiu na utilização de expansor removível com grade palatina e uso noturno da mentoneira. A mordida aberta anterior foi corrigida e melhor relação transversal dos arcos foi obtida. O tratamento precoce utilizando grade palatina associada à mentoneira permite alcançar resultados favoráveis na resolução da mordida aberta anterior. (AU)

17.
J. health sci. (Londrina) ; 21(2): https://seer.pgsskroton.com/index.php/JHealthSci/article/view/6603, 19/06/2019.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1051253

RESUMO

The presence of supernumeraries may lead to irruptive problems, such as impacted teeth, functional and aesthetic disorders. The present study describes two clinical cases, with anterior teeth eruption disorders caused by additional dental elements, treated early. Patients presented with aesthetic involvement, with delay in the emergence of the upper incisors. The clinical and radiographic examinations detected the presence of obstacles to the teeth eruption. Early treatment with 2x4 appliance was realized, followed by final corrective orthodontics. After restoration of the dimension for retained teeth, there was spontaneous eruption in clinical case 1 and need of traction in clinical case 2. When patients reached the complete permanent dentition, a corrective phase was performed with the objective of detailing the dental occlusion and finishing the treatment. The early diagnosis of teeth impacted and supernumerary, provide the achievement of adequate occlusion and positive aesthetic of patients, with good prognosis, avoiding psychological and functional problems caused by absence of anterior teeth. (AU).


A presença de supranumerários pode ocasionar problemas irruptivos, como impacção de dentes, desordens funcionais e estéticas. O presente trabalho descreve dois casos clínicos abordados precocemente, com alterações na irrupção de dentes anteriores devido a presença de supranumerários. Os pacientes apresentavam queixas estéticas, com atraso no aparecimento dos incisivos superiores. Os exames clínico e radiográfico detectaram a presença de barreiras irruptivas. Realizou-se tratamento precoce com auxílio da mecânica 4x2, seguido pela ortodontia corretiva final. Após etapa de restabelecimento da dimensão para os dentes retidos, houve irrompimento espontâneo no caso clínico 1 e necessidade de tracionamento no caso clínico 2. Quando pacientes atingiram a dentição permanente completa, realizou-se uma fase corretiva com o objetivo de detalhamento da oclusão dentária e finalização do tratamento. O diagnóstico precoce de impacção dentária e detecção de supranumerários favoreceu a restituição de oclusão adequada e estética dos pacientes, com prognóstico muito favorável, evitando problemas psicológicos e funcionais provocados pela ausência de dentes anteriores. (AU).

18.
Am J Orthod Dentofacial Orthop ; 155(2): 224-233, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30712694

RESUMO

INTRODUCTION: The present study aimed to assess the influence of facial pattern in smile attractiveness on different levels of gingival exposure evaluated by dental specialists and laypersons. METHODS: Frontal photographs of 2 white Brazilian women, one with a long face and the other with a balanced face, were acquired and subsequently modified to simulate gingival exposure from 0 to 6 mm. Four groups of evaluators of both sexes (mean age 34 y), including laypersons (n = 24) and dental specialists (n = 72; 24 orthodontists, 24 periodontists, and 24 maxillofacial surgeons), used a Likert-type scale to evaluate the attractiveness of the smiles of these subjects with different levels of gingival exposure. Kruskal-Wallis and Friedman tests were used to compare the perceptions of the dental specialists and laypersons. Spearman rank correlation coefficient was used to associate the age of the examiners with their rating outcomes. Statistical significance was set at P < 0.05. RESULTS: Statistically significant differences were observed for the following levels of exposure for the long-faced subject: 0 mm, 4 mm, 5 mm, and 6 mm. Laypersons were less critical than dental specialists. In the balanced-face subject, statistically significant differences were observed between laypersons and dental specialists for gingival exposure levels of 4 mm, 5 mm, and 6 mm. Laypersons perceived gingival exposure to a lesser extent for the balanced-face subject than for the long-face subject. The balanced face was better rated than the long face by dental specialists and laypersons for all levels of gingival exposure. CONCLUSIONS: Facial patterns influenced the smile attractiveness evaluation. The facial characteristics of a balanced facial pattern attenuated the perception of gingival exposure.


Assuntos
Atitude , Odontologia , Estética Dentária , Gengiva/anatomia & histologia , Sorriso , Adolescente , Adulto , Idoso , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
Rev. Salusvita (Online) ; 38(3): 693-711, 2019.
Artigo em Português | LILACS | ID: biblio-1051660

RESUMO

Introdução: A Síndrome de apnéia e/ou hipopnéia obstrutiva do sono (SAHOS) é caracterizada pela obstrução repetida das vias aéreas ou redução da respiração durante o sono. Esta síndrome é causada por colapso faríngeo contra aumento do esforço espiratório durante o sono. A SAHOS leva à deterioração da qualidade do sono associado à queixa de sonolência diurna excessiva e a efeitos desfavoráveis no sistema cardiovascular. Características orofaciais como retrognatismo mandibular e/ou associado a retrognatismo maxilar, má oclusão de Classe II, com ou sem mordida aberta, e diminuição das vias aéreas orofaríngeas fazem parte do seu quadro. Objetivo: Relato do tratamento ortocirúrgico de um paciente com 31 anos de idade com caraterísticas de SAHOS, má oclusão de Classe II, deficiência mandibular, mordida cruzada posterior e aberta anterior, diminuição da altura facial anteroinferior, aprofundamento do sulco mentolabial, pouca exposição do lábio inferior e nítido desequilíbrio facial. Relato e Resultados: Tratamentos não invasivos para SAHOS passam pelos dispositivos de pressão nasal contínua positiva nas vias aéreas ou aparelhos intra-bucais com o objetivo de manter a mandíbula em posição anteriorizada durante o sono. Nos tratamentos invasivos, a cirurgia de avanço mandibular evita a rotação no sentido anti-horário do complexo maxilomandibular com aumento do espaço orofaríngeo das vias aéreas médias e inferiores. Nas situações com grande impacto esquelético dentofacial associado ao grau de obstrução das vias aéreas será necessário um tratamento descompensatório ortocirúrgico, permitindo assim um restabelecimento respiratório e estético da face. Conclusão: O tratamento descompensatório com avanço cirúrgico bimaxilar foi responsável pela correção da má oclusão e aumento do espaço aéreo, contemplando a expectativa respiratória, funcional e estética.


Introduction: Obstructive sleep apnea and/or hypopnea syndrome (OSAHS) is characterized by repeated obstruction of the airway or reduction of breathing during sleep. This syndrome is caused by pharyngeal collapse against increased respiratory effort during sleep. SAHOS leads to deterioration of sleep quality associated with clinical complaints of excessive daytime sleepiness and unfavorable effects on the cardiovascular system. Orofacial features such as mandibular retrognathism and/or associated maxillary retrognathism, Class II malocclusion, with or without open bite and reduction of the oropharyngeal airway characterize this syndrome. Objective: It is reported an orthosurgical treatment of a 31 years old male patient, with OSAHS characteristics, Class II malocclusion, mandibular deficiency, posterior crossbite and anterior open bite, lower anterior facial height decrease, deepening of the labial sulcus, little exposure of the lower lip and unbalanced face. Report and Results: Non-invasive treatments for OSAHS pass through positive continuous nasal pressure devices in the airways or intra-oral appliances in order to maintain the mandible in an anterior position during sleep. In the invasive treatments protocol, mandibular advancement surgery prevents rotation in the anti-clockwise direction of the maxillomandibular complex with an increase in the oropharyngeal space of the middle and lower airways. In cases with great skeletal dentofacial impact associated with the degree of obstruction of the airway will be necessary an ortho-surgical decompensatory treatment, to allow a respiratory and aesthetic restoration of the face. Conclusion: The decompensatory treatment with bimaxillary surgical advancement corrected the malocclusion, increasing the air space contemplating the respiratory, functional and aesthetic expectation.


Assuntos
Má Oclusão Classe II de Angle , Apneia Obstrutiva do Sono
20.
J. health sci. (Londrina) ; 20(3)31/10/2018.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-965548

RESUMO

The treatment of Class II can have a positive or a negative impact on the facial profile aesthetic. The present study aims to evaluate the impact of two methods of orthodontic treatment of Class II malocclusion on the facial profile aesthetics. The facial profiles of 46 patients with Class II malocclusion were outlined by radiography before and after treatment; 23 of the patients were treated by the extraction of two maxillary first premolars (EXT group), and the other 23, with the Thurow Appliance (TA group), followed by braces. The profile silhouettes were filled in using the Corel Draw program. An album containing the patient's silhouettes of both groups was created randomly, with two profiles of a patient per page. The preferences of 30 orthodontists, 30 dentists, and 30 laypersons in relation to the profile were recorded along with their perceived differences between the pre-treatment and post-treatment profiles, according to the visual analog scale. All groups of evaluators preferred the post-treatment profile more frequently. There were statistically significant differences in the evaluators' preferences only between the orthodontists' and the laypersons' groups. None of the evaluators' groups indicated substantial differences between the pre-treatment and post-treatment profiles. It may be concluded that both Class II treatment protocols, i.e., the double-extraction of the first premolars and the use of TA, improved the patients' facial profile aesthetics. (AU).


As modalidades de tratamentos da Classe II tem um impacto sobre a estética da face que pode ser positivo ou negativo. O objetivo deste estudo foi avaliar o impacto da estética do perfil facial decorrente de dois tipos de tratamento para a Classe II. Foram traçados os perfis faciais das telerradiografias pré e pós-tratamento de 46 pacientes Classe II, sendo 23 de um grupo tratado com extração de dois primeiros pré-molares superiores e 23 de um grupo tratado com AEB Conjugado seguido de aparelho fixo, e estes traçados foram preenchidos com o programa Corel Draw. Foi montado um álbum com as silhuetas dos pacientes (AEB e EXO) de forma aleatória, sendo dois perfis em cada folha do mesmo paciente. Foi pedido para 30 ortodontistas, 30 cirurgiões-dentistas e 30 leigos para verificarem a sua preferência em relação ao perfil e a quantidade de diferença entre os perfis pré e pós-tratamento, de acordo com a escala analógica visual. Os 3 grupos de avaliadores preferiram o perfil pós-tratamento com maior frequência. Houve diferenças estatisticamente significantes somente entre os grupos de avaliadores ortodontistas e leigos; os 3 grupos de avaliadores indicaram que os perfis pré e pós-tratamento, não diferiram substancialmente. Pode-se concluir que o tratamento da Classe II, com extração de dois primeiros pré-molares, e com o uso do aparelho AEB Conjugado produziu um impacto positivo na estética do perfil. (AU).

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