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1.
Angle Orthod ; 2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36066265

RESUMO

OBJECTIVES: To compare the efficacy and efficiency between clear aligners and 2 × 4 fixed appliances for correcting maxillary incisor position irregularities in the mixed dentition. MATERIALS AND METHODS: The sample comprised 32 patients from 7 to 11 years of age randomly allocated into two parallel treatment groups: the clear aligners group, 14 patients (6 girls, 8 boys) with a mean initial age of 9.33 years (standard deviation [SD] = 1.01) treated with clear aligners; and the fixed appliances group, 13 patients (9 girls, 4 boys) with a mean initial age of 9.65 years (SD = 0.80) treated with partial (2 × 4) fixed appliances. Digital models were acquired before treatment and after appliance removal. Primary outcomes were incisor irregularity index and treatment time. Secondary outcomes were arch width, perimeter, length, size and shape, incisor leveling, incisor mesiodistal angulation, plaque index, and white spot lesion formation (International Caries Detection and Assessment System index). Intergroup comparisons were evaluated using t-tests or Mann-Whitney U-tests with Holm-Bonferroni correction (P < .05). RESULTS: Treatment time was approximately 8 months in both groups. No intergroup differences were observed for changes in any of the variables. Similar posttreatment arch shapes were observed in both groups. CONCLUSIONS: Clear aligners and 2 × 4 mechanics displayed similar efficacy and efficiency for maxillary incisor position corrections in the mixed dentition. The choice of appliance should be guided by clinician and family preference.

2.
J World Fed Orthod ; 2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-35934619

RESUMO

BACKGROUND: To evaluate the reliability of a new instrument to clinically measure the anteroposterior relationship of the maxillary central incisors to the forehead. METHODS: An analytical cross-sectional study using a sample of 84 (67% female and 33% male) young adult participants was conducted. Measurements were performed according to Element II of the Andrews' Six Elements of Orofacial Harmony by assessing the horizontal distance between the facial axis point of the maxillary central incisor and the forehead's anterior limit line. The instrument tested was a transparent plastic template having a leveling meter, reference lines, and an embedded millimeter ruler. Two orthodontists evaluated the sample twice with a minimum of a two-week interval between evaluations. The reliability was evaluated using the intraclass correlation coefficient. Repeated-measures ANOVA was also performed. RESULTS: Good to excellent intra- and interexaminer agreement, with intraclass correlation coefficient values of 0.874 (95% confidence interval 0.800-0.921; P < 0.001) and 0.876 (95% confidence interval 0.739-0.948; P < 0.001), respectively, were calculated. There were no statistically significant differences between all the repeated measurements assessed (P = 0.820). CONCLUSIONS: The instrument showed good to excellent reliability for determining the anteroposterior relationship of the maxillary central incisors to the forehead and could be used to help orthodontists and maxillofacial surgeons indirectly evaluate the anteroposterior position of the maxilla.

3.
Artigo em Inglês | MEDLINE | ID: mdl-35985966

RESUMO

INTRODUCTION: This study aimed to assess the long-term stability of Class II malocclusion treatment with the Cantilever Bite Jumper (CBJ) after 13 years of follow-up. METHODS: The treatment group comprised 10 Class II Division 1 malocclusion patients treated with the CBJ, followed by fixed appliances, analyzed at 3 stages: pretreatment (aged 11.56-14.32 years), posttreatment (aged 16.34-19.58 years), and long-term posttreatment (aged 29.04-32.33 years). The control group included 15 subjects with normal occlusion. Intragroup treatment changes comparison was performed with repeated measures and analysis of variance followed by Tukey tests. Intergroup comparisons regarding the long-term posttreatment changes were performed with t tests. RESULTS: No statistically significant relapse was observed during the follow-up period. Morever, the treated group presented a significantly smaller increase in lower anterior facial height and greater retrusion of the lower lip than the control group in the posttreatment period. CONCLUSIONS: Treatment with the CBJ, followed by fixed appliances, is a stable alternative for Class II Division 1 malocclusion correction. The dentoskeletal and soft-tissue changes obtained during treatment remained stable in the long-term posttreatment follow-up.

4.
Sci Rep ; 12(1): 12378, 2022 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-35858941

RESUMO

This randomized clinical trial aimed to compare the three-dimensional dentoalveolar maxillary changes after anterior open bite treatment with bonded spurs and build-ups versus bonded spurs alone. Patients from 7 to 11 years of age with anterior open bite were randomly allocated into two groups. Bonded spurs and posterior build-ups were used in the experimental group and only bonded spurs were used in the comparison group. The randomization sequence was generated at www.randomization.com . Opaque, sealed and sequentially numbered envelopes were part of the allocation concealment. Digital dental models were acquired before (T1) and after 12 months of treatment (T2) and de-identified for analysis purposes. Three-dimensional changes of maxillary permanent incisors and first molars were evaluated by means of T1 and T2 dental model superimposition. Landmark-based registration on the posterior teeth and registration on the palate using regions of interest were performed. T or Mann-Whitney U tests were used for intergroup comparisons (P < 0.05). Mean difference (MD) and 95% confidence interval (CI) were calculated. Twenty-four children (17 girls and 7 boys) were included in the experimental group (mean age 8.22 ± 1.06 years) and 25 children (14 girls and 11 boys) were included in the comparison group (mean age 8.30 ± 0.99 years). After 12 months of treatment, inferior displacements of maxillary incisors were similar in the experimental (1.55-2.92 mm) and comparison (1.40-2.65 mm) groups. Inferior displacement of the maxillary molars was also similar in both groups (MD: - 0.13 mm; 95% CI - 0.38, 0.12). The experimental and comparison groups showed medial and lateral displacements of the permanent first molars, respectively (MD, - 0.31 mm; 95% CI - 0.51, - 0.11). Lingual inclination of the permanent first molars were observed in the experimental group and buccal inclination in the comparison group (MD, - 2.16°; 95% CI - 3.72, - 0.60). Similar three-dimensional displacements of maxillary central and lateral incisors, and inferior displacements of maxillary permanent first molars were observed in both groups. Bonded spurs associated with posterior build-ups demonstrated some medial displacement and lingual inclination of the maxillary permanent first molars while opposite changes were noticed in the comparison group.Trial registration: Clinicaltrials.gov; NCT03702881, date of registration: October 11, 2018.


Assuntos
Mordida Aberta , Criança , Dentição Mista , Feminino , Seguimentos , Humanos , Masculino , Maxila , Dente Molar , Mordida Aberta/terapia
6.
Am J Orthod Dentofacial Orthop ; 162(3): 367-373, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35534399

RESUMO

INTRODUCTION: Premolars are the teeth most often extracted to provide space to correct crowding, excessive dental and/or labial protrusion, and to compensate for the sagittal discrepancy. After treatment, the extraction spaces have to remain closed. Nevertheless, several studies have shown a tendency for some relapse even in patients finished with an adequate occlusion. Thus, the objective of this study was to compare the stability of extraction space closure of the first and second premolars. METHODS: Dental casts of 72 patients were digitized using a 3-dimensional scanner (R700; 3Shape, Copenhagen, Denmark) and divided into 2 groups. Group 1 (29 patients; mean age, 13.79 years; 4.57 years after treatment; 116 extraction spaces) was treated with first premolar extractions, and group 2 (43 patients; mean age, 15.20 years; 3.97 years after treatment; 100 extraction spaces) was treated with second premolar extractions. Chi-square tests were used to compare the numbers of open and closed extraction spaces after treatment and at the long-term posttreatment stage. t Tests were used to compare the number of spaces posttreatment and at the long-term posttreatment stages. These tests were also performed in subgroups with completely closed extraction sites posttreatment. RESULTS: The groups showed similar numbers of extraction sites reopening. The first and second premolar extraction space closure presents a similar tendency for reopening. Considering only the patients that showed completely closed extraction spaces in the final dental models, maxillary extraction space reopening was larger in the first premolar extraction group. CONCLUSIONS: First and second premolar extraction space closure present similar stability.


Assuntos
Má Oclusão , Extração Dentária , Adolescente , Dente Pré-Molar/cirurgia , Cefalometria , Oclusão Dentária , Humanos , Má Oclusão/cirurgia , Maxila , Extração Dentária/métodos
9.
Dental Press J Orthod ; 27(1): e2220229, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35416863

RESUMO

INTRODUCTION: Quarantine protocols for coronavirus disease 2019 (COVID-19) pandemic has modified orthodontic appointments. OBJECTIVE: to evaluate self-reported experience and needs of orthodontic patients during the quarantine period without in-person appointments. METHODS: Thirty patients, aged 8 to 21 years, under active orthodontic treatment were randomly selected. A phone call questionnaire including questions on physical and emotional impacts of the quarantine of COVID-19 was applied during the second month of Brazilian quarantine. RESULTS: Sixteen percent of the patients reported pain related to the orthodontic appliance. Appliance breakage was observed in 23.33%. Twenty percent felt the need of an emergency orthodontic appointment and 3.33% visited a private practice. Moreover, 23% reported that even in an emergency need, they would not search for an appointment, preferring to communicate with the orthodontist by WhatsApp. Oral hygiene self-perception status showed improvement in 36.67% and worsening in 6.67% of the patients, while 56.66% reported maintenance of the same hygiene status. Sixty percent were concerned about the orthodontic treatment. General concerns were primary related to health and a possible extension of the quarantine time. CONCLUSIONS: During COVID-19 quarantine, orthodontic patients demonstrated a low frequency of orthodontic appliance interference in daily life, and most of them reported a maintenance of oral hygiene habits. The frequency of appliance related pain and breakage was 16.67% and 23.33%, respectively. Patients' main concern during the quarantine period was the fear of getting sick and the uncertainness about the extension of the quarantine period.


Assuntos
COVID-19 , Adolescente , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Humanos , Dor , Pandemias/prevenção & controle , Quarentena , SARS-CoV-2 , Adulto Jovem
10.
J Appl Oral Sci ; 30: e20210492, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35352790

RESUMO

BACKGROUND: The aim of this study was to evaluate the clinical and radiographic periodontal status of impacted permanent maxillary central incisors (Mx.1) after a long term of orthodontic traction. METHODOLOGY: This split-mouth study evaluated a sample of 11 patients (five females, six males) treated with Mx.1 unilateral traction one to 28 years after the removal of orthodontic appliances. The traction Group (TG) consisted of 11 Mx.1 and the Comparison Group (CG) comprised 11 spontaneously erupted contralateral Mx.1. High-resolution CBCT exams of central incisors were performed using Accuitomo (J. Morita, Kyoto, Japan). Cross-section imagens passing through the center of maxillary central incisors were used to measure buccal and lingual alveolar bone level. Presence of fenestration, root dilacerations, root coverage, and position of the root apex were also assessed in the same images. Clinical parameters included periodontal probing depth, attachment level, gingival bleeding index, plaque index, degree of gingival recession, amount of gingival mucosa, and evaluation of interproximal papilla and black triangle. Digital model analysis included an assessment of clinical crown height and width. Intergroup comparisons were performed using paired t-, McNemar's, and Wilcoxon tests (p<0.05). RESULTS: Compared to CG, we found a significantly thinner labial bone plate thickness in TG at the middle (p=0.000) and apical (p=0.009) root level. We also observed an apical displaced labial bone crest level in TG (p=0.000). The Traction Group showed a greater frequency of root dilacerations and gingival recessions, a decreased amount of keratinized mucosa, and a decreased clinical attachment level at the labial aspect compared to contralateral teeth. CONCLUSIONS: A decreased thickness and height of labial alveolar bone and gingival recessions were found in maxillary central incisors 15 years after orthodontic traction. Though incisor traction might cause some periodontal impact, differences are acceptable under a clinical point of view considering the cost-benefit ratio.


Assuntos
Incisivo , Dente Impactado , Tomografia Computadorizada de Feixe Cônico , Feminino , Seguimentos , Humanos , Incisivo/diagnóstico por imagem , Masculino , Maxila , Dente Impactado/terapia
11.
J Orthod ; : 14653125221087289, 2022 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-35323076

RESUMO

Orthodontic treatment in patients with cleft lip and palate (CLP) is challenging. Alignment of the maxillary segments and orthodontic levelling of the teeth adjacent to the cleft area are important before alveolar bone grafting (ABG), in the permanent dentition. In this clinical report, orthodontic procedures, before and after late ABG, are described as an alternative that can optimise the orthodontic and periodontal results. The gingival margins of the teeth adjacent to the cleft area were levelled. Root divergence was corrected. Interdental papilla and improvement of the periodontal condition were obtained.

12.
Angle Orthod ; 92(3): 333-339, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-35099525

RESUMO

OBJECTIVES: To evaluate the null hypothesis that there would be no difference between the labial bone crest level of the mandibular anterior teeth evaluated with an indirect bone-probing method (IBP) and cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Twenty-nine adult patients with a mean age of 32.15 ± 8.75 years were enrolled. An IBP based on indirect tactile perception was used to determine the labial bone crest level of the mandibular anterior teeth clinically. Bone crest perception degree, gingival thickness, and patient discomfort during IBP were also recorded. CBCT scans were used to evaluate the level and thickness of the labial bone crest. IBP and CBCT methods were compared statistically. The significance level was set at 5%. RESULTS: There was a significant difference between the labial bone crest level diagnosed by IBP and CBCT. However, the difference was not clinically significant. IBP and CBCT measurements were significantly and strongly correlated (R = 0.74). Thinner gingival tissue was associated with a higher perception of bone crest. Only two patients reported mild to moderate discomfort during IBP. CONCLUSIONS: IBP allowed the labial bone crest level to be determined with acceptable clinical accuracy, especially in patients with thinner gingival tissue.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Maxila , Adulto , Tomografia Computadorizada de Feixe Cônico/métodos , Gengiva/diagnóstico por imagem , Humanos , Incisivo , Reprodutibilidade dos Testes , Adulto Jovem
13.
Angle Orthod ; 92(1): 95-100, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34338736

RESUMO

OBJECTIVES: To evaluate tooth movement, orofacial pain, and leptin, interleukin (IL)-1ß, and tumor necrosis factor (TNF)-α cytokine levels in the gingival crevicular fluid (GCF) during orthodontic treatment in obese adolescents. MATERIALS AND METHODS: Participants included adolescent patients aged 12-18 years: group 1, obese (n = 30), and group 2, nonobese controls (n = 30). They were evaluated before (T0) and after 1 hour (T1), 24 hours (T2), and 1 week (T3) of fixed appliance bonding. Periodontal examination (T0), collection of GCF (T1, T2, T3), and evaluation of Little's irregularity index (T0, T3) were performed, and a visual analog scale was used to measure pain (T1, T2, T3). Evaluation of IL-1ß, TNF-α, and leptin cytokines was performed using a Luminex assay. Mann-Whitney and t-tests were used for intergroup comparisons, and a generalized estimating equation and cluster analyses were used for comparisons among observation times (P < .05). RESULTS: The obese group had a higher prevalence of probing depth of ≥4 mm and bleeding on probing. Orthodontic tooth movement was similar in both groups. Peak of pain was at T2 in both groups and was higher in the obese patients. TNF-α showed a slight increase at T1, followed by a gradual decrease at T2 and T3 in both groups. The obese group had a higher concentration of IL-1ß before and during orthodontic treatment. There was no difference in tooth movement between obese and control patients during the first week of orthodontic treatment. CONCLUSIONS: Obese adolescents had a greater subjective report of orofacial pain after 24 hours of orthodontic treatment and higher concentrations of IL-1ß proinflammatory cytokine before and during tooth movement as compared with nonobese control adolescents.


Assuntos
Interleucina-1beta , Leptina , Obesidade Pediátrica , Técnicas de Movimentação Dentária , Fator de Necrose Tumoral alfa , Adolescente , Dor Facial/etiologia , Líquido do Sulco Gengival/química , Humanos , Interleucina-1beta/análise , Leptina/análise , Fator de Necrose Tumoral alfa/análise
14.
Orthod Craniofac Res ; 25(2): 269-279, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34543518

RESUMO

OBJECTIVE: To compare and assess the reproducibility of 3 methods for registration of maxillary digital dental models in patients with anterior open bite. Settings and sample population Digital dental models of 16 children with an anterior open bite in the mixed dentition were obtained before (T1) and after 12 months of treatment with bonded spurs (T2). METHODS: Landmarks were placed on all T2 models and 3 registration methods (R1, R2 and R3) were independently performed by 2 observers. R1 was based on 10 landmarks placed on posterior teeth. R2 was based on 5 landmarks on the palate (2 anterior, 2 posterior and 1 central). R3 used regions of interest around the 5 palatal landmarks used in R2. The differences between the registration methods were calculated by comparing the mean differences and standard deviations between the corresponding x, y and z coordinates of 6 corresponding landmarks in the T2 registered models. Repeated measures analysis of variance followed by post-hoc Bonferroni tests were used for comparisons (P < .05). The agreement between methods and the intra and interobserver reproducibility were assessed with Bland-Altman tests and intraclass correlation coefficients (ICC). RESULTS: Comparisons of R2 with R3 methods showed greater agreement, mean differences ≤0.50 mm for all landmarks, than comparisons of R1 with R2, and R1 with R3, mean differences >0.50 mm for most of the y and z coordinates (P < .05). The R1 and R3 methods presented excellent intra and interobserver reproducibility and R2 method had moderate interobserver reproducibility. CONCLUSIONS: Longitudinal assessments of open bite treatment using digital dental models could consider the posterior teeth and/or the palate as references. The R1 and R3 methods showed adequate reproducibility and yield different quantitative results. The choice will depend on the posterior teeth changes and dental models' characteristics.


Assuntos
Mordida Aberta , Criança , Humanos , Maxila , Mordida Aberta/diagnóstico por imagem , Mordida Aberta/terapia , Palato , Reprodutibilidade dos Testes
15.
Clin Oral Investig ; 26(1): 183-195, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34041608

RESUMO

OBJECTIVES: The aim of this study was to compare the upper airway space changes after miniscrew-anchored maxillary protraction with hybrid (HH) and conventional hyrax (CH) expanders. MATERIAL AND METHODS: The sample comprised Class III malocclusion growing patients that were randomized into two groups of miniscrew-anchored maxillary protraction. The group HH was treated with a hybrid hyrax appliance in the maxilla and two miniscrews distally to the canines in the mandible. Class III elastics were used from the maxillary first molar to the mandibular miniscrews until anterior crossbite correction. The group CH was treated with a similar protocol except for the conventional hyrax expander in the maxilla. Cone-beam computed tomography was obtained before (T1) and after 12 months of therapy (T2). The shape and size of upper airway were assessed. Intergroup comparisons were performed using Mann-Whitney U test (p < 0.05). RESULTS: The group HH was composed of 20 patients (8 female, 12 male) with a mean age of 10.76 years. The group CH was composed of 15 patients (6 female, 9 male) with a mean age of 11.52 years. Anteroposterior and transverse increases of the upper airway were found for both groups. The oropharynx and the most constricted area increased similarly in both groups. CONCLUSIONS: No differences in upper airway changes were observed using protraction anchored on hybrid or conventional hyrax expanders. CLINICAL RELEVANCE: Maxillary protraction anchored on hybrid or conventional hyrax expanders may benefit patients with breathing disorders due to the increase of the upper airway volume and most constricted area. Registration: ClinicalTrials.gov (NCT03712007).


Assuntos
Procaviídeos , Má Oclusão Classe III de Angle , Animais , Cefalometria , Criança , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Má Oclusão Classe III de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/terapia , Mandíbula , Maxila , Técnica de Expansão Palatina
16.
J Orthod ; 49(1): 64-70, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34032163

RESUMO

This case report describes a simple alternative for treatment of mesioangulation of mandibular second molars. An 11-year-old girl was diagnosed with unilateral posterior crossbite, moderate incisor crowding and mesioangulation of the right mandibular second molar. The ectopic second molar was uprighted using a modified lingual arch with a distal hook and elastic chains. Orthodontic traction began after appliance installation and was activated once per month using 120 g of force. After six months, the right mandibular second molar was in an upright position. Orthodontic treatment continued with teeth levelling and alignment until acceptable occlusal and aesthetic results were achieved. Adequate stability was observed one year after debonding. The modified mandibular lingual arch with a distal hook is a simple and effective alternative to manage mesioangulation of mandibular second molars with minimum adverse effects and stable outcomes.


Assuntos
Estética Dentária , Má Oclusão , Criança , Feminino , Humanos , Incisivo , Má Oclusão/terapia , Mandíbula , Dente Molar , Técnicas de Movimentação Dentária
17.
Orthod Craniofac Res ; 25(2): 226-233, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34402185

RESUMO

INTRODUCTION: This study aimed to assess the changes in third molars angulation and their available space after Class II subdivision malocclusion treatment with asymmetric premolar extractions. METHODS: The sample consisted of 37 patients (17 male, 20 female and mean age 13.18 ± 1.99 years) in group 1 (Type 1 Class II subdivision) and 25 (10 male, 15 female, mean age 13.56 ± 2.46 years) in group 2 (Type 2 Class II subdivision). In group 1, extractions were performed in the two maxillary quadrants and in the Class I mandibular quadrant. In group 2, extraction was performed in the Class II maxillary quadrant. Panoramic radiographs were used to evaluate third molar angulations and their available space pre- and post-treatment. Radiographic measurements were performed with Dolphin® Imaging 11.9. Paired t tests were used for intragroup comparison between stages and sides. RESULTS: In Type 1, there were similar improvements in third molar angulations and increases in the space available on the extraction quadrants in the maxillary arch. In the mandibular arch, there was significantly greater improvement in angulation and greater space availability in the extraction quadrant after treatment. In Type 2, there was significantly greater improvement in angulation and available space for the maxillary third molar on the extraction quadrant. In the mandibular arch, there was a similar improvement in the available space for the third molars. CONCLUSIONS: After treatment, both groups presented better angulation and significantly greater space for third molar eruptions on the extraction quadrants, when compared to the homologous non-extraction quadrants.


Assuntos
Má Oclusão Classe II de Angle , Dente Serotino , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/cirurgia , Cefalometria/métodos , Feminino , Humanos , Masculino , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe II de Angle/terapia , Mandíbula/diagnóstico por imagem , Dente Molar , Dente Serotino/diagnóstico por imagem , Extração Dentária
18.
Eur J Orthod ; 44(2): 187-196, 2022 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-34719722

RESUMO

BACKGROUND: In orthodontics, the retention phase can be considered challenging and unpredictable. Therefore, evidence obtained from different retention protocols is important to facilitate clinical decision-making. OBJECTIVES: This systematic review aimed to compare the clinical effectiveness of bonded versus vacuum-formed retainers (VFRs) regarding their capacity to maintain treatment stability, periodontal effects, and failure rates. SEARCH METHODS AND ELIGIBILITY CRITERIA: Ten databases comprising published and unpublished literature were systematically searched up to August 2021. Randomized clinical trials (RCTs) comparing both retainers were included. DATA COLLECTION AND ANALYSIS: The risk of bias (RoB) evaluation was performed with the Cochrane Collaboration RoB Tool 2.0. All steps of the screening phase and RoB assessment were performed independently by two reviewers. The Grade of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of the evidence. RESULTS: Initial database search yielded 923 studies. After duplicates removal and full-text assessment, five RCTs remained. Overall, the studies presented Low RoB, except one study judged with 'Some concerns'. Based on the included studies, on a short-term (3-6 months) and long-term (4 years) basis, bonded retainers (BRs) were more effective to maintain treatment stability than VFRs in the lower arch. However, from 12 to 24 months both retainers presented the same efficacy. In the upper arch, the retainers were equally effective. BRs were associated with greater plaque and calculus accumulation than VFRs after 12 months. The retainers' failure rates were similar in the upper arch on the first year of retention; however, after 2 years VFRs showed significantly greater failure rates. Contrarily, BRs presented greater failure rates in the lower arch than VFRs. LIMITATIONS: The findings of the included studies may be influenced by different factors related to the unpredictability of relapse. CONCLUSIONS: Most of the evidence generated in this systematic review derived from a moderate level of certainty. In the lower arch, BRs are more effective than VFRs to maintain treatment stability in the initial 6 months of retention and in the long term. In the upper arch, both retention protocols are equally effective. REGISTRATION: Regist0ration number: PROSPERO CRD42020199392. FUNDING: Coordination for the Improvement of Higher Educational Personnel (CAPES, Process code-001).


Assuntos
Desenho de Aparelho Ortodôntico , Contenções Ortodônticas , Humanos , Aparelhos Ortodônticos Fixos , Ensaios Clínicos Controlados Aleatórios como Assunto , Vácuo
19.
J. appl. oral sci ; 30: e20210492, 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1365011

RESUMO

Abstract The aim of this study was to evaluate the clinical and radiographic periodontal status of impacted permanent maxillary central incisors (Mx.1) after a long term of orthodontic traction. Methodology This split-mouth study evaluated a sample of 11 patients (five females, six males) treated with Mx.1 unilateral traction one to 28 years after the removal of orthodontic appliances. The traction Group (TG) consisted of 11 Mx.1 and the Comparison Group (CG) comprised 11 spontaneously erupted contralateral Mx.1. High-resolution CBCT exams of central incisors were performed using Accuitomo (J. Morita, Kyoto, Japan). Cross-section imagens passing through the center of maxillary central incisors were used to measure buccal and lingual alveolar bone level. Presence of fenestration, root dilacerations, root coverage, and position of the root apex were also assessed in the same images. Clinical parameters included periodontal probing depth, attachment level, gingival bleeding index, plaque index, degree of gingival recession, amount of gingival mucosa, and evaluation of interproximal papilla and black triangle. Digital model analysis included an assessment of clinical crown height and width. Intergroup comparisons were performed using paired t-, McNemar's, and Wilcoxon tests (p<0.05). Results Compared to CG, we found a significantly thinner labial bone plate thickness in TG at the middle (p=0.000) and apical (p=0.009) root level. We also observed an apical displaced labial bone crest level in TG (p=0.000). The Traction Group showed a greater frequency of root dilacerations and gingival recessions, a decreased amount of keratinized mucosa, and a decreased clinical attachment level at the labial aspect compared to contralateral teeth. Conclusions A decreased thickness and height of labial alveolar bone and gingival recessions were found in maxillary central incisors 15 years after orthodontic traction. Though incisor traction might cause some periodontal impact, differences are acceptable under a clinical point of view considering the cost-benefit ratio.

20.
Am J Orthod Dentofacial Orthop ; 161(3): 457-470, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34924286

RESUMO

Correcting a complete Class II malocclusion in an adult patient can be quite difficult. If the patient has a large skeletal discrepancy, orthognathic surgery is the treatment of choice. However, if the discrepancy is small or if the situation is borderline and the mandibular incisors are retroclined, Class II correctors can be used. This clinical report presents the orthodontic treatment of a 24-year-old woman with Class II malocclusion. Clinically, her maxilla was slightly protruded, and the mandible was well-positioned. She had uprighted maxillary and mandibular anterior teeth and a deepbite, and she opted for a more esthetically appealing orthodontic appliance. The treatment plan included leveling and alignment of the teeth in both arches, Class II correction, establishing Class I molar and canine relationships, correction of overbite and overjet, adjustment of midlines, and improvement of facial and dental esthetics. Orthodontic treatment consisted of customized lingual appliances combined with a Class II fixed corrector.


Assuntos
Má Oclusão Classe II de Angle , Sobremordida , Adulto , Cefalometria , Feminino , Humanos , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe II de Angle/terapia , Mandíbula/cirurgia , Maxila , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Sobremordida/terapia , Adulto Jovem
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