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1.
Artigo em Inglês | MEDLINE | ID: mdl-33795189

RESUMO

INTRODUCTION: This single-center, 2-arm, parallel-group randomized clinical trial aimed to compare the dimensional dental arch changes after anterior open bite (AOB) treatment with bonded spurs associated with posterior build-ups vs bonded spurs alone. METHODS: Patients aged between 7 and 11 years with AOB were recruited at a university clinic and randomly allocated into 2 groups. The experimental group was treated with bonded spurs associated with posterior build-ups (SBU) and the comparison group with bonded spurs alone (S). Digital dental models were obtained at pretreatment and after 12 months of treatment. The overbite change was the primary outcome. The randomization list was obtained at the Web site www.randomization.com. Allocation concealment involved sequentially numbered, sealed, and opaque envelopes. The outcomes' assessment was blinded. Analysis of covariance was used for intergroup comparisons (P <0.05). Mean difference (MD) and 95% confidence interval (CI) were obtained. RESULTS: Twenty-four patients (mean age, 8.22 ± 1.06 years; 7 males and 17 females) were included in the SBU group, and 25 patients (mean age, 8.30 ± 0.99 years; 11 males and 14 females) were included in the comparison group. After a 12-month follow-up, the overbite increased approximately 4 mm in both groups (MD, -0.11 mm; 95% CI, -1.03 to 0.80). Means of anterior dentoalveolar vertical development ranged from 2.24 mm (S group) to 2.49 mm (SBU group) and from 1.31 mm (SBU group) to 1.55 mm (S group) for the maxilla (MD, -0.24 mm; 95% CI, -0.91 to 0.44) and mandible (MD, 0.29 mm; 95% CI, -0.39 to 0.96), respectively. The maxillary intermolar distance decreased in the SBU group and increased in the S group (MD, -0.48 mm; 95% CI, -0.92 to -0.03). The mandibular intermolar distance increased in the SBU group and decreased in the comparison group (MD, 0.26 mm; 95% CI, 0.004-0.52). Plaque accumulation around the spurs was observed in some patients. CONCLUSIONS: Both protocols demonstrated similar improvements in the AOB with similar effects on the dental arches. The SBU group showed a slight decrease in the maxillary intermolar distance and a slight increase in the mandibular intermolar distance, whereas opposite changes were observed for the S group. REGISTRATION: This trial was registered at Clinicaltrials.gov (Identifier NCT03702881). PROTOCOL: The study protocol was not published. FUNDING: This work was supported by the São Paulo Research Foundation (FAPESP) grants nos. 2017/06440-3, 2018/05238-9, and 2018/24003-2; and financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES), Finance Code 001.

2.
Prog Orthod ; 22(1): 9, 2021 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-33748887

RESUMO

BACKGROUND: The mechanical strength of mini-implants is a critical factor due to their small diameters. Currently, it is not possible to state whether there is a relevant difference between the mechanical properties of stainless steel (SS-MIs) and titanium alloy mini-implants (TA-MIs). The objective of this study was to test the null hypothesis that there is no difference in the mechanical strength of SS-MIs and TA-MIs, and to analyze, by scanning electron microscopy (SEM), the SS-MI, and TA-MI threads resistance to morphological damage after insertion. METHODS: A standardized sample of 504 SS-MIs and TA-MIs with diameters ranging from 1.2 mm to 1.8 mm was used. Torsional fracture was performed in 154 MIs. Flexural strength of 280 MIs was evaluated at 1 mm and 2 mm-deflection. The threads of 70 MIs were morphologically analyzed by scanning electron microscopy (SEM), before and after their insertion in high-density artificial bone blocks. Comparisons between SS-MIs and TA-MIs were performed with t tests or Mann-Whitney U tests. A multiple linear regression analysis was used to evaluate the influence of variables on the ranging of MI mechanical strength. RESULTS: SS-MIs had higher fracture torque. The mean difference between the SS-MIs and TA-MIs fracture torque was of 4.09 Ncm. The MI diameter explained 90.3% of the total variation in fracture torque, while only 2.2% was explained by the metallic alloy. The SS-MI group presented a higher deformation force during the 1mm and 2mm-deflection. The mean difference between the flexural strength of SS and TA-MIs at 1 mm and 2 mm-deflection was of 18.21 N and 17.55 N, respectively. There was no noticeable morphological damage to the threads of SS-MIs and TA-MIs. CONCLUSIONS: The null hypothesis was rejected. SS-MIs were 13.2% and 20.2% more resistant to torsional fracture and deflection, respectively. The threads of the SS-MIs and TA-MIs were not damaged during the insertion and removal process. Thus, the use of SS-MI can reduce the fracture risk without increasing the MI diameter.


Assuntos
Procedimentos de Ancoragem Ortodôntica , Aço Inoxidável , Ligas , Humanos , Laboratórios , Teste de Materiais , Desenho de Aparelho Ortodôntico , Estresse Mecânico , Titânio , Torque
4.
Dental Press J Orthod ; 26(1): e2119133, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33759961

RESUMO

INTRODUCTION: McNamara's Jr. cephalometric analysis is a tool to diagnose dental and skeletal discrepancies and is widely used, guiding diagnosis for surgical procedures to be performed or for the use of functional devices. Few studies have shown that different ethnic groups have different cephalometric patterns. Thus, single characteristics should be respected to support the diagnosis and to help the treatment plan for different ethnic groups and their different patterns of miscegenation. OBJECTIVE: Obtain normal values for McNamara's cephalometric analysis for adolescent Japanese-Brazilian descents with normal occlusion, as well as to compare this sample with similar samples of White-Brazilian and Japanese. METHODS: Lateral headfilms from 40 White-Brazilian, 33 Japanese and 32 Japanese-Brazilian descents were selected. The three groups were composed by individuals with normal occlusion, well-balanced profiles and were separated by sex. The data were statistically analyzed with ANOVA, t-test, ANCOVA and MANCOVA tests. RESULTS: White-Brazilian males had significantly greater nasolabial angle than Japanese males. Japanese-Brazilian displayed an intermediate value between White-Brazilian and Japanese. CONCLUSION: White-Brazilian, Japanese and Japanese-Brazilian present different cephalometric characteristics of McNamara analysis. Japanese males have a significantly more acute nasolabial angle than White-Brazilian subjects.


Assuntos
Grupo com Ancestrais do Continente Europeu , Face , Adolescente , Brasil , Cefalometria , Face/anatomia & histologia , Humanos , Japão , Masculino
6.
Clin Oral Investig ; 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33580351

RESUMO

OBJECTIVES: The aim of this study was to compare the maxillary dentoskeletal outcomes of the expander with differential opening (EDO) and the fan-type expander (FE). MATERIAL AND METHODS: Forty-eight patients with maxillary arch constriction in the mixed dentition were randomly allocated into EDO and FE groups. Cone-beam computed tomography scans were acquired before and after expansion. Linear and angular three-dimensional changes were assessed after cranial base superimposition using the ITK-SNAP and the 3D Slicer software. T or Mann-Whitney U tests were used for intergroup comparisons (P<0.05). RESULTS: The EDO group comprised 24 patients treated with the EDO (13 female, 11 male; 7.6 years). The FE group comprised 24 patients treated with the FE (14 female, 10 male; 7.8 years). Skeletal lateral displacements were greater in the EDO group with greater expansion in the orbital, nasal cavity, zygomatic bone, and palate regions (mean intergroup differences of 0.4, 0.8, 0.9, and 1.1 mm, respectively). Intercanine expansion and canine buccal inclination were greater in the FE group, while intermolar distance changes and molar buccal inclination were greater in the EDO group. Similar changes were observed for vertical and anteroposterior displacements and palatal plane rotation. CONCLUSIONS: The EDO produced greater transverse skeletal expansion compared to the FE, with similar vertical and anteroposterior effects. Dental changes were greater in the molar region for patients treated with the EDO and in the canine region for patients treated with the FE. CLINICAL RELEVANCE: The EDO and the FE are capable of producing skeletal changes in the mixed dentition. The decision between both expanders will depend on the amount of expansion required in the molar region and in the nasomaxillary complex. TRIAL REGISTRATION: The trial was registered at ClinicalTrials.gov , under the identifier NCT03705871.

7.
Am J Orthod Dentofacial Orthop ; 159(2): 184-192, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33388202

RESUMO

INTRODUCTION: This study aimed to evaluate the 3-dimensional (3D) mandibular dental changes over 42 years using the registration of digital models. METHODS: The sample comprised digital dental models of 8 untreated subjects (4 males and 4 females) with normal occlusion measured longitudinally at ages 17 years (T1) and 60 years (T2). Using 13 landmarks placed on the mucogingival junction, we registered the T2 model on the T1 model. Three-dimensional changes in the position of the landmarks on the buccal cusp tip of the posterior teeth and incisal edge of the central incisors were measured by 2 examiners. Registration and measurements were performed using SlicerCMF (version 3.1; http://www.slicer.org) software. Intra- and interrater agreements were evaluated using intraclass correlation coefficients and the Bland-Altman method. One-sample t tests were used for evaluating interphase 3D dental changes (P <0.05). RESULTS: Adequate intra- and interrater reproducibility was found. From T1 to T2, the mandibular teeth showed significant 3D positional changes. A significant dental eruption relative to the mucogingival junction was observed for the anterior and posterior teeth. Anteroposterior movements of mandibular teeth were not significant except for the right molar that drifted mesially. Transverse movements included slight lingual tipping at canines and premolars regions. CONCLUSIONS: Dental changes in untreated normal occlusion were very slight from early to mature adulthood. The eruption of the mandibular teeth was the most consistent finding. A tendency for mesial movement of molars and lingual movement of first premolars and canines was observed in the mandible during the aging process.


Assuntos
Mandíbula , Dente Molar , Adolescente , Adulto , Envelhecimento , Dente Pré-Molar , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Reprodutibilidade dos Testes
8.
Angle Orthod ; 91(2): 178-186, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33434282

RESUMO

OBJECTIVES: To compare the effects of a hybrid miniscrew-supported expander versus a conventional Hyrax (CH) expander in growing patients. MATERIALS AND METHODS: Forty patients were randomized into two groups: a hybrid Hyrax (HH) expander group using a Hyrax expander with two miniscrews and a CH expander group. The final sample had 18 subjects (8 female, 10 male; initial age of 10.8 years) in the HH group and 14 subjects (6 female, 8 male; initial age of 11.4 years) in the CH group. Cone-beam computed tomography examinations and digital dental models were obtained before expansion and 11 months postexpansion. The primary outcomes included the orthopedic transverse effects of expansion. Intergroup comparison was performed using analysis of covariance (P < .05). RESULTS: Significantly greater increases in the nasal cavity width, maxillary width, and buccal alveolar crest width were found for the HH group. No intergroup differences were observed for dental arch width or shape changes. CONCLUSIONS: The HH group showed greater increases in the nasal cavity width, maxillary width, and buccal alveolar crest width. No differences were observed for intermolar, interpremolar, or intercanine widths; arch length; or arch perimeter. Arch size and shape showed similar changes in both groups.


Assuntos
Procaviídeos , Processo Alveolar , Animais , Criança , Tomografia Computadorizada de Feixe Cônico , Arco Dental , Feminino , Humanos , Masculino , Maxila , Técnica de Expansão Palatina
10.
Angle Orthod ; 90(5): 627-633, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378481

RESUMO

OBJECTIVES: To evaluate the stability of maxillary interincisor diastema closure and the relationship between space relapse and interincisor diastema width, overjet, overbite, angulations between adjacent maxillary anterior teeth and presence of intermaxillary osseous cleft after orthodontic treatment with extractions. MATERIALS AND METHODS: Twenty-four individuals with a maxillary interincisor diastema pretreatment, treated with maxillary first premolar extractions were evaluated. Dental casts and panoramic radiographs taken at pretreatment (T1), posttreatment (T2), and posttreatment follow-up (T3) were assessed. Periapical radiographs at T1 and T2 were also evaluated. Diastema relapse was assumed when T3-T2 interincisor space change was greater than zero. Diastema relapse was considered clinically significant when it was at least 0.50 mm. Data were analyzed using repeated-measures analysis of variance followed by post hoc Tukey tests or Friedman followed by Wilcoxon tests. T-test or Mann-Whitney U-test, Pearson correlation coefficient, and multiple linear regression analyses were also performed. RESULTS: No statistically significant relapse of maxillary interincisor diastemas was found. The percentage of clinically significant relapse of the maxillary interincisor diastemas was 27.78%. Specifically, for the interincisor midline diastema, it was 8.33%. CONCLUSIONS: Maxillary interincisor diastema closure showed no statistically significant relapse after orthodontic treatment with premolar extractions. Clinically significant stability for maxillary interincisor diastema closure was 72.22% and, specifically, for interincisor midline diastema closure, it was 91.67%.


Assuntos
Diastema , Má Oclusão de Angle Classe II , Sobremordida , Diastema/terapia , Humanos , Incisivo , Maxila/diagnóstico por imagem
11.
Orthod Craniofac Res ; 2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33352006

RESUMO

OBJECTIVE: To compare the efficacy of vacuum-formed and banded space maintainers for deciduous second molar space maintenance during the mixed dentition. SETTING AND SAMPLE POPULATION: The study sample comprised thirty children in the mixed dentition (age range, 5.9 to 9.8 years) with early loss of at least one deciduous second molar. METHODS: This was a parallel-group, randomized, active-controlled clinical trial. Patients were randomly allocated to space maintenance performed with vacuum-formed or banded space maintainers with a 1:1 allocation ratio. The main outcome was any change in mesiodistal width of the extraction space. Secondary outcomes included the lingual rolling or axial rotation of the permanent first molar adjacent to the extraction site and extrusion of the antagonist tooth. Dental casts were obtained before appliance installation (T0), after 3 months (T1) and after 6 months (T2). Digital dental casts were measured using Dolphin 3D software. Chi-square, t test or Mann-Whitney and ANOVA or Friedman test were used for intra- and intergroup comparisons (P < .05). RESULTS: Baseline characteristics were similar between groups except for chronological age. Statistically, but not clinically significant space loss (mean, 0.32 mm; SD, ± 0.39) occurred with the vacuum-formed space maintainer only at the first trimester (T0-T1). Lingual rolling and axial rotation of the first permanent molar were not significant, as well as extrusion of the antagonist tooth. CONCLUSIONS: The results of this study suggested that both tested devices were effective in maintaining space after early extraction of the deciduous second molar over a period of 6 months.

12.
Artigo em Inglês | MEDLINE | ID: mdl-33234459

RESUMO

INTRODUCTION: To evaluate the influence of compensatory tipping of maxillary and mandibular incisors on the anterior arch length ratio and canine relationship in skeletal Class II malocclusion. METHODS: The study was based on posttreatment lateral head films and dental casts of 88 patients. The sample was divided into a Class II malocclusion group (32 patients; ANB ≥5° and mean [± standard deviation] age, 20.82 ± 7.67 years) and a Class I malocclusion group (56 patients; 1° ≤ ANB ≤ 2.5° and mean [± standard deviation] age, 19.20 ± 5.04 years). Measurements obtained for anterior arch length and width, Bolton discrepancy, canine relationship, growth pattern, and incisor position were compared between the groups. The canine relationship was correlated with dental and skeletal variables (P <0.05). RESULTS: The mean ANB angles were 6.21° and 1.78° for the Class II and Class I malocclusion groups, respectively. The skeletal Class II group presented significantly larger mandibular anterior arch length, producing an unbalanced anterior arch length ratio. The canine relationship was more displaced toward Class II in this group. Anterior arch length ratio was the most influential variable in the canine relationship. The mandibular incisors had a higher compensation degree than the maxillary incisors. The groups were similar regarding overjet, overbite, and growth pattern. CONCLUSIONS: Class II malocclusion camouflage treatment with excessive proclination of the mandibular incisors was associated with an increase in mandibular arch length, negatively influencing the anterior arch length ratio and the final canine relationship. Mandibular anterior arch length reduction by interproximal stripping may be necessary in moderate to severe skeletal Class II malocclusion orthodontic treatment.

13.
Artigo em Inglês | MEDLINE | ID: mdl-33221096

RESUMO

INTRODUCTION: This single-center 2-arm parallel randomized clinical trial aimed to compare the dentoskeletal effects of bonded spurs combined with posterior build-ups vs conventional bonded spurs in the treatment of anterior open bite malocclusion in the mixed dentition. METHODS: Patients aged from 7 to 11 years with anterior open bite, recruited at a university orthodontic clinic, were randomly allocated into 2 groups. The experimental group consisted of patients treated with bonded spurs combined with posterior build-ups. The comparison group comprised patients treated with conventional bonded spurs. Lateral headfilms were obtained at pretreatment and after 12 months of treatment. The primary outcome was the change in the overbite. Randomization was performed using the Web site www.randomization.com. Sequentially numbered opaque and sealed envelopes were used for allocation concealment. Blinding was applicable for outcome assessment only. Intergroup comparisons were performed using t or Mann-Whitney U tests (P <0.05). Mean difference (MD) and 95% confidence interval (CI) were obtained. RESULTS: The experimental group included 24 patients (17 female, 7 male; mean age, 8.22 ± 1.06 years) and the comparison group comprised 25 patients (14 female, 11 male; mean age, 8.30 ± 0.99 years). Baseline demographic and cephalometric characteristics were similar between groups. After 12 months, all patients showed improvements. Both groups showed similar improvements of the overbite (MD, 0.00 mm; 95% CI, -0.92 to 0.91), similar slight decreases of the gonial (MD, 0.02°; 95% CI, -1.11 to 1.15) and mandibular plane (MD, 0.15°; 95% CI, -0.64 to 0.93) angles, and similar mandibular molar extrusion (MD, 0.14 mm; 95% CI, -0.27 to 0.56). The experimental group showed significantly smaller extrusion of the maxillary first molar than the comparison group (MD, -0.70 mm; 95% CI, -0.92 to -0.49). The other dentoskeletal variables showed similar changes without statistically significant intergroup differences. No serious harm was observed other than plaque accumulation around the spurs. CONCLUSIONS: Similar overbite increases and dentoskeletal changes were observed in both groups after 12 months of treatment. Although the experimental group showed significantly smaller extrusion of the maxillary molars, no greater counterclockwise rotation of the mandible than the comparison group was observed. REGISTRATION: This trial was registered at Clinicaltrials.gov (Identifier NCT03702881). PROTOCOL: The protocol was not published. FUNDING: This trial was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES), Finance Code 001; and by grants: no. 2017/06440-3, no. 2018/05238-9 and no. 2018/24003-2, São Paulo Research Foundation (FAPESP).

14.
Eur J Orthod ; 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32968763

RESUMO

BACKGROUND/OBJECTIVE: To quantify the expected amount of orthodontically induced root resorption (OIRR) after orthodontic intrusion and assess the treatment-related factors. SEARCH METHODS AND ELIGIBILITY CRITERIA: Six electronic databases and partial grey literature were searched without limitations regarding language or publication year until April 2020. Randomized clinical trials and non-randomized prospective and retrospective studies evaluating root resorption after orthodontic intrusion were included. DATA COLLECTION AND ANALYSIS: Risk of bias (RoB) assessment was performed with the Cochrane Collaboration's RoB Tool 2.0 and ROBINS-I tool for the randomized and non-randomized studies, respectively. The data were combined into two random-effects meta-analyses estimating OIRR following orthodontic intrusion. One evaluated OIRR in the anterior region, while the other assessed OIRR in the posterior region. Sub-group analyses regarding the type of mechanics applied, duration of intrusion, amount of force, and sensitivity analysis of the study design and imaging examinations were also performed. The certainty of the evidence was assessed through the Grade of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: The qualitative analysis included 14 studies; however, the meta-analysis was performed with 7 records. The random-effects model assumes that 0.72 mm [95% confidence interval (CI): 0.16 to 1.28] and 0.41 mm (95% CI: -0.24 to 1.07) of OIRR should be expected in the incisors and the molars, respectively. Sub-group analyses showed that the assessed treatment-related factors presented minimum impact in OIRR after orthodontic intrusion. The GRADE resulted in moderate and low certainty regarding the meta-analysis. LIMITATIONS: The major limitation of the present meta-analysis is that OIRR can be affected by several factors, some of which are assessed in this review. CONCLUSIONS: Orthodontic intrusion, evaluated as an isolated mechanic, caused less than 1 mm of OIRR, which is within the acceptable limits for clinical implication. Treatment-related factors did not show a significant influence on OIRR. REGISTRATION: This review was registered in PROSPERO, protocol number CRD42018098495.

15.
Int J Dent ; 2020: 7083940, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32963533

RESUMO

Objective: The aim of this study was to compare the profile attractiveness between orthodontic camouflage of the Class III malocclusion and the predictive tracing simulating orthognathic surgery evaluated by dentists and laypeople. Settings and sample population. The sample consisted of 21 patients (9 male; 12 female) with Class III malocclusion treated with orthodontic camouflage and Class III intermaxillary elastics. Material and Methods. The mean initial age of the patients was 24.38 years (SD 3.32), and the mean ANB angle was -1.91° (SD 0.83°). Patients presented skeletal Class III and normal growth patterns. Initial and final lateral cephalograms of each patient were used. The initial cephalogram was used to perform the treatment simulation of orthognathic surgery, and its silhouette was compared to the silhouette obtained from the final cephalogram after Class III orthodontic camouflage. A subjective analysis of profile attractiveness was performed by 47 laypeople and 60 dentists, with scores from 1 (less attractive) to 10 (most attractive). Mann-Whitney tests were used to compare profile attractiveness between the orthodontic treatment and the predictive tracing groups and between dentists and laypeople. Results: The predictive tracing of orthognathic surgery showed to be statistically significantly more attractive (mean score 4.57, SD 2.47) than that of the Class III camouflage orthodontic treatment (mean score 4.22, SD 2.40), with a mean numerical but significant difference of 0.35 (SD 2.01) (P < 0.001). Laypeople were more critical than dentists in evaluating profile attractiveness, but numerical difference between the groups was also small. Conclusion: The profile silhouette of predictive tracing simulating orthognathic surgery showed to be more attractive than that of Class III camouflage orthodontic treatment; however, differences were small but statistically significant. Laypeople showed to be more critical than dentists.

16.
Dental Press J Orthod ; 25(4): 24-32, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965384

RESUMO

OBJECTIVE: The aim of this retrospective study was to evaluate the cephalometric and occlusal changes of orthodontically treated Class III malocclusion patients. METHODS: The experimental groups comprised 37 Class III patients treated: G1) without (n=19) and G2) with extractions (n=18) . The control group (G3), matched by age and sex with the experimental groups, consisted of 18 subjects with untreated Class III malocclusion. Cephalometric (radiographs) and occlusal (study models) changes were assessed between the beginning (T1) and the end (T2) of treatment. Intergroup comparisons were performed with one-way ANOVA followed by Kruskal-Wallis tests (p< 0.05). Occlusal changes were evaluated by the peer assessment rating (PAR) index (ANOVA and Kruskal-Wallis tests), and the treatment outcomes were evaluated by the Objective Grading System (OGS) (t-tests). RESULTS: The experimental groups showed a restrictive effect on mandibular anterior displacement and a discrete improvement in the maxillomandibular relationship. Extraction treatment resulted in a greater retrusive movement of the incisors and significant improvements in the overjet and molar relationship in both groups. The PAR indexes were significantly reduced with treatment, and the OGS scores were 25.6 (G1) and 28.6 (G2), with no significant intergroup difference. CONCLUSIONS: Orthodontic treatment of Class III malocclusion patients with fixed appliances improved the sagittal relationships, with greater incisor retrusion in the extraction group. Both the extraction and non-extraction treatments significantly decreased the initial malocclusion severity, with adequate and similar occlusal outcomes of treatment.


Assuntos
Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/terapia , Má Oclusão de Angle Classe II , Sobremordida , Cefalometria , Humanos , Mandíbula/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento
17.
Int Orthod ; 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32893148

RESUMO

The presence of root resorption and its correlated factors are concerns that must be considered in orthodontic planning. This case report describes the orthodontic retreatment of a patient with a dental to facial midline discrepancy, a severe apical root resorption, and with maxillary and mandibular incisors presenting accentuated labial tipping and protrusion. The treatment included self-ligating brackets, maxillary unilateral distalization with skeletal anchorage and a mandibular extraction, followed by retraction. The orthodontic planning was based on simple and efficient mechanics and the treatment duration was of 19 months. Based on the acceptable final results it can be assumed that the treatment choices enabled a successful approach, maintaining a stable root condition.

18.
Eur J Dent ; 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32869221

RESUMO

OBJECTIVE: The aim of this study was to evaluate dentoskeletal changes in the treatment of Class II malocclusion with the Herbst Cantilever Bite Jumper (CBJ) appliance, associated with multibracket appliances after the growth peak, at pretreatment. MATERIALS AND METHODS: A sample of 37 individuals was divided into two groups: the experimental group comprised 16 patients treated consecutively for a mean period of 2.52 years with the Herbst CBJ appliance associated with multibracket appliances. A total of 21 subjects (10 males and 11 females) with Class II malocclusion and mean age at T1 of 16.08 years were followed for a mean period of 2.12 years composed the control group. Comparisons between the two groups were performed using initial and final lateral cephalograms. Comparisons between experimental and control groups at pretreatment and of the treatment changes were performed by Mann-Whitney or independent t-tests. RESULTS: Experimental group exhibited a significantly greater labial inclination of the mandibular incisors in comparison to the control group. Additionally, significantly greater corrections in overbite, overjet, and molar relationship were observed in the experimental than in the control groups. CONCLUSION: The effects of the Herbst CBJ appliance, associated with fixed appliances after the growth peak in Class II malocclusion treatment are correction in molar relationship toward a Class I relationship, decrease of the overjet, decrease of the overbite, and mandibular incisors labial inclination.

19.
Am J Orthod Dentofacial Orthop ; 158(4): e17-e27, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32863088

RESUMO

INTRODUCTION: The objective of this research was to evaluate the treatment outcomes, long-term occlusal changes, and patient satisfaction after 37 years of nonextraction and extraction treatments. METHODS: Fifty-seven patients with Class I and Class II malocclusion were divided into 2 groups. Group 1 included 16 patients treated with nonextraction therapy, with mean initial (T1), final (T2), and long-term posttreatment (T3) ages of 13.2, 15.0, and 50.3 years, respectively. Mean treatment time (T2 - T1) and long-term follow-up time (T3 - T2) were 1.8 and 35.2 years, respectively. Group 2 included 41 patients treated with extraction of 4 first premolars, with mean ages at T1, T2, and T3 of 13.3, 15.6, and 53.6 years, respectively. Mean treatment (T2 - T1) and long-term follow-up (T3 - T2) times were 2.3 and 37.9 years, respectively. The Peer Assessment Rating (PAR) index and Objective Grading System (OGS) indexes were evaluated at T1, T2, and T3 stages. The subjects also answered an online questionnaire regarding esthetic and occlusal self-perception at T3. Intergroup comparison was performed with t tests. RESULTS: The PAR index improved with treatment and similarly worsened at T3 for both groups. OGS scores were close to the passing score at T2 for both groups. The nonextraction group presented worse OGS scores at T3 than the extraction group. Nonextraction patients perceived more changes in alignment over time, but overall satisfaction was similar. CONCLUSIONS: The PAR index improved with treatment, and the PAR and OGS scores showed a significant increase, indicating great occlusal changes in the long-term stage. The nonextraction group showed more occlusal changes and perceived more changes in their alignment over time, but overall patient satisfaction was similar in both groups.


Assuntos
Má Oclusão de Angle Classe II/terapia , Satisfação do Paciente , Dente Pré-Molar , Estética Dentária , Humanos , Pessoa de Meia-Idade , Ortodontia Corretiva , Extração Dentária , Resultado do Tratamento
20.
Clin Oral Investig ; 2020 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-32780295

RESUMO

OBJECTIVE: This retrospective study aimed to compare the occlusal and dentoskeletal initial features of patients treated with four first premolar extractions in the 1970s and after 2000. MATERIALS AND METHODS: Group 70' was composed by 30 subjects with Class I malocclusion (mean age of 12.8 years, 10 male, 20 female) treated in the 1970s with four first premolar extractions and comprehensive orthodontic treatment. Group NM comprised 30 subjects with Class I malocclusion (mean age of 13.4 years, 13 male, 17 female) treated in the new millennium, similarly to Group 70'. Initial dental models and lateral cephalograms were digitized and measured using OrthoAnalyzerTM 3D software and Dolphin Imaging 11.0 software, respectively. Initial occlusal and dentoskeletal features were analyzed and compared. Intergroup comparison was performed using t tests (p < 0.05). Holm-Bonferroni correction for multiple comparison was applied. RESULTS: Group NM showed significantly greater maxillary and mandibular effective lengths and greater maxillary and mandibular incisor protrusion in comparison with Group 70'. Group NM presented a significantly greater lower anterior facial height. Group NM also showed significantly smaller nasolabial angle and protruded inferior lip. CONCLUSION: Patients with Class I malocclusion treated with four first premolar extractions in the new millennium present a greater degree of dental and labial protrusion, increased lower anterior facial height, and more acute nasolabial angle compared with patients treated similarly in the 1970s. Greater dental and labial protrusion determines first premolar extractions in the new millennium. CLINICAL RELEVANCE: Despite the decrease of tooth extraction frequency, four first premolar extractions may be justified in cases with severe dental and skeletal protrusions.

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