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1.
Artigo em Inglês | MEDLINE | ID: mdl-33317118

RESUMO

BACKGROUND: To evaluate the effectiveness of conservative treatment with functional appliances for condylar fractures in pediatric age. METHODS: Four electronic databases (PubMed, EBSCO, Scopus, and Web of Science) were consulted with no restriction of publication status or year, up to 31 August 2020. SELECTION CRITERIA: based on the PICOS criteria, the selection criteria were set for observational human studies, with at least 10 patients and six months of follow-up. The study population included pediatric patients (aged 5-16 years), with unilateral or bilateral condylar fracture, treated with functional appliances. Condylar remodeling and mandibular growth were analyzed through sequential radiographic examinations. DATA COLLECTION AND ANALYSIS: Two independent reviewers carried out title-abstract screening, and a senior investigator was involved to solve any disagreement. The quality of the evidence was assessed through the Canada Institute of Health Economics (IHE) quality appraisal checklist, and the National Institutes of Health (NIH) quality assessment tool. RESULTS: A total of 971 articles were retrieved from the electronic search; among them, three studies met the eligibility criteria. A moderate risk of bias was detected in all the studies, due to common limitations (absence of multicenter studies, prospective design, blindness of the investigators, patients' drop-out). At follow-up examinations (between 6 months and 4.9 years), the difference of condylar neck length between the "injured" and "healthy" side was approximately 2 mm, while the anteroposterior condylar width discrepancy was recorded up to 1 mm. CONCLUSIONS: Short- and long-term data revealed that conservative treatment with functional appliances led to partial or full radiological recovery of the joint morphology, along with good to excellent functional results. Patients' age has a crucial role on the treatment choice, and the type of fracture (presence of condylar displacement, or dislocation) is also a major prognostic indicator of the radiologic outcome. LIMITATION: To confirm the effectiveness of functional appliances, more prospective clinical long-term follow-up studies with homogeneous samples of condylar fractures are deemed necessary. Registration: The study protocol was registered on PROSPERO (CRD42020205650).


Assuntos
Tratamento Conservador , Fraturas Mandibulares , Adolescente , Canadá , Criança , Pré-Escolar , Tratamento Conservador/estatística & dados numéricos , Humanos , Fraturas Mandibulares/diagnóstico por imagem , Fraturas Mandibulares/terapia , Aparelhos Ortodônticos Fixos/estatística & dados numéricos , Estudos Prospectivos , Radiografia Panorâmica , Estudos Retrospectivos , Resultado do Tratamento
2.
Am J Orthod Dentofacial Orthop ; 158(6): 783-798.e20, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33077369

RESUMO

INTRODUCTION: Safe zone maps are useful for the clinician to plan miniscrew insertion and possibly reduce radiation exposure. This study aimed to investigate the available evidence regarding the presence of sufficient interradicular space and adequate cortical bone thickness in patients with a complete permanent dentition, in the vestibular and palatal or lingual interradicular sites, mesial to the second molar. METHODS: PubMed, Scopus, Web of Science, Cochrane Library, and OpenGrey databases were searched up to January 2019 for observational studies involving patients with fully erupted second molars that investigated the amount of interradicular space and/or the cortical thickness of the alveolar processes using 3-dimensional data sets. A custom tool was prepared and used to assess the risk of bias in individual studies. A meta-analysis was performed when at least 4 different studies evaluated 1 identical parameter homogeneously. Publication bias was assessed with the Egger linear regression test. RESULTS: Twenty-seven observational articles were included in the qualitative synthesis. Only 11 articles were at low risk of bias. Fifteen articles were included in the meta-analysis. The results were graphically reported in "safe-zone" maps. CONCLUSIONS: In the maxilla, the most suitable insertion sites are those from mesial to the first molar to distal to the first premolar, and between the canine and the lateral incisor, all at 6 mm from the cementoenamel junction. In those areas, the cortical bone has adequate thickness, not requiring predrilling. In the mandible, the preferable vestibular interradicular spaces are those between first and second molars and between first and second premolars, both at 5 mm from the cementoenamel junction, and predrilling is suggested in these areas. TRIAL REGISTRATION NUMBER: PROSPERO CRD42016042081.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Raiz Dentária , Osso Cortical/diagnóstico por imagem , Humanos , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
3.
Dent J (Basel) ; 8(4)2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-33007807

RESUMO

The purpose of this study was to evaluate the shear bond strength and adhesive remnant index ARI) of orthodontic brackets following enamel conditioning with acid etching, hydroabrasion, and with both procedures. Thirty extracted human premolars were divided into three groups and received either acid etching, hydroabrasion or both procedures. Orthodontic brackets were bonded with composite resin. Shear bond strength was tested with a tensile machine, then the teeth were observed under a stereomicroscope to evaluate ARI scores. The enamel morphology after each conditioning method was evaluated with scanning electron microscope imaging. A one-way ANOVA and a Kruskal-Wallis H test were used to compare the bond strength and the ARI scores among the three groups. Hydroabrasion alone produced shear bond strength values below clinical acceptability, while the combination of acid etching and hydroabrasion produced the highest values. The ARI scores in the hydroabrasion group were significantly different from the other groups. Hydroabrasion followed by acid etching was effective in increasing the shear bond strength of orthodontic brackets. Further in vivo studies are needed to confirm the cost and benefits of this technique.

4.
Prog Orthod ; 21(1): 32, 2020 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-32924097

RESUMO

BACKGROUND: The loss of third-order information in pre-adjusted brackets due to torsional play is a problem in clinical orthodontics. The aim of this study was to evaluate the impact of slot height, archwire height, width and edge bevel's radius on the torsional play for three brackets/archwire systems. METHODS: Ninety brackets with a 0.022 × 0.028 in. slot with McLaughlin-Bennett-Trevisi prescription from three different manufacturers were selected, and the slot's height and depth were measured using a profile projector. Sixty stainless-steel rectangular archwires from three different manufacturers were sectioned and observed with a SEM to measure their height, width, and radius of edge bevel. The recorded data were used to calculate the theoretical torsional play between different slot-archwire combinations. One-way ANOVA was used to compare the measurements within different bracket types and among different manufacturers. RESULTS: Slot height was usually oversized. Archwire's height was usually undersized, but oversized wires were also observed. The radius edge bevel was the most variable parameter. A certain degree of torsional play is always present that differs from one bracket type to another of the same producer and that can even be doubled from one manufacturer to another. CONCLUSIONS: Due to production tolerance, differences between the nominal values and the real dimensions of any components of a slot/archwire system are common. This results in a torsional play that limits torque expression. The archwire's edge bevel plays an important role in torque expression, and clearer information should be provided by the manufacturers regarding this aspect.


Assuntos
Braquetes Ortodônticos , Fios Ortodônticos , Desenho de Aparelho Ortodôntico , Aço Inoxidável , Torque
5.
Artigo em Inglês | MEDLINE | ID: mdl-32943377

RESUMO

INTRODUCTION: Obstructive sleep apnea is characterized by a reduced airflow through the upper airways during sleep. Two forms of obstructive sleep apnea are described: the central form and the obstructive form. The obstructive form is related to many factors, such as the craniofacial morphology. OBJECTIVE: To evaluate the correlation between the morphology of the cranial base, of the mandible and the maxilla, and obstructive sleep apnea severity. METHODS: Eighty-four patients, mean age of 50.4 years old; 73 males and 11 females with obstructive sleep apnea were enrolled in the present study. Patients with high body mass index and comorbidities were excluded. Lateral cephalograms and polysomnography were collected for each patient to evaluate the correlation between craniofacial morphology and obstructive sleep apnea severity. A Spearman's rho correlation test between cephalometric measurements and obstructive sleep apnea indexes was computed. Statistical significance was set at p < 0.05. RESULTS: Patients with a severe obstructive sleep apnea presented a reduction of sagittal growth of both effective mandibular length and cranio-basal length. The mandibular length was the only variable with a statistical correlation with apnea-hypopnea index. Vertical dimension showed a weak correlation with the severity of obstructive sleep apnea. No correlation with maxillary sagittal dimension was shown. CONCLUSION: Obstructive sleep apnea severity may be correlated to mandibular and cranial base growth. Facial vertical dimension had no correlation with obstructive sleep apnea severity.

6.
Eur J Orthod ; 2020 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-32815989

RESUMO

OBJECTIVE: The aim of this systematic review was to determine which evidence level supports maxillary advancement after bone-anchored maxillary protraction (BAMP) in growing patients compared to controls. SEARCH METHODS: PubMed, Cochrane, Embase, Scopus, and Web-of-Science databases were searched with no restrictions on publication status or year. SELECTION CRITERIA: Prospective and retrospective human studies about BAMP, in at least three patients, were included. Authors were contacted when necessary, and reference lists of the included studies were screened. DATA COLLECTION AND ANALYSIS: Two authors undertook independent data extraction with conflict resolution by a third author. Risks of bias were assessed. A meta-analysis for estimates of changes for ANB angle, Wits appraisal, and incisor to mandibular plane angle (IMPA) angle of BAMP treatment compared to control groups was performed. RESULTS: A total of 449 articles were initially retrieved; 28 full-text articles met the inclusion criteria. Sample sizes ranged from 3 to 52 patients. There was heterogeneity in cephalometric outcomes reported, which prevented the comparison of certain outcomes. ANB angle improved more with BAMP in the maxilla combined with facemask (bone-anchored facemask, BAFM) compared to traditional facemask therapy: this was statistically but not clinically significant (0.2 degrees). No data are available for BAMP with skeletal anchorage in both jaws in combination with Class III elastics (bone-anchored Class III elastics, BAC3E). Likewise, no statistically significant differences in Wits appraisal were found (less than 1 mm). Lower incisor retroclination and facial height seemed to be better controlled with BAC3E compared to BAFM. CONCLUSIONS: The level of evidence available to support the maxillary advancement effect after BAMP was low. Publications reporting results based on identical samples tended to suggest overly positive results of BAMP. The differences in sagittal correction between BAMP and traditional facemask therapy were small and of questionable clinical significance. Long-term follow-up results are not available and, therefore, much needed. LIMITATIONS: Most articles had a low level of evidence and some included a historical control group. REGISTRATION: PROSPERO database number CRD42015023366.

7.
J Clin Med ; 9(7)2020 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-32635413

RESUMO

In periodontitis patients, furcation defects are crucial sites to regenerate due to their complex anatomy. Various modern surgical techniques and use of biomaterials have been suggested in the literature. Among all, platelet-rich fibrin (PRF) has potential in tissue regeneration thanks to its role in the release of growth factors. Therefore, the purpose of this study was to evaluate the beneficial effect of the addition of PRF to open flap debridement (OFD) or as an adjuvant to other biomaterials such as bone grafts in the treatment of grade 2 mandibular furcation defects. Systematic research was carried out on the databases Medline, Scopus, Embase, and Cochrane Library and registered on PROSPERO (CRD42020167662). According to the PICO guidelines by Cochrane, randomized trials and prospective non-randomized trials were evaluated, with a minimum follow-up period of 6 months. The inclusion criteria were the absence of systemic diseases, non-smoking patients, and a population aged from 18 to 65 years. Vertical pocket probing depth (PPD), vertical clinical attachment level (VCAL), and gingival recession (REC) were the primary outcomes. Vertical furcation depth (VFD), and the percentage of bone defect fill (%v-BDF) were considered as secondary outcomes. A meta-analysis of the primary and secondary outcomes was performed. Publication bias was assessed through a funnel plot. Eighty-four articles were initially extracted. Eight randomized clinical trials were analyzed according to the exclusion and inclusion criteria. The Quality assessment instrument (QAI) revealed four articles at low risk of bias, one at moderate, and three at high risk of bias. The metanalysis showed significant data regarding PPD, VCAL, VFD and %v-BDF in the comparison between PRF + OFD vs. OFD alone. The adjunct of PRF to a bone graft showed a significant difference for VCAL and a not statistically significant result for the other involved parameters. In conclusion, the adjunctive use of PRF to OFD seems to enhance the periodontal regeneration in the treatment of grade 2 furcation defects. The combination of PRF and bone graft did not show better clinical results, except for VCAL, although the amount of literature with low risk of bias is scarce. Further well-designed studies to evaluate the combination of these two materials are therefore needed.

8.
Eur J Dent ; 14(4): 683-691, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32726858

RESUMO

A current topic in dentistry concerns the biocompatibility of the materials, and in particular, conservative dentistry and endodontics ones. The mineral trioxide aggregate (MTA) is a dental material with biocompatibility properties to oral and dental tissues. MTA was developed for dental root repair in endodontic treatment and it is formulated from commercial Portland cement, combined with bismuth oxide powder for radiopacity. MTA is used for creating apical plugs during apexification, repairing root perforations during root canal therapy, treating internal root resorption, and pulp capping. The objective of this article is to investigate MTA features from a clinical point of view, even compared with other biomaterials. All the clinical data regarding this dental material will be evaluated in this review article. Data obtained from the analysis of the past 10 years' literature highlighted 19 articles in which the MTA clinical aspects could be recorded. The results obtained in this article are an important step to demonstrate the safety and predictability of oral rehabilitations with these biomaterials and to promote a line to improve their properties in the future.

10.
Cranio ; 38(5): 342-350, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30332921

RESUMO

OBJECTIVE: To compare morphologic findings in MRI and skeletal divergence of a group of patients with temporomandibular joint disorders (TMD) subdivided into condylar symmetric and asymmetric. METHODS: Fifty-nine adults (26.7 years old) with TMD were retrospectively recruited. Condylar height symmetry was evaluated by orthopantomography (Habets's method) and used to divide patients into Symmetric and Asymmetric groups; skeletal divergence was assessed on lateral cephalograms. MRI was used to evaluate the condylar long axis' angle, the glenoid fossa morphology, and the degree of disc displacement. RESULTS: Asymmetric subjects showed a hyperdivergent skeletal pattern (p = 0.036), asymmetric condylar long axis (p = 0.018), and deeper (p = 0.025) and asymmetric (p = 0.001) glenoid fossa compared to symmetric subjects. CONCLUSION: Patients with TMD and condylar asymmetry diagnosed with orthopantomography are more likely to show hyperdivergent skull in cephalometry, condylar asymmetry of both height and major axis, and a steeper glenoid fossa in MRI.


Assuntos
Transtornos da Articulação Temporomandibular , Articulação Temporomandibular , Adulto , Cefalometria , Humanos , Imagem por Ressonância Magnética , Côndilo Mandibular , Estudos Retrospectivos
11.
Dent Mater J ; 39(3): 367-374, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-31827057

RESUMO

The aim of the present study was to evaluate how hydroabrasion performs during composite removal. A standardized amount of composite was bonded to 40 enamel surfaces of extracted third molars, then removed with either a tungsten carbide bur mounted on a micro-motor handpiece without irrigation, a tungsten carbide bur mounted on a micro-motor handpiece with irrigation, a tungsten carbide bur mounted on an air-rotor handpiece, or hydroabrasion. The four treatment methods were compared using the enamel-surface-index and the adhesive-remnant-index and performing a Kruskal-Wallis statistical test to detect differences between each method' scores. Hydroabrasion produced significantly less damage to the enamel surface compared to the other three methods. Hydroabrasion was the cleaning method that produced less damages to the enamel surface, at a cost of a less efficient composite removal than tungsten carbide burs on micro-motor handpiece.


Assuntos
Descolagem Dentária , Braquetes Ortodônticos , Cimentos Dentários , Esmalte Dentário , Propriedades de Superfície
12.
J Clin Exp Dent ; 11(12): e1133-e1138, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31824593

RESUMO

Background: The aim of this investigation was to describe the healing reactions following root damage caused by placement of a miniplate anchorage system. Material and Methods: In 4 beagle dogs, 4 titanium miniplates (2 self-tapping screws per miniplate) were placed in each maxilla, after drilling of pilot-holes. Six fixation screws were unintentionally inserted damaging the root of maxillary canines. Two weeks later, half of the miniplates were loaded with a coil spring. Two dogs were euthanized 7 weeks after placement of the miniplates, while the remaining two after 29 weeks. Histological sections were prepared, microradiographed, observed under U.V. light, then stained and analysed under ordinary light. Results: Four screws caused direct root damage; one was damaged during the drilling process; one caused damage to the periodontal ligament only. Among these 6 screws, 2 were mobile and 4 were stable at sacrifice. Limited root damage showed some repair after 29 weeks, consisting in a thick layer of mineralized cementum including anchoring periodontal fibres. Tissue repair was not related to screw stability or loading status. Conclusions: Limited root damage has shown potential to heal, while extensive root damage has not. Precise position of insertion of the miniplates is thus of utmost importance. Key words:Temporary anchorage devices, animal studies, root resorption.

13.
Sci Rep ; 9(1): 19309, 2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31848435

RESUMO

The aim of this study was to evaluate the differences in sella dimensions and shape between growing patients with Class I, Class II, and Class III skeletal malocclusions, evaluated through morphometric analysis. Seventy-eight subjects aged between 9 and 13 years were selected and assigned to either the Class I, Class II, or Class III groups according to the measured ANB angle (the angle between the Nasion, skeletal A-point and skeletal B-point). Six landmarks were digitised to outline the shape of the sella turcica. Linear measurements of the sella length and depth were also performed. Procrustes superimposition, principal component analysis, and canonical variate analysis were used to evaluate the differences in sella shape between the three groups. A one-way MANOVA and Tukey's or Games-Howell tests were used to evaluate the presence of differences in sella dimensions between the three groups, gender, and age. The canonical variate analysis revealed a statistically significant difference in sella shape between the Class I and the Class II groups, mostly explained by the CV1 axis and related to the posterior clinoidal process and the floor of the sella. No differences were found regarding linear measurements, except between subjects with different age. These differences in sella shape, that are present in the earlier developmental stages, could be used as a predictor of facial growth, but further studies are needed.


Assuntos
Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe I/diagnóstico por imagem , Sela Túrcica/diagnóstico por imagem , Adolescente , Fatores Etários , Pesos e Medidas Corporais/métodos , Cefalometria/métodos , Criança , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe I/fisiopatologia , Má Oclusão de Angle Classe II/fisiopatologia , Má Oclusão de Angle Classe III/fisiopatologia , Análise de Componente Principal , Sela Túrcica/fisiopatologia
15.
J Clin Exp Dent ; 11(5): e432-e438, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31275515

RESUMO

Background: To evaluate the relative influence of different criteria in the choice between extraction and nonextraction treatment in current orthodontics, and to assess how the percentage of extractions has evolved over time. Material and Methods: Pre-treatment records (panoramic radiograph, lateral cephalogram, study casts and photographs) of fourteen cases in permanent dentition (adult or adolescent) with class I molar relationship and moderate anterior crowding were evaluated by 28 orthodontists. For each case, each orthodontist filled out a questionnaire reporting his treatment plan proposal (extraction or nonextraction) and the importance of specific parameters in his decision-making process, using categorical scales. Orthodontists practicing for more than 15 years were also asked to compare this decision with the one they would have taken at the beginning of their professional career. Results: The two most important factors in the decision-making were the soft tissue profile and the amount of crowding. The least important factor was the presence of third molars. In cases of nonextraction treatment, the lack of space was managed mostly by dental expansion and stripping. Twenty percent of the case evaluations revealed extraction(s) decisions. Among the orthodontists practicing for more than 15 years, the current extraction rate reached 24%, whereas the same orthodontists reported they would have extracted in 39% of the cases in the past. Conclusions: The present study suggests that soft tissue profile has a higher impact than traditional criteria such as cephalometric measurements in the extraction decision. This is associated with a decreased extractions rate compared to the past. Key words:Orthodontics, extractions, survey, treatment planning.

16.
Orthod Craniofac Res ; 22(4): 236-247, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31207100

RESUMO

OBJECTIVES: To evaluate whether changes in the concentration of different biomarkers in the gingival crevicular fluid (GCF) can be used to detect the root resorption process in adult or adolescent patients undergoing treatment with a fixed appliance, in comparison with untreated subjects or treated patients not showing signs of root resorption. MATERIAL AND METHODS: The following databases were analysed in the period between June 2017 and March 2018, without any language and initial date restrictions: PubMed, EMBASE, Scopus, Web of Science and Cochrane Library. A quality assessment instrument (QAI) was developed to establish the risk of bias. RESULTS: A total of 1127 articles were analysed. Based on the inclusion and exclusion criteria, seven studies qualified for the final review. The QAI tool revealed that five articles were at a moderate risk of bias and two articles were at a low risk of bias. CONCLUSION: Dentine phosphoprotein (DPP) may be considered a relatively useful marker for root resorption. Dentinal sialoprotein (DSP) could be a potential biomarker but is not highly helpful at detecting root shortening. Inflammatory cytokines (pro- and anti-resorption), osteopontin (OPN), osteoprotegerin (OPG), RANKL and alkaline phosphatase (ALP) are useful biomarkers to explain the biological mechanisms that occur during orthodontic movement but are not specific enough. Further studies are required to clarify the role of GM-CSF as a potential biomarker to distinguish subjects at a risk of severe root resorption in the early phase.


Assuntos
Reabsorção da Raiz , Adolescente , Adulto , Biomarcadores , Citocinas , Líquido do Sulco Gengival , Humanos , Técnicas de Movimentação Dentária
17.
Oral Oncol ; 93: 66-75, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31109698

RESUMO

OBJECTIVE: Tumor associated macrophages (TAMs) are among the most abundant cells of the tumor microenvironment. Several studies have been performed to investigate whether TAM markers, namely CD68 and CD163, could serve as prognostic factors in patients with squamous cell carcinoma of the head and neck (SCCHN). The aim of this systematic review and meta-analysis was to synthetize the available evidence of the literature about the role of CD68+ and CD163+ TAMs as prognostic factors in SCCHN. MATERIALS AND METHODS: This systematic review was performed according to the guidelines reported in the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Meta-analysis of overall survival, disease-free survival and progression-free survival was performed using the inverse of variance test. A random- or a fixed- effect model was used on the basis of the presence of heterogeneity. Risk of bias assessment and subgroup analysis were also performed. RESULTS: High stromal expression of CD163+ TAMs correlated with both poor overall survival (HR, 2.26; 95% CI: [1.47, 3.47]; P < 0.001) and progression-free survival (HR, 2.29; 95% CI: [1.11, 4.71]; P = 0.03). Conversely, abundance of CD68+ TAMs was not associated with overall survival (HR, 1.25; 95% CI: [0.86, 1.80]; P = 0.24) and disease-free survival (HR, 2.06; 95% CI: [0.84, 5.05]; P = 0.11). CONCLUSIONS: Findings from this study revealed that whilst IHC analysis of the generic macrophage marker CD68+ has no prognostic utility in patients with SCCHN, the M2-like marker CD163+ predicts poor prognosis. Our data suggest that assessment of CD163+ TAMs in SCCHN has potential for future clinical use. Further well-standardized studies should be performed to confirm these results.


Assuntos
Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/metabolismo , Fibroblastos Associados a Câncer/imunologia , Neoplasias de Cabeça e Pescoço/imunologia , Receptores de Superfície Celular/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/imunologia , Biomarcadores Tumorais/metabolismo , Progressão da Doença , Feminino , Humanos , Masculino , Prognóstico , Análise de Sobrevida , Microambiente Tumoral
18.
Minerva Stomatol ; 68(3): 118-125, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31014061

RESUMO

BACKGROUND: The soft tissue profile outcome after functional treatment of Class II malocclusion is important for a patient's aesthetic and psychosocial results. The soft tissue effects of the Sander bite-jumping appliance (BJA), which is the device that produces the greatest mandibular advancement according to a systematic review, have never been investigated. The aim of the present study was to assess the soft tissue effects of the BJA in comparison to matched untreated controls. METHODS: A total of 19 patients treated with BJA during puberty were retrospectively recruited, and 15 untreated controls were retrieved from a previous growth study to match the treated group. Lateral cephalograms were used to evaluate the pre- and post-treatment differences in the ANB angle, the inclination of the upper and lower incisors, facial convexity, the nasolabial angle and the sagittal position of the skeletal and soft tissue at points A and B. Independent t-tests or Mann-Whitney U tests were used to detect differences between the two groups. RESULTS: Statistically significant differences were found for the ANB angle, the inclination of the upper incisors and facial convexity. CONCLUSIONS: Functional treatment of Class II patients with the Sander BJA during puberty was effective at improving the profile and reducing the facial convexity angle in the short term.


Assuntos
Má Oclusão de Angle Classe II , Maxila , Cefalometria , Estética Dentária , Humanos , Mandíbula , Estudos Retrospectivos , Resultado do Tratamento
19.
J Clin Exp Dent ; 10(9): e869-e875, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30386519

RESUMO

Background: The aim of the present study was to evaluate if the different muscular activity correlated to different degrees of facial divergence has an effect on the time needed to extrude a palatally impacted maxillary canine. Material and Methods: Twenty-six patients were retrospectively selected, all treated with a specific cantilever appliance that allows extrusion of the impacted canine applying a physiologic amount of force below 0.6 N in a predictable way. For all the patients, pre-treatment cephalometric tracings were used to evaluate facial divergence through the FMA angle, the angle between the maxillary and mandibular plane, and the angles between the occlusal plane and either the maxillary and mandibular plane. Linear bivariate regression was calculated to evaluate if facial divergence can predict the time needed for canine extrusion. Results: The linear regression model was not able to predict extrusion time from variables explaining the facial divergence. Conclusions: Palatally impacted maxillary canines can be treated with the application of physiologic extrusion force regardless of patients' facial divergence and muscular activity. Key words:Impacted canines, cantilever, facial divergence, muscular activity.

20.
Dental Press J Orthod ; 23(5): 39.e1-39.e13, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30427499

RESUMO

INTRODUCTION: The selection of appropriate sites for miniscrew insertion is critical for clinical success. OBJECTIVES: The aim of the present study was to evaluate how interradicular spaces measured on panoramic radiograph compare with Cone-Beam Computed Tomography (CBCT), and how crowding can influence the presence of available space for miniscrew insertion, in order to define a new "safe zones" map. METHODS: A total of 80 pre-treatment panoramic radiographs and 80 CBCT scans with corresponding digital models were selected from the archives of the department of Dentistry, Aarhus University. Crowding was measured on digital models, while interradicular spaces mesial to the second molars were measured on panoramic radiographs and CBCTs. For panoramic radiographs, a magnification factor was calculated using tooth widths measured on digital models. Statistical analyses were performed to investigate the correlation between the amount of crowding and the available interradicular space. Visual maps showing the amount of interradicular spaces measured were drawn. RESULTS: The most convenient interradicular spaces are those between the second molar and the first premolar in the mandible, and between the central incisors in the maxilla. However, some spaces were revealed to be influenced by crowding. CONCLUSIONS: Calibration of panoramic radiographs is of utmost importance. Generally, panoramic radiographs underestimate the available space. Preliminary assessment of miniscrew insertion feasibility and the related selection of required radiographs can be facilitated using the new "safe zone" maps presented in this article.


Assuntos
Parafusos Ósseos , Arco Dental/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Procedimentos de Ancoragem Ortodôntica/métodos , Adolescente , Adulto , Calibragem , Criança , Tomografia Computadorizada de Feixe Cônico , Arco Dental/anatomia & histologia , Implantação Dentária/métodos , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Dente Molar/anatomia & histologia , Radiografia Panorâmica , Estudos Retrospectivos , Adulto Jovem
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