Periodontal evaluation after maxillary expansion with a tooth-bone-borne expander in growing patients : A randomized clinical trial.

PURPOSE: This two-arm parallel randomized controlled trial aimed to evaluate and compare periodontal changes due to rapid maxillary expansion (RME) using tooth-bone-borne and tooth-borne devices in growing patients via clinical examinations and cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Forty-two eligible patients (aged 11-14 years; transverse maxillary deficiency, posterior crossbite) were screened and divided into two groups based on the treatment received (randomization was performed using computer-generated numeric sequences): hybrid hyrax tooth-bone-borne group (TBB) and hyrax tooth-borne group (TB). The primary outcome was the change in cortical bone thickness (by CBCT). In addition, the clinical attachment level (CAL), gingival recession, and bleeding were assessed. Both examinations were performed before and 3 months after the activation phase. Intergroup comparisons were performed using analysis of covariance (ANCOVA; P < 0.05). RESULTS: Twenty-one patients (12 girls and 9 boys; mean initial age, 13.3 years) were included in the TBB group and 21 (5 girls and 16 boys; mean initial age, 13.2 years) were included in the TB group. The TB group exhibited a decrease in buccal bone thickness in the first premolars and first molars at all three evaluated levels. Specifically, tooth 14 at 3 mm from the enamel-cement junction showed a significant width reduction (0.7 mm; p < 0.001), accompanied by a notable increase in palatal cortical thickness at 6 mm of enamel-cement junction (1.13 mm; p < 0.001). CONCLUSIONS: RME resulted in buccal bone thickness reduction at the first premolar with hyrax treatment. In the molar region, both devices resulted in cortical bone alterations that were less pronounced in the TBB group.

Expression of artefacts from different orthodontic brackets and wires in cone beam computed tomography scans-an in vitro study.

OBJECTIVES: To investigate artefacts produced by different orthodontic brackets and wires in cone-beam computed tomography (CBCT) scans. MATERIALS AND METHODS: Two dental arches were made using extracted human teeth and plaster. Three pairs of acetate plates containing different brackets - metallic, ceramic, and self-ligating ceramic with NiTi clip - along with a control plate (i.e., without brackets) were prepared. Wire changes (NiTi and steel) were made during CBCT acquisitions, performed with a fixed exposure protocol. Axial slices were selected for mean gray values and standard deviation measurement in three regions of interest (buccal, lingual, and tooth). Noise and contrast-to-noise ratio (CNR) were calculated and compared among the different brackets and wires by ANOVA with a significance level of 5%. RESULTS: Overall, the buccal and tooth region were mostly affected by the metallic and self-ligating brackets, showing higher noise, and lower CNR (p < 0.05). On the other hand, less impact of ceramic brackets in the image quality was observed (p ≥ 0.05). The lingual region did not show expressive differences among the brackets and wire combinations (p ≥ 0.05). The presence of wire associated with the brackets did not worsen image quality (p ≥ 0.05). CONCLUSIONS: In conclusion, metallic and self-ligating brackets have greater artefact expression than ceramic brackets. The wire did not influence image quality. CLINICAL RELEVANCE: One should pay attention to the type of brackets when requesting a CBCT scan during treatment, as metallic and self-ligating brackets may express greater artefacts than ceramic brackets.

The Effect of Motivational Interviewing on Oral Hygiene Behavior in Patients With Fixed Orthodontic Appliances: A Randomised Clinical Trial

The aim of this study was to evaluate the effectiveness of motivational interviewing on improving oral hygiene behavior in patients with fixed orthodontics appliances. A parallel-group randomized clinical trial was conducted with 45 patients of the Orthodontic Clinic of Unibe's Postgraduate Unit. A computer-generated list of numbers created with SPSS V21.0 was used to randomly allocate participants into the experimental or the control group. Monthly oral hygiene instructions and an oral hygiene kit from GUM® with special orthodontic hygiene tools were given to the participants. Furthermore, the experimental group underwent motivational interviewing sessions facilitated by a periodontist who received training from two expert psychologists. These psychologists also provided supervision to the interviewer, ensuring the accurate implementation of the intervention. Simplified Oral Hygiene Index (SOHI), Gingival Index (GI), Periodontal Probing Depth (PPD) and Bleeding on Probing (BoP) were recorded at baseline, three and six months after the beginning of the study. The participant and the evaluator (another periodontist who recorded the data) were masked. Repeated-measures mixed- model analysis of variance and chi-squared test were conducted. Mean SOHI, GI, PPD and BoP scores did not differ significantly across the three time points (baseline, three and six months). Nevertheless, a significant interaction on SOHI scores (F (2, 58) = 3.463, p = .038, h2 = .052) was found between the sessions and the treatment conditions (experimental vs control group) at the third and sixth month. Motivational interviewing plus oral hygiene instructions appears to maintain a better control of dental biofilm and calculus in comparison with conventional oral hygiene instructions alone.

El objetivo de este trabajo fue evaluar la efectividad de las entrevistas motivacionales para mejorar el comportamiento de higiene oral en pacientes con aparatos ortodóncicos fijos. Se llevó a cabo un ensayo clínico aleatorizado de grupos paralelos con 45 pacientes de la Clínica de Ortodoncia de la Unidad de Posgrado de Unibe. Se utilizó una lista de números generada por computadora con SPSS V21.0 para asignar aleatoriamente a los participantes al grupo experimental o de control. Se les proporcionó a los participantes instrucciones mensuales de higiene oral y un kit de higiene oral de GUM® con utensilios de higiene especiales para ortodoncia. Además, el grupo experimental recibió sesiones de entrevista motivacional facilitadas por un periodoncista capacitado por dos psicólogas expertas. Estas psicólogas también supervisaron al entrevistador, asegurando la implementación precisa de la intervención. Se registró el Índice Simplificado de Higiene Oral (IHO-S), el Índice Gingival (IG), la Profundidad de Sondaje Periodontal (PS) y el Sangrado al Sondaje (SS) al inicio, a los tres y seis meses después del inicio del estudio. Tanto el participante como el evaluador (otro periodoncista que registró los datos) estaban enmascarados. Se realizaron análisis de varianza de medidas repetidas con modelo mixto y pruebas de chi-cuadrado. Las puntuaciones medias del IHO-S, IG, PS y SS no difirieron significativamente en los tres momentos (inicio, tres y seis meses). Sin embargo, se encontró una interacción significativa en las puntuaciones del IHO-S (F (2, 58) = 3.463, p = .038, h2 = .052) entre las sesiones y las condiciones de tratamiento (grupo experimental vs grupo de control) en el tercer y sexto mes. Las entrevistas motivacionales junto con las instrucciones de higiene oral parecen mantener un mejor control de la biopelícula dental y el cálculo en comparación con las instrucciones convencionales de higiene oral por sí solas.

A utilização de torques resistentes ao movimento compensatório dos dentes anteriores no tratamento da Classe III no paciente adulto / The use of torques resistant to compensatory movement of anterior teeth in the treatment of Class III in adult patients

Este trabalho visou relatar o caso clínico de um paciente padrão III com mordida cruzada anterior, através de um tratamento compensatório com o uso de bráquetes que geram torques resistentes nos incisivos. O paciente JPCN, 42 anos, leucoderma, gênero masculino, procurou a clínica ortodôntica com a queixa principal de mordida cruzada anterior. Na análise extrabucal, observou-se a presença de padrão horizontal, simetria facial, maxila deficiente, ângulo nasolabial fechado, presença de selamento labial passivo e perfil côncavo com o lábio inferior à frente do superior. A prescrição utilizada foi a biofuncional, apresentado 0° de torque nos incisivos superiores e 10° nos incisivos inferiores. Foram realizados o alinhamento e nivelamento, mecânica de acentuação da curva de Spee no arco superior e reversão no arco inferior simultaneamente aos elásticos intermaxilares. Ao final do tratamento, foram observados correção da relação anteroposterior e intercuspidação dentária, trespasse horizontal e vertical normais, linhas médias coincidentes e selamento labial passivo. Concluiu-se que a utilização de torques resistentes nos incisivos gerados pelo uso de bráquetes da técnica biofuncional foi eficiente para manter uma boa inclinação desses dentes durante a correção damá oclusão de Classe III com o uso de elásticos intermaxilares (AU)

This study aimed to report the clinical case of a patient with pattern III with anterior crossbite, through a compensatory treatment with the use of brackets that generate resistant torques in the incisors. Patient JPCN, 42 years old, caucasian, male, came to the orthodontic clinic with the main complaint of anterior crossbite. In the extraoral analysis, it was observed the presence of a horizontal pattern, facial symmetry, deficient maxilla, closed nasolabial angle, presence of passive lip seal, and concave profile with the lower lip in front of the upper. The prescription used was the biofunctional, with 0° of torque on the upper incisors and 10° on the lower incisors. Alignment and leveling, orthodontic mechanics of Spee curve accentuation in the maxillary arch and reversal in the mandibular arch were performed simultaneously with intermaxillary elastics. At the end of the treatment, Class III correction, correction of the anteroposterior relationship and dental intercuspation, normal overbite and overjet, coinci-dent midlines and passive lip seal were observed. It was concluded that the use of resistant torques on the incisors promoted by the use of biofunctional technique brackets was efficient to maintain a good inclination of these teeth during the correction of Class III malocclusion with the use of intermaxillary elastics (AU)

Tratamento ortodôntico após cirurgia ortognática de benefício antecipado em paciente com síndrome da apneia obstrutiva do sono / Orthodontic treatment after surgery first approach in patient with obstructive sleep apnea

O objetivo do presente estudo é apresentar o caso de um paciente adulto com má oclusão de Classe II esquelética e síndrome da apneia obstrutiva do sono (SAOS), tratado com cirurgia ortognática de benefício antecipado. Paciente do sexo masculino, 46 anos de idade, Padrão II birretruso, má oclusão de Classe II bilateral e com diagnóstico de SAOS leve. O tratamento proposto foi a cirurgia ortognática de benefício antecipado com avanço bimaxilar para correção esquelética e aumento do espaço aéreo superior. Após a cirurgia, pode-se observar um satisfatório avanço maxilar e mandibular, melhora no perfil facial e correção da relação molar bilateral. Além disso, notou-se o aumento das vias aéreas superiores e consequente melhora da respiração e qualidade do sono. A cirurgia ortognática de benefício antecipado mostrou-se uma alternativa terapêutica eficaz para a correção esquelética e funcional. Um ganho estético e funcional foi obtido após o tratamento ortodôntico cirúrgico.(AU)

The aim of this study is to report the orthodontic treatment of a male adult patient with skeletal Class II malocclusion and obstructive sleep apnea (OSA), treated with surgery first approach. Male patient, 46 years old, Class II facial pattern, bilateral Class II malocclusion, and mild OSA. The treatment proposed was the surgery first approach with bimaxillary advancement to correct the skeletal discrepancy and to enlarge the upper airway. After surgery, a satisfactory maxillary and mandibular advancement, facial profile improvement, and correction of the molar relationship were observed. In addition, an increase in the upper airway dimension and improvement in the breathing and sleep quality were obtained. The surgery first approach was an effective treatment alternative to correct the functional and skeletal discrepancies. Esthetical and functional satisfactory changes were obtained after the combined orthodontic/surgical treatment.(AU)

Comparação "na terapia" entre alinhadores x ortodontia fixa ­ revisão sistemática / Comparison "in therapy" between aligners and fixed orthodontics ­ systematic review

A aparência do sorriso tem grande impacto socialmente, portanto, é compreensível a busca por um tratamento ortodôntico que não prejudique a aparência facial. Assim, surgiram os alinhadores como alternativa aos aparelhos fixos convencionais. Todavia, além da estética, há muitos fatores a serem avaliados ao escolher entre os dois tratamentos, como limitações na rotina diária, consumo alimentar, sintomas orais, satisfação com o tratamento e dor. Este estudo objetivou comparar, por meio de uma revisão sistemática, as vantagens e desvantagens dos aparelhos fixos e alinhadores. Foi realizada uma pesquisa nas bases de dados National Library of Medicine/NLM (PubMed), Cochrane Library, SciELO e LILACS. Para esta revisão, foram incluídos ensaios clínicos e estudos observacionais publicados a partir de 2019, em inglês. Foram encontrados 201 artigos na base de dados PubMed e, após aplicados os critérios de elegibilidade, 5 artigos foram incluídos. Nas bases de dados SciELO e LILACS, não foram encontrados artigos que atendiam aos critérios e, na Cochrane, foi encontrado 1 artigo. Assim, 6 artigos foram escolhidos para essa revisão. Os resultados mostraram eficácia equivalente em ambos os aparelhos, porém, a avaliação do número de consultas/emergência mostrou melhores resultados para alinhadores. Ainda assim, eles afetam a pronúncia e a apresentação da fala a curto prazo. Concluiu-se que os dois tipos de aparelho apresentam eficácia semelhante. Entretanto, os alinhadores são mais vantajosos em comparação aos aparelhos fixos quanto ao menor tempo de tratamento, menos sintomatologia dolorosa, menos dificuldade para se alimentar e maior estética para os adultos.(AU)

The appearance of the smile has a great social impact, therefore, the search for an orthodontic treatment that does not harm the facial appearance is understandable. Thus, aligners emerged as an alternative to conventional fixed appliances. However, in addition to aesthetics, there are many factors to be evaluated when choosing between the two treatments, such as limitations in daily routine, food consumption, oral symptoms, satisfaction with treatment, and pain. This study aimed to compare, through a systematic review, the advantages and disadvantages of fixed appliances and aligners. A search was carried out in the National Library of Medicine/NLM (PubMed), Cochrane Library, SciELO, and LILACS databases. Clinical trials and observational studies published from 2019 onwards, in English, were included for this review. Two hundred and one articles were found in the PubMed database and, after applying the eligibility criteria, 5 articles were included. In the SciELO and LILACS databases, no articles were found that met the criteria and, in Cochrane, 1 article was found. Thus, 6 articles were The appearance of the smile has a great social impact, therefore, the search for an orthodontic treatment that does not harm the facial appearance is understandable. Thus, aligners emerged as an alternative to conventional fixed appliances. However, in addition to aesthetics, there are many factors to be evaluated when choosing between the two treatments, such as limitations in daily routine, food consumption, oral symptoms, satisfaction with treatment, and pain. This study aimed to compare, through a systematic review, the advantages and disadvantages of fixed appliances and aligners. A search was carried out in the National Library of Medicine/NLM (PubMed), Cochrane Library, SciELO, and LILACS databases. Clinical trials and observational studies published from 2019 onwards, in English, were included for this review. Two hundred and one articles were found in the PubMed database and, after applying the eligibility criteria, 5 articles were included. In the SciELO and LILACS databases, no articles were found that met the criteria and, in Cochrane, 1 article was found. Thus, 6 articles were (AU)

Tempo de tratamento ortodôntico com aparelhos autoligados: revisão de literatura

Introdução: Atualmente, braquetes autoligados têm sido sugeridos para reduzir o tempo de tratamento na Ortodontia. Objetivo: Dessa maneira, o presente estudo objetivou revisar a literatura acerca do tempo de tratamento com esses braquetes, em comparação com outros braquetes e tratamentos sugeridos. Revisão de literatura: Foi realizada pesquisa bibliográfica de caráter descritivo, que compreendeu o levantamento de referencial teórico na base de dados eletrônica Medline ­ PubMed. A seleção de artigos foi feita a partir dos títulos e resumos e a revisão compreendeu 4 artigos publicados na língua inglesa no período de 2019 a 2023. Conclusão: Há uma escassez de estudos clínicos envolvendo essa temática e o tratamento ortodôntico com aparelhos autoligados parece apresentar menor tempo de tratamento em comparação com aparelhos fixos tradicionais. No entanto, os estudos não mostraram diferenças estatisticamente significativas na redução desse tempo. Pode-se sugerir que mais estudos clínicos sejam conduzidos no intuito de elucidar essa questão.

Introduction: Currently, self-ligating brackets have been suggested to reduce treatment time in Orthodontics. Objective: Therefore, the present study aimed to review the literature about the treatment time with these brackets, in comparison with other brackets and suggested treatments. Literature review: Descriptive bibliographical research was carried out, which included the survey of theoretical references in the electronic database Medline ­ PubMed. The selection of articles was made based on titles and abstracts and the review comprised 4 articles published in the English language from 2019 to 2023. Conclusion: there is a shortage of clinical studies involving this topic and orthodontic treatment with self-ligating appliances seems to present shorter treatment time compared to traditional fixed appliances. However, the studies did not show statistically significant differences in reducing this time. It can be suggested that more clinical studies be conducted to elucidate this issue.

Orthodontic resins loaded with niobium silicate particles: Impact of filler concentration on the physicochemical and biological properties.

OBJECTIVES: White spot lesions (WSL) are prevalent in patients using orthodontic appliances. The presence of ion-releasing compounds in the tooth-appliance interface may limit enamel demineralization to control WSL incidence. Thus, this study aims to evaluate the mineral formation on SiNb-containing experimental orthodontic resins and the influence of these fillers on the physicochemical and biological properties of developed materials. MATERIALS AND METHODS: The SiNb particles were synthesized via the sol-gel route and characterized by their molecular structure and morphology. Photopolymerizable orthodontic resins were produced with a 75 wt% Bis-GMA/25 wt% TEGDMA and 10 wt%, 20 wt%, or 30 wt% addition of SiNb. A control group was formulated without SiNb. These resins were tested for their degree of conversion, softening in solvent, cytotoxicity in fibroblasts, flexural strength, shear bond strength (SBS), and mineral deposition. RESULTS: The addition of 10 wt% of SiNb did not impair the conversion of monomers, cytotoxicity, and flexural strength. All groups with SiNb addition presented similar softening in solvent. The presence of these particles did not affect the bond strength between metallic brackets and enamel, with SBS values ranging from 16.41 to 18.66 MPa. The mineral deposition was observed for all groups. CONCLUSION: The use of niobium silicate as filler particles in resins may be a strategy for the adhesion of orthodontic appliances. The 10 wt% SiNb concentration resulted in a material with suitable physicochemical and biological properties while maintaining the bond strength to tooth enamel and promoting mineral deposition.

O distalizador Carriere como coadjuvante no tratamento da má oclusão de Classe II, Divisão 1 / The Carriere distalizer as an adjunct in the treatment of Class II, Division 1 malocclusion

Resumo O objetivo deste relato de caso é descrever o tratamento ortodôntico realizado em uma paciente de 15 anos, sexo feminino, com má oclusão Classe II, Divisão 1, com aparelho Carriere Motion 3D (ACM), seguido de aparelhos fixos completos. O exame intraoral mostrou uma má oclusão de Classe II, Divisão 1, com overbite de 1 mm e overjet de 3,5 mm. O arco superior com morfologia triangular e o mandibular parabólico, além da ausência da coroa clínica do primeiro molar inferior direito. O tratamento iniciou com a utilização simultânea do ACM e de uma contenção Essix para ancoragem do arco mandibular. Nesse período, elásticos de Classe II foram empregados durante 5 meses, obtendo-se a relação molar e canino de Classe I. Posteriormente, bráquetes metálicos MBT .022" foram utilizados em ambas as arcadas. Os resultados demonstraram estabilidade ao longo de um período de dois anos de acompanhamento, com satisfação da paciente (AU)

Abstract The aim of this case report is to describe the orthodontic treatment performed on a 15-year-old female patient, with Class II, Division 1 malocclusion, using the Carriere Motion 3D appliance (ACM) followed by full fixed appliances. The intraoral examination showed a Class II, Division 1 malocclusion, with 1 mm overbite and 3.5 mm overjet. The maxillary arch had a triangular morphology and the mandibular arch was parabolic, in addition to the absence of the clinical crown of the right mandibular first molar. Treatment began with the simultaneous use of ACM and an Essix retainer for anchoring the mandibular arch. During this period, Class II elastics were applied for 5 months, achieving Class I molar and canine relation. Subsequently, MBT .022" metal brackets were used on both arches. The results demonstrated stability over a two-year follow-up period, with patient satisfaction (AU)

Alignment efficiency and three-dimensional assessment of root resorption after alignment with conventional and copper-nickel-titanium archwires: A randomized controlled trial

ABSTRACT Objective: To compare alignment efficiency and root resorption between nickel-titanium (NiTi) and copper-nickel-titanium (CuNiTi) archwires after complete alignment in mandibular anterior region. Methods: In this two-arm parallel single-blind randomized controlled trial, forty-four patients with Class I malocclusion with mandibular anterior crowding were recruited form orthodontic clinic of All India Institute of Medical Sciences (Jodhpur, India). Patients were randomly allocated into NiTi and CuNiTi groups, with a 1:1 allocation. Alignment was performed using 0.014-in, 0.016-in, 0.018-in, 0.019x0.025-in archwire sequence in the respective groups, which terminated in 0.019 x 0.025-in stainless-steel working archwire. The primary outcome was alignment efficiency, measured on study models from baseline (T0) to the first, second, third, fourth and fifth-month (T5). Secondary outcome was root resorption, measured from CBCT scans taken at T0 and T5. Mixed-factorial ANOVA was used to compare Little's Irregularity Index (LII). For assessing the proportion of patients with complete alignment at the end of each month, Kaplan-Meier survival curve was built and time to treatment completion was compared between groups using log rank test. Paired t-test was used to assess external apical root resorption (EARR) within groups, whereas independent t-test was used to evaluate LII and EARR between the groups. Results: Twenty-two patients were recruited in each group. One patient was lost to follow-up in the CuNiTi group. No statistically significant differences were observed in alignment efficiency between the groups (p>0.05). Intergroup comparison revealed that the changes in root measurement in three-dimensions were not statistically significant (p>0.05), except for mandibular right central incisor, which showed increased resorption at root apex in NiTi group (p<0.01). Conclusion: The two alignment archwires showed similar rate of alignment at all time points. Root resorption measurement did not differ between the NiTi and CuNiTi groups, except for the mandibular right central incisor, which showed more resorption in NiTi group.

RESUMO Objetivo: Comparar os fios de níquel-titânio (NiTi) e de cobre-níquel-titânio (CuNiTi) quanto à eficiência do alinhamento e quantidade de reabsorção radicular, após alinhamento completo dos dentes da região anterior inferior. Métodos: Neste estudo clínico randomizado, cego, paralelo, de dois braços, quarenta e quatro pacientes com má oclusão Classe I e apinhamento anterior inferior foram recrutados na clínica ortodôntica do All India Institute of Medical Sciences (Jodhpur, India). Os pacientes foram alocados aleatoriamente nos grupos NiTi e CuNiTi, na proporção de 1:1. O alinhamento foi realizado usando a sequência de fios 0,014", 0,016", 0,018" e 0,019" x 0,025" nos respectivos grupos, finalizando com o arco de trabalho 0,019" x 0,025" de aço inoxidável. O desfecho primário foi a eficiência do alinhamento, medida nos modelos de estudo nos tempos inicial (T0) e após um, dois, três, quatro e cinco meses (T5). O desfecho secundário foi a reabsorção radicular, medida a partir de tomografias computadorizadas realizadas em T0 e T5. ANOVA fatorial mista foi utilizada para comparar o Índice de Irregularidade de Little (IIL). Para avaliar a proporção de pacientes com alinhamento completo ao fim de cada mês, foi construída uma curva de sobrevida pelo método de Kaplan-Meier, e o tempo até o fim do tratamento foi comparado entre os grupos por meio do teste log-rank. Um teste t pareado foi utilizado para avaliar a reabsorção radicular apical externa (RRAE) dentro dos grupos, enquanto um teste t independente foi utilizado para avaliar o IIL e a RRAE entre os grupos. Resultados: Vinte e dois pacientes foram recrutados em cada grupo. Um paciente perdeu o acompanhamento no grupo CuNiTi. Não foram observadas diferenças estatisticamente significativas entre os grupos quanto à eficiência do alinhamento (p>0,05). A comparação intergrupos revelou que as alterações na RRAE medida em três dimensões não foram estatisticamente significativas (p>0,05), exceto para o incisivo central inferior direito, que apresentou aumento da RRAE no grupo NiTi (p<0,01). Conclusão: Os dois tipos de fios de alinhamento apresentaram taxa de alinhamento semelhante em todos os momentos. A medida da reabsorção radicular não diferiu entre o grupo NiTi e CuNiTi, exceto para o incisivo central inferior direito, que apresentou maior reabsorção no grupo NiTi.

Stress distribution in lower second molar mesialization using mini-implants: a pilot study using 3D finite element analysis / Distribuição de tensões na mesialização do segundo molar inferior usando mini-implantes: um estudo piloto usando análise de elementos finitos 3D

Objective: to analyze the stress distribution in a 3D model that simulates second molar mesialization using two different types of mini-implants. Material and Methods: a mandible bone model was obtained by recomposing a computed tomography performed by a software program. The cortical and trabecular bone, a lower second molar, periodontal ligament, orthodontic tube, resin cement and the mini-implants were designed and modeled using the Rhinoceros 4.0 software program. The characteristics of self-drilling orthodontic mini-implants were: one with 7 mm length, 1 mm transmucosal neck section and 1.6 mm diameter and another with 5 mm length and 1.5 mm diameter. A total of 235.161 and 224.505 elements were used for the mesh. These models were inserted into the bone block and then subjected to loads of 200 cN (centinewton). The results were calculated and analyzed by the Ansys 17.0 software program for qualitative verification through displacement and maximum principal stress maps. Results: it was possible to observe that the periodontal ligament presented low displacement and stress values. However, the physiological values presented are among those capable to provide orthodontic movement, with compression and tensile area visualization staggered between 0.1 and -0.1 MPa (megapascal). Conclusion: within the limitations of the study, the mini-implants tested showed similar results where the load on the tooth allowed dental displacement (molar mesialization), with a tendency to rotate it, theoretically allowing the second molar to take the location of the first molar. (AU)

Objetivo: analisar a distribuição de tensões em um modelo 3D que simula a mesialização do segundo molar usando dois tipos diferentes de mini-implantes. Material e Métodos: um modelo de osso mandibular foi obtido por recomposição de uma tomografia computadorizada realizada por um software. O osso cortical e trabecular, um segundo molar inferior, ligamento periodontal, tubo ortodôntico, cimento resinoso e os mini-implantes foram projetados e modelados no software Rhinoceros 4.0. As características dos mini-implantes ortodônticos auto perfurantes foram: um com 7 mm de comprimento, 1 mm de secção transmucosa e 1,6 mm de diâmetro e outro com 5 mm de comprimento e 1,5 mm de diâmetro. Para a malha, foram utilizados 235.161 e 224.505 elementos. Esses modelos foram inseridos no bloco ósseo e então submetidos a cargas de 200 cN (centinewton). Os resultados foram calculados e analisados pelo software Ansys 17.0 para verificação qualitativa por meio de mapas de deslocamento e tensões máximas principais. Resultados: foi possível observar que o ligamento periodontal apresentou baixos valores de deslocamento e tensões. Porém, os valores fisiológicos apresentados são capazes de proporcionar movimentação ortodôntica, com visualização da área de compressão e tração escalonada entre 0,1 e -0,1 MPa (megapascal). Conclusão: dentro das limitações do estudo, os mini-implantes testados apresentaram resultados semelhantes onde a carga sobre o dente permitiu o deslocamento dentário (mesialização do molar), com tendência a girá-lo, permitindo teoricamente que o segundo molar ocupe do lugar do primeiro molar (AU)

Cambios en el pH salival de pacientes con ortodoncia fija, tras la aplicación de dos tipos de enjuagues bucales / Changes in salivary pH in patients with fixed orthodontics following the use of two types of mouthwashes

Introducción: Los enjuagues bucales contribuyen a la inhibición de la formación de la placa bacteriana y, por tanto, pueden ayudar a mantener el pH salival cercano a neutro. Objetivo: Identificar cambios en el pH salival de pacientes portadores de aparatología ortodóncica fija, después del enjuague con una solución de Stevia rebaudiana Bertoni y un enjuague comercial de aceites esenciales. Métodos: Se realizó un experimento clínico con un diseño factorial mixto en pacientes portadores de aparatología ortodóncica fija. Una vez firmado el consentimiento informado, treinta y dos pacientes fueron asignados aleatoriamente a uno de 2 grupos: la solución de S. rebaudiana B. al 2 por ciento o un enjuague comercial de aceites esenciales. Se utilizaron 15 ml de enjuague durante 60 s en todos los pacientes. El pH salival fue medido por dos observadores independientes calibrados, utilizando papel medidor de pH antes del enjuague (medición basal) y después del enjuague, a los 5 y 20 min. Los datos fueron analizados mediante el ANOVA mixto. Resultados: Se encontró una interacción estadísticamente significativa entre el tipo de tratamiento y el momento de medición del pH. Los pH medio de los grupos S. rebaudiana y aceites esenciales fueron respectivamente en la medición basal: 6,61 y 6,52 (p = 0,72); a los 5 min: 7,61 y 7,77 (p = 0,40); y a los 20 min: 7,72 y 6,82 (p < 0,001). Conclusiones: Ambos enjuagues tenían el efecto de aumentar el pH salival a niveles alcalinos a los 5 min, pero solo el enjuague de S. rebaudiana B. al 2 por ciento mantuvo el pH básico a los 20 min(AU)

Introduction: Mouthwashes contribute to the inhibition of bacterial plaque formation and, therefore, may help to maintain salivary pH close to neutral. Objective: To identify changes in salivary pH in patients with fixed orthodontics after using a Stevia rebaudiana Bertoni solution and a commercial essential oil mouthwash. Methods: A clinical experiment with a mixed factorial design was carried out in patients with fixed orthodontic appliances. Once informed consent was signed, thirty-two patients were randomly assigned to one of 2 groups: 2 % S. rebaudiana B. solution or a commercial essential oil mouthwash. Fifteen ml of mouthwash was used for 60 s in all patients. Salivary pH was measured by two independent calibrated observers using pH-measuring paper before rinsing (basal measurement) and after rinsing, after 5 and 20 min. The data were analyzed by mixed ANOVA. Results: A statistically significant interaction was found between the type of treatment and the time of pH measurement. The medium pH of the S. rebaudiana and essential oil groups were respectively as per basal measurement: 6.61 and 6.52 (p = 0.72); after 5 min: 7.61 and 7.77 (p = 0.40); and after 20 min: 7.72 and 6.82 (p < 0.001). Conclusions: Both mouthwashes had the effect of increasing salivary pH to alkaline levels after 5 min, but only the 2 percent S. rebaudiana B. mouthwash maintained the basic pH after 20 min(AU)

Information and Communications Technology in Dentistry: an informative and educational approach for patients with fixed orthodontic appliances

ABSTRACT Objective: To develop and make available, at no cost to the user, Information and Communications Technology (ICT) tools for Dentistry, providing dental information and advice geared toward patients undergoing orthodontic treatment with fixed appliances. Material and Methods: A Dentistry-based content that contemplated information and advice concerning orthodontic treatment with fixed appliances was elaborated. The materials, which included instructions on oral hygiene and treatment strategies when faced with possible complications, were evaluated and validated by specialists, whose assessments reached a 85% approval. From the validated content, products using four distinct ICT tools were formulated. Results: The following technological products were developed: a program for community radios, three blog posts, four educational and informative videos, and a smartphone application - using texts, as well as images and videos. These ICT tools, geared toward patients wearing fixed orthodontic appliances, were made available by internet at no cost to the user, and the number of accesses is already expressive. Conclusion: These technological-scientific tools, developed and provided freely to the population, can aid patients during their treatment with fixed orthodontic appliances, contributing to the dissemination of reliable information, and clarifying doubts that may arise during orthodontic therapy. These free ICT tools serve to facilitate access to scientific knowledge, thereby favoring social inclusion, bearing in mind that this educational and informative material was offered in a simple and accessible manner to the general population.

RESUMO Objetivos: Desenvolver e disponibilizar, gratuitamente, ferramentas de tecnologia da informação e comunicação (TIC) para a Odontologia, abordando informações e orientações direcionadas a pacientes em tratamento ortodôntico com aparelho fixo. Material e Métodos: Foi elaborado um conteúdo que contemplou informações e orientações concernentes ao tratamento ortodôntico com aparelho fixo. O material, que abrangeu instruções sobre higiene bucal e sobre abordagens diante de possíveis intercorrências, foi avaliado e validado por especialistas. A partir do conteúdo validado, foram elaborados produtos utilizando quatro ferramentas distintas de TIC. Resultados: Foram desenvolvidos os seguintes produtos tecnológicos: um programa para rádios comunitárias, três postagens para blog, quatro vídeos educacionais e informativos, e um aplicativo para smartphones, utilizando não apenas textos, mas também imagens e vídeos. Essas ferramentas de TIC direcionadas a pacientes fazendo uso de aparelho ortodôntico fixo foram disponibilizadas gratuitamente via internet, e já contam com expressivo número de acessos. Conclusões: As ferramentas técnico-científicas, desenvolvidas e fornecidas livremente à população, podem auxiliar pacientes durante o tratamento com aparelho ortodôntico fixo, contribuir para disseminar informações confiáveis e esclarecer dúvidas que surgem durante a terapia ortodôntica. Essas ferramentas gratuitas de TIC facilitam o acesso ao conhecimento científico e, consequentemente, favorecem a inserção social, tendo em vista que esse material educacional e informativo foi ofertado de maneira simples e acessível à população.

A double-blinded randomized clinical trial of pain perception during orthodontic treatment / Ensaio clínico randomizado duplo cego de percepção da dor durante tratamento ortodôntico

Introduction: Orthodontic movement can cause painful symptoms, especially in the early stages of treatment. Objective: This study aimed to compare the performance of chewing gum and ibuprofen in pain control during the initial period of orthodontic treatment. Material and method: A randomized blind clinical trial, with an allocation ratio of 1:1, was developed with patients aged ≥18 years old. The sample size was established considering a significance level of 5% and test power of 80%, resulting in a minimum of 30 volunteers per group (n=90). Participants were paired regarding sex, age, the severity of malocclusion, defined by the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN), and crowding, determined by Little's irregularity index. The sample was randomly allocated to three groups: Group I (control) placebo; Group II chewing gum; and Group III Ibuprofen. Pain perception was evaluated by the Visual Analog Scale (VAS) in the first 24, 36, and 48 hours after activation of the orthodontic appliance. The data were analyzed by generalized linear models for repeated measures in time. Result: No statistically significant difference (p>0.05) was observed among the groups for the methods of pain therapy evaluated in 24, 36, and 48 hours post-activation. Conclusion: There was no difference among the method used for pain control during the orthodontic treatment.

Introdução: A movimentação ortodôntica pode causar sintomatologia dolorosa, principalmente nas fases iniciais do tratamento. Objetivo: Este estudo teve como objetivo comparar o desempenho da goma de mascar e do ibuprofeno no controle da dor durante o período inicial do tratamento ortodôntico. Material e método: Foi desenvolvido um ensaio clínico randomizado cego, com razão de alocação de 1:1, com pacientes com idade ≥ 18 anos. O tamanho da amostra foi estabelecido considerando um nível de significância de 5% e poder do teste de 80%, resultando em um mínimo de 30 voluntários por grupo (n=90). Os participantes foram pareados quanto ao sexo, idade, gravidade da má oclusão, definida pelo Componente de Saúde Bucal (DHC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN), e apinhamento, determinado pelo índice de irregularidade de Little. A amostra foi distribuída aleatoriamente em três grupos: Grupo I (controle) placebo; Goma de mascar Grupo II; e Grupo III Ibuprofeno. A percepção da dor foi avaliada pela Escala Visual Analógica (EVA) nas primeiras 24, 36 e 48 horas após a ativação do aparelho ortodôntico. Os dados foram analisados por modelos lineares generalizados para medidas repetidas no tempo. Resultado Não foi observada diferença estatisticamente significativa (p>0.05) entre os grupos para os métodos de terapia da dor avaliados em 24, 36 e 48 horas pós-ativação. Conclusão: Não houve diferença entre o método utilizado para controle da dor durante o tratamento ortodôntico.

Alinhadores Ortodônticos Removíveis Versus Aparelhos Ortodônticos Fixos: uma Revisão da Literatura / Removable Orthodontic Aligners Versus Fixed Orthodontic Appliances: a Literarture Review

Com intuito de pontuar os paralelos entre as técnicas ortodônticas com aparelhagem fixa e alinhadores transparentes, este estudo propôs revisar a literatura científica sobre alinhadores ortodônticos removíveis versus aparelhos ortodônticos fixos. Foram selecionados artigos de 2005 a 2021, utilizando as bases de dados PubMed, Scopus, Web of Science, Cochrane Library, Clinical Trials e Opengrey. Os artigos abordavam temáticas como sensação dolorosa, saúde periodontal, higiene, microbiota, reabsorção radicular, qualidade de vida e efetividade do tratamento. Os alinhadores apresentaram maior aceitabilidade pelos pacientes e vantagens claras em relação à dor, higiene, qualidade de vida, reabsorção radicular e saúde periodontal, sendo inferior aos aparelhos ortodônticos fixos na efetividade do tratamento e na interferência na fala.

In order to point out the parallels between orthodontic techniques with fixed appliances and transparent aligners, this study proposed to review the scientific literature on removable orthodontic aligners versus fixed orthodontic appliances. Articles from 2005 to 2021 were selected, using the PubMed, Scopus, Web of Science, Cochrane Library, Clinical Trials and OpenGrey databases. The articles addressed issues such as pain, periodontal health, hygiene, microbiota, root resorption, quality of life and treatment effectiveness. Aligners showed greater acceptability by patients and clear advantages in relation to pain, hygiene, quality of life, root resorption and periodontal health, being inferior to fixed orthodontic appliances in terms of effectiveness and speech capacity.

Soft tissue profile changes in Angle class II patients treated with Twin Force or intermaxillary elastics-a comparison.

PROPOSITION: This study aimed to compare soft tissue profile changes in Angle class II malocclusion patients treated with a Twin Force appliance (Ortho Organizers, Inc., Carlsbad, CA, USA) or class II elastics. METHODS: The sample comprised 47 class II malocclusion patients treated orthodontically without extractions, divided into two groups. Group 1 (Twin Force): 25 patients were treated with the Twin Force, with initial and final mean ages of 17.91 and 20.45 years, respectively, and mean treatment time of 2.53 years. Group 2 (elastics): 22 patients were treated with class II elastics, with initial and final mean age of 15.87 and 18.63 years, respectively, and mean treatment time of 2.75 years. The lateral cephalograms were evaluated at the initial and final stages. Intragroup comparisons were performed with dependent t-tests and intergroup comparisons were performed with independent t-tests. RESULTS: Treatment-related changes in the Twin Force group included reduction of facial convexity, retrusion of the upper lip, increase of the H­Nose distance, and decrease in Sn­H distance, indicating improvement in facial profile. In the elastics group, treatment resulted in an increase in nasolabial angle, retrusion of the upper lip, increase of the H­Nose distance, and decrease in Sn­H distance, indicating improvement in facial profile. The Twin Force group showed a greater reduction of the facial convexity with treatment than the elastics group. CONCLUSIONS: Class II patients treated with the Twin Force appliance showed greater reduction in facial convexity than patients treated with class II elastics. The other soft tissue changes were similar for both groups.

Bráquete ortodôntico duplo slot convencional / Conventional double slot orthodontic bracket

Resumo A evolução da Ortodontia, desde os seus primórdios, teve acontecimentos marcantes como o surgimento da Técnica Straight Wire, desenvolvimento de prescrições variadas, utilização de slots com dimensões distintas, sistemas de ancoragem esquelética, tomografia, entre outros. Apesar disso, os desenhos e recursos que os bráquetes apresentavam eram sempre os mesmos e limitados. A história de grandes ideias é vasta, pórem faltava unir as mesmas em uma única peça. Foi o que fizeram os autores deste artigo ao desenvolverem um novo design de bráquete, que apresenta dois slots centrais e cada um com dimensões distintas, um slot apresenta dimensões de 0,018" X 0,030" e o outro 0,022" X 0,028", com isso um leque de possibilidades está sendo aberto. A partir de agora se tem uma ferramenta de trabalho com diversos recursos, que gera grandes benefícios para os profissionais e para os pacientes, ganhando cada dia mais adeptos (AU)

Abstract The evolution of Orthodontics, since its beginning, have had remarkable events such as the appearance of the Straight Wire Technique, the development of varied prescriptions, the use of slots with different dimensions, skeletal anchoring systems, tomography, among others. Despite this, the designs, and features that the brackets presented were always the same and limited. The history of great ideas is vast, but they needed to be united in one piece. This is what the authors of this article have done, when developing a new bracket design that features two central slots and each with different dimensions, one slot has dimensions of 0.018" X 0.030" and the other 0.022" X 0.028" with this a lot of possibilities are being opened. From now on, there is a work tool with several resources, which generates great benefits for professionals and patients and that is gaining more and more followers every day. (AU)

Tooth color alteration after debonding in orthodontic patients with adhesive removal using composite bur or tungsten carbide bur: a single center, randomized controlled clinical trial / Alteração da cor do dente após descolagem de braquetes em pacientes ortodônticos pela remoção de adesivo usando broca de compósito ou broca carbide de tungstênio: ensaio clínico unicêntrico randomizado e controlado

Objective: The objective of this study was to determine whether recently developed fiber reinforced composite burs provided better results by comparing tooth discoloration after debonding of orthodontic brackets. Material and Methods: A split-mouth, randomized controlled trial was carried out in one orthodontic office; including 23 patients with intact, vital and caries-free four upper incisors aged 12 to 30 years who completed their fixed orthodontic treatment. For each patient, upper central and lateral incisors on each side of the mouth were randomly selected to remove the adhesive with either a tungsten carbide bur (TC) (n = 46) or a fiber-reinforced composite bur (FC) (n=46). Color evaluation of each tooth was conducted at two time points: immediately after finishing and polishing procedure and two months afterwards. The primary outcome would be the amount of color change in each group during the post treatment phase. The participants, the person assessing the color change and the statistician were blinded to TC group assignment. Color changes in each group were analyzed with the Paired T-test. The color change corresponding to the resin removal method was also statistically analyzed with the Independent T-test at α=0.05 as the level of significance. Results: 86 teeth, 43 in each group, were analyzed. The ΔE value was 3.713±1.161, for teeth finished TC and 2.114±0.514 for teeth finished with FC (p<0.01). Conclusion: Adhesive removal with FC bur results in a more color-resistant tooth surface in comparison with tungsten carbide bur. (AU)

Objetivo: O objetivo deste estudo foi determinar se as brocas de material compósito reforçadas com fibras, recentemente desenvolvidas, proporcionam melhores resultados, pela comparação da descoloração dentária após a remoção de braquetes ortodônticos. Material e Métodos: Um ensaio clínico controlado randomizado com boca dividida foi realizado em um consultório ortodôntico, incluindo 23 pacientes, com idade entre 12 e 30 anos, com incisivos superiores intactos, vitais e livres de cárie, que completaram o tratamento ortodôntico com aparelho fixo. Para cada paciente, incisivos centrais e laterais superiores de cada lado da boca foram selecionados aleatoriamente para remover o adesivo ortodôntico com uma broca carbide de tungstênio (TC) (n = 46) ou uma broca de compósito reforçada com fibra (FC) (n = 46). A avaliação da cor de cada dente foi realizada em dois momentos: imediatamente após o acabamento e polimento e dois meses após. O resultado primário foi a quantidade de mudança de cor em cada grupo durante a fase pós-tratamento. Os participantes, a pessoa que avaliou a mudança de cor e o estatístico não tinham conhecimento da atribuição ao grupo TC. As mudanças de cor em cada grupo foram analisadas com o teste-t pareado. A mudança de cor correspondente ao método de remoção da resina também foi analisada estatisticamente com o teste-t independente considerando um nível de significância α = 0,05. Resultados: foram analisados 86 dentes, 43 em cada grupo. O valor de ΔE foi 3,713 ± 1,161, para dentes finalizados com broca TC e 2,114 ± 0,514 para dentes finalizados com broca FC (p <0,01). Conclusão: A remoção do adesivo com broca FC resulta em uma superfície de dente mais resistente à cor em comparação com a broca carbide de tungstênio (AU)