The National Dental Practice-Based Research Network Adult Anterior Open Bite Study: Treatment recommendations and their association with patient and practitioner characteristics.

INTRODUCTION: This aim of this paper is to describe and identify the practitioner and patient characteristics that are associated with treatment recommendations for adult anterior open bite patients across the United States. METHODS: Practitioners and patients were recruited within the framework of the National Dental Practice-Based Research Network. Practitioners were asked about their demographic characteristics and their treatment recommendations for these patients. The practitioners also reported on their patients' dentofacial characteristics and provided initial cephalometric scans and intraoral photographs. Patients were asked about their demographic characteristics, previous orthodontic treatment, and goals for treatment. Four main treatment groups were evaluated: aligners, fixed appliances, temporary anchorage devices (TADs), and orthognathic surgery. Extractions were also investigated. Predictive multivariable models were created comparing various categories of treatment as well as extraction/nonextraction decisions. RESULTS: Ninety-one practitioners (mostly orthodontists) and 347 patients were recruited from October 2015 to December 2016. Increased aligner recommendations were associated with white and Asian patients, the presence of tongue habits, and female practitioners. TADs were recommended more often in academic settings. Recommendations for orthognathic surgery were associated with demographic factors, such as availability of insurance coverage and practitioner race/ethnicity, and dentofacial characteristics, such as anteroposterior discrepancies, more severe open bites, and steeper mandibular plane angles. Extraction recommendations were largely associated with severe crowding and incisor proclination. CONCLUSIONS: Both doctor and patient demographic factors, as well as dentofacial characteristics, were significantly associated with treatment recommendations for adult anterior open bite patients.

Poor oral habits and malocclusions after usage of orthodontic pacifiers: an observational study on 3-5 years old children.

BACKGROUND: Pacifier sucking habit has been associated in the literature with alterations of dental occlusion, and it could be a predisposing factor for other poor oral habits among children. Orthodontic pacifiers have been introduced in the market aiming to reduce these disadvantages caused by the conventional type of pacifiers. The aim of this study was to evaluate the prevalence of poor oral habits and malocclusions, after usage of orthodontic pacifiers in children with primary dentition. METHODS: A sample of 198 pre-school children, aged 3-5 years, (96 males and 102 females) who had exclusively used an orthodontic pacifier were included in order to assess the level of poor oral habits and the absence/presence of dental malocclusion. Firstly, children's parents/legal guardians were given a validated questionnaire, then the children were clinically examined at a dental clinic. RESULTS: Most of the children (79.79%) had started using the orthodontic pacifier within the first 3 months of life, and the 43.49% of them continued using it over a period of 2 years. The recorded percentage for those who had used it throughout sleep was 89.39%. Mouth breathing during the night was reported for 36.04% of the children. Tongue thrust swallow affected 16.16% of the sample. The 5.56% of the data indicated the presence of fingersucking/thumbsucking habit. The noted percentages for children with lip biting, lingual interposition between teeth at rest and those with nail biting, were 5.56, 12.63 and 15.15%, respectively. The regression revealed a significant contribution between early start of using an orthodontic pacifier with the prevalence of fingersucking/thumbsucking (OR 0.13, 95% CI 0.04-0.47, p = 0.0004). This also reported a noticeable increase of the malocclusion prevalence among the female gender (OR 2.74, 95% CI 1.42-5.31), as well as those who were not exclusively breastfed (OR 2.26, 95% CI 1.17-4.37). CONCLUSIONS: Orthodontic pacifiers does not favor the development of poor oral habits, even if it has been used for a period of 2 years in children with primary dentition. Children who begin to use orthodontic pacifier between 0 and 3 months, are less likely to acquire fingersucking/thumbsucking habit. The use of an orthodontic pacifier appears not to be correlated with the prevalence of malocclusion in primary dentition, differently from what stated in literature about the conventional type of pacifier.

Aparatos funcionales preferidos por ortodoncistas en Colombia para tratar maloclusiones clases II y III / Preferred functional appliances among orthodontists in colombia to treat class II and III malocclusions / Aparelhos funcionais preferidos entre ortodontistas na Colômbia para tratar maloclusões de classe II e III

Antecedentes: La preferencia de los ortodoncistas en Colombia en el uso de aparatos funcionales y los factores diagnósticos que pueden influenciar la indicación del clínico de una determinada aparatología no es bien conocidos. Objetivo: Comparar las preferencias en el uso de aparatos funcionales para tratamiento de maloclusiones clases II y III entre un posgrado de ortodoncia y una población de ortodoncistas y evaluar la asociación entre el aparato indicado y las características demográficas y diagnósticas de los pacientes del postgrado de ortodoncia. Métodos: Estudio de corte transversal. Se revisaron 565 historias clínicas, de un programa de posgrado de ortodoncia y 180 encuestas a miembros de la Sociedad Colombiana de Ortodoncia (SCO). Para evaluar asociación se utilizó la prueba Chi2 y prueba t. La significancia estadística fue establecida en P < 0,05. Resultados: En el posgrado de ortodoncia el aparato funcional más utilizado para tratar la maloclusión Clase II fue el Simoes Network (55,42 %) y para Clase III fue el Lázaro (28,95 %). La mayoría de los miembros de la SCO prefiere tratar la maloclusión de Clase II con las Pistas Indirectas Planas (32,78 %) y la Clase III con la Máscara Facial (62,22 %). Se encontraron diferencias estadísticamente significativas (P < 0,05) entre las preferencias de uso de aparatos funcionales por los ortodoncistas de SCO y el postgrado de ortodoncia evaluado. Conclusiones: Los resultados sugieren que la indicación de los aparatos funcionales para el manejo de maloclusiones Clase II y Clase III no solamente está guiada por la maloclusión, sino que también por la formación académica y preferencias individuales de los ortodoncistas.

Background: The preference for the functional appliances to treat Class II and Class III malocclusions by orthodontists in Colombia and their reasons to select them is not well established, yet. Purpose: To compare the preferences in the use of functional appliances to treat Class II and Class III malocclusions between an orthodontic graduate program and the orthodontist members of the Colombian Society of Orthodontists (CSO) and to evaluate the association between the indicated functional appliance and the diagnostic and demographic characteristics of the patients in the orthodontic program. Methods: In this cross-sectional study were reviewed 565 clinical records of the orthodontic graduate program and the survey of 180 members of the CSO. Chi square and t test at a level of significance P < 0.05 were used to compare both groups. Results: the most frequently functional appliance used to treat Class II malocclusion in the orthodontic graduate program was Simoes Network (55, 42 %) and to treat Class III was the Lazaro (28, 95 %). CSO members preferred Planas indirect tracks (32,78 %) to treat Class II and Facial Mask (62,22 %) to treat Class III. Statistically significant differences (P < 0, 05) in the use preference of functional appliances between the orthodontic graduate program and the orthodontist from the CSO were found. Conclusions: The results suggest that the selection of functional appliances to treat Class II and Class III malocclusions is not only guided by the malocclusion but by the orthodontist´s academic background and individual preferences as well.

Antecedentes: A preferência pelos aparelhos funcionais para tratar as más oclusões de Classe II e Classe III por ortodontistas na Colômbia e seus motivos para selecioná-los ainda não está bem estabelecida. Objetivo: Comparar as preferências no uso de aparelhos funcionais para tratamento de más oclusões Classe II e Classe III entre um programa de pós-graduação ortodôntica e os membros ortodontistas da Sociedade Colombiana de Ortodontistas (CSO) e avaliar a associação entre o aparelho funcional indicado e o características diagnósticas e demográficas dos pacientes no programa ortodôntico. Métodos: Neste estudo transversal foram revisados 565 prontuários clínicos do programa de pós-graduação ortodôntica e a pesquisa de 180 membros da OSC. Qui-quadrado e teste t ao nível de significância P <0,05 foram usados para comparar ambos os grupos. Resultados: o aparelho funcional mais frequentemente utilizado para tratar a má oclusão de Classe II no programa de pós-graduação ortodôntica foi a Rede Simões (55, 42%) e para tratar a Classe III foi o Lazaro (28, 95%). Os membros da OSC preferiram as pistas indiretas Planas (32,78%) para tratar a Classe II e a Máscara Facial (62,22%) para tratar a Classe III. Diferenças estatisticamente significantes (P <0,05) na preferência de uso de aparelhos funcionais entre o programa de pós-graduação ortodôntica e o ortodontista da OSC foram encontradas. Conclusões: Os resultados sugerem que a seleção de aparelhos funcionais para tratar as más oclusões de Classe II e Classe III não é guiada apenas pela má oclusão, mas também pela formação acadêmica do ortodontista e preferências individuais.

Study of Associated Factors With Probable Sleep Bruxism Among Adolescents.

STUDY OBJECTIVES: To evaluate the prevalence of probable sleep bruxism (SB) and its association with sleep features, orthodontic fixed appliance wearing, and extraoral and intraoral clinical signs and symptoms in a population of adolescents. METHODS: Two hundred thirty-nine 12-year-old adolescents enrolled in private and public schools in Brumadinho, southeast Brazil, and their parents were invited to participate. They answered a questionnaire containing information regarding adolescents' sleep features and history of SB. Extraoral and intraoral examination was performed to identify some clinical signs (ie, absence of lip competence, presence of mouth breathing, clicks in the temporomandibular joint [TMJ], tooth wear) and symptoms (ie, pain in the masseter muscle upon palpation), and ongoing orthodontic treatment with fixed appliances. Parental report and clinical examination were used to determine probable SB. Descriptive statistics and logistic regression were performed to identify association of probable SB with independent variables. RESULTS: Of 239 adolescents initially selected, 231 (96.6%) participated in the study. Prevalence of probable SB was 16.9%. Adolescents who snored during sleep (odds ratio [OR] = 3.14; 95% confidence interval [CI] = 1.47-6.70), adolescents who did not have clicks in the TMJ (OR = 3.37; 95% CI = 1.11-10.15), and those who wore orthodontic appliances (OR = 2.72; 95% CI = 1.04-7.14) were more likely to be in the group with probable SB. CONCLUSIONS: Snoring, absence of clicks in the TMJ, and fixed appliance wearing were associated with probable SB among adolescents. This study adds to the ongoing research on SB in adolescents and its associated factors. COMMENTARY: A commentary on this article appears in this issue on page 1281.

Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed appliances and Invisalign system: A meta-analysis.

BACKGROUND: At present, many scholars have studied the periodontal health status of patients undergoing orthodontic treatment with fixed appliances and invisalign. However, those results are inconsistent. Therefore, we conducted this meta-analysis, and then provide reference for clinical treatment. METHODS: Most databases, such as the Cochrane Library, EMBASE, PubMed, Medline, Chinese Biomedical Literature Database, CNKI, and Wan Fang Data were retrieved for related articles from the establishment of the database to October 2017. Meanwhile, we also searched the references of the related literatures manually, in order to increase the included literatures. Two researchers screened the related literatures according to the inclusion criteria and exclusion criteria. Stata 12.0 software was used for data analysis, and results are estimated by odds ratio (OR) and 95% confidence interval (CI). RESULTS: Finally, 7 articles, including 368 patients, were included into our meta-analysis. Meta-analysis results showed that there was no statistically significant difference of gingival index (GI) and sulcus probing depth (SPD) status between the invisalign group and the control group, including at 1, 3, and 6 months (all P > .05). When compared with the control group, the invisalign group presented a lower plaque index (PLI) and sulcus bleeding index (SBI) status at 1 month (OR = -0.53, 95% CI: -0.89 to -0.18; OR = -0.44, 95% CI: -0.70 to -0.19, respectively), 3 months (OR = -0.69, 95% CI: -1.12 to -0.27; OR = -0.49, 95% CI: -0.93 to -0.05, respectively), and 6 months (OR = -0.91, 95% CI: -1.47 to -0.35; OR = -0.40, 95% CI: -0.63 to -0.07, respectively). Subgroup analysis showed that the SPD status was lower in the invisalign group at 6 months when measured the teeth using Ramfjord index (OR = -0.74, 95% CI: -1.35 to -0.12). However, there was no statistically significant difference between the 2 groups when using other measure methods (OR = 0.12, 95% CI: -0.26 to 0.17). CONCLUSION: Our meta-analysis suggests that comparing with the traditional fixed appliances, patients treated with invisalign have a better periodontal health. However, more studies are needed to confirm this conclusion in the future.

Impact of orthodontic treatment on adolescents' quality of life: a longitudinal evaluation of treated and untreated individuals.

PURPOSE: To assess the impact of fixed appliance therapy on the quality of life of a cohort of Brazilian adolescents. METHODS: The treatment group was composed of individuals who started orthodontic treatment. The control group was composed of individuals not selected for immediate treatment. Adolescents answered the Brazilian short form of the Child Perceptions Questionnaire (CPQ11-14). Higher scores indicate a greater negative impact on quality of life. Adolescents in the treatment group completed four sets of interviews: prior to appliances' bonding (T1), 1 month (T2), 6 months (T3) and 12 months (T4) after appliances' placement. Adolescents in the control group were assigned to a comparable schedule. Statistics included inter-group comparisons, Friedman and Wilcoxon tests, and mixed-effects models. RESULTS: In the treatment group, the functional limitation score was higher at T1 (p = 0.004) and T2 (p = 0.007) compared to T4. The emotional well-being score was higher at T1 compared to T2 (p < 0.001), T3 (p < 0.001) and T4 (p < 0.001). The overall CPQ11-14 score was higher at T1 compared to T2 (p = 0.005), T3 (p < 0.001) and T4 (p < 0.001). The overall CPQ11-14 score was also higher at T2 compared to T3 (p = 0.001). No significant change was found in the control group. In the mixed-effects models, the interaction between group (treatment) and time was significant for functional limitations (p < 0.001), emotional well-being (p < 0.001), social well-being (p = 0.004) and the overall CPQ11-14 score (p < 0.001). CONCLUSION: Quality of life improved among adolescents undergoing orthodontic treatment. Orthodontists should inform patients what they might expect regarding the physical and the psychosocial repercussions of appliance therapy.

Conservative management of keratocystic odontogenic tumour in a young child with decompression and an intraoral appliance: 5-year follow-up.

Keratocystic odontogenic tumour (KCOT) is considered one of the most aggressive odontogenic lesions presenting high recurrence rate which varies according to treatment modalities employed for management. The treatment rendered should have a lowest possible risk of recurrence and least morbidity while still eradicating the lesion. Although the radical treatment options like enucleation and en bloc resection are associated with lesser recurrences, these can lead to greater morbidity, especially in children with developing teeth and jaw bones, thus, emphasising need to consider more conservative treatment options like decompression and marsupialisation. The purpose of this article was to report the case of an 11-year-old male child with KCOT in the mandibular region associated with impacted premolar treated successfully with decompression and intraoral appliance. After 24 months of follow-up, the spontaneous eruption of premolar was noted with complete resolution of periapical radiolucency. No recurrence was noted even after 5-year follow-up.

Comparison Between Nickel and Chromium Levels in Serum and Urine in Patients Treated with Fixed Orthodontic Appliances: A Longitudinal Study

Objective: To compare levels of nickel and chromium in serum and urine in orthodontic patients treated with fixed orthodontic appliances. Material and Methods: Nickel and chromium ion concentration were measured in serum and urine of twenty patients (12 females and 8 males, aged 17-28 years old) who had fixed orthodontic treatment using Coupled Plasma-Atomic Emission Spectroscopy. The samples were taken before treatment (Baseline), two months, and six months later during treatment. Data were analyzed using repeated ANOVA, Bonferroni post-hoc test, and paired t-tests. The level of significance was set at 5%. Results: Average serum nickel level changed from 6.420 ppb to 6.855 ppb. Average serum chromium level changed from 5.305 ppb to 5.505 ppb in 6 months. Average urinary nickel level changed from 5.320 ppb to 5.610 ppb. Average urinary chromium level changed from 5.370 ppb to 5.520 ppb in 6 months. There was a statistically significant difference in serum (p<0.001) and urinary chromium (p=0.007) levels between observation times. Conclusion: Orthodontic treatment might raise both urinary and serum nickel levels, but the differences were not statistically significant; the alterations in chromium levels were not consistent; nickel levels were higher in serum than in urine; chromium levels were higher in urine than in serum.

Clinical evaluation of marketed orthodontic products: are researchers behind the times? A meta-epidemiological study.

BACKGROUND: The role of marketing and industry in the treatment decisions of orthodontists has received increasing attention in recent years with clinical research typically undertaken subsequent to established use of these devices and often failing to confirm the promise of manufacturers' claims. This meta-epidemiological study was undertaken to assess the proportion of clinical trials in orthodontics evaluating commercially marketed products and to evaluate the direction of the results of these studies. METHODS: Electronic searching was undertaken to identify randomized controlled trials (RCTs) published over a 5-year period (1 January 2012 to 31 December 2016). Data obtained included the type of marketed intervention, direction of effect and declaration of both industry sponsorship and conflict of interest. RESULTS: Eighty-four RCTs published in 23 scientific journals were included with the highest percentage in the American Journal of Dentofacial Orthopedics (AJO-DO) (23.8%), followed by the European Journal of Orthodontics (EJO) (14.3%), Journal of Orthodontics (JO) (10.7%) and Angle Orthodontist (AO) (10.7%). Overall, 45% (38/84) of clinical trials assessed involved analysis of marketed products after their introduction. Interventions to improve oral health or circumvent the risk of iatrogenic damage, such as white spot lesions, were most commonly assessed (15.8%), with the relative merits of non-surgical adjuncts (14.1%) and other orthodontic auxiliaries (13.1%) also frequently evaluated. In 44% of RCTs, a positive effect of the marketed intervention was not reported. Industry sponsorship of the research was declared in 9.5% RCTs. No significant associations between the direction of the effect and both declaration of industry sponsorship (p = 0.56) and conflict of interest (p = 0.96) were detected. Moreover, for marketed and non-marketed products, no significant associations for both declaration of industry sponsorship (p = 0.44) and conflict of interest (p = 0.28) were found. CONCLUSIONS: Almost half of orthodontic clinical trials over the past 5 years involve analysis of marketed products after their introduction. The results highlight a potential source of waste in orthodontic research emanating from existing approaches to licensing and marketing of orthodontic products.

Pendulum and modified pendulum appliances for maxillary molar distalization in Class II malocclusion - a systematic review.

OBJECTIVE: The main purpose of the present systematic review was to evaluate the quantitative effects of the pendulum appliance and modified pendulum appliances for maxillary molar distalization in Class II malocclusion. MATERIALS AND METHODS: Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus and key journals and review articles; the date of the last search was 30 January 2017. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP). RESULTS: In total, 203 studies were identified for screening, and 25 studies were eligible. The quality assessment rated four (16%) of the study as being of strong quality and 21 (84%) of these studies as being of moderate quality. The pendulum appliances showed mean molar distalization of 2-6.4 mm, distal tipping of molars from 6.67° to 14.50° and anchorage loss with mean premolar and incisor mesial movement of 1.63-3.6 mm and 0.9-6.5 mm, respectively. The bone anchored pendulum appliances (BAPAs) showed mean molar distalization of 4.8-6.4 mm, distal tipping of molars from 9° to 11.3° and mean premolar distalization of 2.7-5.4 mm. CONCLUSIONS: Pendulum and modified pendulum appliances are effective in molar distalization. Pendulum appliance with K-loop modification, implant supported pendulum appliance and BAPA significantly reduced anchorage loss of the anterior teeth and distal tipping of the molar teeth.

Treatment of infants with Syndromic Robin sequence with modified palatal plates: a minimally invasive treatment option.

BACKGROUND: Infants with Robin sequence (RS) suffer from upper airway obstruction (UAO) and feeding problems. We developed an oral appliance with a velar extension in combination with functional treatment and appropriate feeding techniques, which was proven effective in isolated RS. As the above problems are particularly challenging in syndromic RS, we set out to evaluate our treatment concept also in these patients. METHODS: We searched our electronic departmental database to identify all children admitted to our department between 01/01/2003 and 31/12/2009 because of syndromic RS. UAO was quantified by cardiorespiratory sleep studies performed before and during treatment with a modified palatal plate. This appliance consists of a palatal part, covering the hard palate as well as the alveolar ridges and the potential cleft, and a velar extension shifting the tongue in a more anterior position, thereby opening the pharyngeal airway. It is adjusted by fiberoptic nasopharyngoscopy and controlled by cardiorespiratory sleep studies. Obstructive sleep apnea was defined as a mixed obstructive sleep apnea index (MOAI) >3/h. Feeding modalities before and after treatment and weight gain, determined as standard deviation score, were also evaluated. RESULTS: Of 68 children meeting inclusion criteria, 56 completed treatment (46 of these being infants). Underlying diagnoses included craniofacial dysostosis (N = 13) and synostosis syndromes (N = 5), unspecified dysmorphic syndromes (N = 23) and miscellaneous rare conditions (N = 27). Median MOAI decreased from 8.5 (range 0.3-76.0) at admission to 1.1 (0.0-5.2) at discharge (p < 0.001). 51 children received only a TPP and 5 additionally continuous positive airway pressure (CPAP) or high-flow nasal cannula during sleep for mild residual OSA. Three children ultimately required tracheostomy. The number of exclusively gavage fed infants was reduced from 23 to 7. Conversely, the number of children fed exclusively by mouth increased from 18 to 30. Median SDS for weight decreased from -1.6 (-3.5-1.7) to -1.3 (-4.1-2.5). Twelve children had their treatment prematurely discontinued, e.g. due to laryngeal collapse/laryngomalacia. No patient died during treatment. CONCLUSION: Treatment of UAO and feeding problems in these children with syndromic RS by a modified palatal plate with a velar extension was shown to be effective and safe. If confirmed in prospective studies, it may help to avoid more invasive interventions.

Salivary levels of nickel, chromium, iron, and copper in patients treated with metal or esthetic fixed orthodontic appliances: A retrospective cohort study.

The purpose of this retrospective cohort study was to measure the salivary levels of nickel (Ni), chromium (Cr), iron (Fe) and copper (Cu) released from metal and esthetic fixed orthodontic appliances. Ninety patients were divided into three groups (n=30): control (those who had never undergone orthodontic treatment), metal appliance (stainless steel brackets and bands, and nitinol archwires) and esthetic appliance (polycarbonate brackets and tubes, and rhodium-coated nitinol archwires). Patients undergoing orthodontic treatment had used their appliances for periods between one and six months. Ni, Cr, Fe and Cu salivary concentrations were measured by the Total Reflection X-Ray Fluorescence technique. Kruskal-Wallis and Bonferroni-Dunn test showed that Ni (p=0.027) and Cr (p=0.040) concentrations were significantly higher for patients undergoing metallic orthodontic treatment than for the esthetic group. No significant difference regarding Ni and Cr (p=0.447) concentrations were observed between the metal and the control groups (p=0.464 and p=0.447, respectively) or between the esthetic and the control groups (p=0.698 and p=0.912, respectively). Ni and Cr concentrations were significantly influenced by the type of appliance used. Fe and Cu concentrations were not affected by the type or use of orthodontic appliances.

Accounts of bullying on Twitter in relation to dentofacial features and orthodontic treatment.

Social media offers an accessible resource for gaining valuable insights into the social culture of bullying. The purpose of this study was to qualitatively analyse Twitter posts for common themes relating to dentofacial features, braces and bullying. Twitter's database was searched from 2010 to 2014 using keywords relevant to bullying, teeth and orthodontics. Two investigators assessed the Twitter posts, and selected those that conveyed the experiences or opinions of bullying victims. The posts were qualitatively analysed using thematic analysis. Of the 548 posts screened, 321 were included in the final sample. Four primary categories relating to 'dental-related bullying' were identified: (i) morphological features, (ii) psychological and psychosocial impact, (iii) coping mechanisms and (iv) the role of family. Bullied individuals reported a diverse range of psychological impacts and coping mechanisms. Secondary categories were also identified. Family members, for example, were found to play both a contributory and mediatory role in bullying. In summary, social media can provide new and valuable information about the causal factors and social issues associated with oral health-related bullying. Importantly, some coping mechanisms may mitigate the negative effects of bullying.

Associação entre provável bruxismo do sono e o uso de aparelhos ortodônticos fixos / Association between likely sleep bruxism and the use of fixed orthodontic appliances

O objetivo desse estudo foi avaliar a associação entre provável bruxismo do sono e o uso de aparelho ortodôntico fixo, características do sono e características intra e extra orais entre adolescentes. Esse estudo transversal foi desenvolvido em Brumadinho, na região sudeste do Brasil. Um total de 239 adolescentes de 12 anos de idade, matriculados em escolas públicas e privadas da cidade, e seus pais/responsáveis, foram convidados a participar. Para participar os adolescentes deveriam ser alfabetizados e ter desenvolvimento normal, sem síndromes e/ou alterações neurológicas. Os pais/responsáveis receberam um termo de consentimento livre e esclarecido, contendo informações sobre os objetivos e riscos do estudo e os procedimentos a serem realizados. A confidencialidade foi assegurada. Eles também receberam um questionário contendo perguntas a respeito dos hábitos e características do sono dos adolescentes, queixa de dores orofaciais e ocorrência de bruxismo do sono. Após a concordância dos pais, os adolescentes assinaram o termo de assentimento livre e esclarecido e responderam a um questionário com perguntas sobre seus hábitos, características do sono, histórico de dor muscular e ocorrência de bruxismo do sono e em vigília. Em seguida foi realizado um exame clínico extra e intra oral para identificar a presença de disparidade entre os lados direito e esquerdo da face, ausência de selamento labial, respiração bucal, estalido/desvios na articulação temporomandibular, presença de aparelho ortodôntico fixo, dor à palpação nos músculos masseter e temporal e desgaste dentário. O provável bruxismo do sono foi diagnosticado a partir do relato dos pais somado à presença de desgaste dentário e/ou dor à palpação no músculo masseter. A análise estatística incluiu a análise descritiva, o teste qui-quadrado e a regressão logística. Um total de 231 adolescentes participou do estudo, com uma perda de 3,34% da amostra. A maioria dos adolescentes era do gênero feminino (54,10%). A prevalência encontrada para o provável bruxismo do sono e em vigília foi 16,90% e 23,90%, respectivamente. Babar no travesseiro (p=0,034) e roncar durante o sono (p=0,003) foram fatores associados ao provável bruxismo do sono. Adolescentes que roncavam durante o sono (Prevalence Ratio [PR] = 3,05 95% Intervalo de confiança [IC] = 1,42 6,52), que não apresentaram estalidos/desvios na articulação temporomandibular (PR = 3,52; 95% IC = 1,16 10,62) e que usavam aparelho ortodôntico fixo (PR=2,71; 95% IC = 1,03 7,13) tiveram mais chance de pertencer ao grupo com provável bruxismo do sono. Esse estudo concluiu que adolescentes aos 12 anos de idade usando aparelho ortodôntico fixo, que 9 roncam durante o sono e sem estalos/desvios na articulação temporomandibular têm mais chance de apresentar o bruxismo do sono

The aim of this study was to evaluate the association between probable sleep bruxism and orthodontic fixed appliances wearing, sleep characteristics and intra and extra oral characteistics among adolescents. This transversal study was carried out in Brumadinho, southeast of Brazil. A total of 239 12-year-old adolescents enrolled in private and public schools and their parents were invited to participate in the study...

Satisfacción del uso de brackets metálicos en relación a higiene oral, confort y autopercepción estética / Satisfaction with the use of metal brackets in relation to oral hygiene, comfort and esthetic self-perception

Introducción: aunque el uso de braquets está destinado a mejorar la estética dental, también se asocia a reacciones negativas al requerir de aparatos fijos visibles que alteran la fisonomía, aspectos funcionales y de higiene oral del paciente. Esto podría determinar una baja adherencia al tratamiento ortodóncico. Objetivo: evaluar la satisfacción del paciente con brackets metálicos en relación con la higiene oral, confort y autopercepción estética en la primera y cuarta semana de tratamiento. Métodos: se desarrolló un estudio observacional, longitudinal, prospectivo de base individual. A partir del juicio de tres expertos se construyó un cuestionario de satisfacción para tratamiento ortodóncico basado en 10 preguntas referidas a las dimensiones de higiene oral, confort y autopercepción estética. Del universo de pacientes próximos a comenzar su tratamiento en el Instituto Nacional de Ortodoncia en Santiago de Chile, se estimó una muestra 45 individuos, según los antecedentes descritos por Caniklioglu. Fueron seleccionados por conveniencia, entre mayo y junio de 2012. Los criterios de inclusión consideraron hombres y mujeres mayores de 15 años. Se excluyó a quienes habían mantenido tratamientos ortodóncicos previos o que tuvieran enfermedades invalidantes para responder el cuestionario. Resultados: la confiabilidad final del cuestionario alcanzó un α= 0,769. El cambio en los puntajes entre la primera y segunda medición fue de 8,06 ± 1,65 a 10,82 ± 1,52 puntos en la dimensión de higiene oral; de 10,51 ± 2,2 a 15,42 ± 1,97 puntos en la de confort y de 8,64 ± 1,83 a 11,37 ± 1,64 puntos en la autopercepción estética. El puntaje total fue de 27,2 ± 4,48 puntos en la primera semana de tratamiento y de 37,6 ± 4,02 puntos en la cuarta semana. Conclusiones: el nivel de satisfacción general en pacientes chilenos portadores de braquets metálicos mejora de la primera a la cuarta semana de instalados los aparatos, así como en cada una de sus dimensiones: higiene oral, confort y autopercepción estética(AU)

Introduction: although brackets are intended to improve dental esthetics, they are also associated with negative reactions, due to the need to use visible fixed appliances altering the patient's physiognomy, functional capacity and oral hygiene. This could lead to low adherence to orthodontic treatment. Objective: evaluate patient satisfaction with metal brackets in relation to oral hygiene, comfort and esthetic self-perception in the first and fourth weeks of treatment. Methods: an longitudinal prospective observational study was conducted on an individual basis. Starting from the judgment of three experts, an orthodontic treatment satisfaction questionnaire was developed based on 10 questions about the variables oral hygiene, comfort and esthetic self-perception. From the universe of patients about to start treatment at the National Institute of Orthodontics in Santiago de Chile, a sample of 45 individuals was selected applying the antecedents described by Caniklioglu. Participants were selected by convenience between May and June 2012. All male and female patients aged over 15 years were included, except for those who had undergone previous orthodontic treatment or suffered from conditions preventing them from answering the questionnaire. Results: final reliability of the questionnaire was α= 0.769. Score variation between the first and the second measurement was 8.06 ± 1.65 to 10.82 ± 1.52 points for oral hygiene, 10.51 ± 2.2 to 15.42 ± 1.97 points for comfort and 8.64 ± 1.83 to 11.37 ± 1.64 points for esthetic self-perception. Total score was 27.2 ± 4.48 points for the first week of treatment and 37.6 ± 4.02 points for the fourth week. Conclusions: overall satisfaction among Chilean patients wearing metal brackets improves from the first to the fourth week after installation of the appliance. This applies to all three dimensions: oral hygiene, comfort and esthetic self-perception(AU)

Change of mandibular position during two-phase orthodontic treatment of skeletal class II in the Chinese population.

The aim of this study was to evaluate the change in mandibular position during a two-phase orthodontic treatment of skeletal Class II malocclusion. Thirty consecutively treated Chinese male adolescents who had undergone two-phase treatment with Herbst appliance and fixed appliance and fulfilled the specific selection criteria were sampled. Cephalograms taken at T0 (before treatment), T1 (at the end of functional appliance treatment), and T2 (at the end of fixed appliance treatment) were analyzed. The change in sagittal positioning of the mandible was 6.8 ± 3.44 mm in phase I (T0-T1), 0.4 ± 2.79 mm in phase II (T1-T2), and 7.2 ± 4.61 mm in total. The mandible came forward in 100% of the patients at T1. In phase II, it came forward in one-third (positive group) remained unchanged in one-third (stable group) and went backward in one-third (negative group) of the patients. At T2, it came forward twice as much in the positive group compared to the negative group. Mandibular length was significantly increased in 100% of the patients in both phases. In conclusion, during the treatment with functional appliance, the mandibular prognathism increases in all patients, whereas during the treatment with fixed appliance there is no significant change in mandibular prognathism.

Utilização do Distalizador Carrière na correção da maloclusão de Classe II / Use of Distalizador Carrière in Class II malocclusion correction

Uma opção de tratamento para a maloclusão de Classe II de Angle é a distalização dos molares superiores, que pode ser obtida através de diferentes estratégias. O Distalizador Carrière é uma alternativa recente para a correção desse tipo de maloclusão e vem alcançando resultados bastante satisfatórios, por meio da distalização em bloco do segmento posterior superior, com controle tridimensional do movimento dentário. Esse aparelho apresenta um design moderno e pode ser utilizado tanto nos casos de Classe II unilaterais como bilaterais. O objetivo deste trabalho foi fazer uma revisão de literatura sobre o Distalizador Carrière e apresentar o caso de um paciente de 14 anos, portador de uma maloclusão de Classe II divisão 2, que foi tratado com o uso bilateral desse dispositivo e ancoragem inferior com arco lingual de Nance. A correção da Classe II ocorreu em quatro meses e, posteriormente, foi instalado aparelho fixo total superior e inferior para alinhamento, nivelamento e finalização do caso. Efeitos colaterais como mesialização e extrusão do molar e proclinação dos incisivos foram observados no arco inferior. O Distalizador Carrière é uma opção eficaz e de fácil utilização para o tratamento das maloclusões de Classe II

A treatment option for Angle Class II malocclusion is the distal movement of the upper molars, which can be obtained by using different strategies. The Carrière Distalizer is a recent alternative to correct this type of malocclusion and has achieved good results through the block distalization in the upper posterior segment, with three-dimensional control of tooth movement. This appliance features a modern design and can be used either in cases of unilateral and bilateral Class II. This study aimed to make a literature review about the Carrière Distalizer and present the case of a 14 years old patient with a Class II division 2 malocclusion, which was treated with the bilateral use of this device and lower anchoring with Nance lingual arch. The Class II correction occurred in four months and subsequently was installed upper and lower total fixed appliance for the alignment, leveling and finish the case. Side effects like mesial movement and extrusion of molars and buccal tipping of the incisors were observed in the lower arch. The Carrière Distalizer is an effective and easily applicable option for the treatment of Class II malocclusions

Análise comparativa da eficácia dos aparelhos de contenção fixos e removíveis na prevenção da recidiva do apinhamento anteroinferior: um estudo-piloto / Comparative analysis of the effectiveness of fixed and removable containment devices in preventing recurrence of the anteroinferior crowding: a pilot study

A recidiva do apinhamento anteroinferior é um problema recorrente e um dos fatores que levam os pacientes a optar pelo retratamento ortodôntico. Entretanto, não há consenso na literatura sobre a eficácia dos diversos tipos de aparelhos de contenção utilizados. O objetivo deste trabalho é realizar um estudo-piloto com o intuito de analisar e comparar a eficácia dos aparelhos de contenção fixos e removíveis com relação à prevenção da recidiva do apinhamento anteroinferior, após a fase ativa do tratamento ortodôntico, em pacientes do Curso de Especialização em Ortodontia e Ortopedia Facial da Faculdade de Odontologia da Universidade Federal de Minas Gerais. Uma amostra de 28 pacientes em fase de controle de contenção foi aleatoriamente recrutada e dividida em dois grupos: Grupo 1: contenção fixa; Grupo 2: contenção removível. O Índice de Irregularidade dos Incisivos de Little foi utilizado para mensurar o apinhamento anteroinferior, através da análise de modelos de gesso confeccionados antes do tratamento (T0), após o tratamento (T1) e pelo menos um ano pós-tratamento (T2). Os Testes estatísticos de Mann-Whitney e de Sinais foram realizados para avaliar a variação do apinhamento durante os três tempos. Apesar da maior variabilidade no índice de irregularidade no Grupo 2 (Grupo: 1mediana: 0,47; Intervalo Interquartílico: [0,02; 0,89]; Grupo: 2mediana: 0,82; Intervalo Interquartílico: [0,31; 3,22]), não houve diferenças estatisticamente significantes no grau de recidiva de apinhamento em T2 entre os dois grupos (p = 0,084). Ambos os aparelhos de contenção analisados apresentam eficácia estatisticamente semelhante na manutenção do alinhamento anteroinferior, após o tratamento ortodôntico ativo

The relapse of the lower anterior crowding is a recurrent problem and one of the factors that lead patients to opt for orthodontic retreatment. However, there is no agreement in the literature about the effectiveness of various types of orthodontics retainers used. The aim of this study is to conduct a pilot study in order to analyze and compare the effectiveness of fixed and removable orthodontics retainers regarding prevention of relapse of the lower anterior crowding after the active phase of orthodontic treatment in patients of the Specialization Course in Orthodontics and Facial Orthopedics at School of Dentistry, Universidade Federal de Minas Gerais. A randomly sample of 28 patients in retention control phase was recruited and divided into two groups: Group 1: fixed retainer; Group 2: removable retainer. The Irregularity Index of Little was used to measure the lower anterior crowding, by analysis of plaster casts made before treatment (T0), after treatment (T1) and at least one year after treatment (T2). The statistical Mann-Whitney and Signals' tests were performed to evaluate the variation of crowding along the three times. Although the greatest variability in Irregularity Index in Group 2 (Group: 1median: 0,47; interquartile range: [0,02; 0,89]; Group: 2median: 0,82; interquartile range: [0,31; 3,22]), there were no statistically significant differences in the degree of relapse of crowding in T2 between the two groups (p = 0,084). The two types of orthodontics retainers analyzed have statistically similar efficacy in maintaining the lower anterior alignment, after the active orthodontic treatment