Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 839
Filtrar
1.
Int J Esthet Dent ; 15 Suppl 1: S14-S31, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32467932

RESUMO

In patients with missing maxillary anterior teeth, orthodontic space closure is an evidence-based, effective treatment option: probably the best if the goal is long-term periodontal health. Nowadays, this approach is possible in all malocclusions as the first step of an interdisciplinary approach, which aims not only at an optimum esthetic and functional result, but moreover at reducing the -invasiveness of the subsequent restorative treatment. Space closure should be considered the first alternative in growing patients and when the gingival margins are visible. This essay presents the rationale for space closure and provides clinical tips for interdisciplinary treatment planning and finishing.


Assuntos
Anodontia , Má Oclusão , Estética Dentária , Humanos , Incisivo , Fechamento de Espaço Ortodôntico
2.
Rev. ADM ; 77(1): 41-45, ene.-feb. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1088066

RESUMO

Introducción: La maloclusión clase III es considerada como severa y en la mayoría de los pacientes la etiología suele estar combinada entre componentes esqueléticos y dentoalveolares. Las posibilidades terapéuticas dependerán de la edad biológica del paciente y del tipo de maloclusión. Conforme va aumentando la edad del paciente va menguando la capacidad de crecimiento y se va asentando la relación de clase III esquelética. Las maloclusiones de clase III esqueléticas se pueden corregir mediante extracciones dentales y cirugía ortognática. Caso clínico: Paciente masculino de 13 años de edad con protrusión mandibular, discrepancia óseo dentaria negativa, convexidad facial disminuida y clase III dental y esqueletal. Resultados: Se resolvió la discrepancia óseo dentaria negativa del paciente, se logró la clase I Molar y canina con una sobremordida adecuada (AU)


Introduction: Class III malocclusion is considered severe and in most patients the etiology is usually combined between skeletal and dentoalveolar components. The therapeutic possibilities depend on the biological age of the patient and the type of malocclusion. As it increases the age of the patient wanes growth capacity and Will settled the relationship skeletal class III. The skeletal class III malocclusion can be corrected by tooth extractions and orthognathic surgery. Case report: Male patient 13 years old with mandibular protrusion, negative tooth bone discrepancy, decreased facial convexity and dental and skeletal class III. Results: Dental patient refusal bone discrepancy was resolved, I molar and canine class and adequate overbite was achieved (AU)


Assuntos
Humanos , Masculino , Adolescente , Técnica de Expansão Palatina , Aparelhos de Tração Extrabucal , Aparelhos Ortodônticos Fixos , Má Oclusão de Angle Classe III/terapia , Planejamento de Assistência ao Paciente , Extração Dentária , Fechamento de Espaço Ortodôntico
3.
Am J Orthod Dentofacial Orthop ; 156(2): 178-185, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375227

RESUMO

INTRODUCTION: This study aimed to identify significant factors affecting the spontaneous angular changes of impacted mandibular third molars as a result of second molar protraction. Temporary skeletal anchorage devices in the missing mandibular first molar (ML-6) or missing deciduous mandibular second molar (ML-E) with missing succedaneous premolar spaces provided traction. METHODS: Forty-one mandibular third molars of 34 patients (10 male and 24 female; mean age 18.3 ± 3.7 years) that erupted after second molar protraction were included in this study. They were classified into upright (U) and tilted (T) groups. Linear and angular measurements were performed at the time of treatment initiation (T1) and of ML-6 or ML-E space closure (T2). Regression analyses were used to identify significant factors related to third molar uprighting. RESULTS: Nolla stage (odds ratio [OR] 4.1), sex (OR 0.003 for male), third molar angulation at T1 (OR 1.1), missing tooth space (OR 0.006), rate of third molar eruption (OR 23.3), and rate of second molar protraction (OR 0.2) significantly affected third molar uprighting. Age, third molar angulation at T1, rate of third molar eruption, and rate of second molar protraction were significant factors for predicting third molar angulation at T2. CONCLUSIONS: Available space for third molar eruption before and after second molar protraction is not associated with uprighting of erupting third molars. Older patients whose third molars are in greater Nolla stage, are in a more upright position at T1, and have a greater eruption rate have a greater chance for third molar uprighting. Alternatively, an increase in second molar protraction rate results in mesial tipping of the third molars.


Assuntos
Má Oclusão/prevenção & controle , Má Oclusão/fisiopatologia , Mandíbula/fisiopatologia , Dente Serotino/fisiopatologia , Dente Impactado/fisiopatologia , Adolescente , Adulto , Pontos de Referência Anatômicos , Dente Pré-Molar , Feminino , Humanos , Masculino , Má Oclusão/diagnóstico por imagem , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Dente Molar/fisiopatologia , Dente Serotino/anatomia & histologia , Dente Serotino/diagnóstico por imagem , Aparelhos Ortodônticos , Fechamento de Espaço Ortodôntico , Ortodontia Corretiva , Erupção Dentária , Dente Decíduo , Dente Impactado/complicações , Dente Impactado/diagnóstico por imagem , Adulto Jovem
4.
Am J Orthod Dentofacial Orthop ; 156(2): 210-219, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375231

RESUMO

INTRODUCTION: More patients are choosing customized orthodontic appliances because of their excellent esthetics. It is essential that clinicians understand the biomechanics of the tooth movement tendency in customized lingual orthodontics. This study aimed to evaluate the tooth movement tendency during space closure in maxillary anterior teeth with the use of miniscrew anchorage in customized lingual orthodontics with various power arm locations. METHODS: Three-dimensional finite element models of the maxilla were created with miniscrews and power arms; the positions were varied to change the force directions. A retraction force (1.5 N) was applied from the top of the miniscrews to the selected points on the power arm, and the initial displacements of the reference nodes of the maxillary teeth were analyzed. RESULTS: After applying force in different directions, power arms located at the distal side of the canines led to larger initial lingual crown tipping and occlusal crown extrusion of the maxillary incisors compared with power arms located at the midpoint between the lateral incisors and canines, and caused a decreasing trend of the intercanine width. CONCLUSIONS: In customized lingual orthodontic treatment, power arms located at the distal side of the canines are unfavorable for anterior teeth torque control and intercanine width control. Power arms located at the midpoint between the lateral incisors and canines can get better torque control, but still cannot achieve excepted torque without extra torque control methods, no matter whether its force application point is higher than, lower than, or equal to the level of the top of the miniscrews.


Assuntos
Parafusos Ósseos , Análise de Elementos Finitos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Fechamento de Espaço Ortodôntico , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Adulto , Fenômenos Biomecânicos , Simulação por Computador , Dente Canino/patologia , Humanos , Imageamento Tridimensional/métodos , Incisivo/patologia , Maxila , Modelos Biológicos , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Braquetes Ortodônticos , Fechamento de Espaço Ortodôntico/instrumentação , Fechamento de Espaço Ortodôntico/métodos , Fios Ortodônticos , Planejamento de Assistência ao Paciente , Estresse Mecânico , Coroa do Dente , Torque , Resultado do Tratamento
5.
Rev. ADM ; 76(4): 234-241, jul.-ago 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1024001

RESUMO

La resorción radicular externa generalizada representa un problema a la hora de realizar un tratamiento de ortodoncia, requiere la toma de decisiones que siempre debe estar fundamentada en el diagnóstico llevado a cabo mediante un equipo interdisciplinario. Objetivo: Describir el tratamiento a una paciente con resorción radicular generalizada ante un proceso completo de diagnóstico que debe ser seguido, buscando preservar la estructura dentaria y la inserción conectiva. Caso clínico: Mujer de 14 años de edad, con motivo de consulta: «tengo un diente fuera de lugar¼, con un biótopo dolicofacial, y maloclusión clase II esquelética, clase I molar, clase I canina, discrepancia osteodentaria negativa, perfil convexo, incompetencia labial, incisivo lateral superior cruzado, resorción radicular generalizada, que predomina en incisivos anteriores superiores. El tratamiento fue ortodoncia (con aparatología fija Roth slot 22), extracciones de segundos premolares superiores e inferiores, cierre de espacios acelerado y ajuste oclusal. Resultado: Al finalizar el tratamiento, se logró mejorar la estética, preservación de la inserción conectiva, estructura dental y una oclusión funcional. Conclusiones: Los pacientes con resorción radicular generalizada necesitan ser diagnosticados correctamente, es importante saber que los resultados se limitan a utilizar fuerzas ligeras y controladas, y es de gran utilidad el aprovechamiento del fenómeno de aceleración regional que está dado por las extracciones dentales, cerrando los espacios desde estadios iniciales del tratamiento (AU)


Generalized external root resorption represents a problem when performing orthodontic treatment, it requires making decisions that should always be based on the diagnosis carried out by an interdisciplinary team. Objective: To describe the treatment of a patient with generalized radicular resorption with a complete diagnostic process that must be followed in order to preserve the tooth structure and the connective insertion. Case report: 14-year-old female patient, with reason for consultation: «I have a tooth out of place¼', with a dolichofacial biotype, class II skeletal malocclusion, class I molar, class I dog, negative osseous discrepancy, convex profile, lip incompetence, superior lateral incisor crossed, generalized radicular resorption, which predominates in upper anterior incisors. The treatment was orthodontics (with Roth slot 22 fixed appliances), extractions of upper and lower second premolars, accelerated space closure and occlusal adjustment. Result: At the end of the treatment, aesthetics, preservation of the insertion and dental structure and a functional occlusion were achieved. Conclusions: Patients with generalized root resorption need to be diagnosed correctly, it is important to know that the results are limited to use light and controlled forces and it is very useful to take advantage of the phenomenon of regional acceleration that is given by the dental extractions, closing the spaces from initial stages of treatment (AU)


Assuntos
Humanos , Feminino , Adolescente , Equipe de Assistência ao Paciente , Reabsorção da Raiz/terapia , Extração Dentária , Resultado do Tratamento , Ajuste Oclusal , Fechamento de Espaço Ortodôntico , Má Oclusão de Angle Classe II
6.
Am J Orthod Dentofacial Orthop ; 155(5): 725-732, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31053288

RESUMO

A unique clinical challenge presents when dealing with a compromised first permanent molar. A compelling treatment option for consideration is the removal of a nonrestorable first permanent molar, with the subsequent "replacement" through controlled mesial tooth movement of viable second and third molars. To reinforce the anchorage support associated with such a planned movement, indirect or direct implant-supported mechanics may be used. With the use of direct anchorage, orthodontic brackets are not required and space closure can be commenced immediately. In this article, we report the clinical procedure and design of direct-anchorage mechanics used for the successful closure of a maxillary first permanent molar space with the use of an implant-supported appliance (Mesialslider). Treatment was completed in just under 12 months, with successful mesial movement of the maxillary second and third molars without the need for the bonding of orthodontic brackets on the anterior dentition. The result was determined to be stable over a 3-year period.


Assuntos
Implantes Dentários , Dente Molar , Procedimentos de Ancoragem Ortodôntica/instrumentação , Fechamento de Espaço Ortodôntico/métodos , Técnicas de Movimentação Dentária/instrumentação , Adolescente , Cefalometria , Feminino , Humanos , Radiografia Panorâmica
7.
Quintessence Int ; 50(4): 306-314, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30887964

RESUMO

Preorthodontic socket preservation after tooth extraction is intended to enhance favorable dentoalveolar ridge morphology and architecture, and facilitate orthodontic tooth movement (OTM) and extraction space closure. This 13-year-old skeletal Class II case presents a unique opportunity to evaluate and compare the OTM extraction space closure by means of a split-mouth analysis in a single patient. The comprehensive orthodontic-periodontal treatment included nonsimultaneous extraction of the bilateral periodontally compromised mandibular first molars and the eruption of bilateral impacted mandibular canines. While the right post-extraction space underwent a natural healing process, the left one was grafted using 4BONE BCH (hydroxyapatite ß-tricalcium phosphate [HA-ß-TCP], HA 60%, and ß-TCP 40%). The 3-year multidisciplinary treatment approach resulted in Class I relationships on the right side and Class II on the left side, improved facial appearance, and dento-skeletal jaw relationships. However, a 3-mm residual alveolar space remained unclosed on the grafted left-site, along with an unerupted left third molar. This split-mouth comparative analysis of the orthodontic space closure demonstrated a significant clinical difference in the outcome. Preorthodontic placement of HA-ß-TCP grafting material on the left segment, proved to be an obstacle for OTM extraction space closure, hindering the establishment of good occlusion.


Assuntos
Fechamento de Espaço Ortodôntico , Dente Impactado , Adolescente , Humanos , Dente Serotino , Extração Dentária , Alvéolo Dental
8.
Am J Orthod Dentofacial Orthop ; 155(2): 276-287, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30712699

RESUMO

Congenital absence of permanent teeth can be treated by means of dental implants and prosthetics. Tooth autotransplantation is an alternative in growing patients because continued eruption of the transplanted tooth and associated alveolar bone growth can be expected. This clinical report presents tooth autotransplantation in a 10-year-old boy with chronic maxillary rhinosinusitis, diagnosed by the department of otorhinolaryngology. The patient's mandibular second premolars were transplanted to a congenitally edentulous maxillary premolar region. There was insufficient alveolar bone during transplantation because of pneumatization, but normal root development with vertical alveolar bone growth was observed during a 3-year follow-up. Healing of the transplant in the right side without closing of the apex and without signs of obliteration after 4 years is exceptional.


Assuntos
Dente Pré-Molar/anormalidades , Dente Pré-Molar/transplante , Fechamento de Espaço Ortodôntico , Criança , Doença Crônica , Humanos , Masculino , Mandíbula , Sinusite Maxilar/complicações , Rinite/complicações , Transplante Autólogo
9.
J Clin Pediatr Dent ; 43(2): 131-136, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30730802

RESUMO

Missing posterior teeth and posterior tooth extractions are commonly seen and needed within orthodontic practices. With the invention of temporary skeletal anchorage devices (TSADs), clinicians can now effectively close posterior tooth spaces. Various molar occlusions are discussed to help clinicians envision post-treatment occlusions after posterior teeth space closure using TSADs.


Assuntos
Procedimentos de Ancoragem Ortodôntica , Fechamento de Espaço Ortodôntico , Extração Dentária , Humanos , Dente Molar , Técnicas de Movimentação Dentária
10.
J Int Med Res ; 47(2): 803-814, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30616411

RESUMO

OBJECTIVE: To examine the effect of clinical use on both force retention and the deactivation of closed-coil nickel-titanium (NiTi) springs in a 16-week trial. METHODS: The force-activation curves for NiTi springs were determined before and after clinical use. The rate of tooth movement and maximum force (MF), hysteresis between activation and deactivation, and mean force of the deactivation plateau (MDF) were examined and correlated as a function of 4, 8, 12 and 16 weeks of clinical use. To recover the force properties, the springs were heat treated at 100°C and the results were compared with the preceding data. RESULTS: A total of 36 springs were analysed. The MF loss after use was 60, 74, 55, and 48 g for the 4-, 8-, 12- and 16-week springs, respectively. Heat treating had little effect on the MF. Clinical use lowered hysteresis by a mean of 180 g*mm compared with the pre-clinical use data, and heat treating increased the hysteresis by a mean of 59 g*mm above the post clinic testing data. The MDF was nominally 100 g less than the MF. Teeth moved approximately 1 mm/month, independent of the force loss. CONCLUSIONS: The loss of MF and the lowering of the MDF was not time dependent. Heat treating can partially recover the mechanical properties of the used springs.


Assuntos
Ligas Dentárias/química , Níquel/química , Fechamento de Espaço Ortodôntico/instrumentação , Fios Ortodônticos , Titânio/química , Adolescente , Criança , Feminino , Seguimentos , Humanos , Masculino , Teste de Materiais , Fenômenos Mecânicos , Prognóstico , Estudos Prospectivos
11.
Artigo em Inglês | MEDLINE | ID: mdl-30543730

RESUMO

This case report presents treatment of a severe localized horizontal bone loss combined with infrabony defects adjacent to pathologically migrated teeth by orthodontic intrusion following a graft of enamel matrix derivative (EMD) without root surface conditioning. The patient was diagnosed with Angle Class II malocclusion, anterior spacing, and pathologically migrated incisors. Graft of EMD mixed with bone materials was applied for periodontal regeneration before orthodontic treatment, and periapical radiographs were taken every 3 months for radiographic evaluation. After closure of anterior spaces by orthodontic treatment, infrabony defects improved dramatically, with a favorable alveolar bone level and periodontal pocket depth.


Assuntos
Perda do Osso Alveolar/cirurgia , Proteínas do Esmalte Dentário/uso terapêutico , Regeneração Tecidual Guiada Periodontal/métodos , Incisivo/anormalidades , Má Oclusão de Angle Classe II/terapia , Fechamento de Espaço Ortodôntico/métodos , Técnicas de Movimentação Dentária/métodos , Terapia Combinada , Feminino , Humanos , Maxila , Pessoa de Meia-Idade
12.
Am J Orthod Dentofacial Orthop ; 155(1): 127-134, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30591156

RESUMO

Tooth autotransplantation is performed in patients with congenitally missing teeth and those with traumatic tooth loss. We report a course of edgewise treatment of a girl with multiple congenitally missing teeth and residual features of ectodermal dysplasia, who was treated with autotransplantation of 2 premolars with developing roots. She was 8 years old at the beginning of the treatment. No signs of inflammation, root resorption, or pulp symptoms were observed during the 2.5 years of edgewise treatment after autotransplantation. Cervical external root resorption was detected 31 months postoperatively in 1 transplanted tooth (maxillary first premolar), and the same problem occurred in the other transplanted tooth (mandibular second premolar) 2 years later. Root canal treatment was immediately undertaken and resulted in inhibition of further pathology. Consequently, the survival of both transplanted teeth was achieved. The orthodontic treatment that included intervals related to diagnosis and treatment of root resorption of the transplanted premolars is described in detail.


Assuntos
Anodontia/cirurgia , Dente Pré-Molar/transplante , Criança , Feminino , Humanos , Fechamento de Espaço Ortodôntico/métodos , Tratamento do Canal Radicular , Reabsorção da Raiz/terapia , Transplante Autólogo
13.
Ortho Sci., Orthod. sci. pract ; 12(47): 135-142, 2019. ilus, tab
Artigo em Português | BBO - Odontologia | ID: biblio-1023037

RESUMO

O objetivo deste trabalho é apresentar um relato de caso clínico de fechamento de espaço de molar inferior, utilizando como ancoragem o Aparelho de Protração Mandibular instalado unilateralmente. A paciente do sexo feminino, 24 anos de idade, relatou como queixa principal os múltiplos diastemas e o espaço correspondente ao primeiro molar inferior esquerdo extraído. Apresentava má oclusão de Classe I, perfil reto, selamento labial passivo, simetria facial, linhas médias coincidentes, giroversões, diastemas entre incisivos laterais e caninos nos arcos superior e inferior, entre caninos e primeiros pré-molares inferiores e espaço referente ao primeiro molar inferior esquerdo extraído. Foi proposto o fechamento do espaço através da mesialização do segundo e terceiro molar com alça de Bull, utilizando o Aparelho de Protração Mandibular (APM) como ancoragem dos dentes anteriores inferiores. A técnica Multiloop Edgewise Archwire (MEAW) com elásticos intermaxilares 1/8 força média foi utilizada para corrigir os efeitos colaterais provocados pelo uso unilateral do APM. Ao final do tratamento, foi obtido o fechamento de todos os diastemas e do espaço correspondente ao primeiro molar inferior esquerdo. O Aparelho de Protração Mandibular utilizado unilateralmente mostrou eficácia como dispositivo de ancoragem durante o fechamento de espaço do elemento posterior extraído (AU)


The aim of this work is to present a clinical case report of lower molar space closure using as anchorage Mandibular Protraction Appliance unilaterally installed. A female patient, 24 years old, reported as main complaint multiple diastemas and the space corresponding to the extracted lower left first molar. She presented Class I malocclusion, straight profile, passive labial sealing, facial symmetry, coincident median lines, gyroversions, diastemas between lateral incisors and canines in the maxillary and mandibular arches, between canines and lower first premolars and space of the extracted lower first molar. It was proposed closure of the space through mesialization of the second and third molars with Bull loop, using the Mandibular Protraction Appliance (MPA) as anchorage of lower anterior teeth. Multiloop Edgewise Archwire (MEAW) technique with 1/8 medium strength intermaxillary elastics were used to correct the side effects caused by unilateral use of MPA. At the end of treatment, all diastemas and the space corresponding to the first lower left molar were closed. The Mandibular Protraction Appliance used unilaterally proved to be effective as an anchor device during space closure of the extracted posterior element (AU)


Assuntos
Humanos , Feminino , Adulto , Fechamento de Espaço Ortodôntico , Procedimentos de Ancoragem Ortodôntica , Má Oclusão de Angle Classe I
14.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 53(11): 780-783, 2018 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-30419661

RESUMO

Gingival invagination is a type of gingival cleft that occurs during orthodontic space closure in some of the orthodontic patients who received tooth extraction. Clinical manifestations may be fine folds in attached gingiva surface, or deep cleft that penetrates the interdental papilla from the buccal to the lingual alveolar process. Gingival invagination can affect the health of local periodontal tissues, the effect and stability of orthodontic treatment. This article reviews the research progress of gingival invagination studies, including the definition, manifestations, causes, influencing factors and effects.


Assuntos
Gengiva , Doenças da Gengiva , Fechamento de Espaço Ortodôntico , Processo Alveolar , Humanos , Extração Dentária
15.
Dental Press J Orthod ; 23(5): 65-74, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30427495

RESUMO

OBJECTIVE: The aim of this study was to evaluate the degree of perception of attractiveness of the smile among dentists, dental students, and lay persons in cases of agenesis of the maxillary lateral incisors replaced by canines for space closure. METHODS: A smiling front view extraoral photograph of a 20-year-old woman was digitally altered simulating agenesis and its treatment, by means of: repositioning, reshaping or bleaching the canine, and gingival contour. A questionnaire was distributed to individuals of the three groups (n= 150), with a view to evaluating their degree of esthetic perception. An attractiveness scale was also used, with '0' representing unattractive and '10', very attractive. RESULTS: In the comparative evaluation among all the photographs, the original image obtained the highest level of acceptance. Photograph 'i' (agenesis of both lateral incisors treated with reposition and reshaping of the canines) was ranked as the least attractive by the dentists, whereas the student and lay persons ranked photograph 'f' (agenesis of both lateral incisors treated with reposition of the canines, gingival contour, bleaching and reshaping) as the worst. CONCLUSION: The methods of treatment most accepted among the dentists and students were those that involved changes in the gingival contour, whereas among lay persons, they were those that involved only reshaping.


Assuntos
Dente Canino/anatomia & histologia , Estética Dentária , Fechamento de Espaço Ortodôntico , Adulto , Anodontia/terapia , Beleza , Estética Dentária/psicologia , Feminino , Humanos , Incisivo/anormalidades , Masculino , Fechamento de Espaço Ortodôntico/psicologia , Fotografia Dentária , Sorriso , Inquéritos e Questionários , Coroa do Dente/anatomia & histologia , Adulto Jovem
16.
Am J Orthod Dentofacial Orthop ; 154(5): 677-682, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30384938

RESUMO

INTRODUCTION: Orthodontic space closure after premolar extraction commonly results in the formation of a gingival cleft, which may contribute to orthodontic relapse and poor periodontal health. The purpose of this study was to examine clinical parameters that may predispose patients to gingival clefts. METHODS: Twenty-nine patients planned for treatment with premolar extractions (n = 87) and orthodontic space closure were evaluated in this prospective study. The clinical measures included width of keratinized buccal gingiva, thickness of buccal gingiva, thickness of buccal bone, time of space closure, and the occurrence (presence or absence) and severity (volume) of cleft formation. The association of the clinical measures with gingival cleft formation and severity was assessed separately for patients according to age group: young adolescent (≤13 years of age), adolescent (14-18 years of age), and adult (≥19 years of age). RESULTS: The overall incidence of gingival cleft formation was 73.2%, with a trend toward greater cleft formation in the young adolescents (79.4%) than in the adolescent and adult groups (69.2% and 68.2%, respectively). The mean severity of clefts exhibited a significant positive association with age group-young adolescent (26.6 mm2), adolescent (27.9 mm2), and adult (41.5 mm2). Buccal bone thickness was significantly correlated with gingival phenotype in the adolescent and adult groups (r = 0.42 and r = 0.52, respectively; both, P <0.05). Rate of space closure was significantly correlated with cleft formation (r = 0.71; P <0.001) in the adult group. CONCLUSIONS: The formation of gingival clefts is common after premolar extraction and space closure. Adults with a thinner gingival phenotype were more likely to develop gingival clefts of greater severity. The rate of space closure was significantly and inversely correlated with cleft formation in adults, reflecting a greater likelihood of cleft formation with slower space closure. Although various clinical parameters show a correlation to both severity and incidence of clefts, all patients undergoing postextraction space closure appear to be at risk and should be monitored.


Assuntos
Gengiva/patologia , Doenças da Gengiva/etiologia , Doenças da Gengiva/patologia , Fechamento de Espaço Ortodôntico/efeitos adversos , Complicações Pós-Operatórias/patologia , Extração Dentária , Adolescente , Adulto , Dente Pré-Molar , Criança , Humanos , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
17.
Am J Orthod Dentofacial Orthop ; 154(6): 820-828, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30477780

RESUMO

INTRODUCTION: Missing or peg-shaped maxillary lateral incisors can affect the mesiodistal dimensions of the dentition. METHODS: The pretreatment casts of patients with bilateral (BMLI, n = 35) or unilateral (UMLI, n = 29) missing maxillary lateral incisors or bilateral peg-shaped maxillary lateral incisors (BPLI, n = 16) were evaluated. The mesiodistal widths of all permanent teeth except the second and third molars were measured, and the sums of total and quadrant tooth widths were calculated. The results were compared with a control group (n = 32) with normal maxillary lateral incisors. A quadrant analysis was performed by comparing the quadrants with lateral incisor agenesis, peg-shaped lateral incisors, and normal lateral incisors with each other. Statistical analysis was performed by 1-way analysis of variance followed by Tukey and Tamhane tests. RESULTS: In the BMLI and BPLI groups, significant reductions in individual tooth widths and total tooth widths were seen. The size discrepancies were the greatest in the maxillary central incisors and decreased gradually from the incisors to the molars. Compared with the control group, the tooth-size discrepancy was more pronounced in the BPLI group followed by the BMLI and UMLI groups. Due to the variability in clinical presentations of the UMLI group, the association with the reduction of the tooth sizes was not significant. But the quadrant analysis showed that in quadrants with a missing or peg-shaped lateral incisor, the teeth were significantly narrower than in quadrants with normal incisors; this indicates the importance of the contralateral side in unilaterally affected patients during analysis. CONCLUSIONS: Bilateral missing or peg-shaped maxillary lateral incisors were significantly associated with reduction of individual mesiodistal tooth widths as well as their total and quadrant sums. Patients with a unilaterally missing lateral incisor should be analyzed individually with quadrant analysis, since the variability in the contralateral side would affect the traditional analysis results.


Assuntos
Incisivo/anormalidades , Odontometria/métodos , Anormalidades Dentárias/diagnóstico , Adolescente , Modelos Dentários , Dentição Permanente , Feminino , Humanos , Masculino , Fechamento de Espaço Ortodôntico , Estudos Retrospectivos
18.
Am J Orthod Dentofacial Orthop ; 154(4): 469-476, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30268257

RESUMO

INTRODUCTION: Deepbites can be corrected by intrusion of mandibular anterior teeth. Direct anchorage with miniscrews simplifies complex tooth movements; however, few studies have reported their use for mandibular anterior intrusion. The purpose of this study was to evaluate, by means of the finite element method, initial tooth displacement and periodontal stress distribution using various mandibular anterior intrusion mechanics. Miniscrews were used as skeletal anchorage devices. METHODS: Cone-beam computed tomography scans were used for 3-dimensional reconstruction of the mandible and the mandibular anterior dentition. Models included the 4 incisors with or without the canines. After all surrounding periodontal and bony structures were determined brackets, segmental archwires, and miniscrews were added. Finite element studies were performed to assess initial tooth displacement and periodontal stress distribution with multiple intrusion force vectors. Changes in the location of the miniscrews and loading points on the archwire created 14 scenarios. RESULTS: Minimum buccolingual displacements, a uniform distribution of periodontal stress, and overall group intrusion for both 4-tooth and 6-tooth scenarios were best achieved when applying distointrusive vectors. The highest peaks of periodontal stress were observed when the force was directed at the corners of the segmental archwire. It was found that, in addition to distointrusive vectors, 4 loading points on the archwire were necessary for pure intrusion and uniform distribution of periodontal stress in the 6-tooth scenarios. CONCLUSIONS: The simulations in this study suggest that group intrusion of all 6 mandibular anterior teeth might be achieved by applying distointrusive vectors. Inserting a pair of miniscrews distal to the canine roots, 1 screw per side, and directing 4 loading points on the archwire generates uniform periodontal stress distribution and minimum buccolingual displacements. Local conditions, such as narrow bone width and attached gingiva level, play significant roles in the clinical viability of the proposed virtual scenarios.


Assuntos
Implantes Dentários , Análise de Elementos Finitos , Imageamento Tridimensional/métodos , Incisivo/cirurgia , Mandíbula/cirurgia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Adulto , Processo Alveolar , Fenômenos Biomecânicos , Simulação por Computador , Tomografia Computadorizada de Feixe Cônico/métodos , Módulo de Elasticidade , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Incisivo/patologia , Má Oclusão de Angle Classe I/terapia , Mandíbula/patologia , Fenômenos Mecânicos , Modelos Biológicos , Desenho de Aparelho Ortodôntico , Braquetes Ortodônticos , Fechamento de Espaço Ortodôntico/métodos , Fios Ortodônticos , Estresse Mecânico
19.
Quintessence Int ; 49(10): 789-798, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30349904

RESUMO

This article describes single-retainer resin-bonded fixed dental prostheses (RBFDPs) as an excellent alternative to orthodontic space closure or tooth replacement with implants or conventional fixed dental prostheses for congenitally and traumatically missing anterior teeth. Although the treatment with RBFDPs is technique sensitive, it is extremely reliable given a correct indication and adequate adhesive procedures.


Assuntos
Anodontia/reabilitação , Prótese Adesiva , Incisivo , Perda de Dente/reabilitação , Adolescente , Criança , Implantes Dentários para Um Único Dente , Planejamento de Prótese Dentária , Feminino , Humanos , Masculino , Fechamento de Espaço Ortodôntico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA