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1.
Medicine (Baltimore) ; 99(50): e23165, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327234

RESUMO

BACKGROUND: Although several researchers have analyzed the dental identity of patients experience with corrective methods using fixed and removable appliances, the consequences stay debatable. This meta-analysis intended to verify whether the periodontal status of removable appliances is similar to that of the conventional fixed appliances. METHODS: Relevant literature was retrieved from the database of Cochrane library, PubMed, EMBASE, and CNKI until December 2019, without time or language restrictions. Comparative clinical studies assessing periodontal conditions between removable appliances and fixed appliances were included for analysis. The data was analyzed using the Stata 12.0 software. RESULTS: A total of 13 articles involving 598 subjects were selected for this meta-analysis. We found that the plaque index (PLI) identity of the removable appliances group was significantly lower compared to the fixed appliances group at 3 months (OR = -0.57, 95% CI: -0.98 to -0.16, P = .006) and 6 months (OR = -1.10, 95% CI: -1.60 to -0.61, P = .000). The gingival index (GI) of the removable appliances group was lower at 6 months (OR = -1.14, 95% CI: -1.95 to -0.34, P = .005), but the difference was not statistically significant at 3 months (OR = -0.20, 95% CI: -0.50 to 0.10, P = .185) when compared with that of the fixed appliances group. The sulcus probing depth (SPD) of the removable appliances group was lower compared to the fixed appliances group at 3 months (OR = -0.26, 95% CI: -0.52 to -0.01, P = .047) and 6 months (OR = -0.42, 95% CI: -0.83 to -0.01, P = .045). The shape of the funnel plot was symmetrical, indicating no obvious publication bias in the Begg test (P = .174); the Egger test also indicated no obvious publication bias (P = .1). CONCLUSION: Our meta-analysis demonstrated that malocclusion patients treated with the removable appliances demonstrated a better periodontal status as compared with those treated with fixed orthodontic appliances. However, the analyses of more numbers of clinical trials are warranted to confirm this conclusion.


Assuntos
Má Oclusão/terapia , Aparelhos Ortodônticos Fixos/efeitos adversos , Aparelhos Ortodônticos Removíveis/efeitos adversos , Doenças Periodontais/etiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Má Oclusão/classificação , Má Oclusão/diagnóstico , Pessoa de Meia-Idade , Desenho de Aparelho Ortodôntico/tendências , Aparelhos Ortodônticos/provisão & distribução , Avaliação de Resultados em Cuidados de Saúde , Doenças Periodontais/epidemiologia , Índice Periodontal , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
Am J Orthod Dentofacial Orthop ; 156(4): 464-474.e1, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31582118

RESUMO

INTRODUCTION: The purposes of this study were to assess the role of dental attractiveness in background facial attractiveness and to evaluate how facial and dental attractiveness influenced raters' opinions of the integrity, social attractiveness, and intellectual attractiveness of the models. METHODS: Photographs of male and female individuals rated by peers as unattractive, average, and attractive were combined with oral images of 4 different levels of dental attractiveness (Index of Orthodontic Treatment Need [IOTN] 1, 5, 7, and 10). Sixty-seven participants meeting the inclusion criteria were recruited as raters. Raters viewed closed-lip smile and open-lip, posed smile of 24 models and rated them for facial attractiveness and integrity and multiple social/intellectual attractiveness dimensions using a Visual Analog Scale. RESULTS: Intrarater reliability was fair to excellent. Analysis of variance showed significant 3-way interactions (P < 0.0001=aim 1; P < 0.005=aim 2) for model sex, facial attractiveness, and dental attractiveness. The contribution of dental attractiveness to facial attractiveness was not fixed or linear, but dependent on dental attractiveness level, background facial attractiveness, and model sex. For both sexes, dental impact on facial attractiveness was neutral or negative when teeth were less than ideal, beginning at IOTN 5 for all background facial attractiveness levels. The impact of dental attractiveness on integrity and social and intellectual attractiveness was also dependent on dental attractiveness level, background facial attractiveness, and model sex. Dental attractiveness can make dramatic differences in Average and Attractive male individuals. CONCLUSIONS: The impact of dental attractiveness on facial attractiveness and integrity and social and intellectual attractiveness was dependent on dental attractiveness level, background facial attractiveness, and model sex. The effect of dental esthetics on facial attractiveness was neutral or negative for both male and female individuals when there was a need for treatment (IOTN 5 or higher) for all levels of facial attractiveness. For both male and female models, lower dental esthetics had a greater effect on more attractive faces. Judgments about integrity and social and intellectual attractiveness were strongly affected by dental esthetics, and these effects were more dramatic and consistent for male faces.


Assuntos
Beleza , Estética Dentária/psicologia , Índice de Necessidade de Tratamento Ortodôntico , Má Oclusão/classificação , Má Oclusão/psicologia , Sorriso/psicologia , Desejabilidade Social , Adolescente , Adulto , Feminino , Humanos , Masculino , Fotografação , Reprodutibilidade dos Testes , Escala Visual Analógica
3.
Am J Orthod Dentofacial Orthop ; 156(3): 391-400, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474269

RESUMO

INTRODUCTION: Orthodontic traction of a maxillary impacted canine (MIC) increases the orthodontic treatment time. Therefore, the objective of this study was to evaluate the influence of MIC characteristics and factors associated with orthodontic treatment on the duration of active orthodontic traction. METHODS: This follow-up and retrospective study included 45 MICs orthodontically tractioned into the occlusal plane with the use of a standardized protocol. MIC characteristics, including type, sector, side, location, height, and complexity of impaction, as well as α and ß angles and canine root length and area were measured. Likewise, factors associated with orthodontic treatment, including sex, age, malocclusion, premolar extractions, previous incisor root resorption, ANB, APDI, and SNA angles, and PNS-ANS distance were also evaluated. The statistical analysis included multiple linear regressions to estimate the influence of all variables on the duration of traction (α = 0.05). RESULTS: Sex had significant influence (P = 0.027) on the time of traction; in female patients, the time was 2.05 months more than in male patients. Bilateral impaction treatment increased the time by 2.74 months compared with unilateral cases (P = 0.001). Traction of bicortically centered impacted canines increased the duration of traction by 2.85 months (P = 0.001). Finally, the traction time increased in 2.35 months (P = 0.046) when the impaction sectors were 4 or 5 (close to the midline). CONCLUSIONS: The duration of active orthodontic traction of MIC is mainly influenced by sex, bilateral type, bicortically centered location, or when MIC is located in sector 4 or 5 close to midline, increasing the traction time by some months.


Assuntos
Dente Canino/cirurgia , Maxila/cirurgia , Ortodontia Corretiva/métodos , Dente Impactado/complicações , Dente Impactado/terapia , Adolescente , Dente Canino/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Incisivo , Masculino , Má Oclusão/classificação , Má Oclusão/terapia , Maxila/diagnóstico por imagem , Procedimentos Cirúrgicos Bucais , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva/instrumentação , Avaliação de Processos e Resultados em Cuidados de Saúde , Planejamento de Assistência ao Paciente , Radiografia Dentária , Estudos Retrospectivos , Reabsorção da Raiz/complicações , Fatores Sexuais , Fatores de Tempo , Erupção Dentária , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia , Tração , Resultado do Tratamento
4.
Int Orthod ; 17(3): 544-553, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31279754

RESUMO

INTRODUCTION: Although a "catch-up" growth occurs in early childhood, respiratory system immaturity and the use of oral and naso-gastric probes for prematurely born children are responsible for palatal and cranio-facial alterations. OBJECTIVE: To assess whether prematurity is a risk factor in orthodontics in terms of malocclusions, dysmorphoses and orthodontic treatment need compared to term-born children. To compare the differences of risk factors among these preterm birth subtypes according the severity. MATERIALS AND METHODS: Distributed questionnaires within an orthodontic practice and in the Department of Odontology, Lyon Hospital, France. The evaluation criteria were calculated from the casts, photographs and radiographies carried out during the initial assessment. A statistical intergroup comparison was performed. RESULTS: Of the 537 questionnaires obtained, 47 preterm patients and 150 term-born patients were included in our study. Preterm infants had significantly more bilateral crossed-occlusions than patients in the term group (P=0.003). In addition, very preterm and extremely preterm children had significantly more impacted tooth (P=0.049) and a higher Index of Orthodontic Treatment Need (IOTN grade 5, P=0.003) compared with term children. CONCLUSION: Very preterm and extremely preterm births (occurring more than 8 weeks before the term) represent a risk factor in orthodontics and, therefore, a public health problem.


Assuntos
Má Oclusão/epidemiologia , Ortodontia , Nascimento Prematuro , Adolescente , Cefalometria , Criança , Estudos Transversais , Feminino , Humanos , Recém-Nascido Prematuro , Masculino , Má Oclusão/classificação , Má Oclusão/terapia , Fatores de Risco , Inquéritos e Questionários
5.
Rev. ADM ; 76(3): 156-161, mayo-jun. 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1022128

RESUMO

Durante el crecimiento y desarrollo de la cabeza, ésta lo hace en diferentes direcciones y proporciones, habiendo un límite entre la armonía /desarmonía conocido como umbral. Se hace referencia a este concepto, la forma de escribirlo y leerlo por medio de un código que lo simboliza. Objetivo: Poner al alcance de la comunidad médica un código de lectura e identificación de fenotipos craneofaciales sindrómicos y no sindrómicos. Conclusiones: Se considera que este concepto de umbral craneofacial y su código de lectura pueden ser usados en la enseñanza e investigación de la armonía-desarmonía durante el crecimiento y desarrollo de la cabeza, resultando ser de gran utilidad en la comprensión rápida y sencilla de la lectura del fenotipo craneofacial (AU)


During the growth and development of the head, it does so in different directions and proportions, there being a limit between the harmony / disharmony known as threshold. Reference is made to this concept, the way of writing it and reading it by means of a code that symbolizes it. Objective: To put within reach of the medical community, a code of reading and identification of syndromic and non-syndromic craniofacial phenotypes. Conclusions: It is considered that this concept of a craniofacial threshold and its reading code can be used in the teaching and research of harmony / disharmony during the growth and development of the head, being very useful in the quick and easy comprehension of the reading of the craniofacial phenotype (AU)


Assuntos
Humanos , Fenótipo , Herança Multifatorial , Desenvolvimento Maxilofacial , Prognatismo , Retrognatismo , Cefalometria , Anormalidades Craniofaciais/classificação , Códigos , Estudos de Associação Genética , Cabeça/crescimento & desenvolvimento , Má Oclusão/classificação
6.
Rev. habanera cienc. méd ; 18(2): 270-280, mar.-abr. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1014168

RESUMO

Introducción: Los pacientes con el Síndrome de clase II división 2, además de presentar clínicamente una relación de molares y caninos en disto-oclusión, muestran una retroinclinación de los incisivos centrales superiores con proinclinación de los laterales y sobremordida profunda, lo cual puede llegar a convertirse en un factor de riesgo que provoca disfunción temporomandibular. Objetivo: Identificar la relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular. Material y Métodos: Se realizó una revisión bibliográfica automatizada en las bases de datos de los sistemas MEDLINE, PubMed, Hinari y Google; se utilizó un total de 17 artículos. Desarrollo: Por las características clínicas de la oclusión en los pacientes con este síndrome, el rango de movimiento mandibular está limitado, y produce un efecto traumático que se relaciona con una posición de los cóndilos desplazados hacia atrás e intruidos en la fosa glenoidea. Este desplazamiento más distal produce la presión del espacio retrodiscal ricamente inervado y sería causa de inflamación de los tejidos circundantes y afectación de la función de la articulación por elongación de los ligamentos discales o adelgazamiento del disco que afecta el complejo cóndilo-disco. Conclusiones: Los estudios consultados muestran la relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular, dada las características clínicas presentes en este síndrome, que afectan el funcionamiento de la articulación temporomandibular y que al sobrepasar las capacidades adaptativas del paciente producen la disfunción en la misma(AU)


Introduction: Patients with Syndrome type II division 2 malocclusions, besides presenting a clinically established relationship between molars and canines in a distal occlusion, show a retro-inclination of the upper front teeth with pro-inclination of the lateral incisors and a deep overbite, which can result in a risk factor of temporomandibular dysfunction. Objective: To identify the relationship between Syndrome type II division 2 malocclusions and the temporomandibular dysfunction. Material and Methods: A bibliographic review was carried out through a search of databases such as MEDLINE, PubMed, Hinari, and Scholar Google. A total of 17 articles were used. Development: Because of the clinical characteristics of the occlusion in the patients with this syndrome, the range of jaw movement is limited, producing a traumatic effect that is related with a position of the condyles displaced backward and with glenoid fossa intrusion. This more distal displacement produces the pressure of the richly innervated retrodiscal tissue, which could be the cause of inflammation of the surrounding tissues and the affectation of the joint function due to an elongation of the discal ligaments or a thinning of the disc affecting the disc-condyle complex. Conclusions: The studies conducted demonstrate the relationship between the Syndrome type II division 2 and the temporomandibular joint dysfunction, given the clinical characteristics that are present in this syndrome, which affect the functioning of the temporomandibular joint, and produce its dysfunction when exceeding the adaptive capacities of the patient(AU)


Assuntos
Humanos , Masculino , Feminino , Síndrome da Disfunção da Articulação Temporomandibular/complicações , Má Oclusão de Angle Classe II/complicações , Bibliografias como Assunto , Sobremordida/etiologia , Má Oclusão/classificação
7.
Int Orthod ; 17(1): 143-150, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30770330

RESUMO

OBJECTIVES: Bolton ratio is used as a method for diagnosis of tooth size discrepancy. Tooth size discrepancy has an important role in the stability of results of final orthodontic treatment. The aim of this study was to determine and compare Bolton ratio in normal occlusion and different malocclusion groups of Iranian population. MATERIALS AND METHODS: This descriptive-analytic study comprises 240 orthodontic patient casts (for every malocclusion group: class I, class II division 1, class II division 2, class III, 30 males and 30 females) which have fully erupted and complete permanent dentitions from first molar to first molar, and also 60 persons (30 male-30 female) with normal occlusion. The mesiodistal tooth sizes were measured using digital caliper two times with a 4-week interval. RESULTS: The average mesiodistal size of all teeth in the malocclusion group was significantly bigger than in the normal occlusion group. Although there was no relationship between anterior ratio and gender or malocclusion groups, but a significant relationship between total ratio in Class II division 1 and normal occlusion was seen. Furthermore, a significant difference between anterior and total ratios in the present study and original Bolton's values was found. CONCLUSIONS: In the normal occlusion group, the anterior and total ratios were bigger than those in Bolton's original study. Also, "class II division 1" showed the lowest values of Bolton ratio among the other normal occlusion and malocclusion groups. Therefore, the original Bolton's values should be used conservatively in Iranian population.


Assuntos
Má Oclusão/classificação , Má Oclusão/diagnóstico , Má Oclusão/epidemiologia , Odontometria/métodos , Adolescente , Adulto , Criança , Dentição Permanente , Feminino , Humanos , Irã (Geográfico) , Masculino , Má Oclusão/patologia , Mandíbula/anatomia & histologia , Maxila/anatomia & histologia , Dente/anatomia & histologia , Adulto Jovem
8.
Int Orthod ; 17(1): 151-158, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30772351

RESUMO

OBJECTIVE: Comparison of dental measurements between conventional plaster models, digital models obtained by impression scanning and plaster model scanning. PURPOSE: To evaluate and to compare the accuracy and reliability of tooth size, arch width and Bolton tooth size discrepancy measurements on 3 Dimensional (3D) digital models obtained by plaster dental model scanning, dental impression scanning and conventional plaster models. MATERIAL AND METHODS: This study was carried out on the maxillary and mandibular dental models of 25 patients with Angle Class I molar relationship and minimal crowding. Mesio-distal dimensions of the teeth, intercanine and intermolar arch width, and Bolton tooth size discrepancy measurements were calculated by conventional methods on plaster models, digital methods and on 3D models obtained from plaster model scanning and impression scanning. All measurements were repeated after three weeks for each of the investigated methods. Reliability of measurements was evaluated by Dahlberg formula and Pearson Correlation Coefficient. Comparisons of dental measurements between three methods were achieved with ANOVA Test. RESULTS: The repeated measurements were highly correlated for all methods. Method error was found within clinically acceptable limits. There was no significant difference between dental measurements on plaster dental models, digital models obtained from plaster dental model scanning and dental impression scanning. Results showed the methods being highly reliable and accurate for tooth size, arch width and Bolton analysis at total and anterior proportion calculation. CONCLUSION: Digital measurements of tooth size, arch width and Bolton tooth size discrepancy on digital models obtained from plaster dental model scanning and dental impression scanning showed high accuracy and reliability. There was no significant difference between the three methods for dental measurements.


Assuntos
Desenho Assistido por Computador , Técnica de Moldagem Odontológica , Modelos Dentários , Odontometria/métodos , Arco Dental , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Má Oclusão/classificação , Má Oclusão/diagnóstico , Má Oclusão/patologia , Má Oclusão de Angle Classe I/diagnóstico , Má Oclusão de Angle Classe I/patologia , Mandíbula , Maxila , Ortodontia , Reprodutibilidade dos Testes , Dente/patologia
9.
Braz Oral Res ; 32: e101, 2018 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-30328893

RESUMO

This study aimed to evaluate the influence of breastfeeding and pacifier use on the occlusal status of preschool children. A cross-sectional study was conducted with children (n = 489) aged 2-5 years in private and public schools in Pelotas, South Brazil. Mothers answered a questionnaire on demographic, socioeconomic and behavioral variables, including breastfeeding and non-nutritive sucking habits. Malocclusion was classified as normal/mild and moderate/severe, according to WHO criteria. The association between breastfeeding and pacifier use with malocclusion was tested using multivariate logistic regression. The prevalence of malocclusion was 37.83% (95%CI 33.52-42.14), and 57.87% of the children used a pacifier. A total of 46.01% of the sample was exclusively breastfed for 6 months, and 24.74% were never breastfed. Malocclusion was associated with pacifier use, and with both non-exclusively breastfed and never breastfed. After adjustments for demographic and socioeconomic variables, the children who used a pacifier and were never breastfed (OR = 19.08; 95%CI 8.54-42.63), or who used a pacifier and were not exclusively breastfed (OR = 13.74; 95%CI 6.11-30.92), showed worse occlusal conditions, compared with the children who were exclusively breastfed and never used a pacifier. Pacifier use modifies the relationship between breastfeeding and occlusal status.


Assuntos
Aleitamento Materno/efeitos adversos , Má Oclusão/etiologia , Chupetas/efeitos adversos , Distribuição por Idade , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Má Oclusão/classificação , Má Oclusão/epidemiologia , Mães , Prevalência , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Fatores Socioeconômicos , Comportamento de Sucção/fisiologia , Fatores de Tempo
11.
Acta Otorhinolaryngol Ital ; 38(2): 160-165, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29967561

RESUMO

SUMMARY: The primary aim of this study was to illustrate the prevalence of facial skeletal discrepancy in an Italian sample. Another aim was to evaluate the effectiveness of the sagittal skeletal discrepancy classification in order to establish a morphologic pattern of growth useful for diagnosis and prediction of therapeutic results. The authors considered a sample of 732 patients (426 females and 306 males) aged between 6 and 17 years old. Cephalometric parameters were evaluated in order to establish a relationship between sagittal skeletal discrepancy and the classification of facial rotations (Lavergne and Petrovic). Facial types with neutral mandibular growth direction were the most prevalent, and were most observed in classes I and II; the latter was more represented than others in our sample. Facial types with posterior mandibular growth direction were the most prevalent in class III. Sagittal skeletal discrepancy classification is not able to establish a specific facial type or predict an individual responsiveness to treatment.


Assuntos
Má Oclusão/classificação , Adolescente , Criança , Estudos Epidemiológicos , Feminino , Humanos , Masculino , Má Oclusão/epidemiologia , Estudos Retrospectivos
12.
J Contemp Dent Pract ; 19(6): 647-650, 2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29959290

RESUMO

AIM: This study was aimed to explore the effect of pretreatment severity of malocclusion on the duration of the treatment using The American Board of Orthodontics discrepancy index (ABO-DI). MATERIALS AND METHODS: This clinical retrospective study consisted of orthodontics records of 37 patients who were treated with comprehensive fixed orthodontic appliance from 2011 to 2013. The sample of the study was collected so as to exclude, to the maximum possible, the patient cooperation variability by reviewing all patient chart entries. The DI measurements were used to gather the information of the pretreatment and relate it to the time duration of the treatment. Statistical analyses were performed using the chi-square test and Pearson correlation coefficient. RESULTS: The average treatment time was 24.5 months. The DI scores mean for class I and II was 14.30 and 20.15 respectively. Age and sex did not significantly influence the treatment duration (p > 0.05). CONCLUSION: The results of this study showed that the ABO-DI could be a useful tool to predict orthodontic treatment time. CLINICAL SIGNIFICANCE: The ABO-DI can significantly aid in orthodontic treatment time planning.


Assuntos
Má Oclusão/terapia , Ortodontia Corretiva/métodos , Adolescente , Feminino , Humanos , Masculino , Má Oclusão/classificação , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva/normas , Ortodontia Corretiva/estatística & dados numéricos , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo
13.
Int Orthod ; 16(2): 361-373, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29685399

RESUMO

INTRODUCTION: The aim of this regression analysis was to identify the determining factors, which impact the curve of Spee during its genesis, its therapeutic reconstruction, and its stability, within a continuously evolving craniofacial morphology throughout life. MATERIAL AND METHODS: We selected a total of 107 patients, according to the inclusion criteria. A morphological and functional clinical examination was performed for each patient: plaster models, tracing of the curve of Spee, crowding, Angle's classification, overjet and overbite were thus recorded. Then, we made a cephalometric analysis based on the standardized lateral cephalograms. In the sagittal dimension, we measured the values of angles ANB, SNA, SNB, SND, I/i; and the following distances: AoBo, I/NA, i/NB, SE and SL. In the vertical dimension, we measured the values of angles FMA, GoGn/SN, the occlusal plane, and the following distances: SAr, ArD, Ar/Con, Con/Gn, GoPo, HFP, HFA and IF. The statistical analysis was performed using the SPSS software with a significance level of 0.05. RESULTS: Our sample including 107 subjects was composed of 77 female patients (71.3%) and 30 male patients (27.8%) 7 hypodivergent patients (6.5%), 56 hyperdivergent patients (52.3%) and 44 normodivergent patients (41.1%). Patients' mean age was 19.35±5.95 years. The hypodivergent patients presented more pronounced curves of Spee compared to the normodivergent and the hyperdivergent populations; patients in skeletal Class I presented less pronounced curves of Spee compared to patients in skeletal Class II and Class III. These differences were non significant (P>0.05). The curve of Spee was positively and moderately correlated with Angle's classification, overjet, overbite, sellion-articulare distance, and breathing type (P<0.05). We found no correlation between age, gender and the other parameters included in the study with the curve of Spee (P>0.05). Seventy five percent (75%) of the hyperdivergent patients with an oral breathing presented an overbite of 3mm, which is quite excessive given the characteristics often admitted for this typology; this parameter could explain the overbite observed in the hyperdivergent population included in this study. For the multivariate analysis, the overbite and the sellion-articulare distance remained independently related to the curve of Spee according to the breathing type, Angle's classification, and overjet. This regression model explains 21.4% of the changes in the curve of Spee.


Assuntos
Arco Dental/anatomia & histologia , Má Oclusão/classificação , Má Oclusão/complicações , Sobremordida/classificação , Sobremordida/complicações , Adolescente , Adulto , Pontos de Referência Anatômicos , Cefalometria/métodos , Oclusão Dentária , Face/anatomia & histologia , Feminino , Humanos , Incisivo/anatomia & histologia , Masculino , Má Oclusão de Angle Classe II/classificação , Má Oclusão de Angle Classe II/complicações , Mandíbula/anatomia & histologia , Análise Multivariada , Análise de Regressão , Estatísticas não Paramétricas , Dimensão Vertical , Adulto Jovem
14.
Br J Oral Maxillofac Surg ; 56(5): 416-420, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29678373

RESUMO

To assess the functional needs of orthognathic patients who had been accepted for treatment by Christchurch Hospital, New Zealand, we made a retrospective assessment of 80 consecutive patients using the Index of Orthognathic Functional Treatment Need (IOFTN). Eligibility was based on the Severity and Outcome Index (SOI) score of ≤3 derived from seven lateral cephalometric measurements (three skeletal, three dental, and one soft tissue), which made allowances for asymmetrical or reported important functional issues. The IOFTN grades 4 or 5 indicated "great" or "very great" need for treatment, and we also used a self-reported oral health-related quality of life (QoL) questionnaire (OHIP-14). Sixty-eight patients were considered eligible using the SOI, and 71 when the IOFTN was used. Eight who were eligible using the SOI would not have been eligible using the IOFTN while 11 who were not considered eligible using the SOI scored ≥4 using the IOFTN. However, when it was compared with the SOI, the IOFTN tended to underscore those patients who were Class III/skeletal 3 with reverse overjets of <3mm and with no reported functional difficulties, while it tended to overscore Class II/skeletal 2 patients with overjets ≥6mm. We found no association found between the OHIP-14 and the SOI or the IOFTN. Further investigations are required to clarify functional difficulties that are applicable to the IOFTN grading, and to find out the most appropriate self-reported, oral-health-related QoL measure(s) to complement the use of the IOFTN.


Assuntos
Definição da Elegibilidade , Má Oclusão/classificação , Má Oclusão/cirurgia , Procedimentos Cirúrgicos Ortognáticos , Índice de Gravidade de Doença , Adolescente , Adulto , Cefalometria , Feminino , Humanos , Masculino , Má Oclusão/diagnóstico , Qualidade de Vida , Estudos Retrospectivos , Adulto Jovem
15.
Am J Orthod Dentofacial Orthop ; 153(4): 469-480.e4, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29602338

RESUMO

INTRODUCTION: A multicenter parallel 3-arm randomized clinical trial was carried out in 3 university hospitals in the United Kingdom to investigate the effect of supplemental vibratory force on space closure and treatment outcome with fixed appliances. METHODS: Eighty-one subjects less than 20 years of age with mandibular incisor irregularity undergoing extraction-based fixed appliance treatment were randomly allocated to supplementary (20 minutes/day) use of an intraoral vibrational device (AcceleDent; OrthoAccel Technologies, Houston, Tex) (n = 29), an identical nonfunctional (sham) device (n = 25), or fixed-appliance only (n = 27). Space closure in the mandibular arch was measured from dental study casts taken at the start of space closure, at the next appointment, and at completion of space closure. Final records were taken at completion of treatment. Data were analyzed blindly on a per-protocol basis with descriptive statistics, 1-way analysis of variance, and linear regression modeling with 95% confidence intervals. RESULTS: Sixty-one subjects remained in the trial at start of space closure, with all 3 groups comparable for baseline characteristics. The overall median rate of initial mandibular arch space closure (primary outcome) was 0.89 mm per month with no difference for either the AcceleDent group (difference, -0.09 mm/month; 95% CI, -0.39 to 0.22 mm/month; P = 0.57) or the sham group (difference, -0.02 mm/month; 95% CI, -0.32 to 0.29 mm/month; P = 0.91) compared with the fixed only group. Similarly, no significant differences were identified between groups for secondary outcomes, including overall treatment duration (median, 18.6 months; P >0.05), number of visits (median, 12; P >0.05), and percentage of improvement in the Peer Assessment Rating (median, 90.0%; P >0.05). CONCLUSIONS: Supplemental vibratory force during orthodontic treatment with fixed appliances does not affect space closure, treatment duration, total number of visits, or final occlusal outcome. REGISTRATION: NCT02314975. PROTOCOL: The protocol was not published before trial commencement. FUNDING: AcceleDent units were donated by OrthoAccel Technologies; no contribution to the conduct or the writing of this study was made by the manufacturer.


Assuntos
Técnicas de Movimentação Dentária/métodos , Vibração/uso terapêutico , Adolescente , Análise de Variância , Criança , Arco Dental , Feminino , Humanos , Masculino , Má Oclusão/classificação , Mandíbula , Aparelhos Ortodônticos , Braquetes Ortodônticos , Fios Ortodônticos , Fatores de Tempo , Extração Dentária , Técnicas de Movimentação Dentária/efeitos adversos , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento , Reino Unido
16.
Am J Orthod Dentofacial Orthop ; 153(4): 512-522, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29602343

RESUMO

INTRODUCTION: The objective of this study was to investigate the association between incisor crowding, irregularity, and periodontal disease progression in the anterior teeth. METHODS: Data collected over 35 years from men enrolled in the Veterans Affairs Dental Longitudinal Study included information concerning pocket depth and alveolar bone loss. Plaster casts of the maxillary (n = 400) and mandibular (n = 408) arches were available for baseline measurements. Periodontal disease in the anterior teeth was defined as per arch sum of pathologic pocket depth and sum of teeth with any alveolar bone loss in the anterior sextants. Incisor malalignment status was defined by the anterior tooth size-arch length discrepancy index and Little's Irregularity Index. Adjusted mixed effects linear models computed the beta (ß) estimates and 95% confidence intervals (95% CI) of the amounts of change in periodontal disease outcomes by the level of malalignment. RESULTS: In the anterior maxillary arch, crowding and spacing were significantly associated with an increased per-arch sum of pathologic pocket depth (ß, 0.70 mm; 95% CI, 0.20-1.21, and ß, 0.49 mm; 95% CI, 0.06-0.91, respectively). In the anterior mandibular arch, incisor crowding and irregularity were significantly associated with an increased per-arch sum of pathologic pocket depth (mild crowding: ß, 0.47 mm; 95% CI, 0.01-0.93; severe irregularity: ß, 0.94 mm; 95% CI, 0.50-1.38), and the sum number of teeth with alveolar bone loss (mild and moderate-to-severe crowding: ß, 0.45 teeth; 95% CI, 0.08-0.82; and ß, 0.45 teeth; 95% CI, 0.13-0.83, respectively; moderate irregularity: ß, 0.34 teeth; 95% CI, 0.06-0.62). CONCLUSIONS: Certain incisor malalignment traits (ie, maxillary incisor crowding, maxillary incisor spacing, mandibular incisor mild crowding, mandibular incisor moderate-to-severe crowding, mandibular incisor moderate irregularity, and mandibular incisor severe irregularity) are associated with significant periodontal disease progression.


Assuntos
Progressão da Doença , Incisivo/patologia , Má Oclusão/complicações , Doenças Periodontais/etiologia , Adolescente , Adulto , Perda do Osso Alveolar/etiologia , Perda do Osso Alveolar/patologia , Boston , Criança , Arco Dental/patologia , Índice de Placa Dentária , Doenças da Gengiva/patologia , Humanos , Incisivo/anatomia & histologia , Estudos Longitudinais , Masculino , Má Oclusão/classificação , Má Oclusão/patologia , Doenças Mandibulares/etiologia , Doenças Mandibulares/patologia , Doenças Maxilares/etiologia , Doenças Maxilares/patologia , Doenças Periodontais/patologia , Índice Periodontal , Bolsa Periodontal/patologia , Fatores de Risco , Estatísticas não Paramétricas , Estados Unidos , Veteranos , Adulto Jovem
17.
Am J Orthod Dentofacial Orthop ; 153(4): 523-533, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29602344

RESUMO

INTRODUCTION: Recently, greater emphasis has been placed on smile esthetics in dentistry. Eye tracking has been used to objectively evaluate attention to the dentition (mouth) in female models with different levels of dental esthetics quantified by the aesthetic component of the Index of Orthodontic Treatment Need (IOTN). This has not been accomplished in men. Our objective was to determine the visual attention to the mouth in men with different levels of dental esthetics (IOTN levels) and background facial attractiveness, for both male and female raters, using eye tracking. METHODS: Facial images of men rated as unattractive, average, and attractive were digitally manipulated and paired with validated oral images, IOTN levels 1 (no treatment need), 7 (borderline treatment need), and 10 (definite treatment need). Sixty-four raters meeting the inclusion criteria were included in the data analysis. Each rater was calibrated in the eye tracker and randomly viewed the composite images for 3 seconds, twice for reliability. RESULTS: Reliability was good or excellent (intraclass correlation coefficients, 0.6-0.9). Significant interactions were observed with factorial repeated-measures analysis of variance and the Tukey-Kramer method for density and duration of fixations in the interactions of model facial attractiveness by area of the face (P <0.0001, P <0.0001, respectively), dental esthetics (IOTN) by area of the face (P <0.0001, P <0.0001, respectively), and rater sex by area of the face (P = 0.0166, P = 0.0290, respectively). For area by facial attractiveness, the hierarchy of visual attention in unattractive and attractive models was eye, mouth, and nose, but for men of average attractiveness, it was mouth, eye, and nose. For dental esthetics by area, at IOTN 7, the mouth had significantly more visual attention than it did at IOTN 1 and significantly more than the nose. At IOTN 10, the mouth received significantly more attention than at IOTN 7 and surpassed the nose and eye. These findings were irrespective of facial attractiveness levels. For rater sex by area in visual density, women showed significantly more attention to the eyes than did men, and only men showed significantly more attention to the mouth over the nose. CONCLUSIONS: Visual attention to the mouth was the greatest in men of average facial attractiveness, irrespective of dental esthetics. In borderline dental esthetics (IOTN 7), the eye and mouth were statistically indistinguishable, but in the most unesthetic dental attractiveness level (IOTN 10), the mouth exceeded the eye. The most unesthetic malocclusion significantly attracted visual attention in men. Male and female raters showed differences in their visual attention to male faces. Laypersons gave significant visual attention to poor dental esthetics in men, irrespective of background attractiveness; this was counter to what was seen in women.


Assuntos
Atenção , Beleza , Estética Dentária , Olho/anatomia & histologia , Face/anatomia & histologia , Adulto , Análise de Variância , Face/diagnóstico por imagem , Humanos , Índice de Necessidade de Tratamento Ortodôntico , Masculino , Má Oclusão/classificação , Má Oclusão/psicologia , Má Oclusão/terapia , Boca/anatomia & histologia , Nariz/anatomia & histologia , Reprodutibilidade dos Testes , Fatores Sexuais , Sorriso , Adulto Jovem
18.
J Orofac Orthop ; 79(1): 39-47, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29330612

RESUMO

PURPOSE: The present study evaluated electromyographic activity (EMG), masticatory performance, and tongue strength in children without and with orthodontic treatment needs. PATIENTS AND METHODS: A total of 90 children were screened and divided into the following groups: Group I (no treatment needed; mean age: 8.00 ± 0.43 years; n = 26), Group II (few malocclusions, treatment needed; mean age: 8.89 ± 0.43 years; n = 28), and Group III (slight-to-borderline treatment needed; mean age: 8.44 ± 0.22 years; n = 36). Orthodontic treatment need was classified on the basis of IOTN-DHC (Index of Orthodontic Treatment Need - Dental Health Component). The electromyographic Trigno EMG Systems was used for muscle analysis and the Iowa Oral Pressure Instrument (IOPI) was used to measure tongue strength. Data were analyzed using normality tests and one-way analysis of variance with a Bonferroni post hoc test (p ≤ 0.05). RESULTS: EMG in almost all mandibular movements was higher in Group III with statistically significant differences compared to position at rest: right masseter (p = 0.03); protrusion: left temporal (p = 0.02); saliva swallowing: left temporal (p = 0.05) and water swallowing: orbicularis oris mouth, right upper segment (p = 0.05). Lower masticatory performance was found in Group III, but the difference compared to Group I and II was not significant. There were no significant differences between the groups in terms of tongue strength. CONCLUSIONS: Children with borderline orthodontic treatment needs show functional disorders of the stomatognathic system.


Assuntos
Assistência Odontológica para Crianças , Necessidades e Demandas de Serviços de Saúde , Má Oclusão/terapia , Ortodontia Corretiva , Anormalidades do Sistema Estomatognático/terapia , Criança , Eletromiografia , Feminino , Alemanha , Humanos , Masculino , Má Oclusão/classificação , Má Oclusão/diagnóstico , Anormalidades do Sistema Estomatognático/classificação , Anormalidades do Sistema Estomatognático/diagnóstico
19.
Arch Oral Biol ; 88: 19-23, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29358133

RESUMO

The identification of clinical patterns of tooth agenesis in individuals born with craniofacial deformities may be a useful tool for risk determination of these defects. We hypothesize that specific craniofacial deformities are associated with third molar agenesis. OBJECTIVE: The aim of this study was to identify if third molar agenesis could have a relation with other craniofacial structure alterations, such as cleft lip and palate, skeletal malocclusion, or specific growth patterns in humans. DESIGN: Data were obtained from 550 individuals ascertained as part of studies aiming to identify genetic contributions to oral clefts. 831 dental records of patients aged over eight years seeking orthodontic treatment were also included. SN-GoGn angle were used to classify the growth pattern (hypo-divergent, normal and hyper-divergent), and the ANB angle was used to verify the skeletal malocclusion pattern (Class I, II and III). Panoramic radiographs were used to determine third molar agenesis. RESULTS: A high frequency of third molar agenesis among individuals born with cleft lip with or without cleft palate (55%), as well as among their relatives (93.5%) was found. Third molar agenesis was not associated to skeletal malocclusion or growth pattern. CONCLUSION: It appears that third molar agenesis is associated with the disturbances that lead to cleft lip and palate.


Assuntos
Anodontia/complicações , Anodontia/epidemiologia , Anormalidades Craniofaciais/complicações , Anormalidades Craniofaciais/etnologia , Dente Serotino/anormalidades , Anormalidades Múltiplas/epidemiologia , Adolescente , Adulto , Biomarcadores , Criança , Fenda Labial/epidemiologia , Fenda Labial/etnologia , Fenda Labial/genética , Fissura Palatina/epidemiologia , Feminino , Humanos , Masculino , Má Oclusão/classificação , Má Oclusão/etiologia , Mandíbula/anormalidades , Mandíbula/patologia , Maxila/anormalidades , Maxila/patologia , Ortodontia , Fenótipo , Estudos Prospectivos , Radiografia Panorâmica , Adulto Jovem
20.
Cleft Palate Craniofac J ; 55(7): 983-988, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-28092164

RESUMO

OBJECTIVE: To test the reliability of the modified Huddart-Bodenham (MHB) numerical scoring system and its agreement with the GOSLON Yardstick categorization for assessing the dental arch relationships in unilateral cleft lip and palate (UCLP) cases. DESIGN: A retrospective study. SETTING: Faculty of Dentistry, The University of Hong Kong. PATIENTS: Forty-one nonsyndromic UCLP consecutive patients attending the Joint Cleft Lip/Palate Clinic at Faculty of Dentistry in the University of Hong Kong were selected. INTERVENTIONS: Study models at 8 to 10 years old (T1) and 10 to 12 years old (T2) were obtained from each patient. MAIN OUTCOME MEASURES: Models were rated with the MHB scoring system and GOSLON Yardstick index. The intra- and interexaminer reliabilities as well as correlation of both scoring systems were evaluated. Furthermore, to investigate the outcome measurements consistency, the MHB scoring system and GOSLON Yardstick were independently used to compare the dental arch relationships from T1 to T2, with the samples split into intervention and nonintervention groups. RESULTS: The MHB scoring system presented good intra- and interexaminer agreement, which were comparable to those of the GOSLON Yardstick. The correlation between the MHB scoring system and GOSLON Yardstick scores was good. Both scoring systems showed similar results when assessing the change in the dental arch relationships from T1 to T2. CONCLUSIONS: The MHB scoring system can be used as an alternative method to the commonly used GOSLON Yardstick for assessing dental deformities in UCLP patients. Both scoring systems showed similar results in assessing the improvement in dental arch relationships.


Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Arco Dental/anormalidades , Má Oclusão/classificação , Criança , Modelos Dentários , Feminino , Hong Kong , Humanos , Masculino , Desenvolvimento Maxilofacial , Reprodutibilidade dos Testes
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