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1.
Braz Oral Res ; 34: e003, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32022222

RESUMO

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.


Assuntos
Estética Dentária , Face/patologia , Má Oclusão de Angle Classe II/patologia , Má Oclusão de Angle Classe II/terapia , Extração Dentária/métodos , Adolescente , Análise de Variância , Dente Pré-Molar/cirurgia , Cefalometria , Criança , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva/métodos , Ortodontistas , Percepção , Estudos Retrospectivos , Estatísticas não Paramétricas , Resultado do Tratamento
2.
BMC Oral Health ; 20(1): 22, 2020 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992277

RESUMO

BACKGROUND: Periodontally accelerated osteogenic orthodontics (PAOO) is a treatment for bone defects associated with a lack of bone graft stability, especially in coronal locations. This study aimed to compare a modified technique of membrane fixation that utilizes periosteal sutures (using a pouch design) with the traditional approach, which does not use membrane fixation. METHODS: Twenty-eight patients with a total of 168 teeth treated were divided into two groups: 1-A, in which patients were treated using the modified technique (with membrane fixation), and group 2-B, in which patients were treated using the traditional technique (without membrane fixation). The postoperative bone thickness was evaluated via radiographic examination. RESULTS: Postoperative improvements in bone augmentation were detected in both groups. At 12 months, the values of the CHBT (measured from the midpoint of the coronal third to the labial cortical surface, 0.84 ± 0.33 mm) and the values of VBL (measured from the alveolar crest to the cemento-enamel junction, - 2.35 ± 0.80 mm)were significantly greater in the modified technique group than those in the traditional technique group (CHBT:0.12 ± 0.21 mm and VBL:-1.39 ± 0.99 mm; P = 0.00 and P = 0.01). CONCLUSIONS: This study shows that compared to the traditional technique, the modified PAOO technique with membrane fixation using periosteal sutures provides improved graft stabilization, superior coronal augmentation and satisfactory vertical volume.


Assuntos
Processo Alveolar/cirurgia , Transplante Ósseo/métodos , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Osteogênese/fisiologia , Osteotomia/métodos , Aumento do Rebordo Alveolar/métodos , Humanos , Ortodontia Corretiva/instrumentação , Técnicas de Movimentação Dentária/métodos , Resultado do Tratamento
3.
Oral Maxillofac Surg Clin North Am ; 32(1): 71-82, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31744601

RESUMO

Complications in orthognathic surgery are commonly a result of inadequate preoperative planning and communication between the surgeon and orthodontist. Unfavorable outcomes can often be avoided when overall treatment goals along with a surgical and orthodontic plan are developed and agreed upon by the orthodontist, surgeon, and patient before the start of active tooth movement or any surgical procedures. Continuous evaluation of the patient's progress throughout treatment and subsequent communication between the surgeon and orthodontist are recommended to prevent frequent errors, such as inadequate dental decompensation, poor appliance selection or management, and occasional contraindicated orthodontic elastic traction or tooth movements.


Assuntos
Má Oclusão , Ortodontia Corretiva/métodos , Ortodontia , Cirurgia Ortognática/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Planejamento de Assistência ao Paciente , Humanos , Equipe de Assistência ao Paciente , Complicações Pós-Operatórias
4.
Georgian Med News ; (294): 62-68, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687951

RESUMO

Recently, there has been a tendency for the growth of dentognathic deformities of various origins, accompanied by phonetic abnormalities. Aim - to increase the effectiveness of orthodontic treatment of dentognathic deformities, accompanied by phonetic disorders, by developing and justifying a set of diagnostic and therapeutic measures based on a multidisciplinary approach. The influence of the state of ENT organs on the formation of dentognathic deformities and phonetic disturbances is studied in 155 children. A clinical dental examination and orthodontic treatment is performed in 82 patients aged 6-12 years. Individual corrective speech therapy work has been carried out to overcome the defects of the phonological side of speech. A certain pathological "chain" of cause-effect relationships of dentognathic deformities with phonetic disorders and diseases of the ENT organs became the basis for a multidisciplinary approach to solving the problems identified. The qualitative and quantitative dependence of sound deterioration on the type of orthognathic deformities is established. A complex of diagnostic and therapeutic measures for patients with dental deformities accompanied by phonetic disorders, consisting of motivational, diagnostic and therapeutic blocks, has been developed and introduced into practice. The proposed complex of diagnostic and treatment measures made it possible to increase the efficiency of orthodontic treatment of children with dentognathic deformities with disturbances of sound pronunciation depending on the type of bite by means of a multidisciplinary approach involving an otolaryngologist, speech therapist, children's therapist and surgeon, which was confirmed in 86.6% of patients by the improvement of electromyography, anthropometric measurements of scanned models of jaws, cephalometry; the analysis of cone-beam computed tomography data showed a significant increase in the upper respiratory tract volume by 53.8±4.2%.


Assuntos
Anormalidades Maxilofaciais/diagnóstico , Anormalidades Maxilofaciais/cirurgia , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Fonética , Prognatismo/cirurgia , Distúrbios da Fala/cirurgia , Cefalometria , Criança , Humanos , Imageamento Tridimensional , Prognatismo/diagnóstico por imagem , Reprodutibilidade dos Testes , Distúrbios da Fala/diagnóstico , Resultado do Tratamento
5.
Am J Orthod Dentofacial Orthop ; 156(4): 531-544, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31582125

RESUMO

Progressive condylar resorption, also known as idiopathic condylar resorption, is an uncommon, aggressive, degenerative disease of the temporomandibular joint (TMJ) seen mostly in adolescent girls and young women. This condition leads to loss of condylar bone mass, decrease of mandibular ramal height, steep mandibular and occlusal plane angles, and an anterior open bite. In 3 case reports, we review the pathogenesis of TMJ degenerative disease and the clinical management of TMJ arthrosis. We emphasize that TMJ arthritic disease should be discussed in dental circles as a pathologic entity in the same way that orthodontists discuss arthritic disease in orthopedic circles. Regarding the degenerative pathology of the TMJ, treatment goals include restored function and pain reduction. The treatment methods used to achieve these goals can range from noninvasive therapy to minimally invasive and invasive surgery. Most patients can be treated noninvasively, and the importance of disease prevention and conservative management in the overall treatment of TMJ disease must be acknowledged. The decision to manage TMJ osteoarthrosis surgically must be based on evaluation of the patient's response to noninvasive treatments, mandibular form and function, and effect of the condition on his or her quality of life.


Assuntos
Reabsorção Óssea/diagnóstico por imagem , Reabsorção Óssea/cirurgia , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Osteoartrite/diagnóstico por imagem , Osteoartrite/cirurgia , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/terapia , Adulto , Reabsorção Óssea/patologia , Criança , Terapia Combinada , Progressão da Doença , Feminino , Humanos , Côndilo Mandibular/patologia , Côndilo Mandibular/cirurgia , Osteoartrite/patologia , Qualidade de Vida , Transtornos da Articulação Temporomandibular/patologia , Resultado do Tratamento
6.
Am J Orthod Dentofacial Orthop ; 156(4): 555-565, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31582127

RESUMO

A common dilemma when treating anterior open bite is understanding its etiology. Idiopathic condylar resorption (ICR) can cause open bite in affected individuals. Although it is prudent to not treat patients with ICR until active resorption has ceased, orthodontists may begin treating them because anterior open bite from ICR may not appear before or during their orthodontic treatment. This article reports a 12-year-old female who was diagnosed with ICR 10 months after completion of her orthodontic treatment for a Class II Division 1 malocclusion. When a young patient with a high mandibular angle and previous skeletal or dental Class II malocclusion returns with an open bite during the retention phase, the patient's condyles must be carefully examined to determine whether any temporomandibular joint disorder, such as ICR, is present. Currently, the controversy over the cause and the cure for ICR is continuing to challenge orthodontists in diagnoses and treatments. Orthodontists should closely monitor and offer informed treatment options to patients with risk factors for ICR or signs of its pathology that might develop at any stage of orthodontic treatment, including the retention period.


Assuntos
Reabsorção Óssea/complicações , Reabsorção Óssea/terapia , Má Oclusão de Angle Classe II/terapia , Côndilo Mandibular/patologia , Doenças Mandibulares/patologia , Doenças Mandibulares/terapia , Mordida Aberta/etiologia , Mordida Aberta/terapia , Ortodontia Corretiva/métodos , Transtornos da Articulação Temporomandibular/terapia , Reabsorção Óssea/diagnóstico por imagem , Cefalometria , Criança , Terapia Combinada , Estética Dentária , Feminino , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Doenças Mandibulares/diagnóstico por imagem , Mordida Aberta/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Resultado do Tratamento
7.
Saudi Med J ; 40(9): 954-957, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31522225

RESUMO

OBJECTIVES: To investigated the diagnostic performance of circumpubertal eruption stages which identify skeletal maturity stages using the cervical vertebral maturation (CVM) method in a Saudi population. METHODS: This is a retrospective cross-sectional study. Lateral cephalograms, panoramic radiographs, and intraoral pictures of 600 orthodontic patients (284 boys, 316 girls) who met inclusion criteria were assessed. Records were retrieved between January 2016 and April 2018. The diagnostic performance of eruption stages for identifying skeletal maturity was tested with positive likelihood ratios (LHR+). RESULTS: Prevalence of each CVM stage in the eruption stages was reported. For every eruption stage, LHR+ was reported in order to identify every CVM stage. The majority of the LHR+ values were ≤3.5, with a significant value of ≥10 for the identification of the post-pubertal growth stage. The other eruptions stages did not strongly predict skeletal maturity. CONCLUSION: In treatment planning for cases that require identifying the growth peak, the use of eruption stages is not recommended as an indicator of skeletal maturity except for the early permanent dentition stage where strong diagnostic performance for identifying post-pubertal skeletal growth stage has been shown.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Desenvolvimento Ósseo/fisiologia , Vértebras Cervicais/diagnóstico por imagem , Dentição Permanente , Erupção Dentária/fisiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Ortodontia Corretiva/métodos , Radiografia Panorâmica , Estudos Retrospectivos
8.
Am J Orthod Dentofacial Orthop ; 156(3): 312-325, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474261

RESUMO

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.


Assuntos
Mordida Aberta/terapia , Ortodontia Corretiva/estatística & dados numéricos , Ortodontistas/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Idoso , Cefalometria , Feminino , Humanos , Incisivo , Masculino , Mandíbula , Pessoa de Meia-Idade , Mordida Aberta/diagnóstico por imagem , Mordida Aberta/epidemiologia , Aparelhos Ortodônticos/estatística & dados numéricos , Ortodontia Corretiva/instrumentação , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos , Inquéritos e Questionários , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Técnicas de Movimentação Dentária/estatística & dados numéricos , Estados Unidos/epidemiologia
9.
Am J Orthod Dentofacial Orthop ; 156(3): 375-382, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474267

RESUMO

INTRODUCTION: The aim of this work was to compare the skeletal and dental outcomes of 1- versus 2-phase treatment in Class II subjects with difficult-to-treat high-angle severe Class II malocclusions. METHODS: The sample of 120 cases was collected from the private offices of 3 experienced clinicians. The following selection criteria were used: (1) ANB ≥6°, (2) SN-GoGn ≥37° or mandibular plane to Frankfort horizontal plane ≥30°; and (3) overjet ≥6 mm. Patients were classified into either the early or the late treatment group according to dental age (early Tx: ≥5 primary teeth; late Tx: otherwise). Thirty-four angular, linear, and proportional measurements were determined for each patient. Statistical significance was assessed with the use of a 2-tailed t test, analysis of covariance test, and chi-square test. RESULTS: The results showed that early 2-phase treatment for severe Class II high-angle patients offered no skeletal anteroposterior advantages over late 1-phase treatment. Severe high-angle Class II patients also showed similar dental anteroposterior outcomes with the use of both approaches. Vertically there was a higher frequency of increased mandibular plane angles and extrusion of upper incisors and lower molars in the late treatment group. CONCLUSIONS: Early 2-phase treatment for severe Class II high-angle patients offered no skeletal or dental advantage over late 1-phase treatment.


Assuntos
Má Oclusão de Angle Classe II/terapia , Ortodontia Corretiva/métodos , Adolescente , Cefalometria/métodos , Criança , Feminino , Humanos , Incisivo , Masculino , Mandíbula , Maxila , Dente Molar , Sobremordida/terapia , Fatores de Tempo , Resultado do Tratamento
10.
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
11.
Am J Orthod Dentofacial Orthop ; 156(1): 113-124, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256824

RESUMO

Scissor bite often remains unnoticed by patients although it can adversely affect facial symmetry, jaw growth, and mastication. This case report illustrates the efficacy of temporary skeletal anchorage devices (TSADs) and a modified lingual arch in correcting severe scissor bite. A 28-year-old woman presented with severe scissor bite in the mandibular right posterior segment. To treat this condition, TSADs were used for maxillary posterior intrusion and a modified lingual arch for buccally uprighting mandibular posterior teeth. Long-term retention records demonstrate stable treatment results.


Assuntos
Oclusão Dentária , Má Oclusão de Angle Classe II/terapia , Má Oclusão de Angle Classe I/terapia , Ortodontia Corretiva/métodos , Adulto , Cefalometria/métodos , Modelos Dentários , Feminino , Humanos , Má Oclusão de Angle Classe I/diagnóstico por imagem , Má Oclusão de Angle Classe I/cirurgia , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/cirurgia , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Maxila/diagnóstico por imagem , Maxila/patologia , Maxila/cirurgia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Fios Ortodônticos , Ortodontia Corretiva/instrumentação , Técnica de Expansão Palatina , Planejamento de Assistência ao Paciente , Fatores de Tempo , Resultado do Tratamento
12.
Am J Orthod Dentofacial Orthop ; 156(1): 125-136, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256825

RESUMO

This case report describes the successful treatment of a 14-year-old girl with severe bilateral idiopathic condylar resorption and resultant mandibular retrusion, increased overjet, and anterior open bite. The nonextraction treatment plan included (1) aligning and leveling the teeth in both arches, (2) performing Le Fort I maxillary osteotomy, bilateral condylectomy, and mandibular joint replacement, and (3) postsurgical correction of the malocclusion. The orthodontic treatment was initiated with the use of custom lingual appliances followed by orthognathic surgery planned with virtual surgical planning. Patient-fitted and customized temporomandibular joint implants were designed and manufactured based on the patient's stereolithic bone anatomic model. Treatment was concluded with detailed orthodontic finishing. Optimum esthetic and functional results were achieved with the cooperation of 2 specialties and the use of state-of-the-art technology.


Assuntos
Braquetes , Prótese Articular , Côndilo Mandibular/cirurgia , Mordida Aberta/cirurgia , Mordida Aberta/terapia , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Transtornos da Articulação Temporomandibular/terapia , Adolescente , Pontos de Referência Anatômicos , Reabsorção Óssea/complicações , Reabsorção Óssea/diagnóstico por imagem , Reabsorção Óssea/cirurgia , Reabsorção Óssea/terapia , Cefalometria , Estética Dentária , Feminino , Humanos , Imageamento Tridimensional , Mandíbula/cirurgia , Côndilo Mandibular/diagnóstico por imagem , Maxila/cirurgia , Mordida Aberta/diagnóstico por imagem , Aparelhos Ortodônticos , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva/instrumentação , Osteotomia , Planejamento de Assistência ao Paciente , Radiografia Panorâmica , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgia , Resultado do Tratamento
13.
Am J Orthod Dentofacial Orthop ; 156(1): 137-147, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256827

RESUMO

A 16-year-old patient sought orthodontic correction for profile improvement and labially inclined maxillary incisors. She had Class II malocclusion, protrusive maxillary and mandibular incisors, and increased overjet and overbite with an American Board of Orthodontics discrepancy index value of 25. She was treated with maxillary premolar extractions and miniscrew-supported en masse retraction assisted with piezoincisions. Extraction spaces (7.5 mm per side) were closed with maximum anchorage in 10 months. Total treatment time was 23 months. Twenty-seven months after debonding, a pink spot was noted at the buccocervial region of the left central incisor. Radiographic evaluation on cone-beam computed tomographic scans revealed a severe case of invasive cervical resorption on both central incisors, around which the piezosurgical cuts had been made. Treatment proceeded with a nonintervention approach and the affected teeth were reinforced with a lingual retainer.


Assuntos
Má Oclusão de Angle Classe II/terapia , Ortodontia Corretiva/métodos , Sobremordida/terapia , Piezocirurgia/efeitos adversos , Adolescente , Dente Pré-Molar/cirurgia , Parafusos Ósseos , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Incisivo/diagnóstico por imagem , Incisivo/patologia , Incisivo/cirurgia , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/cirurgia , Mandíbula , Maxila/diagnóstico por imagem , Maxila/patologia , Maxila/cirurgia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Braquetes Ortodônticos , Fios Ortodônticos , Sobremordida/diagnóstico por imagem , Sobremordida/cirurgia , Radiografia Panorâmica , Reabsorção da Raiz/etiologia , Técnicas de Movimentação Dentária/métodos , Resultado do Tratamento , Dimensão Vertical
14.
Curr Opin Otolaryngol Head Neck Surg ; 27(4): 302-309, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31219831

RESUMO

PURPOSE OF REVIEW: To discuss multidisciplinary treatment options for the protuberant premaxilla associated with bilateral cleft lip and palate. Lessons have been learned throughout the years regarding the effect of growth restriction after early and aggressive therapy. Multiple surgical and orthodontic interventions are discussed. Recent literature will be highlighted and discussed. RECENT FINDINGS: A paucity of long-term studies was noted. Recent literature revealed numerous studies introducing innovative presurgical orthopedic devices as less expensive and easier to use alternatives to nasoalveolar molding. Multiple approaches to premaxillary setback were presented, offering multiple approaches to improve success rates and minimize burden to the patient. Novel orthodontic and advanced microvascular procedures were discussed as additional tools for treatment of the malpositioned premaxilla once skeletal maturity is reached. SUMMARY: Multidisciplinary team management of the protuberant premaxilla and bilateral cleft lip and palate is becoming increasingly embraced worldwide. Numerous surgical procedures and orthodontic treatments are required to optimally reposition the premaxilla; however, these interventions can inhibit growth, resulting in maxillary retrusion. Long-term follow-up studies are needed to determine what protocol is best. Studies should also include ways to overcome barriers to treatment success, such as late intervention, resource disparity, and limited access to care.


Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Maxila/anormalidades , Maxila/cirurgia , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Humanos , Microcirurgia/métodos , Procedimentos Ortopédicos/métodos
15.
Medicina (Kaunas) ; 55(6)2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31181706

RESUMO

Objectives: This review investigated the effects of orthodontic or functional orthopedic therapy on masseter muscle thickness through the use of ultrasonography (US) in growing subjects when compared with untreated subjects. Materials and Methods: This review systematically assessed studies that investigated growing subjects undergoing orthopedic therapy for the correction of malocclusion of vertical, sagittal and transversal plane. Electronic databases (CENTRAL, MEDLINE-PubMed, Scopus and Web of Science) were searched up to February 2019, including available RCTs and CCTs, without language restrictions. The primary outcome was the effect of orthopedic or functional treatment on masseter muscle thickness. The risk of bias of included studies was assessed through the Newcastle-Ottawa quality assessment scale with the aim of defining their methodological quality. A random-effects meta-analysis analyzing mean differences with 95% confidence intervals was used for quantitative analysis. Results: The search retrieved 749 titles, but the studies selection resulted in a final sample of 5 CCTs. The studies retrieved data from 233 children (age range: 5-22 years) and were conducted at university dental clinics. Children were treated for Class II malocclusion, increased vertical dimension or lateral cross-bite variably with rapid or slow maxillary expansion, twin block, bite block, mandibular activators, quad helix, alone or in combination. Risk of bias was assessed as medium for three studies, low for one and high for another. The meta-analysis determined that at the end of orthopedic or functional treatment masseter muscle thickness, measured through the use of US, is significantly reduced (MD -0.79 mm; 95% CI -1.28 to -0.31). The reduction in muscle thickness, therefore, could be considered an indicator for the evaluation of the success of therapy with orthodontic appliances. Conclusions: Although the meta-analysis revealed that US could be considered a less invasive and effective method to evaluate the masseter muscle thickness, single-blinded RCTs, are required to confirm US reliability in this field of application. This review was registered on PROSPERO with the following registration number: CRD42018068402.


Assuntos
Músculo Masseter/anormalidades , Ortodontia Corretiva/normas , Ultrassonografia/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Mandíbula/anormalidades , Músculo Masseter/fisiopatologia , Ortodontia Corretiva/métodos , Procedimentos Ortopédicos/métodos , Procedimentos Ortopédicos/normas , Adulto Jovem
16.
J Appl Oral Sci ; 27: e20180434, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31215598

RESUMO

This study aimed to compare the linear dimensions of the dental arches of adult patients with complete unilateral cleft lip and palate (UCLP) after orthodontic and prosthetic treatment with fixed partial dentures (FPD) to patients without clefts, using 3D technology. This retrospective longitudinal study sample consisted of 35 subjects divided into two groups. Included in this sample were 15 complete UCLP individuals who had received orthodontic treatment before rehabilitation with a fixed partial denture (FG), as well as 20 patients without cleft as control group (CG). All patients were aged between 18 and 30 years. Digital dental casts were obtained in two stages: (T1) end of orthodontic treatment and (T2) one year after prosthetic rehabilitation (FG); and (T1) end of orthodontic treatment and (T2) one year after removal of the orthodontic appliance (CG). Intercanine, interfirst premolar and intermolar distances, and incisor-molar length were obtained. A precalibrated and trained examiner performed the assessments. Intergroup differences between T2 and T1 were compared between the groups using the t test or Mann-Whitney test with a significance level of 5% (p<0.05). The intercanine distance variation (T2-T1) showed statistical difference (p=0.005) increasing in the FG group and decreasing in the CG group. In the interfirst premolar distance variation, FG decreased, while CG increased with statistically significant difference (p=0.008). The intercanine distance of individuals with cleft showed stability, while that of the CG had no stability. The CG showed stability in the interfirst premolar distance, while FG had no stability. These findings showed that the FPD is capable of restricting orthodontic results, leading to a stabilization of the dental arches.


Assuntos
Fenda Labial/reabilitação , Fissura Palatina/reabilitação , Arco Dental/patologia , Prótese Dentária Fixada por Implante/métodos , Imageamento Tridimensional/métodos , Ortodontia Corretiva/métodos , Adolescente , Adulto , Pontos de Referência Anatômicos , Fenda Labial/patologia , Fissura Palatina/patologia , Feminino , Humanos , Masculino , Maxila/patologia , Aparelhos Ortodônticos , Valores de Referência , Estudos Retrospectivos , Estatísticas não Paramétricas , Resultado do Tratamento , Adulto Jovem
17.
Am J Orthod Dentofacial Orthop ; 155(5): 662-669, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31053282

RESUMO

OBJECTIVES: The aim of this work was to compare the duration of treatment between orthodontic treatment combined with piezocorticision (OT-PC) and conventional orthodontic treatment (COT), as well as to evaluate the safety, inflammatory process, periodontal health, and soft tissue healing in the OT-PC group. METHODS: Twelve patients were included in each group, and their treatment times were compared for preliminary bracket alignment (PBA) and for overall treatment. In the OT-PC group, the inflammatory process was evaluated by quantifying cytokines in the gingival crevicular fluid. A calibrated examiner measured the probing depth (PD), the distance between the gingival margin and the cementoenamel junction (GM-CEJ), and the clinical attachment level (CAL), before and after OT-PC. The presence of gingival scars was evaluated. Bone and root injuries were assessed with the use of cone-beam computed tomography. RESULTS: The treatment time was significantly reduced in the OT-PC group for PBA in both maxilla (45%; P = 0.001) and mandible (31%; P = 0.023), as well as for overall treatment (52%; P < 0.0001). Although not statistically significant, several inflammatory mediators demonstrated peaks at 3-5 and 16 weeks. There were not significant changes in PD and GM-CEJ after OT-PC treatment, unlike CAL (0.09 ± 0.12 mm; P = 0.024); 47.5% of piezocorticisions caused gingival scars. Only one patient showed no scars. Four cortical bones did not heal completely, and 2 roots had piezoelectric injuries. CONCLUSION: OT-PC was effective at reducing the orthodontic treatment time.


Assuntos
Citocinas/metabolismo , Líquido do Sulco Gengival/química , Má Oclusão/terapia , Ortodontia Corretiva/métodos , Piezocirurgia/métodos , Adolescente , Adulto , Terapia Combinada , Diagnóstico por Imagem , Feminino , Gengiva/anatomia & histologia , Humanos , Masculino , Satisfação do Paciente , Perda da Inserção Periodontal , Índice Periodontal , Fatores de Tempo , Colo do Dente/anatomia & histologia , Resultado do Tratamento
18.
J Pak Med Assoc ; 69(5): 705-710, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31105292

RESUMO

The face is the most expressive zone of the human body that communicates our feelings and thoughts. This may also influence the interaction between people. The aesthetic adjunctive procedures are life-changing. In contemporary orthodontic treatment, orthognathic surgeries are performed to correct the functional aspects of dento facial deformities. In cases where the aesthetic outcome is not improved, patient dissatisfaction is often encountered. Many adjunctive surgical procedures can be used to enhance the anaesthetics of orthodontic or orthognathic surgical cases. Dwelling not merely on the ideal occlusion, the results could be enhanced by analysing the whole-face to improve the overall treatment outcome.


Assuntos
Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Terapia Combinada , Estética , Osso Frontal , Humanos , Osteotomia , Rinoplastia , Ritidoplastia
19.
Orthod Fr ; 90(1): 65-74, 2019 Mar.
Artigo em Francês | MEDLINE | ID: mdl-30994450

RESUMO

INTRODUCTION: Asymmetrical orthodontic cases frequently prove very difficult to correct. Anchorage mini-screws are often needed to treat these cases when the malocclusion is of maxillary origin. Nonetheless, a precise biomechanical assessment must be made to avoid undesirable sideeffects resulting from the mechanics used. Whether one uses a continuous or a segmented archwire, adverse events can occur and must be planned for in order to contain them. MATERIALS AND METHODS: The authors will first give an overview of the possible undesirable effects using the continuous arch technique and the principles underlying the segmented archwire technique. Various clinical cases will also be described to support their argument. CONCLUSION: The advantage of the segmented techniques lies in the precision and speed of the movements obtained in the three dimensions of space. However, they can also present major drawbacks. In practice, these techniques seem best-suited to complex atypical cases, and particularly cases involving asymmetry of the frontal and transverse planes.


Assuntos
Assimetria Facial/complicações , Assimetria Facial/terapia , Má Oclusão/complicações , Má Oclusão/terapia , Desenho de Aparelho Ortodôntico , Fios Ortodônticos/classificação , Artefatos , Fenômenos Biomecânicos , Parafusos Ósseos , Feminino , Humanos , Mandíbula/cirurgia , Maxila/patologia , Maxila/cirurgia , Procedimentos de Ancoragem Ortodôntica/efeitos adversos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico/efeitos adversos , Desenho de Aparelho Ortodôntico/classificação , Desenho de Aparelho Ortodôntico/métodos , Ortodontia Corretiva/efeitos adversos , Ortodontia Corretiva/instrumentação , Ortodontia Corretiva/métodos , Planejamento de Assistência ao Paciente/normas
20.
Am J Orthod Dentofacial Orthop ; 155(4): 560-571, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935611

RESUMO

INTRODUCTION: We report the successful treatment of a 38-year-old woman with bilateral idiopathic condylar resorption and anterior open bite. She had incompetent lips, a gummy smile, increased lower facial height, high mandibular plane angle, skeletal and dental Class II malocclusion with mild mandibular crowding, increased overjet, and mandibular midline deviation to the right. METHODS: The treatment plan included: (1) presurgical alignment and leveling of the teeth in both arches; (2) jaw motion tracking (JMT) to detect mandibular movement; (3) 3-piece maxillary osteotomies with mandibular reconstruction and bilateral coronoidectomies; and (4) postsurgical correction of the malocclusion. The orthodontic treatment was performed with the use of custom lingual braces and clear brackets and the orthognathic surgery was planned with the use of virtual surgical planning. RESULTS: The idiopathic condylar resorption and anterior open bite were treated, crowding was eliminated in the lower anterior segment, correction of skeletal and dental Class II malocclusion was obtained, mandibular plane angle was reduced, and facial profile improved. CONCLUSIONS: The results suggest that esthetic and functional results can be achieved with the cooperation of 2 specialties and with the use of state-of-the-art technology.


Assuntos
Reabsorção Óssea/cirurgia , Mordida Aberta/cirurgia , Aparelhos Ortodônticos Fixos , Transtornos da Articulação Temporomandibular/cirurgia , Adulto , Reabsorção Óssea/complicações , Reabsorção Óssea/diagnóstico por imagem , Reabsorção Óssea/terapia , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Imageamento Tridimensional , Mordida Aberta/complicações , Mordida Aberta/diagnóstico por imagem , Mordida Aberta/terapia , Aparelhos Ortodônticos , Ortodontia Corretiva/instrumentação , Ortodontia Corretiva/métodos , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/terapia
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