RESUMO
UNLABELLED: White spot lesions (WSL) associated with fixed orthodontic appliances are a common adverse effect of orthodontic treatment and represent a significant challenge to achieving esthetic excellence. The purpose of this article is to review the current evidence regarding diagnosis, risk assessment, prevention, intratreatment management, and postorthodontic treatment of WSL, and to provide clinical recommendations useful for both the orthodontist and the general dentist. Caries risk assessment should be incorporated into initial evaluations of orthodontic patients, and risk-specific prevention and management protocols can help to eliminate or minimize this clinical problem. There are multiple options for treatment of WSL, ranging from conservative to invasive techniques; the severity of lesions is a determinant of which option is most appropriate. CLINICAL SIGNIFICANCE: White spot lesions associated with orthodontic treatment are a common problem that can be minimized with appropriate prevention, management, and treatment approaches.
Assuntos
Cárie Dentária/etiologia , Aparelhos Ortodônticos/efeitos adversos , Biofilmes , Cariostáticos/uso terapêutico , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Esmalte Dentário/patologia , Humanos , Medição de Risco , Remineralização Dentária/métodosRESUMO
INTRODUCTION: Early Class III treatment with reverse-pull headgear generally results in maxillary skeletal protraction but is frequently also accompanied by unfavorable dentoalveolar effects. An alternative treatment with intermaxillary elastics from a temporary anchorage device might permit equivalent favorable skeletal changes without the unwanted dentoalveolar effects. METHODS: Six consecutive patients (3 boys, 3 girls; ages, 10-13 years 3 months) with Class III occlusion and maxillary deficiency were treated by using intermaxillary elastics to titanium miniplates. Cone-beam computed tomography scans taken before and after treatment were used to create 3-dimensional volumetric models that were superimposed on nongrowing structures in the anterior cranial base to determine anatomic changes during treatment. RESULTS: The effect of the intermaxillary elastic forces was throughout the nasomaxillary structures. All 6 patients showed improvements in the skeletal relationship, primarily through maxillary advancement with little effect on the dentoalveolar units or change in mandibular position. CONCLUSIONS: The use of intermaxillary forces applied to temporary anchorage devices appears to be a promising treatment method.
Assuntos
Má Oclusão Classe III de Angle/terapia , Maxila/cirurgia , Aparelhos Ortodônticos Funcionais , Ortodontia Corretiva/métodos , Tração/métodos , Adolescente , Placas Ósseas , Criança , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Má Oclusão Classe III de Angle/patologia , Maxila/crescimento & desenvolvimento , Maxila/patologia , Modelos Dentários , Procedimentos de Ancoragem Ortodôntica/instrumentação , Ortodontia Corretiva/instrumentação , Osteogênese por Distração/instrumentação , Osteogênese por Distração/métodos , Projetos Piloto , Estudos ProspectivosAssuntos
Desenho Assistido por Computador , Desenho de Aparelho Ortodôntico , Tecnologia Odontológica , Colagem Dentária/instrumentação , Colagem Dentária/métodos , Humanos , Aparelhos Ortodônticos Removíveis , Braquetes Ortodônticos , Fios Ortodônticos , Planejamento de Assistência ao Paciente , Técnicas de Movimentação Dentária/instrumentação , Interface Usuário-ComputadorAssuntos
Placas Ósseas , Má Oclusão Classe III de Angle/terapia , Maxila/anormalidades , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico , Tração/instrumentação , Cefalometria/métodos , Criança , Feminino , Seguimentos , Humanos , Mandíbula/patologia , Maxila/patologia , Órbita/patologia , Planejamento de Assistência ao Paciente , Fotografia Dentária , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Resultado do TratamentoRESUMO
UNLABELLED: Recently, there has been a dramatic increase in the use of implantable devices as direct adjuncts to orthodontic treatment. Whereas the use of conventional dental implants has been researched extensively, the body of literature associated with the more recent uses of implantable devices in orthodontics is relatively small. Currently, a limited number of such devices are used to aid in orthodontic treatment. The options include conventional titanium endosseous dental implants, palatal implants, titanium miniscrews (also known as micro- or mini-implants), and mini-bone plates. Integration of dental implants or implantable devices into contemporary orthodontic practice has the following possible advantages: serving as a means of increasing orthodontic anchorage, virtually eliminating patient compliance issues with regard to wearing of appliances, decreasing overall treatment time, and occasionally permitting orthodontic treatments previously thought to be impossible without surgery. CLINICAL SIGNIFICANCE: This article is a review of the currently available options for use of implantable devices as sources of temporary skeletal anchorage in orthodontics.