Retrospective comparison of dental and skeletal effects in the treatment of Class II malocclusion between Herbst and Xbow appliances.

INTRODUCTION: The purpose of this research was to compare dentoskeletal changes produced by Herbst and Xbow appliances in late mixed/early permanent dentition patients with Class II Division 1 malocclusion to an untreated control group. METHODS: The retrospective cohort consisted of 41 patients treated with the Herbst appliance on average for 14 months (mean age of 11.3 years), 41 patients treated with Xbow appliance on average for 14 months (mean age of 11.11 years), and an untreated control sample of 25 patients followed on average for 21 months (mean age of 11.9 years). All patients had Class II Division 1 malocclusion characteristics. Lateral cephalometric radiographs were taken before and after phase 1 treatment/follow-up. Data were analyzed by an analysis of variance followed by Tukey post-hoc tests. RESULTS: Although there was a high equivalence among the groups in the pretreatment cephalometric values, 4 variables showed differences (U6-FHp, L6-FHp, LAFH, and PP-U1). When comparing the mean changes (before and after phase 1 treatment/follow-up), incisor mandibular plane angle (IMPA), Wits appraisal, L6-FHp, Co-Pog, and PP-U1 measurements showed statistically significant differences. In addition, more relative mesial movement of the mandibular molars (an additional 2.4 mm) and a larger increase in mandibular length (an additional 3.2 mm) was noted for the Herbst group. CONCLUSIONS: Class II correction using Herbst and Xbow occurred in both groups through improvement in the maxillomandibular relationship and labial inclination of the mandibular incisors, as well as a relatively increased mesialization of the mandibular molars. Although both appliances improve occlusal features, the portrayed changes were not always similar. Herbst seems to produce more mandibular size increase over a similar treatment period.

Effectiveness of open bite correction when managing deleterious oral habits in growing children and adolescents: a systematic review and meta-analysis.

BACKGROUND/OBJECTIVES: Oral habits are common etiological factors for anterior open bites (AOBs) in growing children and adolescents. The objective of this review was to provide a literature synthesis evaluating the effectiveness of open bite correction in growing individuals with the use of habit-interception appliances. SEARCH METHODS: Electronic searches were conducted on PubMed, Embase, Cochrane Library, Web of Sciences, Scopus, Google Scholar, Scielo, and Lilacs databases. Trials registries were consulted for ongoing trials, and a partial grey literature search was also conducted. SELECTION CRITERIA: The selection criteria included controlled clinical trials enrolling growing subjects who underwent habit-interception orthodontic treatment to correct dental and/or skeletal AOB. DATA COLLECTION ANALYSIS: Data was grouped and analysed descriptively. A meta-analysis was only possible regarding crib therapy effectiveness. Qualitative appraisal was performed according to Cochrane Risk of Bias tool for randomized clinical trials (RCTs) and the MINORS tool for non-randomized clinical trials (nRCTs). RESULTS: Two RCTs and nine nRCTs were identified. Most of them presented relevant limitations. Crib therapy demonstrated to be effective (+3.1mm overbite correction). However, most of the dental effects are seemingly lost with time; and the skeletal effects are still controversial. Other habit-interception appliances, such as spurs, were not sufficiently investigated. CONCLUSIONS: Crib therapy appears to be effective on a short time basis. As for other habit-interception appliances, insufficient evidence could not provide reliable conclusions.

Effectiveness of the open bite treatment in growing children and adolescents. A systematic review.

BACKGROUND: The extensive literature concerning the early treatment of anterior open bite (AOB) is still controversial and covers a wide variety of therapeutic approaches. OBJECTIVES: The objective of this study was to provide a comprehensive review evaluating the effectiveness of the orthodontic correction of AOB in growing individuals. SEARCH METHODS: Search was conducted on PubMed, Embase, Cochrane Library, Web of Science, Scopus, Google Scholar, Scielo, and Lilacs databases. Trials registries were consulted for ongoing trials, and grey literature was also contemplated. SELECTION CRITERIA: Selection process was performed to include controlled trials enrolling growing subjects who underwent orthodontic treatment to correct AOB and/or hyperdivergent facial pattern. DATA COLLECTION AND ANALYSIS: Data were grouped and analysed descriptively. Qualitative appraisal was performed according to the Cochrane risk of bias tool, for randomized clinical trials (RCTs), and MINORS tool for non-RCTs. RESULTS: The 22 studies included in this review mostly considered mixed dentition subjects, and there was a considerable variation regarding therapeutic approaches. Because of poor-quality and/or insufficient evidence, consistent results were not found. However, some useful clinical inferences and suggestions for future studies were provided for each therapeutic modality considered here. CONCLUSIONS: Additional efforts must still be directed to perform, whenever possible, RCTs; or to conduct prospective controlled trials with adequate sample sizes, consecutively assembled subjects, with the comparison of contemporary and equivalent groups.

Dentoskeletal effects produced by removable palatal crib, bonded spurs, and chincup therapy in growing children with anterior open bite.

OBJECTIVE: To evaluate the dentoskeletal effects of different anterior open bite treatment modalities in children. MATERIALS AND METHODS: This cephalometric study assessed changes resulting from different treatment approaches on 77 growing children with anterior open bite. A control group (n = 30) was used for comparison. Lateral cephalograms were available before treatment and after 12 months. The sample was divided into four groups: removable palatal crib associated with a chincup (G1), bonded spurs associated with a chincup (G2), chincup (G3), and nontreated control (G4). Statistical comparisons among the four groups were performed on T1 and the treatment changes using analysis of variance with Tukey's post hoc tests. RESULTS: No statistically significant changes in skeletal variables were found among the groups, except for lower anterior face height (LAFH) increase in G1. Overall, effects in all of the treated groups were exclusively dentoalveolar. A larger overbite (OB) increase was observed in G1 and G2 when compared with G3 and G4. The maxillary incisors in G1 showed increased palatal tipping, retrusion, and more vertical dentoalveolar development as well as increased lingual tipping among mandibular incisors. There was less vertical development of maxillary and mandibular molars in G3. CONCLUSIONS: A removable palatal crib provided an improvement in OB (97.5%), followed by the bonded spurs (84.5%). Conversely, the chincup-only group did not have positive OB effects.

A multidisciplinary treatment of congenitally missing maxillary lateral incisors: a 14-year follow-up case report.

Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and the teeth, including the presentation of malocclusion and the effect on the occlusion must be considered. The objective of this study was to describe the etiology, prevalence and alternative treatment modalities for dental agenesis and to present a clinical case of agenesis of the maxillary lateral incisors treated by the closure of excessive spaces and canine re-anatomization. A clinical case is presented to illustrate the interdisciplinary approach between orthodontics and restorative dentistry for improved esthetic results. In this report, the treatment of a girl with a Class II malocclusion of molars and canines with missing maxillary lateral incisors and convex facial profile is shown. Treatment was successfully achieved and included the space closure of the areas corresponding to the missing upper lateral incisors, through movement of the canines and the posterior teeth to mesial by fixed appliances as well as the canines transformation in the maxillary lateral incisors. This is a 14-year follow-up case report involving orthodontics and restorative dentistry in which pretreatment, posttreatment, and long-term follow-up records for the patient are presented.

Comparison of mechanical properties of beta-titanium wires between leveled and unleveled brackets: an in vitro study.

BACKGROUND: The objective of this study is to evaluate the force-deflection behavior of beta-titanium alloy wires between two leveled and unleveled bracket alignment scenarios using a three-point bending test. METHODS: Six groups of ten beta-titanium alloy wire segments (0.017 × 0.025-in. diameter) of different manufacturers (Orthometric, Ortho Organizers, GAC, Morelli, and Ormco) were used. Both brackets were bonded to an acrylic jig with a 10-mm interbracket distance. A 1-mm deflection test in two hypothetical conditions (with aligned brackets and by simulating a 2-mm horizontal displacement of the brackets) was explored. Forces of activation and deactivation of the wires during both tests were compared by an analysis of variance (ANOVA) tests followed by a Tukey test. RESULTS: A statistically significant difference was found in the force-deflection behavior between some of the wires in both simulated in vitro conditions. For the leveled-type alignment scenario, the differences between wires were up to 70 g (range 110 to 179 g). For the unleveled-type alignment scenario, these differences were up to 65 g (range 111 to 175 g). CONCLUSIONS: The study showed some significant differences in forces generated during activation and deactivation among the five types of beta-titanium wires tested. In comparing leveled and unleveled brackets during activation, only Orthometric Beta Flexy and Ormco Beta-titanium were different between them.

A multidisciplinary treatment of congenitally missing maxillary lateral incisors: a 14-year follow-up case report

Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and the teeth, including the presentation of malocclusion and the effect on the occlusion must be considered. The objective of this study was to describe the etiology, prevalence and alternative treatment modalities for dental agenesis and to present a clinical case of agenesis of the maxillary lateral incisors treated by the closure of excessive spaces and canine re-anatomization. A clinical case is presented to illustrate the interdisciplinary approach between orthodontics and restorative dentistry for improved esthetic results. In this report, the treatment of a girl with a Class II malocclusion of molars and canines with missing maxillary lateral incisors and convex facial profile is shown. Treatment was successfully achieved and included the space closure of the areas corresponding to the missing upper lateral incisors, through movement of the canines and the posterior teeth to mesial by fixed appliances as well as the canines transformation in the maxillary lateral incisors. This is a 14-year follow-up case report involving orthodontics and restorative dentistry in which pretreatment, posttreatment, and long-term follow-up records for the patient are presented.

Estudo fotoelástico das tensões geradas na unidade de ancoragem utilizando arco de intrusão / Photoelastic study of generated tensions on the anchorage unit using the intrusion archwire

O objetivo primário deste estudo foi avaliar e quantificar, pelo método da fotoelasticidade, a tensão gerada no primeiro molar superior durante o movimento de intrusão dos incisivos superiores com arco de intrusão. Secundariamente, objetivou-se analisar o tipo de movimento dentário ocorrido sobre os primeiros molares, seguido da mecânica de intrusão. Foram utilizados dez modelos fotoelásticos, divididos em dois grupos. No grupo 1 (G1), utilizou-se um arco de intrusão de nitinol pré-fabricado (CIA – Connecticut Intrusion Arch, Ortho Organizers, CA, EUA) de .017” x .025”, enquanto que no grupo 2 (G2), utilizou-se um arco de intrusão de .017” x .025" confeccionado com a liga de titânio-molibdênio (TMA, Morelli, São Paulo, Brasil). A leitura da tensão foi realizada em pontos pré-determinados ao redor do dente 16, por meio de um polariscópio de reflexão. Os resultados foram analisados estatisticamente por meio da análise de variância (Anova) seguido do teste de Tukey, com um nível de significância de 5%. Os resultados revelaram que ambos os arcos de intrusão geraram maior concentração de tensão no terço cervical do primeiro molar superior, apresentando diferença significante entre os pontos de medição da tensão. Apesar de utilizar uma força de ativação inicial similar, comparando-se os dois sistemas de arcos, houve maior liberação de tensão com o arco de intrusão construído em TMA. Na região do terço apical, houve diferença significante entre os pontos de tensão e entre os arcos de intrusão. Concluiu-se que, durante a intrusão dos incisivos superiores, a quantidade de força sobre a unidade de ancoragem liberada pelo arco de intrusão de NiTi foi menor, em comparação ao arco de intrusão confeccionado com a liga de TMA. Além disso, um movimento de tip-back parece ocorrer sobre os primeiros molares superiores com o uso de ambos os arcos de intrusão...

The primary objective of this study was to evaluate and quantify the tension generated in the first molar during the intrusion movement of the upper incisors with an intrusion arch by means of a photoelastic method. Secondly, the objective was to analyze the type of tooth movement occurred on the first molars followed by mechanical intrusion. Ten photoelastic models were divided into two groups. In group 1 (G1), we used a prefabricated Nitinol intrusion arch (CIA – Connecticut intrusion arch, Ortho-Organizers, CA) .017"x .025", while in group 2 (G2), we used an intrusion arch (.017"x .025") made with beta-Titanium Alloy (TMA, Morelli, SP, Brazil). The tension reading was performed at predetermined points around the tooth 16, by means of a reflection polariscope. The results were statistically analyzed by Anova and Tukey tests with a 5% significance level. The results revealed that both intrusion arches generated a greater tension concentration at the cervical third of the first molar, with significant difference between points, but not between the intrusion systems. In the apical third region, there was a significant difference between points and between intrusion arches. It was concluded that during the intrusion of the upper incisors, the amount of force on the anchorage unit released by NiTi intrusion arch was lower compared to the intrusion arch made with TMA alloy. It seems that a tip-back movement of the upper first molars occurred during the use of an intrusion arch...

Distalizador com ancoragem máxima, eliminando a dependência do paciente. Parte II / Absolute anchorage provided by an orthodontic device for teeth distalization without relying on the patient's cooperation. Part II

Um dos principais efeitos colaterais dos distalizadores intrabucais é a projeção dos dentes anteriores, aumentando, assim, o tempo de tratamento. Esse trabalho tem como objetivo apresentar uma modificação do Pendulum, aparelho para a correção da má oclusão de Classe II de Angle, já consagrado na Ortodontia, promovendo a distalização dos molares, sem ocasionar a perda de ancoragem dos dentes anteriores. A apresentação desse caso clínico evidencia uma Classe II de Angle completa, sendo um tratamento que gera uma grande dificuldade de correção sem extração, ou que depende do paciente usar elásticos. Serão mostradas suas características, vantagens e sua simples confecção.