External control of fluoridation in the public water supplies of Brazilian cities as a strategy against caries: a systematic review and meta-analysis.

BACKGROUND: Among the methods currently available to provide fluoride in population levels, fluoridated water is the most successful for presenting high efficacy, safety and good cost-benefit. However, recent studies on external control have shown great variability of fluoride concentrations in the water from treatment stations in Brazilian cities, which must present concentration between 0.6 and 0.8 mg/L to be considered acceptable in most cities. Thus, this study aimed to perform a systematic review of the literature to assess the adequacy of fluoride concentration in the water in Brazilian cities using external control. METHODS: The protocol was registered in PROSPERO. Six databases were used as primary search sources and three databases were used to partially capture the "gray literature". Only observational studies that assessed the fluoride concentration of artificially fluoridated water from the public supply network were included. The JBI Critical Appraisal Tools for Systematic Reviews was used to assess the risk of bias of the studies. A proportion meta-analyses using random-effect models were performed. The heterogeneity between studies was determined by I2 statistic. Meta-regressions were conducted to identify relevant moderators to be used in stratified meta-analyses. Publication bias was investigated by Egger's tests. RESULTS: The search provided 2038 results, from which 14 met the eligibility criteria and were included in the data extraction of the review. Overall, the water samples were collected from 449 different sources in three Brazilian regions. Thirteen studies presented a low risk of bias. The mean concentration of fluoride ranged from 0.17 to 0.89 ppmF. The meta-analyis demonstrated that more than half of the water samples analyzed had fluoride concentration levels outside the acceptable range (56.6%; 95% CI 45.5; 67.3), with high heterogeneity. CONCLUSION: More than half of the public water supply analyzed in the studies selected had fluoride concentration levels outside the acceptable range, which may affect the risk of developing oral diseases in the Brazilian population, having an important impact on public health.

Interleukin-31 promotes pathogenic mechanisms underlying skin and lung fibrosis in scleroderma.

OBJECTIVES: Cytokines released by infiltrating T cells may promote mechanisms leading to fibrosis in scleroderma. The aim of this study was to investigate the role of the Th2 cytokine IL-31, and its receptor IL-31RA, in scleroderma skin and lung fibrosis. METHODS: IL-31 was measured by ELISA of plasma, and by immunochemistry of fibrotic skin and lung tissue of scleroderma patients. The receptor, IL-31RA, was assayed by qPCR of tissue resident cells. Next-generation sequencing was used to profile the responses of normal skin fibroblasts to IL-31. In wild-type Balb/c mice, IL-31 was administered by subcutaneous mini pump, with or without additional TGFß, and the fibrotic reaction measured by histology and ELISA of plasma. RESULTS: IL-31 was present at high levels in plasma and fibrotic skin and lung lesions in a subset of scleroderma patients, and the receptor overexpressed by downstream cells relevant to the disease process, including skin and lung fibroblasts, through loss of epigenetic regulation by miR326. In skin fibroblasts, IL-31 induced next generation sequencing profiles associated with cellular growth and proliferation, anaerobic metabolism and mineralization, and negatively associated with angiogenesis and vascular repair, as well as promoting phenotype changes including migration and collagen protein release via pSTAT3, resembling the activation state in the disease. In mice, IL-31 induced skin and lung fibrosis. No synergy was seen with TGFß, which supressed IL-31RA. CONCLUSION: IL-31/IL-31RA is confirmed as a candidate pro-fibrotic pathway, which may contribute to skin and lung fibrosis in a subset of scleroderma patients.

Efficiency of bimaxillary advancement surgery in increasing the volume of the upper airways: a systematic review of observational studies and meta-analysis.

Postsurgical changes of the airways have become a great point of interest because it has been reported that maxillomandibular advancement surgery can improve or eliminate obstructive sleep apnea; however, its treatment effectiveness is still controversial. The purpose of this systematic review and meta-analysis was to assess the effectiveness of maxillomandibular advancement surgery to increase upper airway volume in adults, comparing before and after treatment. Bibliographic searches of observational studies with no restriction of year or language were performed in the electronic databases PubMed, Scopus, ScienceDirect and SciELO for articles published up to April 2015. After verification of duplicate records, 1860 articles were examined. Of these, ten met the eligibility criteria, of which three were excluded for having poor methodological quality. The other seven articles were included in the systematic review and six in the meta-analysis, representing 83 patients. One study whose data were not given in absolute values was excluded from the meta-analysis. The meta-analysis showed a statistically significant difference between the averages of upper airway volume before and after surgery {7.86 cm3 [95 % CI (6.22, 9.49), p = 1.00)}. Clinical evidence suggests that the upper airway volume is increased after maxillomandibular advancement surgery.

Distalization controlled with the use of lip-bumper and mini-screw as anchorage: a new approach.

An increasingly number of patients with Angle Class II has been seeking orthodontic clinics to have their malocclusion treated. Herein, it is presented a new method of promote distal movements in maxillary molars with a combination of limp-bumper (LB) and mini screw. This technique was proven to be fast, practical and with low-cost, thus favoring both the professional and the patient.

The use of Twin Force functional fixed orthopedic appliance in the treatment of Class II division 1 malocclusion.

Fixed protruding appliances are interesting tools for correction of Class II dental malocclusion in adult and growing patients. The appliances most commonly used for this purpose are: Herbst, Forsus and Jasper Jumper. The present clinical case report shows an alternative called Twin Force Bite Corrector which was used for 3 months by a patient aged 10 years and 6 months associated with the Andrews prescription fixed appliance (Abzil 3M). After treatment, malocclusion was found to be adjusted to Class I dental occlusion in a single stage.

The effects of miniscrew-assisted rapid palatal expansion on the upper airway of adults with midpalatal suture in the last two degrees of ossification.

BACKGROUND: Transverse deficiencies of the maxillary basal bone have been treated in adult patients using miniscrew-assisted rapid palatal expansion (MARPE) therapy. However, the midpalatal suture's degree of ossification may affect the upper airway dimensions. This study compared the volumetric changes of the total upper, retropalatal, retroglossal airways, and the minimal transverse airway constriction after MARPE therapy in patients with midpalatal suture in the last stages of ossification. METHODS: This controlled clinical trial included a total of 20 adult patients (mean age 24.5 ± 6.2 years) with maxillary atresia treated with MARPE. Preoperative (T0) cone-beam computed tomography scans were used to determine the degree of midpalatal suture ossification. Two groups were formed considering the last two stages of sutural ossification "D" or "E" (n = 10 per group). After 120 days of the therapy (T1), cone-beam computed tomography assessments were performed to compare the pre and post-treatment outcomes. The total upper, retropalatal, and retroglossal airways and the minimal transverse airway constriction were evaluated. The three-dimensional reconstruction was performed with OsiriX MD software. The comparisons were carried out using mixed models for repeated measures at fixed time points (α = 0.05). RESULTS: Groups D and E showed no significant difference for any of the analyzed parameters (P > 0.05). Both groups showed a statistically significant increase for all airway segments after the treatment with MARPE (P < 0.05). The total upper airway increased (11.6% and 16.1%) for groups D and E, respectively (P = 0.3356). CONCLUSIONS: MARPE therapy resulted in dimensional gains of the upper airway for adult patients, irrespective of the intermaxillary sutural degree of ossification.

Cytokine pattern in very early rheumatoid arthritis favours B-cell activation and survival.

OBJECTIVES: B cells play an important role in the perpetuation of RA, particularly as autoantibody-producing cells. The ICs that further develop deposit in the joints and aggravate the inflammatory process. However, B-cell contribution in the very early stage of the disease remains unknown. The main goal of this work was to determine the concentration of cytokines potentially relevant for B-cell activation in serum from very early polyarthritis patients, with <6 weeks of disease duration, who latter on evolved into very early RA (VERA). METHODS: A proliferation-inducing ligand (APRIL), B-cell activating factor (BAFF) and IL-21 levels were measured by ELISA in the serum of VERA, other very early arthritis (VEA), established RA patients and controls. SF samples of established RA were also analysed. RESULTS: VERA patients have higher levels of APRIL and BAFF as compared with VEA, established RA and controls. Furthermore, APRIL and BAFF levels are also significantly elevated in RA-SF when compared with serum. CONCLUSIONS: The increased levels of APRIL and BAFF in VERA patients suggests that B-cell activation and the development of autoreactive B-cell responses might be crucial in early phases of RA. Therefore, APRIL and BAFF could be promising targets for therapy in the early phase of RA.

Soft-tissue cone-beam computed tomography (ST-CBCT) technique for the analysis of skeletal, dental and periodontal effects of orthopedic rapid maxillary expansion.

BACKGROUND: Orthopedic rapid maxillary expansion (RME) is a common treatment of choice for managing transverse deficiency of the maxilla. This approach may have desired and undesired skeletal, dental and periodontal effects that may be assessed clinically or through imaging techniques. This study aims to investigate the dental, skeletal and periodontal effects of orthopedic RME using the soft-tissue cone-beam computed tomography (CBCT) technique. MATERIAL AND METHODS: The sample consisted of 10 patients (5males and 5 females) aged between 10 and 14 years (mean age: 12.5 years) treated with Hyrax orthopedic device. CBCT scans set for the registration of soft tissue (ST-CBCT) were taken from each patient before (T1) and 120 days after (T2) RME. Skeletal (n=10), dental (n=1) and periodontal (n=4) parameters measured in ST-CBCT were compared between T1 and T2 using t-test within a significance level of 5%. RESULTS: The skeletal parameters with statistically significant increase (p<0.05) in T2 were the width of the buccal alveolar bone crest, the external width of the dental arch at the level of buccal cusps, and the width of the dental arch at the level of most prominent dental surface contour. Representing the dental parameter, the inclination of the anchor teeth was statistically significant for premolars (p<0.05). The only statistically significant outcome in periodontal parameters was the decrease in buccal bone plate thickness of first molars (p<0.05). CONCLUSIONS: Dentists must be aware of the ST-CBCT technique for the analysis of hard and soft tissue after orthodontic and orthopedic treatments. This technique revealed that the RME reached optimal skeletal and dental effects with minimal periodontal side effects. Key words:Cone-beam computed tomography, imaging, orthodontics, orthopedics.

Can 10% hydrofluoric acid be used for reconditioning of orthodontic brackets?

CONTEXT: Bracket debonding is a common problem during orthodontic treatment. This type of failure is associated to masticatory forces, poor adhesion, and the need for repositioning the piece. AIMS: The objective of this work was to compare the shear bond strength of debonded brackets that were reconditioned using different protocols (alumina blasting versus hydrofluoric etching). SETTINGS AND DESIGN: This was an in vitro experimental study with 45 stainless steel orthodontic brackets. SUBJECTS AND METHODS: They were randomly divided into three groups: (1) New brackets (n = 15), (2) brackets reconditioned using 10% hydrofluoric acid for 60 s (n = 15), and (3) brackets reconditioned by aluminum oxide blasting until complete removal of the remaining resin (n = 15). In Groups 2 and 3, the insertion of composite resin proceeded in two stages to simulate a type of bracket failure in which the bonding resin was left at the bracket base. For the shear test, the assembly composed by the metallic support, and specimen was taken to the Instron universal testing machine in which the specimens were loaded using a semicircle-shaped active tip in the region of the bonding interface parallel to the surface of the bracket at a speed of 0.5 mm/min. STATISTICAL ANALYSIS USED: The data were subjected to D'Agostino's normality test to have their distribution checked. Analysis of variance and Tukey's test (P < 0.01) were used to compare the findings between groups. RESULTS: The results indicated that Group 1 (new brackets) showed higher bond strength than that obtained for the group treated with hydrofluoric acid (Group 2, P < 0.01). The bond strength value obtained for the group treated with alumina blasting (Group 3) was statistically similar to those obtained for Groups 1 and 2. CONCLUSIONS: The aluminum oxide blasting technique was effective for the reconditioning of orthodontic brackets. Nevertheless, the reconditioning technique using 10% fluoridric acid for 60 s was not efficient for clinical use.

Comparative analysis of force degradation of latex orthodontic elastics of 5/16'' diameter: an in vitro study.

BACKGROUND: this study aimed to analyze, six commercial brands of latex elastics regarding force degradation according to time, immediately and in time intervals of 12, 24, 48, and 72 hours. METHODS: the elastics were stretched by three times their diameter, measured, immersed in artificial saliva at 37 °C, and stored in a glass container. Data obtained were described by mean parameters, standard deviation, degradation rate, and coefficient of variation and Tukey's post hoc test (p<0.05). RESULTS: American OrthodonticsTM was the brand closest to prescription (94.70%), and UnidenTM was the one with the lowest performance (73.60%). By analyzing the total force degradation rate at the end of the experiment, it is noted that elastics from the OrthometricTM brand presented the highest rate (20.24%). CONCLUSIONS: it is concluded that the latex elastics studied suffer great intensity variation of initial force, and the higher variation rate occurs in the first 12 hours.

Comparative analysis of force degradation of latex orthodontic elastics of 5/16'' diameter: an in vitro study.

BACKGROUND: This study aimed to analyze six commercial brands of latex elastics regarding force degradation based on the time factor, in time intervals of 12, 24, 48, and 72 hours. METHODS: The elastics were stretched by three times their diameter, measured, immersed in artificial saliva at 37° C, and stored in a glass container. Data obtained were described by mean parameters, standard deviation, degradation rate, and coefficient of variation and Tukey's post-hoc Test (P<0.05). RESULTS: American Orthodontics™ was the brand closest to prescription (94.70%), and Uniden™ was the one with the lowest performance (73.60%). By analyzing the total force degradation rate at the end of the experiment, it is noted that elastics from the Orthometric™ brand presented the highest rate (20.24%). CONCLUSIONS: It is concluded that the latex elastics studied suffer great intensity variation of initial force, and the higher variation rate occurs in the first 12 hours.

Determination of vertical characteristics with different cephalometric measurements.

OBJECTIVE: To analyze a possible correlation between different measures in the definition of vertical facial types. MATERIALS AND METHODS: This is an analytical observational study about 95 lateral teleradiographs of Caucasian individuals with normal occlusion, of which 54 were male (56.84%) and 41 female (43.16%), aged between 15 years and 2 months old and 21 years and 4 months old. Facial types were divided into dolichofacial, mesofacial, and brachyfacial, according to the standards established by different authors. A relationship between these measurements was verified using total agreement analysis and the Kappa method, with the interpretation suggested by Landis and Koch. RESULTS: Kappa was considered fair for Jarabak X VERT (0.22 and 60%) and slight for Jarabak X SN. GoGn (0.06 and 36.8%). CONCLUSIONS: Cephalometric studies often present different interpretations on the description of vertical facial types. In this study, the lowest agreement was between Jarabak and SN.GoGn. Such difference in interpretation may lead to distinct therapeutic approaches and thus different results.

Surgical Maxillary Advancement Increases Upper Airway Volume in Skeletal Class III Patients: A Cone Beam Computed Tomography-Based Study.

STUDY OBJECTIVES: Although volumetric changes of the upper airway occur following surgical advancement of the maxilla, few studies investigated these changes using three-dimensional imaging techniques. Thus, the goal of this study was to verify whether the surgical advancement of the maxilla affects the volume of the upper airway and to determine any association of these volume changes with sex and age. METHODS: Preoperative and postoperative cone-beam computed tomography (CBCT) scans of 14 patients (8 male and 6 female) who underwent maxillary advancement to correct skeletal class III deformities were assessed to determine the postoperative volumetric changes in the upper airway. Preoperative and postoperative airway volume measurements were compared by means of paired t-test, which was also used to compare airway volume between genders. Pearson correlation coefficient was used to verify whether a correlation between age and upper airway volume was present. RESULTS: Maxillary advancement produced significant upper airway volume increases (mean 20.94%, p < 0.05) on nearly half of our sample. However, sex and age did not seem to influence upper airway volume in our sample of skeletal class III patients. CONCLUSIONS: Surgical advancement of the maxilla may produce significant volume increases in the upper airway of skeletal class III patients regardless of sex and age.

Pleasantness of facial profile and its correlation with soft tissue cephalometric parameters: Perception of orthodontists and lay people.

OBJECTIVE: This study was aimed to evaluate the perception of orthodontists and of lay people about the facial profile and its possible correlation with cephalometrics parameters. MATERIALS AND METHODS: A total of 20 evaluators were divided into two groups (10 orthodontists and 10 people with no relation to such area - lay people). They were asked to evaluate the photographs of 25 young males and of 25 young females, aged 17-24-year-old (mean age of 22.3 years, standard deviation 2.41 years). Photographs were randomly arranged in a photo album. The evaluators rated each photograph by means of a scale ranging from "good" to "deficient" based on the pleasantness of their facial profile. Nasolabial angle, Holdaway's H-line and the distance from H-line to nose tip were measured, in order to verify a possible relation between these soft tissue profile cephalometric measurements and the subjective ratings. RESULTS: The kappa statistics test showed a concordance of 0.23 among orthodontists and 0.24 among lay people. Regarding the perception of orthodontists and lay people on facial profile, no significant divergence could be detected. For the correlation between cephalometric parameters and subjective ratings, there was a statistically significant correlation between the measures H and H-nose and the rating ascribed to the profile. CONCLUSIONS: It was concluded that smaller the difference from the normal cephalometric pattern, the higher was the rating given to the profile, demonstrating an important relation between subjective and objective criteria.

Pancreatic digestive enzymes are potent generators of mediators for leukocyte activation and mortality.

Shock is associated with a dramatic rise in the level of inflammatory mediators found in plasma. The exact source of these mediators has remained uncertain. We recently examined a previously undescribed mechanism for production of inflammatory mediators in shock involving pancreatic digestive enzymes. The current in vitro study was designed to identify particular pancreatic enzymes and organs that may potentially produce inflammatory mediators. A selection of different organs from the rat (heart, liver, brain, spleen, pancreas, intestine, diaphragm, kidney, and lung) were homogenized and incubated with purified trypsin, chymotrypsin, elastase, lipase, nuclease, or amylase and the supernatant was incubated with fresh naïve leukocytes for 15 min. The level of leukocyte activation in the form of pseudopod formation and the fraction of cell death were measured. Without the addition of purified enzymes, only the homogenate of the pancreas yielded enhanced cell activation. Organs incubated with physiological concentrations of trypsin also stimulated significantly higher levels of pseudopod formation as compared with the undigested organs or enzymatic controls. Lipase and chymotrypsin were able to elicit cellular activation from selected organs such as the heart, intestine, liver and diaphragm. Undigested pancreatic homogenates were capable of producing substantial cell death, as compared with all other undigested organs. Intestinal digests with elastase, lipase, trypsin and chymotrypsin also stimulated significant cell mortality. Lipase-treated heart, liver, intestine, diaphragm, kidney, and lung stimulated cell death as well. We conclude that the intestine, as well as several other organs, may serve as a major source of inflammatory mediators during shock if exposed to digestive enzymes.

Pancreatic enzymes sustain systemic inflammation after an initial endotoxin challenge.

BACKGROUND: Sepsis is accompanied by severe inflammation whose mechanism remains uncertain. We recently demonstrated that pancreatic proteases in the ischemic intestine have the ability to generate powerful inflammatory mediators that can be detected in the portal vein and in the general circulation. This study was designed to examine several circulatory and inflammatory indices during experimental endotoxemia and intraintestinal pancreatic protease inhibition. METHODS: Immediately after intravenous endotoxin administration, the small intestine was subjected to intraluminal lavage with and without gabexate mesilate, an inhibitor of pancreatic proteases. Shams and rats without lavage served as controls. Hemodynamics, leukocyte (neutrophil and monocyte), and endothelial cell activation, as well as organ injury in the intestine and the cremaster muscle, were examined. RESULTS: After endotoxin administration, control rats developed hypotension, tachycardia, hyperventilation, and leukopenia. The intestine and plasma contained mediators that activated leukocytes. The leukocyte-endothelial interaction within the cremaster muscle microcirculation was enhanced. Endotoxin administration resulted in elevated interleukin-6 plasma levels. Histologic evidence indicated liver and intestinal injury. In contrast, blockade of pancreatic proteases in the intestinal lumen significantly improved hemodynamic parameters and reduced all indices of inflammation in plasma and cell injury in skeletal muscle microcirculation. CONCLUSIONS: Inflammatory mediators derived from the intestine by pancreatic proteases may be involved in the prolonged inflammatory response and sustain symptoms of sepsis after endotoxin challenge.

[Biohemorheologic factors and cardiovascular events curve in survivors of transmural acute myocardial infarct--24-month follow-up]. / Factores biohemorreológicos e a curva de eventos cardiovasculares em sobreviventes de enfarte agudo do miocárdio transmural--24 meses de seguimento clínico.

INTRODUCTION: Previous reports have shown several biohemorheological disturbances in acute myocardial infarction (AMI), either in the acute phase and after hospital discharge. There is no clearly established relationship between these parameters and the patients' clinical outcome. OBJECTIVE: To evaluate in transmural AMI survivors, a relationship between biohemorheological parameters and the cardiovascular events curve during a 24 month follow-up period. METHODS: Sixty-four consecutive patients (58.0 +/- 12.0, 59 men), transmural AMI survivors (30 anterior and 34 inferior) were included in the study. Clinical follow-up was 24 months (at 6, 12 and 24 months). The following cardiovascular events (CVE) were collected: cardiovascular death, stroke, AMI, unstable angina, embolism. We determined, at hospital discharge, these biohemorheological parameters: plasma viscosity, fibrinogen, PAI-1 inhibitor, leukocyte count, C protein (C Pt), erythrocyte aggregation (EA). For each parameter we determined the 25, 50 and 75 percentiles and other significant cut-off point, grouping patients according to these values. STATISTICS: Group t test, Kaplan-Meier survival curve (with the log rank test), and Cox logistic regression. RESULTS: (1) Patients with CVE (n = 19) during the 24 months of clinical follow-up had at hospital discharge higher leukocyte count (p < 0.001), lower C Pt (p < 0.01) and lower EA (p < 0.05). (2) The higher the percentile of the leukocyte count higher the probability for a CVE. Patients with leukocyte count above the 50 percentile had 6 times more CVE (p < 0.01); (3) The higher the C Pt lower the risk for a CVE. Patients with C PT lower than the 50 percentile had 9 times more risk for a CVE (p < 0.01), and those above the 75 percentile had no CVE (p < 0.01). (4) For the EA we identified a cutoff point (= 14.5), independent of the percentiles values. Patients with EA below 14.5 had six times more CVE. By multivariate analyses, we identified leukocyte count and C Pt as independent risk predictive factors (p < 0.05). CONCLUSION: In this group of transmural MI survivors a relationship was established between some biohemorheological (leukocyte count, C Pt, EA) and the CVE curve during 24 months of clinical follow-up.

Long-term prognostic value of the hemorheological profile in transmural myocardial infarction survivors: 60-month clinical follow-up.

UNLABELLED: Previous reports have shown several hemorheological and hemostatic abnormalities in acute coronary syndrome survivors. Some of these abnormalities were related to cardiovascular events during a 24-month follow-up. The aim of the present work is to evaluate, in transmural myocardial infarction survivors, the long-term (60 months) prognostic value of the biohemorheological profile determined at hospital discharge. Sixty-four patients (59 men), mean age of 58 +/- 12.0 years, transmural myocardial infarction survivors, were prospectively studied for 60 months (32.0 +/- 17 months, median 33 months). The following cardiovascular events (CVE) were analyzed: death, non-fatal infarction, unstable angina, and stroke. Twenty-nine patients had a CVE (nine died). The following parameters were determined at hospital discharge: plasma viscosity, whole blood viscosity, erythrocyte membrane fluidity, erythrocyte aggregation, protein C, plasminogen inhibitor type I (PAI-1), leukocyte count and elastase. The quartiles were determined for each parameter, grouping patients according to these values. STATISTICS: Group-t-test, Kaplan-Meier survival curve (with log rank test), and Cox logistic regression. RESULTS: 1) Leukocyte count (p < 0.01), protein C activity (p < 0.05) and erythrocyte membrane fluidity (p < 0.05) were predictors of the CVE curve; 2) The higher the value of the leukocyte count quartile, the higher the risk for a CVE (p < 0.05). Patients with a leukocyte count above the median had 4 times more risk for a CVE; 3) The lower the protein C activity, the higher the risk for a CVE. Those with protein C activity lower than the lowest quartile had double the risk; 4) The higher the membrane polarization value (membrane rigidity), the higher the risk of a CVE; 5) By multivariate analysis the 3 parameters were independent predictors of a CVE. CONCLUSION: In the present group of transmural myocardial infarction survivors a close relationship was established between hemorheologic, hemostatic and inflammatory factors and the cardiovascular events curve during long-term follow-up.

Evaluation of changes in clinical crown length of lower anterior teeth after treatment with Frankel-2's appliance.

PURPOSE: The aim of this study was to test the null hypothesis that there is no change in the lower anterior teeth's crown size when measured just after the treatment with Frankel-2's orthopedic appliance and in a long-term posttreatment follow-up. MATERIALS AND METHODS: The sample was composed of 34 plaster models belonging to 9 male and 8 female individuals, treated at the College of Health, Methodist University of São Paulo, São Bernardo do Campo, São Paulo, Brazil, with mean age of 12 years and 6 months (standard deviation [SD] =7 months) at T1 (end of the treatment with Frankel-2's function regulator), and 19 years and 8 months (SD = 7 months) at T2 (7.11 years after the end of the treatment). RESULTS: The distance from the incisal edge to the most concave portion of the gingival margin of the lower incisors and canines was measured using a digital caliper. Data analysis was carried out by means of Student's t-test and paired-t test. Among the lower anterior teeth, the teeth 31, 33, 42 and 43 showed a statistically significant increase in their crown length, whereas the teeth 32 and 41 showed no changes. CONCLUSION: It can be concluded that there is a tendency to increase the clinical crown of lower anterior teeth throughout the years after the mandibular advancement treatment by using functional devices, rejecting the null hypotheisis.