Efeitos do aparelho de Herbst no tratamento proecoce da má oclusão classe II de Angle

Due to its high prevalence in general population, Angle Class II malocclusion has been widely studied by several authors, as well as the methods for its treatment. Among the possible treatment methods stands out the Herbst appliance. Reintroduced more than three decades ago in the orthodontics community, it became the most utilized appliance because it does not require patient compliance, and provides continued action through bilateral telescopic tubes. The objective of the present article was to demonstrate the early treatment of Class II Division 1 malocclusion with mandibular retrusion using Herbst appliance.

Eficiência do aparelho Herbst bandado na correção da Classe II divisão 1 -relato de caso

The current reports the case of a young patient with malocclusion Class II division 1 on permanent dentition treated in two stages, rthopedics and orthodontics, respectively. At first, the banded Herbst appliance was used duringa 7 months period, followed by a T4K appliance, Trainer for Kids used as retention, and on the second stage the corrective Orthodontics was performed. The results showed the acquirement of a Class I dental relationship, which was kept stable, with excellent intercuspation, even after 5 years of the removal of the Herbst appliance, as well as the correction of the overjet and the reduction of the facial profile convexity. It can be concluded that the Herbst appliance was very efficient in correcting the Class II malocclusion, long term, also providing a very favorable effect on the facial profile.

Fechamento de diastema anterior: associação de procedimentos ortodôntico e restaurador

Several aspects beyond the restorative phase itself such as orthodontic movement and periodontal treatment must be considered in cases of closure of diastemas. In such cases, a multidisciplinary approach is essential. As patients during orthodontic treatment may show high risk of developing dental caries and periodontal disease, inflammation of the gingival tissue is a common finding. For this reason, a preliminary basic periodontal treatment is critical to the success of restorative procedure. In addition, postoperative care and instruction in phonetics, oral hygiene and periodic control must be considered by professionals and patients. Thus, this paper demonstrates through a case report, pre and postoperative issues that should be considered during the closure of diastemas using a layering technique with resin composites

Reaproveitamento imediato da ação expansora em um caso de expansão rápida da maxila assistida cirurgicamente

Immediate reutilization of the expanding action in a case of rapid maxillary expansion surgically assisted. The orthopedic rapid maxillary expansion (RME) and rapid maxillary expansion surgically assisted (RMESA) are conducted with the aim of giving an appropriate jaw, capable of providing a normal occlusion. In extreme cases, where there is a severe atresia, it is necessary to perform an expansion beyond that allowed by the expander, followed by another conventional device or a butterfly expander, when the atresia is in the anterior maxillary region. In this situation, there are two options: wait about 90 days to allow intermaxillary suture restructuring and perform a new RME / RMESA or proceed immediately to the expansion process. Considering the biological cost, financial and clinical time, the procedure of reusing the immediate expander action becomes the technique of choice in these cases, been the operational procedure performed simplified and in just four steps. This work will show a case report where, after accomplishing the RMESA was observed that even after changing the shape of the maxillary arch, the severity of atresia could not be corrected, especially in the anterior region, and more expansion was needed. Aiming to correct the atresia in the anterior maxilla, the technique used was to reuse the immediate expander action through the change of an intraoral screw expander for a conventional butterfly type screw expander.

Tratamento da classe II divisão 2 com aparelho de Herbst após o pico de crescimento puberal

Patients with Class II division 2 malocclusion and mandibular retrusion have limited treatment options after the growth peak, such as surgical-orthodontic treatment or mandibular advancement devices. Among bite-jumping devices, the Herbst appliance allows greater increase of mandibular growth since it does not require patient compliance and allows continuous use. This case report presents the treatment of a Class II division 2 malocclusion in a patient after growth peak, performed in two stages. The first stage included the upper incisors proclination and overjet increase with multibracket appliance to benefit next stage. The second stage involved mandibular advancement using Herbst appliance aiming to correct the Class II molar relationship. The treatment resulted in a stable occlusion with periodontal health, normal functions and facial aesthetics improvement. Dental and skeletal changes arising from treatment could be assessed by cephalometric analysis and superimposition of pretreatment and post-treatment cephalometric tracings. Antero-posterior discrepancy was corrected by means of dental movement as well as by mandibular growth increment stimulated by the Herbst appliance.

External apical root resorption in retracted incisors

AIM: To evaluate the occurrence of external apical root resorption (EARR) in the incisors after anterior retraction in corrective orthodontic treatment with first premolar extractions and whether it was related with the type of root apex movement and its inclination. METHOD: The maxillary and mandibular incisors of 22 patients (12 to 25 years of age; 9 males and 13 females) were treated with fixed appliances and premolar extraction. EARR was defined as the difference in root length before and after incisal retraction on periapical radiographs. Distortion of radiographic images and changes due to incisal tipping were controlled for. Pre- and post-incisal retraction lateral cephalometric radiographs established the relationship between EARR and the tipping of the incisors, along with the vertical, horizontal, and total movement of the root apex. RESULTS: There was significant EARR (1.51 to 2.37 mm) during incisor retraction, but this was not related to the movement or the tipping of the root apex of almost all teeth. It was observed that after the retraction stage, EARR occurred in all evaluated incisors, but it was more significant (P < .05) in the mandibular right lateral incisor. CONCLUSION: The EARR that did occur was unrelated to movement or tipping of the root apex, except for the vertical root apex movement of the mandibular left central incisor and the inclination of the maxillary right lateral incisor.

Alterações dimensionais em pacientes submetidos à expansão rápida da maxila com aparelho do tipo Haas

The maxillary atresia is a alteration in the transverse dimension that can result in a unilateral or bilateral crossbite. For correction of atresia of the upper dental arch appliances with the intent to expand the arch of orthopedic or orthodontic manner are used, obtaining across-compatibility between the dental arches. The purpose of this study was to evaluate the dimensional changes of the maxillary in patients in the mixed dentition with atresia in the upper dental arch, using occlusal radiographs taken before, after rapid maxillary expansion and after removal of the appliance. Methods: the sample consisted of 35 patients who used the appliance type conventional Haas, in the mixed dentition, according to the standard protocol for installation, activation, containment and removal of the appliances rapid maxillary expansion. Results: the results confirm that the suture opening occurs in greater quantities in the anterior (4.3 mm) than posterior to (3.74 mm), representing a triangular opening of 7 degrees on average with the posterior opening 87% of the quantity of anterior opening. The molars region expanded about 5 mm, and the base bone 3.7 mm, representing a 74% bone expansion of the expansion teeth.

Análise tomográfica da articulação temporomandibular no tratamento com Herbst em adulto jovem

Class II malocclusion features a high prevalence in Brazil, being considered as a routine in orthodontic clinics. A number of appliances are shown in the literature in order to correct Class II malocclusion with mandibular retrusion. Herbst´s fixed functional appliance, idealized by Emil Herbst (1905) and reintroduced, in the 1980´s, by Hans Pancherz is highlighted for maintaining the mandible continuously advanced, showing a shorter active treament time, an immediate esthetic impact on the facial profile, as well as requiring no patient´s commitment. Recent researches indicate the use of this appliance in individuals after pubertal growth surge. The aim of the present study is to show the orthodontics practitioner the option to use this appliance so as to treat Class II in individuals after the growth surge, obtaining satisfactory outcomes and further Class II correction.

Aparelho de Herbst associado a aparelhos fixos: descrição de técnica

This paper aims at describeconstruction and installation sequences of a new design of appliance that allows continuously protraction of the mandible, using the telescopic mechanism of the Herbst appliance. This appliance has the advantage to be easily assembled by the orthodontist, without the necessity of molding and the assistance of a specialized laboratory, as well as the constant permanence in the mouth of the patient for being fixed.

Camuflagem ortodôntica com dispositivos de ancoragem temporários ou cirurgia ortognática: parâmetros para a decisão

The polemical discussion between orthodontic therapeutic and surgical approaches with relation to borderline cases receives a new impulse with the emergence of temporary anchorage devices. This branch of Orthodontics has brought new treatment perspectives, but it has still been applied empirically, while the various factors involved in determining and conducting the treatment planning are neglected. The objective of the present study is to identify the several factors to be considered in both forms of treatment in order to provide the orthodontist with information that may contribute for the correct decision.

Parâmetros de força ideal aplicada aos principais movimenetos ortodônticos

The orthodontic movement is a result of the system of forces application and it depends on the response of periodontal tissues to this system. The forces must have a magnitude considered ideal, to has maximum response of tissue without pain or root resorption, and keep the health of the periodontal ligament, during all the tooth movement. Therefore, it seems adequate by means of an available literature to estimate parameters of ideal force, for different types of movements; with intention of assisting the orthodontists in optimum control of the tooth movement and thus to diminish the possibility to generate deleterious effects.

Sistema Essix MTM: uma alternativa estética para a movimentação

The increased interest in orthodontics by adults has led companies to develop new treatment alternatives that use less visible and more aesthetic orthodontic appliances. The aesthetic aligners stand out among the treatment options that attend these expectations. This paper presented some relevant aspects of these devices, as well as two cases treated with Essix MTM (Dentsply) system, in which all aesthetic and functional objectives proposed treatment have been achieved. The results of this study support the idea that, when properly indicated, aesthetic aligners are a viable treatment option within the clinical routine of the orthodontist.

Variáveis que afetam o procedimento de colagem direta ortodôntica: procedimentos clinicos

Direct bonding of orthodontics attachments to the teeth or restoration has become a routine in fixed appliance therapy. The technique used seems to be simple, but meticulous attention to detail and steps, a thorough understanding of factors involved are needed to ensure a successful outcome into different surfaces. It is the purpose of this article to review concerning aspects to orthodontic bonding in enamel and restorations fabricated from different materials; affording assistance to the reader wiser accomplishment and successful procedure.

Aplicação clínica da mola T do grupo B para retração dos dentes anteriores

A TAS (Técnica do Arco Segmentado) representa uma alternativa à mecânica de deslizamento, muitas vezes dificultada pela incerteza da quantidade de força de atrito envolvida em cada sistema de forças utilizado. Nesse contexto, sabe-se que poucos cursos de Ortodontia no Brasil têm ensinado efetivamente a filosofia e o modo de trabalhar com a TAS. Portanto, este trabalho procura elucidar a forma de raciocínio das relaçÕes entre força e momento manipuladas na TAS, bem como mostrar a forma de confecção e utilização de mola "T" do grupo B, onde objetiva-se a movimentação recíproca dos segmentos posterior e anterior e, por fim, apresentar um caso clínico tratado com esse tipo de mecânica.

Confecção e montagem do set-up ortodôntico

Diagnosis and planning stages are critical to the success of orthodontic treatment, in which the orthodontist should have many elements that contribute to the most appropriate decision-making. The orthodontic set-up is an important resource in the planning of corrective orthodontics therapy. It consists of the repositioning of the teeth previously removed from the study dental casts and reassembled on its remaining basis. When properly made, the set-up allows a three-dimensional preview of problems and limitations of the case, assisting in decision-making regarding tooth extractions in cases with problems of space, amount of anchorage loss extent and type of tooth movement, discrepancy of dental arch perimeter, discrepancy of inter-arch tooth volume, among others, indicating the best option for treatment. This paper outlines the most important steps for its confection, an evaluation system and its application in the preparation of orthodontic treatment planning.