Estudo cinesiográfico da deglutição em indivíduos com dentição natural e com próteses totais

Pós-graduação em Reabilitação Oral - FOAR

Estudo comparativo da degradação de forças geradas por elásticos ortodônticos sintéticos e molas de níquel-titânio

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência das etapas clínicas da prótese total sobre a separação maxilomandibular durante a pronúncia do som /s/ e a deglutição

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion

Objective: To analyze the long-term skeletal and dentoalveolar effects and to evaluate treatment timing of Class II treatment with functional appliances followed by fixed appliances.Materials and Methods: A group of 40 patients (22 females and 18 males) with Class II malocclusion consecutively treated either with a Bionator or an Activator followed by fixed appliances was compared with a control group of 20 subjects (9 females and 11 males) with untreated Class II malocclusion. Lateral cephalograms were available at the start of treatment (mean age 10 years), end of treatment with functional appliances (mean age 12 years), and long-term observation (mean age 18.6 years). The treated sample also was divided into two groups according to skeletal maturity. The early-treatment group was composed of 20 subjects (12 females and 8 males) treated before puberty, while the late-treatment group included 20 subjects (10 females and 10 males) treated at puberty. Statistical comparisons were performed with analysis of variance followed by Tukey's post hoc tests.Results: Significant long-term mandibular changes (Co-Gn) in the treated group (3.6 mm over the controls) were associated with improvements in the skeletal sagittal intermaxillary relationship, overjet, and molar relationship (similar to 3.0-3.5 mm). Treatment during the pubertal peak was able to produce significantly greater increases in total mandibular length (4.3 mm) and mandibular ramus height (3.1 mm) associated with a significant advancement of the bony chin (3.9 mm) when compared with treatment before puberty.Conclusion: Treatment of Class II malocclusion with functional appliances appears to be more effective at puberty. (Angle Orthod. 2013;83:334-340.)

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.

Influência do ciclo de sinterização da porcelana na adaptação marginal de infraestruturas de NiCrTi em função da biomecânica do preparo

A metal coping may undergo changes during porcelain firing, which compromises its marginal adaptation. The use of NiCrTi alloy proposes to minimize this effect through the high melting point of titanium present in its composition. This study evaluated the influence of porcelain firing cycle on the marginal adaptation of NiCrTi copings in different preparation designs. Forty standardized metal dies were fabricated with the following combinations finish line/convergence of the axial walls: 1) shoulder/6°; 2) shoulder/20°; 3) sloping shoulder/6°; 4) sloping shoulder/20°. On each die a metal ceramic restoration coping was made. The die/coping set was stabilized with orthodontic elastics, divided into four equidistant areas with three measurement points each and a cementation pressure was simulated. The measurements were taken under a stereomicroscope (32×). After the first measurement, the copings were submitted to sintering cycles simulating porcelain application. For repeated measurements, the same procedures described above were performed. Data were submitted to Student’s-t test, 1-way ANOVA and Tukey´s test (α = 0.05). Adaptation means (µm) before and after porcelain firing in different preparations were: 1) 111.92 and 127.31; 2) 124.15 and 135.48; 3) 122.19 and 138.77; 4) 166.09 and 186.72; respectively. The porcelain firing impaired adaptation, regardless of the preparation design. The preparation in a 20° sloping shoulder provided a worse adaptation when compared with preparations that had 6° and 20° shoulder, which were statistically equal. The 6° sloping shoulder was statistically equal to the other three preparation designs.

Fixation of mandibular fractures with 2.0-mm miniplates: review of 191 cases

Our goal was to study the use of 2.0-mm miniplates for the fixation of mandibular fractures. Records of 191 patients who experienced a total of 280 mandibular fractures that were treated with 2.0-mm miniplates were reviewed. One hundred twelve of those patients, presenting 160 fractures, who attended a late follow-up were also clinically evaluated. Miniplates were used in the same positions described by AO/ASIF. No intermaxillary fixation was used. All patients included had a minimum follow-up of 6 months. Demographic data, procedures, postoperative results, and complications were analyzed. Mandibular fractures occurred mainly in males (mean age, 30.3 years). Mean follow-up was 21.92 months. The main etiology was motor vehicle accident. The most common fracture was the angle fracture (28.21%). Twenty-two fractures developed infection, for an overall incidence of 7.85%. When only angle fractures are considered, that incidence is increased to 18.98%. Although only 1 patient (0.89%) described inferior alveolar nerve paresthesia, objective testing revealed sensitivity alterations in 31.52% of the patients who had fractures in regions related to the inferior alveolar nerve. Temporary mild deficit of the marginal mandibular branch was observed in 2.56% of the extraoral approaches performed and 2.48% presented with hypertrophic scars. Incidence of occlusal alterations was 4.0%. Facial asymmetry was observed in 2.67% of the patients, whereas malunion incidence was 1.78%. Fibrous union, mostly partial, occurred in 2.38% of the fractures, but only 1 of those presented with mobility (0.59%). Condylar resorption developed in 6.25% of the fixated condylar fractures. Mean mouth opening was 42.08 mm. The overall incidence of complications, including infections, was similar to those described for more rigid methods of fixation.

Técnicas de obtenção da posição de relação central em pacientes edêntulos

Edentulism causes loss of horizontal intermaxillary relationship, which is defined by the condyle position in the joint cavities, called centric relation. The correct record of centric relation in edentulous pacients has a strong influence on the treatment final result and is considered one of the most difficult clinical steps to achieve success. The aim of this study was to describe the main centric relation recording methods for edentulous patients reported in the literature. The study described physiological methods such as swallowing and pull tongue back, manipulative and graphic methods. It is concluded that the combination of different methods facilitates the correct centric relation record. Dentists must have a good knowledge of those techniques to perform this procedure satisfactorily.

Uso de sistema de retenção magnético como opção de tratamento para solução de caso com espaço interoclusal reduzido

The treatment with overdenture supported by tooth consists in complete or partial removable prosthesis confection in which some satisfactory tooth are maintained and used to aiding retention associated with any retention system. The purpose of this case report is to show the use of magnet attachment in the confection overdenture to improve the oral rehabilitation in cases with restricted intermaxillary space. The treatment was considered successful by the patient and no need for excessive alteration in the prosthesis was required in the follow-up period of 6 months.

Parafunção severa: reabilitação oral com prótese total mandibular x overlay maxilar: relato de caso

In many oral rehabilitation professionals seeking venture renew people smile. However, these procedures have functional implications and aesthetic criteria which must be satisfied so that the final result is predictable. The restoration of relations intermaxillary, phonetics, masticatory function, esthetics and patient comfort are the goals to be achieved. An effective way to achieve these goals when immediate reconstruction with permanent dentures is not possible, make use of a type of partial denture called overlay. Bruxism is a manifestation of biopsychological imbalance that affects the stomatognathic system, characterized by clenching and / or attrition of teeth together so centric or eccentric, can be manifestation of nocturnal or diurnal. Its effects can manifest themselves in different parts of the stomatognathic system, varying the severity of the damage as the resistance of the structures affected, the time of existence, its regularity and the general state of the wearer. The description of the steps followed in solving this case, in which the patient edentulous mandibular arch while the maxillary arch showed absence of teeth 16 and 26 and, except for the teeth 17 and 27, all other teeth showed wear very sharp in the sense denoting incisal cervical, severe impairment of the vertical dimension, the quality of masticatory function and a marked impairment phonetic, this case report aims to guide the beginning of a rehabilitation, as well as the transitional phase of treatment for recovery of functional and aesthetic relationships intermaxillary .

Diastemas: reestablishment of an attractive smile

A healthy and attractive smile is very valued in today s society. Yet this requires better aesthetic and cosmetic solutions from dental surgeons.The present paper presents a case report of diastema closure using an association of tooth movement induced by orthodontic elastics,dental cosmetics and resin-bonded prosthesis. The female patient L.B.A.J., aged 19 years, visited the Integrated Clinic of Araçatuba DentalSchool UNESP mainly complaining of missing teeth and poor esthetics. After anamnesis, clinical and radiographic examination revealedhypodontia of the maxillary right and left first premolars, abnormal maxillary right lateral incisor shape and diastema between the maxillaryright lateral incisor and canine and between the maxillary left lateral incisor and canine. Planning was done which included indication ofdiastema closure with composite resin restoration and metal-free resin-bonded prosthesis, with a structure made of Vectris (Ivoclar VivadentInc., Amherst, NT, USA). The option for dental cosmetics associated with resin-bonded prosthesis after movement with orthodontic elasticsresulted in an excellent aesthetic outcome of low cost and short treatment duration.Indexing terms: composite resins; diastema; fixed resin bonded partial denture.