Aparelho extrabucal como recurso auxiliar para alinhamento e nivelamento no tratamento orto cirúrgico de má oclusão classe III esquelética

When well indicated, the orthodontic surgical approach is the ideal treatment mean for Skeletal Class III adult patients. To improve facial esthetic results from orthognatic surgery, the leveling and alignment of maxillary dental arch must be achieved with minimal inclination and projection or even retro-inclination of anterior upper teeth. During a pre-surgical phase of 12 months, headgear bilateral force of 150 g/F was applied to the upper molars of a 22 years old male compliant patient with Class III skeletal malocclusion, to provide an upper teeth control of mesial tipping and projection during alignment and leveling. The ideal occlusal parameters required for surgical procedure were achieved without dental extractions permitting a total treatment period of 37 months. The outcomes remained stable over 3 years follow up after the removal of the appliance. The results indicate that, although headgear use depends greatly on patient compliance, when well indicated it is an interesting alternativetopromote dentaldecompensationon pre-surgical period, in order to allow surgical correction of skeletal Class III malocclusion.

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.

Dimensões do corredor bucal e sua relação com a distância inter pré-molar e intercomissural

The objective of the study was to analyze the size of buccal corridor during the smile of individuals from 10 to 19 years of age and to determine whether there is a relationship among buccal corridor, inter premolar distance, inter commissure width. Standard digital frontal photographs in posed broad smiles and dental casts were taken of a sample of 150 individuals divided into 5 age groups of 30 individuals: 10-11 years old (G1), 12-13 years old (G2), 14-15 years old (G3), 16-17 years old (G4), 18-19 years old (G5). Distances among the cusps of superior first premolars and buccal corridors were measured for subsequent comparisons using the Image Tool 3.0 program. Data was analyzed using Anova. The SNK test and Tamhane test were applied. The mean values of the buccal corridor ranged from 4.00-to 10.69 mm on the right side and from 4.06 to 11.43 mm on the left side. In percentage related with intercomissure width each side of the buccal corridor ranged from 7.46 to 16.47% on the right side and from 7.58% to 17.61% on the left side. Buccal corridors were different between genders and increased with age. Males have bigger buccal corridors than females, but there is no difference between gender when calculated as a percentage related with the inter commissure width. The inter premolar width is significantly correlated with inter commissure widths of female individuals 14-15 years old and 18-19 years old, and with the right linear buccal corridor of males and females aged 14-15 years old.

Autopercepção e condições de saúde bucal em gestantes

This study ev aluated oral health indic ators by determining the pr evalence of dental c aries, periodontal diseases, prosthetic conditions and need in pr egnant women; identifi ed self-perceived oral health status and evaluated association bet ween variables. A clinical examination was performed in fi fty pregnant women assisted in the Preventive Dentistry Clinic-FOAr-UNESP using traditional oral health indicators: DMFT, C ommunity Periodontal Index ( CPI) and pr osthetic c onditions. A semi-struc tured questionnair e was applied to identify oral health perception and to collect sociodemographic variables. For data analysis, pregnant women were allocated in three groups according to their oral health perception (good, fair, poor) and compared according to clinical variables by the Kruskal-Wallis and Dunn tests. DMFT was high, all of them showed periodontal changes, most do not use and do not r equire any type of prosthesis; 36% considered their oral appearance as good. There was signifi cant diff erence between groups for the DMFT index and prosthetic need. It may be concluded that despite dental caries experience of pregnant women was found to be high, the prosthetic need have been detected in most of them and the presence of calculus was observed in all the volunteers, the majority considered their oral health status satisfactory.

Avaliação da via aérea superior em pacientes classe III submetidos à cirurgia ortognática: revisão de literatura

Introduction: The configuration and dimensions of the upper airway are determined by anatomical structures such as soft tissues, muscles and craniofacial skeleton, composing or surrounding the pharynx. Anatomical abnormalities of the soft tissues and / or craniofacial skeleton may become more narrow upper airway. The orthognathic surgery, which is used in the correction of dentoskeletal deformities, also causes changes in the upper airway. Objective: In view of the facts presented, this article aims to review the literature on the changes of the upper airway in patients’ class III undergoing orthognathic surgery. Methodology: International Literature on Health Sciences (Pubmed ) and Port Journals CAPES original and review published between 1990 and 2010, in two bibliographic databases articles were selected. Results: thirty-nine (39) articles were selected for writing this review. Conclusion: The upper airway deformity and dental- skeletal class III should be carefully evaluated prior to orthognathic surgery and whenever surgical planning permit should prefer the maxillary advances to mandibular setbacks

Prevalência de alterações sistêmicas em pacientes atendidos na disciplina de cirurgia e traumatologia bucomaxilofacial do curso de Odontologia da UNIARA

Introduction: pre-operative assessment is of fundamental importance for the prevention of transoperative and of postoperative complications. Objective: to identify the prevalence of diseases and systemic conditions in patients undergoing surgical treatment in the discipline of surgery and Traumatology of University Center of Araraquara, in the period of 2004 to 2009. Material and method: for the development of this study, a survey in medical records of patients was performed and the factors considered included: age, sex, presence of vices, and systemic conditions that affect the world’s population. The data obtained were analyzed quantitatively and recorded in a table. Result:  Considering all patient records analyzed (693), 340 affirmative responses were detected (49,06%) to one or more diseases. Cardiovascular diseases were the most prevalent (22,34%). Considering the prevalence of diseases related to age, the age of less than 20 years represented 16,32%; of 20-29 years, 43,06%; 30-39 years, 45,16%; 40-44 years, 48,64%; 45-49 years, 56,25%; 50-54 years, 58,33%; 55-59 years, 57,74%; 60-64 years, 70,37%; 65-69 years, 66,66%; and 70 years or more, 68,75%. Conclusion: diseases and systemic alterations with higher prevalence were cardiovascular diseases, anemia, sinusitis and diabetes. The frequency of affirmative answers to systemic conditions was age-dependent and there was a predominance of females. The tobacco addiction was the most frequent. Thus, it was found that the preoperative assessment of the health of patients who will undergo surgical dental treatment is of fundamental importance.

Estudo comparativo da inclinação do plano oclusal de modelos para cirurgia ortognática montados em dois tipos de articuladores semi-ajustáveis

Purpose: The aim of this study was to compare occlusal plane angulation measured in two different types of semi-adjustable articulators with that obtained on the lateral cephalometric radiograph. Materials and Methods: 20 patients due to undergo orthognathic surgery had dental casts mounted in two different types of semi-adjustable articulators through face bow transfer from the position of the maxilla and occlusal recording to the mandible. After mounting, the inclination of the occlusal plane in the articulators was measured and compared with the inclination measured at on both articulators and compared with the inclination measured on the lateral cephalometric radiographs and between the articulators themselves. The results obtained werestatistically analyzed. Results: Mean angulation values for the Bio Art (7.55º) and Kavo (-5.70º) articulators differ by 13.25º, which is statistically significant (p=0.00). When individually compared to the lateral cephalometric radiograph (5.075º), the Bio Art articulator showed more similar angulation values, with a difference of 2.475º, while the Kavo articulator presented a difference of 10.775º. Conclusion: Neither of the models of semi-adjustable articulators accurately reproduced the inclination of the maxillary occlusal plane of patients with dentofacial deformities; the difference between the two articulators tested and the lateral cephalometric radiograph was lower for the Bio Art than for the Kavo articulator.

Complicações Associadas aos Enxertos Ósseos Aposicionais com Osso Autógeno

Introdution: Tooth extraction results in alveolar ridge resorption due to the progressive reabsorption, which frequently is a limitating factor of dental implants treatment, in function of the insufficient bone height for execution, could be indicated the use of grafts for increase of the alveolar edge. However, the success of the bone graft requests the meticulous attendance of the clinical stages. Proposition: The objective of this research was to evaluate the postoperative complications associated to the autogenous bone grafts. Materials and Methods: Through a random retrospective analysis, 90 file records of patients submitted to the surgical procedure of autogenous bone graft in the period of January from 2000 to the March of 2008. A clinical record was elaborated with base in the necessary data for this evaluation. Results: About the file data analysis, 59 female with average of 49,42 years and 31 male with average of 47,90 years. The previous diseases most related were arterial hypertension, stomachache and diabetis. The smokers was noticed in 13,3% of patients. The donor site most used was a mandibular ramus. The postoperative complications in receiving area represented 17,8% of file datas analysed and in the donor site only one patient showed parestesis. Conclusion: Among the total analyzed files it was observed that the postoperative complications associated with the autogenous bone grafts represented 18,9% of the patients submitted to the procedure, more frequently affecting the receiving area, obtaining partial exposure of the bone graft and absence of inserted gingiva on vestibular cortical bone.

Considerações acerca do preparo ortodôntico direcionado à cirurgia ortognática

This work aims at contributing to increase and improve the communication between orthodontists and maxillofacial surgeons, reviewing and discussing the principles of diagnosis and orthodontic movement specific to patients with surgical indication. It describes the elective points in the conduct of the orthodontist so that their decisions could lead to an individualized and appropriate planning, striving for excellence in terms of outcomes for the surgical-orthodontic treatment of dentofacial discrepancies.

Impacto da saúde bucal na qualidade de vida de pacientes maiores de 50 anos de duas instituições públicas do município de Araraquara-SP

Introduction: Oral health can affect quality of life, and the OHIP-14 index (Oral Health Impact Profile) is useful for evaluating this impact. Objective: to investigate the impact of oral health conditions on the quality of life of patients over  50  years, assessing, initially, the consistency of the short form of the Oral Health Impact Profile index (OHIP-14). Material and method: A cross-sectional study was performed among 149 patients of two public institutions for routine dental (UNESP) and medical practice (Municipal). They were interviewed using the OHIP-14 formulary, assessing its internal consistency (Cronbach´s alpha coefficient) and the OHIP-mean (additive method). The patients were distributed according to sex, age, and education level. The comparisons of interest were made using Student´s t test at a 5% level of significance. Result: A total of consecutive patients (n = 149) participated of this study (87% response rate). Cronbach´s alpha coefficient was 0.78, denoting a good consistency of the OHIP index. The OHIP mean was 4.98. The most prevalently affected OHIP domains were dimensions of physical pain: painful aching (11.40%) and uncomfortable eating foods (21.50%). There was non-significant difference (p > 0.05) between the mean OHIP value in relation to each of gender, age, and education level. Conclusion: The OHIP-14 is a reliable instrument of assessing oral health-related quality of life, and among patients under routine practice, it was found a low impact of oral conditions on their quality of life in the studied institutions (UNESP and Municipal).

Aspectos epidemiológicos da saúde bucal de crianças em um município brasileiro

The Health Sciences, prior to the planning of prevention programs, adopt the tools to analyze the population profile, entitled epidemiological surveys, to obtain data on the need for heathcare and the possibility of treating health events. The aim of this study was to evaluate dental conditions in schoolchildren, aged five to fourteen, enrolled in public schools in Américo Brasiliense, SP Brazil. The dmft and DMFT index, caries experience, and prevalence of fluorosis were analyzed. For this epidemiological study, 1,137 children were selected. Four calibrated dentists performed oral exams according to WHO criteria (1997). The data were collected using descriptive analyses. The results showed that 94% of the five-year-old children were caries free, and the value of dmft was 1.44. DMFT was 1.19 in 12-year-olds. The lowest and the highest fluorosis prevalence could be observed in eight and fourteen-year-olds, respectively. It could be concluded that the city of Américo Brasiliense has developed respectful educational and preventive oral health programs which presented satiosfactory results in the present epidemiological study.

Elaboração de um Jogo Digital Educacional sobre Saúde Bucal Direcionado para a População Infantil

Objective: The aim of this study was to develop an educational oral health digital game for 5-to-7-year-old children. Method: The game, called “Dr. Trata Dente”, was based on the approach to three different oral health-related topics: a) bacterial plaque and the main diseases caused by it; b) oral hygiene methods for bacterial plaque control; c) dental caries and preventive measures for this disease. These topics were discussed in sequential order in three different stages of the game. Dr. Trata Dente is represented by the figure of a little super-hero dentist, who talks to the children about oral health during the game. The game is sub-divided according to its propositions to the children, into an association game, a memory game and a coloring game. After its development, the game was evaluated by three professionals of each of the following areas: Dentistry, Pedagogy and Psychology (n=9), who verified the suitability of the concepts presented in the game as regards oral health, linguistic abilities worked with the children, fulfillment of the intended didactic criteria, and the playful aspect of the game. Results: According to the dentists, the dental concepts presented in the game are adequate. According to the pedagogues, the choice of a super-hero was correct and the given explanations are well elaborated, organized and have accessible language, although long. For the psychologists, the game has a potential positive effect on the children’s learning, but there should be more interaction of the character with the children. After this evaluation, changes were made in the game according to the professionals’ suggestions. Conclusion: It was concluded that in spite of the suggested alterations, the game is suitable for teaching oral health by means of children’s play.

Retardo na procura do tratamento odontológico e percepção da saúde bucal em mulheres grávidas

The objective was to assess in women with children under 5 years old what happened to your pregnancy in relation to dental care, coupled with a probable correlation between the level of their knowledge on dental health and possible reasons which lead or have led to a late seeking such treatment. The interviews were conducted in an environment of health center in the city center and the Odontoly Faculty in Araraquara. Among the interviews mothers, 57% refused the dental treatment during pregnancy. It appears on mothers that are afraid to perform a dental treatment during pregnancy. The misinformation on this issue often associated with this belief in the medical field that dental care during the first three months of pregnancy is harmful to the baby. Such information passed on to mothers leads to a hesitancy with dental treatment during this period. The educational level of mothers did not interfere in this pursuit, and 24.5% of them avoid treatment during pregnancy. The difference, however, is between those mothers of high educational level, performing oral prevention before pregnancy.

Promoção de Saúde Bucal em Bebês

This study is a literature review about promotion of oral health in babies and it discusses the importance of early preventive treatment. The conclusions are: 1 - The early treatment aims to reduce the dental caries prevalence in babies and to make familiar the dentistry´s office. It is important the creation of oral habits in children and in their parents. 2 - The high prevalence of dental caries in babies shows the necessity of programs with health promotion in the first infancy. The aim is to keep the oral health of these children. 3 - The success of the oral health promotion in babies depends on the awareness of the parents about the importance of oral hygiene. This fact must be considered during the planning and development of programs to this age.