Scientific use of the finite element method in Orthodontics

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Estudo da estabilidade da cirurgia do tipo sagital da mandíbula com vista a correção de deformidades faciais

This research evaluated the surgical stabilily in patients with mandibular prognathism and retrognathism in which was used sagital split technic to correct those detormities. Twelve patients were selected from the clinic of only one experienced surgeon. Six patients presenter a Class III 6 a Class II molar relationship. A comparative cefalometric analysis using linear and angular measurements was performed of pre-surgery, imediate pós-surgery and 1 year follow-up. The following conclusions were obtained. 1 The Dal Pont sagital split technic modified by Epker to correct mandibular prognathisn and retroghnatism is a stable technic and must be indicated to correct those deformities. 2 Small relapses are easily corrected by the post-surgical orthodontic treatment. 3 A small over correction is advised in cases of large mandibular advancements or set bascks. 4 In those cases which a large amount of mandibular retrusion on advancement need to be performed, a combination of maxillary and mandibular surgery should be used. Rigid fixation technic is also indicated in those cases

Aplicação da análise de jarabak, no estudo da relação entre a altura total facial anterior e posterior, em pacientes portadores de má-oclusão de classe I e classe II divisão 1 de angle, por meio de radiografias cefalométricas

ln order to predict the facial growth using Jarahak's analysis, cephalometric radiographies of 120 subjects during the mixed dentition and between 6 and 10 years of age were studied. From the total, 60 subjects (30 males and 30 females) were classified as Angle's Class I and 60 subjects (30 males and 30 females) were classified as Angle's Class II, Division 1. AIl subjects did not receive any orthodontic treatment. The proportion between anterior and posterior facial heigth (SGo-NMe) was studied, which is determined by the formula PFH x 100/ AFH = %, neither being straight (> 62% < 65), clockwise ( > 58% < 62%) and anti-clockwise ( > 65% - 80%). Mean average, standard deviation and facial height proportion (SGo - NMe) were determined for males and females according to Angle's classification of malocc!usion. Sexual dimorphism was examined with regard to different types of Angle's malocclusion and the direction of the facial growth, and the correlation of four cephalometrics measurements were analvsed

Surgical-orthodontic tractio for impacted maxillary canines: a critical review and suggested protocol

Maxillary canine impaction is a common occurrence, especially in the palate, despite sufficient space in the arch for tooth alignment. A proper approach requires knowledge of different specialties of dentistry, such as orthodontics, surgery, radiology, and periodontology, which are generally not centered on a single professional. The causes for canine impaction may be either generalized or localized, and the diagnosis should be made through specific clinical and radiographic examination. The prognosis of surgical-orthodontic treatment depends on the position of the canine in relation to the neighboring teeth and height of the alveolar process, in addition to careful surgical technique, considering that there are risks involved, such as ankylosis, loss of tooth vitality, root resorption of the involved tooth and adjacent teeth, and damage to supporting tissues. Given the important role played by impacted maxillary canines, their traction is the treatment of choice in orthodontically treated patients. The present study reviews the literature on important factors to be considered when approaching impacted canines, such as therapeutic possibilities, their advantages and disadvantages.

Ocorrência de reabsorção radicular no tratamento ortodôntico: revisão crítica da literatura

The root resorption is one of the possible sequels of greater complexity to the orthodontist, the difficulty of detection and be asymptomatic. The presence, during the orthodontic treatment, is linked to a multifactorial origin, a complex combination of biological activities, anatomical, physiological, genetic variables and mechanical forces. Thus, the aim of this study was perform to critical literature review related to root resorption in orthodontic movement. Were included articles published between 2004 to 2014, indexed in the PUBMED database. Used descriptors contained in the Mesh, being adopted as inclusion criteria: clinical trials in humans, only articles that had clear ideas and objective, articles with English language. The search strategy used resulted in 24 articles and after applied the inclusion and exclusion criteria, 11 articles remained. Based on the results of this study it was concluded that heavy forces of intrusion, inclination and torque leads to a greater degree of root resorption; its etiology is multifactorial, the periodic radiographic control during treatment is needed and further studies are suggested to identify more specifically the causes and risk factors for root resorption.

Fios ortodônticos superelásticos e sua aplicabilidade na clínica ortodôntica: revisão da literatura

During clinical routine, the orthodontist uses several materials, which include metallic alloys in the form of metallic wires. However, it is necessary that the professional has some knowledge of the properties of those wires. Different types of wires are commercially available: stainless steel wires, chrome-cobalt wires, nickel-titanium wires and beta-titanium wires. Among the nickel-titanium wires, there are three subdivisions: a conventional alloy and two superelastic alloys. The superelasticity, associated to the effect of form memory, is a property used in orthodontics to initiate the dental movement in the first phase of the orthodontic treatment. This property is considered to be biologically compatible with the effective dental movement. These wires are available at the market in different transformation temperatures, and they offer the best adaptation in the groove of the bracket, simplicity and a faster treatment. However, they present little formability, and they don’t accept solder. They are also more onerous than other wires. Moreover, the low rigidity of these wires doesn’t allow them to be used for the retraction of the anterior teeth or closing of spaces. Therefore, the coherent use of superelastic orthodontic wires is recommended, accompanied by a detailed diagnosis and planning, so the result will be an efficient orthodontic correction, accomplished in a shorter period of time.

Movimentação dentária e aplicabilidade na clínica ortodôntica

A Ortodontia apresenta como um de seus pilares de sustentação as reações biológicas provenientes da indução mecânica. Desde seu início, vários estudos foram realizados para esclarecer os eventos biológicos decorrentes da movimentação dentária sob indução mecânica. Entretanto, mesmo sabendo-se que entre os procedimentos mecânicos e os fenômenos biológicos que acontecem no cotidiano ortodôntico não deve ocorrer disparidade, frequentemente observa-se uma preponderância para a busca do tipo de aparelhagem e o emprego de forças controladas, principalmente pelos fios. Esses aspectos deixam transparecer, principalmente para o profissional menos experiente, que somente o controle mecânico rege a movimentação dentária. Um exemplo que enfatiza exclusivamente o procedimento mecânico nos cursos de Ortodontia é o typodont. Convém salientar que essa metodologia de ensino é válida para simular a movimentação dentária no aspecto técnico-mecânico, porém, o conhecimento biológico da movimentação deve ter o mesmo nível de importância e não pode haver dicotomia; caso contrário, o resultado da movimentação ortodôntica pode causar prejuízos nas estruturas radiculares, óssea e periodontais, bem como comprometer as diversas estruturas em longo prazo.

Histórico de traumatismo dentoalveolar e movimentação ortodôntica: uma relação perigosa?

O traumatismo dentoalveolar é uma ocorrência cada vez mais comum na população em geral e está relacionado, na maioria das vezes à violência no trânsito, violência urbana e à prática esportiva. Esse aspecto, por conseguinte, tem aumentado sobremaneira o número de pacientes que procuram o tratamento ortodôntico e que relatam ter passado por algum episódio de trauma em seus dentes. Dentro desse contexto, muitas questões surgem com relação ao manejo de dentes com histórico de traumatismo dentoalveolar. Do ponto de vista histológico, quais as diferenças em movimentar-se um dente com histórico de trauma? O fato de um dente ter sido traumatizado pode influenciar no planejamento e no tratamento ortodôntico? E o protocolo das ativações do aparelho deveria ser alterado? O objetivo desse trabalho é apresentar uma breve revisão de literatura, bem como dois casos clínicos de pacientes que sofreram trauma dentário prévio à movimentação ortodôntica, no sentido de gerar subsídios técnicos e científicos para o especialista em Ortodontia, de modo que busque conhecer as implicações e limitações em movimentar dentes traumatizados.

Extrações seriadas: protocolo e inplicações clínicas

A Ortodontia é uma especialidade da Odontologia que visa, entre seus diversos objetivos, proporcionar uma arcada dentária alinhada, estável e funcional. A discrepância dentoalveolar negativa em indivíduos na fase de dentição mista apresenta alta prevalência e requer a utilização de métodos de tratamento que proporcionem a obtenção de espaço. As extrações seriadas constituem uma solução adequada, mas frequentemente questionada quanto às indicações, contraindicações e sequência apropriada. Assim, o propósito deste artigo é apresentar uma discussão, embasada na literatura pertinente, dos principais fatores envolvidos com esse procedimento e ilustrar esta terapia por meio de um caso clínico.

A utilização do diagrama individual anatômico objetivo (DIAO) no contorneameento de arcos ortodônticos

A morfologia das arcadas dentárias sobre as bases ósseas é conseguida utilizando-se fios ortodônticos, os quais detêm o potencial de correção das irregularidades dentárias. O presente artigo discute conceitos acerca da morfologia das arcadas dentárias, bem como demonstra a utilização do Diagrama Individual Anatômico Objetivo (DIAO). A premissa básica para o contorneamento dos arcos de nivelamento reside na individualização da forma da arcada dentária, que deve considerar as bases ósseas e o relacionamento entre elas, bem como os objetivos terapêuticos. O contorneamento dos arcos de nivelamento baseado no diagrama individualizado torna prática a rotina ortodôntica por favorecer a constância de forma e garantir a simetria da arcada dentária.

Utilização dos arcos seccionados para o tratamento da má oclusão de classe II, divisão 2

A má oclusão de Classe II divisão 2 é caracterizada pela verticalização dos incisivos superiores. Nesse tipo de má oclusão, é comum a presença de sobremordida profunda e curva de Spee inferior acentuada. O presente artigo ilustra que o tratamento dessa má oclusão pode ser facilitado com o emprego dos arcos seccionados, como por exemplo, o arco utilidade, segundo a técnica Bioprogressiva de Ricketts.

Multidisciplinary treatment ofadult patients with Class III malocclusion

This article describes the multidisciplinary treatment of an adult patient presenting with Angle Class III malocclusion, alteration of the mandibular position, vertical alveolar bone loss and absence of teeth in the lower posterior region. With advancing age the existence of occlusal interference due to loss of teeth or tooth structure is very common, resulting in periodontal problems due to occlusal trauma. The options for treatment of Class III malocclusion in adolescent and adult patients include compensatory orthodontic treatment in mild to moderate cases and orthognathic surgery for moderate to severe cases. The combination of various dental specialties enabled improvement in the social circumstances of the patient. This can be observed objectively by the final dental relationship and by the skeletal and tegumentary cephalometric comparison between the situation at the beginning and at the end of the treatment. The compensatory treatment performed permitted the successful correction of a Class III malocclusion in the clinical case presented.

Avaliação dos preparos da superfície cerâmica para a colagem de acessórios ortodônticos

The purpose of this study was to evaluate the effects of two conditioning methods used to enhance the shear strength of orthodontic brackets bonded to porcelain surfaces. A total of 18 feldspathic specimens were used. The specimens were divided randomly into two groups (n = 9): group free silane, the porcelain specimens were etched with hidrofuoric acid 10% (Acid Gel-Maquira) for 4 minutes followed by adhesive-primer (Transbond XT) and the metallic brackets (Morelli Roth Light .022" x .030") were bonded with a light-cured microfilled resin (Transbond XT Light Cure Orthodontic Adhesive); group silane, the porcelain specimens were etched with hidrofuoric acid 10% (Acid Gel-Maquira) for 4 minutes followed by silane (Silano Ângelus) for 1 minute, adhesive-primer (Transbond XT) and the metallic brackets (Morelli Roth Light .022" x .030") were bonded with a light-cured microfilled resin (Transbond XT Light Cure Orthodontic Adhesive). All specimens were stored in solution of artificial saliva at ambient temperature for 24 hours. The debonding was done with shear strength through a universal testing machine (DL 500-Emic) calibrated with a fixed speed of 1mm/minute. Statical analysis was performed using the Student t test. The results indicated that in the free silane group the mean bond strength was 9,97 MPA, significantly lower than the silane group, that was 12,38 MPa (p < 0,05). The both groups were effective for bonding, although the silane group had the highest bond strength values.

Protocolo radiográfico para a instalação de mini-implantes: descrição da técnica

In the last decade mini-screws have gained popularity in orthodontics field and a correct placement of mini-screws is a critical point to the success of the skeletal anchorage. A careful clinical and radiographic diagnostic before insertion mini-screw is an essential requirement to achieve the central point of the radicular septum. The correct application of these pre-surgical procedures should avoid possible iatrogenic damages in periodontal ligament, dental roots, nasomaxillary cavities, or even important vascular tissues. As of today, periapical radiographs is a regular pre surgical procedure during mini-screw insertion technique. Nevertheless, accurate execution of the radiographic parallax technique can offer to us useful and precise radiographic images, to decide the right local insertion of mini-screws in to the septum bone. The purpose of this paper is to describe the ¬application of new positioning circular guides in conjunction with a ¬parallax radiographic protocol before placement of orthodontic mini-screws.