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.

Aparelho de Thurow modificado e aparelho ortodôntico fixo no tratamento da classe II com mordida aberta anterior

This work had aim to present two clinical cases with open bite Class II malocclusion that treated in the phase of the mixed dentition with the modified Thurow appliance and in the permanent dentition with fixed appliance. The dentoskeletal effects of these appliances were carefully analyzed with the aid of metallic implants inserted in both maxilla and mandible. The correction of the malocclusion and the improvement of the skeletal, dental and facial relationship were observed in both cases. The modified Thurow appliance followed by fixed-appliance as a two-phase treatment protocol revealed to be an effective treatment approach for the two young people that initially presented a Class II division 1 malocclusion associated to anterior open bite presented.

Descrição do aparelho VABB (Vertically Activated Bite Block) para o tratamento da mordida aberta anterior

Nowadays, the correction of skeletal vertical dysplasia is considered a great challenge in Orthodontics. The skeletal open bite treatment presents limitations related to vertical growth pattern, the extension of open bite and especially the stability, which is very questioned. The treatment of skeletal open bite is mostly realized by the inhibition of vertical alveolar posterior development (relative intrusion) or absolute intrusion of posterior teeth, through vertical forces, generated by the action of masticatory muscles. The purpose of this article is to present a new appliance for the treatment of skeletal open bite, the VABB (Vertically Activated Bite Block) or modified Bite Block, whose action mechanism is to limit the vertical development of the molars, by the action of facial muscles and two bilateral expansion screws that provide a counterclockwise rotation of the mandible. It will also be presented a clinical case and the technical steps for the construction of this appliance.

Osteomielitis crónica con periostitis proliferativa

Chronic osteomyelitis with proliferative periostitis is a kind of osteomyelitis that is characterized by a great periosteal reaction resulting of low grade stimulation, usually a caries lesion associated a periapical pathology. It affects especially children and young adults, with the mandible as the most common site, usually in the inferior aspect. Clinically presents as a painless hard swelling intra and/or extra-oral. Radiographic aspects include bone layers new formed, parallel to each other and to the underlying cortical surface, giving the characteristic appearance of "onion skin". Treatment includes elimination of the cause, with or without antibiotics, being restored the facial symmetry of patient. The present article is a clinical case report of chronic osteomyelitis with proliferative periostitis affecting a female 11 year old patient, caused by a caries lesion in the left permanent first molar, that was submissed to a exodontia and the facial symmetry of the patient was restored with management.

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

Tratamento cirúrgico de canino incluso em mento: relato de caso

The mandibular and maxillary canines when well positioned in the arch, are important functionally and aesthetically. Although these teeth are frequently malpositioned in the dental arch, their absence of eruption are not common, occuring more frequently with the maxillary canine than the mandibular canine. The canine transmigration is a well-known pre eruptive phenomenon in which the tooth goes thru the facial midline, occurring more frequently in the mandible than in maxila. Females are more susceptible than males and the right side more than the left one. Normally the patients do not show any symptoms, and this condition is observed during radiographic exams to diagnose the late exfoliation of the deciduous canine or for any other purpose. Due to the relationship between impacted canines and pathologic lesions, infection, trauma to the adjacent teeth, pain, ectopic eruption and interference with prosthesis, it´s indicated the surgical extraction of these teeth. The goal of this article is to describe and discuss the surgical treatment of an impacted canine (43) in the chin.

Caracterização radiográfica ex vivo de biomateriais utilizados para regeneração óssea em mandíbulas de porcos

Introduction: The radiographic characteristics of a biomaterial, such as its density, may influence the evaluation of the results obtained following its clinical use. Objective: The aim of this study was to evaluate the radiographic density of biomaterials used as bone substitutes, inserted into dental sockets and bone defects in created in the jaws of pigs. The influence of a soft tissue simulator on the results was also evaluated. Material and method: Two and three-millimeter-deep bone defects were created in the pigs mandible and the right first molar extraction socket were used. Commercial samples of five biomaterials were tested: Hydroxyapatite, Lyophilized Bovine Bone, 45S5 bioglass (generic), PerioGlass and β-Tri-Calcium Phosphate, and compared to a positive (mandibular bone) and negative (empty alveolar bone defects) controls. Radiographic images were acquired with and without a 10 mm thick soft-tissue simulator. Result: The results for the extraction sockets showed no differences between the biomaterials and the negative control. For the bone defects, the depth of the defect density influenced the density, both in the negative control (p < 0.01) and biomaterials (p < 0.05) groups. The soft- tissue simulator did not alter the results. Conclusion: The type of the evaluated defect can interfere in the radiographic features presented by each biomaterial, while the simulation of soft tissues was not statistically significant.

Bone-implant contact around crestal and subcrestal dental implants submitted to immediate and conventional loading

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Tratamiento de la deformidad facial causada por la hiperplasia condilar: relato de caso

The condylar hyperplasia is an acquired development anomaly, rare, characterized by an excessive and progressive growing, affecting neck, condilar head, body and the mandible bough, provoking an important facial asymmetry. In the article we present a case of male patient, 22-years-old, reclaiming of painful sintomatology in the region of temporomandibular joint and severe facial asymmetry. It was instituted an orthodontic-surgical treatment by means of orthognathic combined surgery and high condilectomy. After six years of post-surgical controlling, the patient is now in a good shape, without recurrence of facial asymmetry and condylar hyperplasia.

A six-year retrospective study of maxillofacial fractures from radiographic findings in Brazil

Objective: this study aimed to present the causes and prevalence of maxillofacial fractures that occurred in the region of Araraquara-SP – Brazil, during a 6-year period. Methods: information regarding age, gender, etiology, and maxillofacial fracture site, as well as type of radiographic examination were evaluated. Data were gathered from the radiographic examination and radiographic report of the Division of Dentomaxillofacial Radiology, and from charts of the Division of Oral and Maxillofacial Surgery of patients attending for maxillofacial fractures from 2004 to 2009. A descriptive statistical analysis was developed using Epi-Info 3.5.1. Results: from a total of 11,728 patients assisted, 407 patients presented maxillofacial fractures. The prevalent age ranged from 21 to 30 years old. From the total patients, 322 were men and 85 were women (ratio of men to women was 3.8:1). Panoramic radiography (n = 306) was most frequently used to observe maxillofacial fractures. Mandibular fractures were frequent in the body of the mandible (n = 127), followed by symphysis (n = 102), and the prevalent cause was traffic accidents (n = 161). Conclusion: more than half of affected individuals were younger than 40 years of age. The body of the mandible was the most common fracture location visualized by panoramic radiography for traffic accidents and fights.

Avaliação radiográficada fusão das corticias lateral e medial do ramo mandibular: estudo em mandíbulas secas

Purpose: to radiographically evaluate the distance between mandibular lingula and the exact spot where buccal and lingual cortical bone plates merge in the mandibular ramus. Materials and Methods: 54 dry mandibles, divided into 3 subgroups (SG1: dentate, SG2: partially dentate and SG3: edentulous) were used in this study. Lingula position was marked with a metallic sphere and radiographs were taken. The distance between mandibular notch and lingula (I/L) and the distance between mandibular lingula and cortical bone plates fusion (L/FC) were measured. Statistical analysis was applied to the values obtained. Results: mean values for L/FC were 8,18mm, 7,30mm and 8,98mm for SG1, SG2 e SG3 respectively. Moreover, mean values for I/L were 14,02mm, 13,90mm and 12,34mm for SG1, SG 2 and SG3 respectively. The results also showed that cortical bone plates fusion took place in half I/L distance in 28,57% of the mandibles in SG1, in 46,67% of the mandibles in SG2 and in 9,09% of the pieces in SG3. Conclusions: there were no statistically significant differences in the height where cortical bone plates took place in all 3 subgroups. In SG3, the correlation between the mean value for L/FC and the mean value for I/L suggests a reduction in bone density and bone mass, which can correlate to the evaluation of older mandibles in this subgroup.

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.

Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: a case report and literature review

Odontogenic cysts are considered as nonneoplasic benign lesions. Among the cysts, keratocyst odontogenic tumor (KCOT) is an intra‑osseous tumor characterized by parakeratinized stratified squamous epithelium and a potential for aggressive, infiltrative behavior, and for the possibility to develop carcinomas in the lesion wall. Thus, the aim of this study was to describe a clinical case of KCOT in a young patient and discuss the treatment alternatives to solve this case. A 15‑year‑old male was referred for treatment of a giant lesion in his left side of the mandible. After the biopsy, a diagnostic of KCOT was made, and the following procedures were planned for KCOT treatment. Marsupialization was performed for lesion decompression and consequent lesion size reduction. Afterward, enucleation for complete KCOT removal was performed followed by third mandibular molar extraction. After 5 years, no signs of recurrence were observed. The treatment proposed was efficient in removing the KCOT with minimal surgical morbidity and optimal healing process, and the first and second mandibular molars were preserved with pulp vitality. In conclusion, this treatment protocol was an effective and conservative approach for the management of the KCOT, enabling the reduction of the initial lesion, the preservation of anatomical structures and teeth, allowing quicker return to function. No signs of recurrence after 5 years were observed.

Implantes curtos em região posterior da mandíbula

The rehabilitation of edentulous areas with osseointegrated dental implants is a well-documented, predictable procedure in the literature, with high success rates. However, the lack of bone at the recipient bed or proximity to anatomic structures limits the rehabilitation procedure especially at the posterior mandible. Thus, short implants are an alternative treatment for such cases of severe bone resorption. The purpose of this study was to review the success rate of short implants, especially those based in the posterior mandible and to show a clinical case. A literature review was made on electronic databases PubMed and Bireme with articles published between the years 2005 to 2012, using the keywords "short dental implants". It was concluded that the success rates of short implants are similar to those presented by conventional implants but still related to their geometry and surface treatment. Also, short implants can be considered as a viable alternative for the rehabilitation of severely resorbed jaws. However, many authors consider that more research is necessary when a short implant is compared to a long dental implant.