Montagem e confecção 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.

Necessidade de ancoragem do grupo A e o controle biomecanico da mola T pré-ativada por curvatura para o fechamento de espacos

Contemporary orthodontics has sought, beyond the esthetic, occlusal and functional goals, treatments even faster and with less visits to the orthodontist — especially in patients that require dental extractions in which the generated space becomes a nuisance. The segmented arch technic (SAT), by the use of a "T" loop spring, has provided such results within these requirements. Therefore, this study aimed to appraise and demonstrate the confection, activation and biomechanical control of "T" loop spring, in the group with high anchorage necessity (group A), for retraction of anterior teeth; as well as to present a case report, with high anterior retraction necessity, treated with "T" loop spring.

Tratamento ortodôntico da agenesia de incisivo lateral superior com envolvimento de fratura radicular de incisivo central superior

Patients with agenesis of maxillary lateral incisor must have in your planning functional and aesthetic considerations, important to the success of the treatment, regardless of whether the choice of treatment is closing or opening and maintenance of space for rehabilitation with prosthesis. This choice will depend on factors such as skeletal and tooth structure and profile. Children and adolescents are the group of individuals most exposed to trauma and fracture of the maxillary lateral incisor due to the activities they perform. Proper diagnosis and good treatment are essential to the success of the treatment. This article aims to report a case of agenesis of the maxillary lateral incisor along with the involvement of a root fracture of the maxillary central incisor. The orthodontic treatment was successfully finished with a favorable prognosis for the fractured incisor to stay in a esthetic and functional position.

Tratamento ortodôntico lingual individualizado com o sistema Incognito

Introduction: The orthodontic treatment using lingual brackets has been desired by adult patients for esthetic factors. In this paper it is described the clinical steps of an orthodontic treatment using Incognito™ system, individualized lingual brackets and archwires designed by CAD/CAM technology. Methods: The presented case describes the treatment of a patient with mesofacial growth pattern,Class I malocclusion, with mandibular crowding and diastema between the upper central incisors, treated using 100% individualized lingual brackets. Results: After treatment, the molar relation of Class I was kept, the spaces between upper central incisors were closed and mandibular crowding corrected. Conclusion: This case report demonstrated the efficiency of the new method for lingual orthodontic treatment.

Resistência ao cisalhamento de bráquetes fotopolimerizados com arco de plasma, LED e luz halógena utilizando diferentes tempos

This study evaluated in vitro the shear bond strength of brackets bonded with xenon plasma arc light, light-emitting diode (LED) and conventional halogen light using different curing times. Brackets were bonded to the buccal surface of 60 human maxillary premolars allocated to five groups. In groups 1 and 2, the resin was cured with the plasma arc for three and six seconds (s), respectively; in groups 3 and 4, the LED was used for five and ten s, respectively; and in group 5, the halogen light was used for 40 s. The specimens were stored in water for 24 hours and subjected to a shear force until bracket failure. The debonding pattern was classified according to the adhesive remnant index (ARI). The results were assessed by Anova and the SNK post-hoc test. No differences were detected among groups 2, 4 and 5, which showed higher averages than groups 1 and 3, which were not different between themselves. The ARI scores showed no differences among the three types of light sources in all times tested. Plasma arc and LED lights can be used with shorter curing times, within certain limits, than conventional halogen light for bonding orthodontic brackets, without decreasing bond strength.

Resina composta indireta como alternativa funcional e estética em reabilitações protéticas

Due to mechanical and aesthetic improvement properties, continuous fiber-reinforced composites have been developed to replace the metal framework in fixed partial dentures becoming an interesting alternative to conventional treatments. A male patient, 57 years old, attended at Fixed Partial Denture Clinic of Araraquara Dental School - UNESP, complaining about upper right first molar absence. After clinical examination, it was observed: upper right second molar with amalgam restoration and periodontal bone reduction and upper right second premolar unsatisfactory treated. Following the clinical conditions and the patient expectations, it was decided to use a fiber-reinforced composite resin to make a three-element fixed bridge. The patient showed full satisfaction with the aesthetic and functional results. The case has been followed up for 60 months.

Prótese metalocerâmica associada à prótese metaloplástica implantossuportada em paciente desdentado total

The use of different methods and materials should be considered during the planning of implant-supported prostheses. Complications such as fractures of the acrylic resin base, wear and fracture of teeth can occur frequently, creating the need for careful planning for each patient, which can make the selection of the type of treatment more complex. Thus, this article describes the oral rehabilitation of a completely edentulous patient with bimaxillary fixed implant-supported prosthesis, with complaints on aesthetics, loss of vertical dimension and fracture of acrylic resin teeth of the upper arch. After the restoration of vertical dimension, his dentures were replaced with new bimaxillary implant-supported fixed prostheses, ceramic and acrylic resin were used as veneering material for maxilla and mandible, respectively. At the end of the treatment, the patient received bimaxillary flat occlusal splints to protect the teeth and implants of possible parafunctional habits. The approach for the treatment allowed a quick and effective resolution, with aesthetic and functional outcomes very favorable for the patient.

Reabilitação estética do sorriso por meio do sistema cerâmico dissilicato de lítio: relato de caso

The reestablishment of a harmonious smile through dental ceramics, when properly conducted and with specific indications, can achieve extremely predictable results. For aesthetic and functional rehabilitation, many ceramic materials can be used such as zirconia, leucite, alumina, feldspar, and lithium disilicate. Among these materials the lithium disilicate stands out due to the following characteristics: its resistance to wear, to chemical attack, high temperatures and oxidation; low electrical conductivity; near zero thermal expansion; good optical properties and biocompatibility with periodontal; excellent esthetics; color stability and reinforcement of tooth structure. The indications for the use of lithium disilicate are not limited to multiple facets of teeth in cases where there was no favorable response to tooth whitening, and also comprehend teeth with multiple restorations, diastema closure, shape alteration, and dental contouring, replacement of missing or fractured teeth, among others. The versatility of lithium disilicate ceramics allows its utilization in several clinical situations. The concomitant use of lithium disilicate for veneers and over metal has satisfactory aesthetic results, as reported in the present studying cases that require both aesthetics and resistance.

A arte de copiar: restauração estética anterior

Atualmente, os pacientes buscam cada vez mais estética, e o profissional deve ser capaz de suprir a necessidade da demanda atual. Para isso, os profissionais devem estar atentos a não somente devolver funcionalidade a seus procedimentos restauradores, mas acima de tudo buscar excelência estética. Entre esses procedimentos, as restaurações adesivas diretas são capazes de mimetizar o que é artificial, tornando as restaurações naturais. Esse artigo tem o objetivo de expor uma sequência clínica, de certa maneira simplificada, em que o profissional conseguiu uma restauração altamente estética.

Procedimentos conservadores para restabelecimento da estética anterior

A Odontologia atual está direcionada em executar procedimentos cada vez menos invasivos sem perder a objetividade, tais como função e estética. Como tais procedimentos, podemos citar o clareamento dentário e a utilização de resinas compostas diretas, que nos fazem praticar o conceito de uma Odontologia minimamente invasiva. Este artigo tem o objetivo de demonstrar, através de alguns procedimentos conservadores, a possibilidade de se obter resultados satisfatórios.

ScanWhite©: método objetivo para avaliação do nível de clareamento dental

A comparação visual com escalas de cor, universalmente empregada para avaliar o resultado das diferentes substâncias, técnicas e aparelhos utilizados no clareamento dental, tem se mostrado um método limitado, questionável, subjetivo e pouco confiável. Os métodos instrumentais, que utilizam espectroscópios ou imagens digitais, têm se mostrado mais adequados por oferecerem avaliações objetivas, maior reprodutibilidade e confiabilidade. Neste artigo, serão apresentados e discutidos os resultados obtidos com a utilização do ScanWhite© ? software para avaliação objetiva do nível de clareamento dental e apoio à decisão clínica, que baseia sua avaliação no processamento computacional de imagens digitais. Esse tem como principais diferenciais: (1) algoritmo calibrador para compensar as variações de luminosidade do ambiente, (2) apresentação dos resultados em valores numéricos e através do gráfico de evolução do clareamento dental, (3) interface intuitiva e facilidade de uso, (4) determinação dos índices de apoio à decisão (IPS ? índice de possibilidade de sucesso, e IRS ? índice de risco de sensibilidade antes do início do tratamento) e (5) emissão de relatório geral, autorizações e recomendações pós-clareamento.

Associação de prótese fixa, implantes e estética periodontal para reabilitação de pacientes parcialmente edêntulos

Periodontitis is a chronic inflammatory disease that results in the destruction of teeth and their supporting tissues with subsequent tooth loss. The replacement of missing teeth for implant-supported restorations has proven to be a highly predictable treatment method with good long-term prognosis. However, some consequences of tooth loss prevents dental implant placement in an ideal position, where regenerative procedures are necessary for this type of rehabilitation. Less invasive procedures such as conventional prosthesis emerge as a therapeutic option in cases where there is enough bone structure for implants and patient´s non-acceptance for invasive procedures. Thus, this paper aims to present the resolution of rehabilitation through a noninvasive and multidisciplinary treatment. One female patient referred to the clinic presented maladaptive bilateral mandibular fixed prostheses, endodontic lesions, gingival recession, and root sensitivity. For proper resolution of this case, an association among osseointegrated implants, fixed partial prosthesis, tooth extraction, and aesthetic periodontal procedures with the use of subepithelial connective tissue graft was proposed. After two years, the patient shows excellent aesthetics and chewing. Within the limits of this scenario, this paper discusses the various factors that may affect the choice of a particular treatment modality for the rehabilitation of edentulous single spaces.

Reabilitação estético-funcional sobre implantes agulhados e endósseos

This report shows the resolution of a case study whose aim was promote the aesthetic and functional rehabilitation of upper left hemi-arch over endosseous and needle implant prostheses. To improve the position of the needle implants, we performed the bucco-palatal bending of needles splinting them with composite resin; we removed the screwed implant prosthesis in the regions of the premolars (24 and 25) and molar (26). The mini-abutments of the last two implants were replaced, and in the first premolar and canine, we used cemented abutments due to implant angulation having planned soldering because of implant size and contact with one needle implant that could interfere with intimate contact bone/implant damaging biomechanics. Pick-up impressions were performed with an open tray, using a retractor cord in the needle implants and respective transfer copings. Therefore, models were related on semi-adjustable articulator after a face-bow recording and interocclusal indexes. After working cast fabrication and try-in of infra-structures, these were adjusted and related into the articulator again. Then, after ceramic build-up, adjustments, finishing, and torque, chemically-activated resin cement was applied on units 21 to 24. At the end of the case, we concluded that a good aesthetic and functional rehabilitation depends on thorough knowledge of techniques for each clinical situation.

Técnica estrutural: confecção de pilar personalizado cerâmico para otimizar a estética

Na reabilitação protética com implantes, a reconstituição das características anatômicas do tecido peri-implantar é fundamental para a obtenção de uma estética ótima. Como os componentes metálicos não transmitem a luz, fazem com que os pacientes com fenótipos gengivais finos apresentem uma coloração escurecida, resultante da limitação estética desses componentes. Pilares cerâmicos (alumina ou zircônia) têm sido utilizados para resolver esse problema, os quais possibilitam a complementação com próteses metal free. A indústria fornece, para alguns sistemas, componentes pré-fabricados cerâmicos a serem personalizados por desgastes e componentes personalizados confeccionados com sistemas CAD/CAM e CAD/MAN. Tendo em vista as limitações de algumas das conexões desses componentes, o objetivo desse estudo é apresentar a técnica laboratorial para confecção de um pilar personalizado cerâmico realizado sobre pilar UCLA de sobrefundição. Concluiu-se que a utilização da cerâmica feldspática proporciona ótima estética, boa transparência, resistência mecânica, baixo custo, melhor capacidade adesiva, com utilização de cimentos resinosos, e, principalmente, técnica de amplo domínio dos laboratórios.

Reabilitação estética funcional associando onlays em cerômero e resinas nanoparticuladas

Introdução: a perda da dimensão vertical de oclusão (DVO) é resultada de um grande desequilíbrio oclusal, onde não apenas a perda dos dentes pode ser o fator responsável, mas também as parafunções, entre elas, o bruxismo. O restabelecimento da relação maxilomandibular é condição necessária para que uma adequada reabilitação bucal seja executada, devolvendo, assim, função e estética perdidas. Objetivo: descrever um caso clínico de reabilitação em paciente bruxista, com presença de desgastes dentários, desgastes de tratamentos restauradores previamente existentes, fratura de onlay e bordas incisais, restabelecendo uma nova DVO por meio de onlays posteriores em cerômeros, recuperando a estética com restaurações diretas em resinas compostas nos dentes anteriores. Conclusões: a reabilitação bucal com levante de mordida em onlays devolve a DVO perdida de maneira segura.