Prevalence of mesiodens in orthodontic patients with deciduous and mixed dentition and its association with other dental anomalies

OBJECTIVE: To determine the prevalence of mesiodens in deciduous and mixed dentitions and its association with other dental anomalies. MATERIAL AND METHODS: Panoramic radiographs of 1,995 orthodontic patients were analyzed retrospectively, obtaining a final sample of 30 patients with mesiodens. The following aspects were analyzed: gender ; number of mesiodens; proportion between erupted and non-erupted mesiodens; initial position of the supernumerary tooth; related complications; treatment plan accomplished; and associated dental anomalies. The frequency of dental anomalies in the sample was compared to reference values for the general population using the chi-square test (c²), with a significance level set at 5%. RESULTS: The prevalence of mesiodens was 1.5% more common among males (1.5:1). Most of the mesiodens were non-erupted (75%) and in a vertical position, facing the oral cavity. Extraction of the mesiodens was the most common treatment. The main complications associated with mesiodens were: delayed eruption of permanent incisors (34.28%) and midline diastema (28.57%). From all the dental anomalies analyzed, only the prevalence of maxillary lateral incisor agenesis was higher in comparison to the general population. CONCLUSION: There was a low prevalence of mesiodens (1.5%) in deciduous and mixed dentition and the condition was not associated with other dental anomalies, except for the maxillary lateral incisor agenesis.

Cephalometric evaluation of the predictability of bimaxillary surgical-orthodontic treatment outcomes in long face pattern patients: a retrospective study

OBJECTIVE: The aim of this study was to compare by means of McNamara as well as Legan and Burstone's cephalometric analyses, both manual and digitized (by Dentofacial Planner Plus and Dolphin Image software) prediction tracings to post-surgical results. METHODS: Pre and post-surgical teleradiographs (6 months) of 25 long face patients subjected to combined orthognathic surgery were selected. Manual and computerized prediction tracings of each patient were performed and cephalometrically compared to post-surgical outcomes. This protocol was repeated in order to evaluate the method error and statistical evaluation was conducted by means of analysis of variance and Tukey's test. RESULTS: A higher frequency of cephalometric variables, which were not statistically different from the actual post-surgical results for the manual method, was observed. It was followed by DFPlus and Dolphin software; in which similar cephalometric values for most variables were observed. CONCLUSION: It was concluded that the manual method seemed more reliable, although the predictability of the evaluated methods (computerized and manual) proved to be reasonably satisfactory and similar.

Candida spp. adherence to oral epithelial cells and levels of IgA in children with orthodontic appliances

Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis. Orthodontic and other oral appliances seem to favor candidal presence. The aim of this work was to compare the presence of Candida species in saliva, their adherence to oral epithelial cells, and the levels of anti-C. albicans IgA in children with or without orthodontic appliances. This study included 30 children 5 to 12 years old (9.1 ± 1.7 years old) who were users of removable orthodontic devices for at least 6 months and 30 control children of similar ages (7.7 ± 1.5 years old). The presence of yeast species in the saliva was evaluated by microbiological methods. Candida species were identified using phenotypic methods. Anti-C. albicans IgA levels in saliva were analyzed by ELISA. The yeasts adhering to oral epithelial cells were assessed by exfoliative cytology. No statistically significant differences were observed for saliva yeast counts and anti-C. albicans IgA levels between the studied groups. Children with orthodontic devices exhibited more yeast cells adhering to oral epithelial cells and a higher percentage of non-albicans species relative to the control group. In conclusion, orthodontic appliances may favor the adherence of Candida to epithelial cells but do not influence the presence of these yeasts in saliva, and the levels of anti-C. albicans IgA do not correlate with yeast adherence or presence of Candida in the oral cavity

Comparação da razão carga/deflexão entre fios ortodônticos de Ni-Ti termoativados 0,014”x0,025” e 0,016”x0,022”

The knowledge of the mechanical properties of nickel-titanium (NiTi) termoactives of the more accessible of the domestic market is still limited. Given this, the objective of this study was to evaluate and compare through deflection tests in brackets NiTi wires 03 term rectangular gauge 0.014 '' enabled x 0.025 '' and 0.016 '' x 0.022 '' of different brands (MORELLI (R), ORMCO (R) ORTHOSOURCE (R), ORTHOMETRIC (R), EURODONTO (R) and ADITEK (R)). All tests were carried out on universal testing machine EMIC DL 2000 under identical conditions and controlled at a temperature of 36 degrees C +/- 0.5 degrees C. Five measurements (N= 5) were performed for each thickness/wire tag that was deflected up to a limit of 4.0mm at a speed of 1.0mm/min. Each 0.2mm (round trip) of corresponding strength measured deflection for the construction of the graph of force x deflection at Tesc program version 3.04. Each graphic was evaluated according to the following variables: beginning of the Martensitic transformation (cN and mm), maximum strength (cN), the beginning and end of the plateau of deactivation (cN and mm) and length (mm) plateau. The average and standard deviation were calculated for all variables and statistical analysis was made by ANOVA tests 2 criteria and Turkey or Kruskal-Wallis and Dunn, a 5% level of significance. The results showed that the tests of 0.014 '' x0.025 '' ORTHOMETRIC (R) brands and ORMCO (R) showed the best results, as well as the wires of the MORELLI (R) and ORTHOSOURCE (R) to wires 0.016 '' x0.022 ''. In General, the gauge wires 0.014 '' x0.025 '' showed strength levels on the plateau of deactivation to 6 x smaller than 0.016 '' x0.022 '' caliber.

Time reduction of light curing: Influence on conversion degree and microhardness of orthodontic composites

Introduction: The aim of this study was to assess the influence of curing time and power on the degree of conversion and surface microhardness of 3 orthodontic composites. Methods: One hundred eighty discs, 6 mm in diameter, were divided into 3 groups of 60 samples according to the composite used-Transbond XT (3M Unitek, Monrovia, Calif), Opal Bond MV (Ultradent, South Jordan, Utah), and Transbond Plus Color Change (3M Unitek)-and each group was further divided into 3 subgroups (n = 20). Five samples were used to measure conversion, and 15 were used to measure microhardness. A light-emitting diode curing unit with multiwavelength emission of broad light was used for curing at 3 power levels (530, 760, and 1520 mW) and 3 times (8.5, 6, and 3 seconds), always totaling 4.56 joules. Five specimens from each subgroup were ground and mixed with potassium bromide to produce 8-mm tablets to be compared with 5 others made similarly with the respective noncured composite. These were placed into a spectrometer, and software was used for analysis. A microhardness tester was used to take Knoop hardness (KHN) measurements in 15 discs of each subgroup. The data were analyzed with 2 analysis of variance tests at 2 levels. Results: Differences were found in the conversion degree of the composites cured at different times and powers (P < 0.01). The composites showed similar degrees of conversion when light cured at 8.5 seconds (80.7%) and 6 seconds (79.0%), but not at 3 seconds (75.0%). The conversion degrees of the composites were different, with group 3 (87.2%) higher than group 2 (83.5%), which was higher than group 1 (64.0%). Differences in microhardness were also found (P < 0.01), with lower microhardness at 8.5 seconds (35.2 KHN), but no difference was observed between 6 seconds (41.6 KHN) and 3 seconds (42.8 KHN). Group 3 had the highest surface microhardness (35.9 KHN) compared with group 2 (33.7 KHN) and group 1 (30.0 KHN). Conclusions: Curing time can be reduced up to 6 seconds by increasing the power, with a slight decrease in the degree of conversion at 3 seconds; the decrease has a positive effect on the surface microhardness.

Canine retraction and anchorage loss Self-ligating versus conventional brackets in a randomized split-mouth study

Objective: To evaluate the velocity of canine retraction, anchorage loss and changes on canine and first molar inclinations using self-ligating and conventional brackets.Materials and Methods: Twenty-five adults with Class I malocclusion and a treatment plan involving extractions of four first premolars were selected for this randomized split-mouth control trial. Patients had either conventional or self-ligating brackets bonded to maxillary canines randomly. Retraction was accomplished using 100-g nickel-titanium closed coil springs, which were reactivated every 4 weeks. Oblique radiographs were taken before and after canine retraction was completed, and the cephalograms were superimposed on stable structures of the maxilla. Cephalometric points were digitized twice by a blinded operator for error control, and the following landmarks were collected: canine cusp and apex horizontal changes, molar cusp and apex horizontal changes, and angulation changes in canines and molars. The blinded data, which were normally distributed, were analyzed through paired t-tests for group differences.Results: No differences were found between the two groups for all variables tested.Conclusions: Both brackets showed the same velocity of canine retraction and loss of anteroposterior anchorage of the molars. No changes were found between brackets regarding the inclination of canines and first molars.

Association between post-orthodontic treatment gingival margin alterations and symphysis dimensions

Orthodontic therapy is known to be associated with the development of gingival recession. Several factors may be involved in the causal chain of this outcome, including anatomical and behavioral aspects. Among the anatomical aspects, the dimensions of the mandibular symphysis could play a predisposing role. This study evaluated the relationship between the mandibular symphysis dimensions prior to orthodontic therapy and the development of gingival recessions on the lower incisors and cuspids. Records from 189 orthodontically treated adolescents were evaluated, including radiographs, casts and intra-oral photographs. Symphysis dimensions were assessed by cephalograms. Gingival margin alterations were determined in photographs and cast models. Association between gingival margin alterations and symphysis dimensions was tested by chi-square (α=0.05). Occurrence of gingival recession increased after orthodontic therapy. No association was observed on average of symphysis dimensions and the occurrence of gingival recessions. It may be concluded that pretreatment symphysis dimensions may not be used as predictors of gingival recession after orthodontic therapy.

In vitro comparison of the force degradation of orthodontic intraoral elastics from different compositions

The synthetic intermaxillary elastic emerged as an alternative for clinical use in patients with latex sensitivity. However, there are disagreements about this elastic protocol use according to the force degradation. The aim of this study was to evaluate, in vitro, the forces generated by latex and synthetic elastics over time. Material and methods: Sample size of 840 elastics were used (420 latex and 420 synthetic), delivering medium strength (Dental Morelli®) with internal diameter of 1/8", 3/16", 1/4" and 5/16". The elastics were randomly divided into 7 groups according to the time of the force measuring and immersed into distilled water at 37°C. To measure the force in each group, the elastics were stretched in six progressive increases of 100% of its internal diameter with the aid of a testing machine Emic and measured up to 72 hours. Data were analyzed with SPSS 16.0, using one-way analysis of variance (ANOVA). Results: Immediate force level of synthetic elastics was statistically higher than latex elastics in all strains, for the same size. However, the latex elastics mean forceslightly decreased over time, while the synthetic elastics presented an abrupt decrease. Conclusion: In view of these findings, Sudanese homemade alcoholic beverages cause oral epithelial atypical changes, which lead to oral precancerous and cancerous lesions. OEFC is a useful procedure for detection and assessment of oral ET.

In vitro comparison of the force degradation of orthodontic intramural elastic from different compositions

Introduction and Objective: The synthetic intermaxillary elastic emerged as an alternative for clinical use in patients with latex sensitivity. However, there are disagreements about this elastic protocol use according to the force degradation. The aim of this study was to evaluate, in vitro, the forces generated by latex and synthetic elastics over time. Material and methods: Sample size of 840 elastics were used (420 latex and 420 synthetic), delivering medium strength (Dental Morelli®) with internal diameter of 1/8”, 3/16”, 1/4” and 5/16”. The elastics were randomly divided into 7 groups according to the time of the force measuring and immersed into distilled water at 37°C. To measure the force in each group, the elastics were stretched in six progressive increases of 100% of its internal diameter with the aid of a testing machine Emic and measured up to 72 hours. Data were analyzed with SPSS 16.0, using one-way analysis of variance (ANOVA). Results: Immediate force level of synthetic elastics was statistically higher than latex elastics in all strains, for the same size. However, the latex elastics mean force slightly decreased over time, while the synthetic elastics presented an abrupt decrease. Conclusion: The synthetic elastic presented severe force degradation, jeopardizing the cost-benefit ratio, which indicates a higher replacement frequency. The latex elastic showed better mechanical performance in comparison to synthetic ones.

Longitudinal effect of curcumin-photodynamic antimicrobial chemotherapy in adolescents during fixed orthodontic treatment: a single-blind randomized clinical trial study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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.

Improvement of an anterior infrabone defect using combined periodontal and orthodontic therapy: a 6-year follow-up case report

Extensive intraosseous lesions represent a clinical challenge for the periodontist. Sites with bone defects have been shown to be at higher risk of periodontitis progression in patients who had not received periodontal therapy. Thus, the aim of this case report was to describe a novel approach for the treatment of 1-walled intraosseous defect by combining nonsurgical periodontal therapy and orthodontic movement toward the bone defect, avoiding regenerative and surgical procedures. A 47-year-old woman underwent the proposed procedures for the treatment of her left central incisor with 9 mm probing depth and 1-walled intraosseous defect in its mesial aspect. Initially, basic periodontal therapy with scaling and root planning was accomplished. Two months later, an orthodontic treatment was planned to eliminate the intraosseous lesion and to improve the interproximal papillary area. Orthodontic root movement toward the osseous defect was performed for 13 months with light forces. After 6 years postoperative it was concluded that combined basic periodontal therapy and orthodontic movement was capable of eliminating the intraosseous defect and improve the esthetics in the interproximal papillary area between the central incisors.

Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement

Forced orthodontic eruption (FOE) is a non-surgical treatment option that allows modifying the osseous and gingival topography. The aim of this article is to present a clinical case of a FOE, which resulted in an improvement of the amount of available bone and soft-tissues for implant site development. Patient was referred for treatment of mobility and unesthetic appearance of their maxillary incisors. Clinical and radiographic examination revealed inflamed gingival tissue, horizontal and vertical tooth mobility and interproximal angular bone defects. It was chosen a multidisciplinary treatment approach using FOE, tooth extraction, and immediate implant placement to achieve better esthetic results. The use of FOE, in periodontally compromised teeth, promoted the formation of a new bone and soft-tissue in a coronal direction, without additional surgical procedures, enabling an esthetic, and functional implant-supported restoration.

Aesthetic rehabilitation of a complicated crown-root fracture of the maxillary incisor: combination of orthodontic and implant treatment

The aim of this paper is to present a complex rehabilitation, of fractured tooth, with implants in anterior region considering the orthodontics extrusion to clinical success. At 7 years old, the patient fractured the maxillary left central incisor and the dentist did a crown with the fragment. Twenty years later, the patient was referred to a dental clinic for orthodontic treatment, with the chief complaint related to an accentuated deep bite, and a professional started an orthodontic treatment. After sixteen months of orthodontic treatment, tooth 21 fractured. The treatment plan included an orthodontic extrusion of tooth 21 and implant placement. This case has been followed up and the clinical and radiographic examinations show excellence esthetic results and satisfaction of patient. The forced extrusion can be a viable treatment option in the management of crown root fracture of an anterior tooth to gain bone in a vertical direction. This case emphasizes that to achieve the esthetic result a multidisciplinary approach is necessary.

The effect of chlorhexidine on plaque index and mutans streptococci in orthodontic patients: A pilot study

Aim: The purpose of this study was to assess chlorhexidine effects on plaque index and salivary levels of mutans streptococci (MS) when used as the immersion solution for removable orthodontic appliances and added to their acrylic resin composition. Methods: Forty-five patients (6 to 12 years old) were randomly assigned into three groups with 15 patients each. Group I (control)—without orthodontic appliances disinfection; Group II—removable orthodontic appliances which had been immersed in 0.12% chlorhexidine digluconate overnight (8 hours), and Group III—orthodontic appliances in which 0.12% chlorhexidine digluconate solution had been incorporated into their resin composition. Saliva was collected for quantification of MS and evaluation of plaque index was performed before and after installation of orthodontic appliance at 0, 2, 4, 6, 8, and 10 weeks. Data were analyzed by using analysis of variance. Results: Number of MS colonies in saliva and plaque index showed no statistically differences among groups at the different periods (p > 0.05). Conclusions: It could be concluded that chlorhexidine incorporation into the acrylic resin of removable orthodontic appliances at 0.12% concentration and immersion of the appliance into 0.12% chlorhexidine solution were not effective in reducing plaque index and the number of MS in saliva.