426 resultados para maxilla


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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Autogenous bone grafting is the gold-standard technique for bone augmentation procedures prior to implant placement. If the amount of available intraoral donor bone is insufficient, it is necessary to harvest bone graft from extraoral sites, such as calvaria. Although this technique is well established, only a few case reports show the histological analysis of the grafted bone at the moment of implant placement. This article reports the case of a 48-year-old female patient with a critical atrophic maxillary ridge reconstructed using autogenous calvarial bone graft prior to implant placement, with clinical and histological evaluation. Bone was collected under general anesthesia from the parietal bone. The outer cortical originated the bone blocks, and the medullar bone layer between was collected to be used in the sinus augmentation procedure, together with 5 of the bone blocks triturated. Six months after bone augmentation, 8 implants were placed in the grafted area and 2 biopsies were retrieved (anterior and the posterior regions), allowing the visualization of the bone-remodeling process in the grafted areas. The patient had a stable recovery. Our results showed that although necrotic bone could still be seen in the outer layer of the grafted area, the interface between this necrotic bone and the already remodeled bone was consistent with biocompatibility. Two-year radiographic evaluation showed success of the grafts and the implants in supporting an esthetic and functionally stable prosthesis. Summarizing, calvarial bone grafts are a viable alternative for the attainment of adequate bone volume prior to implant placement.

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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.

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

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

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In malocclusion studies, may happen not only dental discrepancies but even skeletal discrepancies. In Class III malocclusion can be observed underdeveloped maxilla, mandible protraction or both of them, and, in most of the times associated with a narrow maxilla that causes anterior or posterior crossbites, in one side or in two sides. The aim of this case report is to evaluate the facial profile and occlusal effects of interceptive orthodontics therapy. The treatment with upper arch expansion and maxilla protraction was done in an early age to be effective in the circummaxillary sutural system and to make the orthopedic effect easier. The facial mask used is positioned on two facial points and allows an anterior maxillary replacement. Patients’ compliance is important to reach treatment success, this because using the mask still in this growth and development phase is essential to make the facial and occlusal effects happen. It is important to mention that patients with Angle Class III malocclusion need to be followed till the end of their growth.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Aim: To demonstrate the magnitude and direction of skeletal changes in the maxilla and mandible during and after the use of bionator, as well as their rotations. Methods: Partial superimposition on the maxilla and mandible on the metallic implants and total superimposition on the cranial base were performed at three periods, T1 before bionator therapy, T2 after bionator therapy, and T3 5.68 years after T2. Results: There was total clockwise maxillary rotation and counterclockwise mandibular rotation, in the North American technique, throughout the study period, as well as extensive remodeling on the condylar region, especially in vertical direction and on the gonial region in horizontal direction. Conclusions: The total maxillary rotation seemed to be significantly affected by therapy than the mandible. There was a clear change in the direction of condylar remodeling compared to the period of bionator therapy and posterior bionator therapy. Considering the entire study period, it was observed that intra-matrix rotation of the maxilla and mandible masked their total rotation, causing minimum changes in the matrix rotation.

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Immediate reutilization of the expanding action in a case of rapid maxillary expansion surgically assisted. The orthopedic rapid maxillary expansion (RME) and rapid maxillary expansion surgically assisted (RMESA) are conducted with the aim of giving an appropriate jaw, capable of providing a normal occlusion. In extreme cases, where there is a severe atresia, it is necessary to perform an expansion beyond that allowed by the expander, followed by another conventional device or a butterfly expander, when the atresia is in the anterior maxillary region. In this situation, there are two options: wait about 90 days to allow intermaxillary suture restructuring and perform a new RME / RMESA or proceed immediately to the expansion process. Considering the biological cost, financial and clinical time, the procedure of reusing the immediate expander action becomes the technique of choice in these cases, been the operational procedure performed simplified and in just four steps. This work will show a case report where, after accomplishing the RMESA was observed that even after changing the shape of the maxillary arch, the severity of atresia could not be corrected, especially in the anterior region, and more expansion was needed. Aiming to correct the atresia in the anterior maxilla, the technique used was to reuse the immediate expander action through the change of an intraoral screw expander for a conventional butterfly type screw expander.

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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.

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The aim of an orthodontic treatment is the achievement of a balanced, esthetic and, most of all, stable, intra and inter arches relationship. A common problem observed in occlusion is posterior crossbite and atresic maxilla. This problem may be treated by slow expansion, rapid expansion or surgically assisted expansion. For the present study cast models of 14 children between 7 and 11 years old were evaluated. There were 7 male and 7 female subjects that presented posterior crossbite and needed rapid maxillary expansion. The Hyrax appliance performed the therapy for correction of this transversal alteration, which is a common possibility in the treatment of this malocclusion. It was observed that the distance between the upper first molars and upper cuspids increased significantly; the length of the upper arch decreased and its perimeter increased significantly. At the lower arch there were no dimensional changes.

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The primary teeth are essential for bone development and establishment of the arches on occlusion. Thus, the congenitally absence of teeth may trigger a shift in the balance of the occlusion, promoting disharmony in the structures of the maxilla-mandibular system. However, some interventions are possible to be performed in these cases even in pediatric patients, to redirect growth, preventing growth deviations and reestablishing the aesthetic. The aim of this paper is to report the treatment of a 4-year-old child presenting congenitally absence of mandibular central and lateral incisors and maxilla lateral incisors, which consequently compromises aesthetics, occlusal function, and the development and the functional growth of the bones. The oral rehabilitation was performed with an adhesive partial denture, which was able to restore the aesthetic and the occlusal function, therefore being a viable alternative in the treatment of this patient of little age.