Profile evaluation of orthodontic professionals as for their legal actions

Objective: Evaluate the legal actions and behavior in the doctor/patient relationship, used by dental surgeons practicing orthodontics. Methods: The population sample of the present study consisted of dental surgeons, active in the field of orthodontics, and registered with Dental Press Publishing Company - Maringá/PR, Brazil, with a total sample size of 525 professionals. The research was conducted using a 17-question survey forwarded to these professionals. Results and Conclusions: The majority of participants in our study are specialized in orthodontics; 75% of professionals use some sort of contract at the office/clinic; 73.7% of professionals periodically request maintenance X-rays; a large percentage of professionals (58.9%) keep patient records on file for life. The interviewed professionals demonstrate good knowledge of the Brazilian Code of Ethics in Dentistry, especially of Chapter XIV - on Communication.

Paresthesia during orthodontic treatment: case report and review.

Paresthesia of the lower lip is uncommon during orthodontic treatment. In the present case, paresthesia occurred during orthodontic leveling of an extruded mandibular left second molar. It was decided to remove this tooth from the appliance and allow it to relapse. A reanatomization was then performed by grinding. The causes and treatment options of this rare disorder are reviewed and discussed. The main cause of paresthesia during orthodontic treatment may be associated with contact between the dental roots and inferior alveolar nerve, which may be well observed on tomography scans. Treatment usually involves tooth movement in the opposite direction of the cause of the disorder.

Conservative reconstruction of the smile by orthodontic, bleaching, and restorative procedures

The following is a clinical case report of a patient whose chief complaint was the presence of generalized spacing in the maxillary anterior segment following orthodontic treatment. After meticulous clinical analyses and discussions of the clinical procedures to be adopted, dental bleaching was performed in both arches with 10% hydrogen peroxide (Opalescence Trèswhite Supreme 10% Hydrogen Peroxide - Ultradent Products, Inc., South Jordan, USA) after the conclusion and stabilization of orthodontic treatment. Then, the orthodontic appliance was removed and the diastemas in the maxillary anterior teeth were closed with Amelogen Plus (Ultradent Products, Inc., South Jordan, USA) resin composite. It was observed that the association of orthodontic, bleaching, and restorative procedures was capable of restoring dental shape, function, and esthetics, allowing the patient to smile without hesitation.

Assessment of force decay in orthodontic elastomeric chains: An in vitro study

Introduction: Elastomeric materials are considered important sources of orthodontic forces. Objective: To assess force degradation over time of four commercially available orthodontic elastomeric chains (Morelli, Ormco, TP and Unitek). Methods: The synthetic elastics were submerged in 37 oC synthetic saliva and stretched by a force of 150 g (15 mm - Morelli and TP; 16mm - Unitek and Ormco). With a dynamometer, the delivered force was evaluated at different intervals: 30 minutes, 7 days, 14 days and 21 days. The results were subjected to ANOVA and Tukey's test. Results: There was a force decay between 19% to 26.67% after 30 minutes, and 36.67% to 57% after 21 days of activation. Conclusions: TP elastomeric chains exhibited the smallest percentage of force decay, with greater stability at all time intervals tested. Meanwhile, the Unitek chains displayed the highest percentage of force degradation, and no statically significant difference was found in force decay between Ormco and Morelli elastomeric chains during the study period.

Effect of fluoride solutions on the shear bond strength of orthodontic brackets

The aim of this in vitro study was to evaluate the shear bond strength of brackets after pre-treatment with different fluoride solutions. This study used 48 freshly extracted sound bovine incisors that were randomly assigned to 4 experimental groups (n=12). CG: (control) without treatment; NF: 4 min application of neutral fluoride; APF: application of 1.23% acidulated phosphate fluoride (APF) for 4 min; and SFV: application of 5% sodium fluoride varnish for 6 h. For each group, after surface treatment, prophylaxis of enamel and bracket bonding with Transbond XT composite resin (3M) were performed following the manufacturer's specifications. The shear bond strength was performed with a universal testing machine 24 h after fixing the brackets. The tooth surfaces were analyzed to verify the adhesive remnant index (ARI). Data were analyzed statistically by ANOVA and Tukey's test (α=0.05). There was statistically significant difference among the groups (p<0.0001). CG and NF groups presented significantly higher bond strength than APF and SFV. There was no significant difference between CG and NF or between APF and SFV (p>0.05). The analysis of ARI scores revealed that most failures occurred at the enamel-resin interface. It may be concluded that the pre-treatment of enamel with 1.23% APF and 5% SFV prior to fixing orthodontic brackets reduces shear bond strength values.

Combination of orthodontic movement and periodontal therapy for full root coverage in a miller class iii recession: A case report with 12 years of follow-up

One of the main purposes of mucogingival therapy is to obtain full root coverage. Several treatment modalities have been developed, but few techniques can provide complete root coverage in a class III Miller recession. Thus, the aim of this case report is to present a successful clinical case of a Miller class III gingival recession in which complete root coverage was obtained by means of a multidisciplinary approach. A 17-year-old Caucasian female was referred for treatment of a gingival recession on the mandibular left central incisor. The following procedures were planned for root coverage in this case: free gingival graft, orthodontic movement by means of alignment and leveling and coronally advanced flap (CAF). The case has been followed up for 12 years and the patient presents no recession, no abnormal probing depth and no bleeding on probing, with a wide attached gingiva band. A compromised tooth with poor prognosis, which would be indicated for extraction, can be treated by orthodontic movement and periodontal therapy, with possibility of 100% root coverage in some class III recessions.

Clinical evaluation of the failure rate of metallic brackets bonded with orthodontic composites

The purpose of the present study was to evaluate in vivo the failure rate of metallic brackets bonded with two orthodontic composites. Nineteen patients with ages ranging from 10.5 to 38.7 years needing corrective orthodontic treatment were selected for study. The enamel surfaces from second premolars to second premolars were treated with Transbond Plus-Self Etching Primer (3M Unitek). Next, 380 orthodontic brackets were bonded on maxillary and mandibular teeth, as follows: 190 with Transbond XT composite (3M Unitek) (control) and 190 with Transbond Plus Color Change (3M Unitek) (experimental) in contralateral quadrants. The bonded brackets were light cured for 40 s, and initial alignment archwires were inserted. Bond failure rates were recorded over a six-month period. At the end of the evaluation, six bond failures occurred, three for each composite. Kaplan-Meyer method and log-rank test (Mantel-Cox) was used for statistical analysis, and no statistically significant difference was found between the materials (p=0.999). Both Transbond XT and Transbond Plus Color Change composites had low debonding rates over the study period.

Induction of ankylosis in the incisor for orthodontic tooth movement in rats

Background/Aim: The present research evaluated the induction of ankylosis and the eruption rate in rat incisors, with the aim of achieving stable anchorage for orthodontic tooth movement (OTM) of the molars. Material and methods: Fifteen male Wistar rats were used. In the Experimental group, the right superior incisor of each animal was extracted, denuded of the PDL and the dental papilla, and reimplanted. The Control group was the left superior incisors. The eruption rate was measured at 7, 10, 12, 14, and 16 days after replantation. NiTi closed springs with a 50cN release force were installed for additional 9 days, and the eruption rate was determined. Then, the rats were sacrificed, and ankylosis was examined by microscopic analysis. Differences with P < 0.01 were defined as statistically significant. Results: The eruption rates were 0 and 0.39 mm day-1 in the Experimental group and Control group, respectively. All incisors of the Experimental group showed ankylosis according to histological analysis. Conclusions: The methodology used to induce ankylosis in this study was effective for anchoring the incisors during the OTM of rat molars, eliminating the undesirable effects consequent to continuous eruption. © 2013 John Wiley & Sons A/S.

Determination of the force systems produced by different configurations of tear drop orthodontic loops

Objective: To determine the mechanical characteristics of teardrop loop with and without helix fabricated using different metal alloy compositions (stainless steel and beta-titanium), submitted to different intensities of bends preactivation (0° and 40°), and with different cross-sectional dimension of the wire used to build these loops (0.017 x 0.025-in and 0.019 x 0.025-in). Methods: Eighty loops used to close spaces were submitted to mechanical tests. The magnitudes of horizontal force, the moment/force ratio, and the load/deflection ratio produced by the specimens were quantified. Loops were submitted to a total activation of 5.0 mm and the values were registered for each 1.0 mm of activation. For statistic data analysis, a analysis of variance was performed and a Tukey's Multiple Comparison test was used as supplement, considering a 5% level of significance. Results: In general, teardrop loops with helix produced lower magnitudes of horizontal force and load/deflection ratio, and higher moment/force ratio than teardrop loops without helix. Among all analyzed variables, metal alloy composition presented greater influence in the horizontal force and in the load/deflection ratio. The moment/force ratio showed to be more influenced by the preactivation of loops for space closure. © 2013 Dental Press Journal of Orthodontics.

Orthodontic force increases interleukin-1β and tumor necrosis factor-α expression and alveolar bone loss in periodontitis

Background: The present study aims to evaluate the effects of orthodontic movement (OM) on the periodontal tissues of rats with ligature-induced periodontal disease. Methods: Eighty-eight rats were divided into four groups: 1) negative control (sham operated); 2) periodontal disease; 3) OM; and 4) periodontal disease followed by OM (OMP). Rats were sacrificed 3 hours or 1, 3, or 7 days after OM commencement. Bone volume fraction (BVF) and bone mineral density (BMD) were assessed in hemimaxillae by microcomputed tomography analysis. Expression of the proinflammatory cytokines interleukin (IL)-1β and tumor necrosis factor (TNF)-α were evaluated in gingival samples by quantitative polymerase chain reaction and enzyme-linked immunosorbent assay, and in the furcation region by immunohistochemistry analysis (IHC). Results: The OMP group had lower BVF and BMD levels compared to the other groups at day 7 (P <0.05). Maximum messenger ribonucleic acid expression of both cytokines was observed in the OMP group at day 1 (P <0.05). In the same period, all proteins were expressed in high levels for all test groups compared to the control group. The number of cells positive for IL-1β and TNF-α by IHC was highest in the OMP group at day 1, with progressive reduction thereafter. Conclusion: The results suggest that OM acts synergistically with periodontal disease in periodontal breakdown through upregulation of proinflammatory cytokines.

Extrusion of flavored corn grits: Structural characteristics, volatile compounds retention and sensory acceptability

The effects of the moisture content of the raw material, extrusion temperature and screw speed on flavor retention, sensory acceptability and structure of corn grits extrudates flavored with isovaleraldehyde, ethyl butyrate and butyric acid were investigated. Higher temperature resulted in more expanded extrudates with lower density and cutting force, while higher moisture content increased ethyl butyrate retention. The most acceptable extrudates were those obtained with low moisture content, under conditions of high extrusion temperature and high screw speed, or low screw speed and low extrusion temperature, whereas the aroma intensity closest to the ideal was observed under conditions of low extrusion temperature and low moisture content of the raw material. © 2013 Elsevier Ltd.

Efeitos da retração dentária sobre o ponto A em pacientes submetidos ao tratamento ortodôntico

Pós-graduação em Odontologia - FOA

Avaliação da intrusão dos molares superiores pela técnica de ancoragem com miniplacas de titânio

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

In vivo color changes of esthetic orthodontic ligatures

OBJETIVO: avaliar as alterações de cor ocorridas em elastômeros estéticos de quatro marcas comerciais, quando expostos ao meio bucal. MÉTODOS: foram examinadas as quatro marcas comerciais mais citadas por ortodontistas — Morelli, Uniden, American Orthodontics (AO) e TP —, em 25 pacientes consecutivos. Os elastômeros foram distribuídos de forma aleatória e ordenados nas quatro hemiarcadas de cada paciente, permanecendo no meio bucal por 30 dias. Após esse período, duas unidades de cada marca em todos os pacientes foram fotografadas de forma padronizada para, posteriormente, serem analisadas através de avaliação visual quanto à variação de cor, por escores (0, 1, 2, 3), por um painel de quatro examinadores. Os escores médios dos examinadores foram analisados estatisticamente por meio da ANOVA e teste de Tukey, com p<0,05. RESULTADOS: os escores médios de pigmentação, após 30 dias no meio intrabucal, obtidos para os elastômeros Morelli (1,80±0,78) e Uniden (1,92±0,66) não foram estatisticamente diferentes entre si. Entretanto, essas marcas estavam significativamente mais pigmentadas após 30 dias no meio intrabucal (p<0,01) quando comparadas às marcas importadas, American Orthodontics (0,97±0,6) e TP (0,83±0,79). CONCLUSÃO: apesar de todas as quatro marcas apresentarem uma indesejável pigmentação após 30 dias no meio intrabucal, as marcas American Orthodontics e TP apresentaram alterações de cor menos significativas do que as marcas Morelli e Uniden.

Factors related to orthodontic treatment time in adult patients

INTRODUÇÃO: o tratamento ortodôntico de pacientes adultos apresenta grande variabilidade no tempo necessário para sua realização. OBJETIVO: o objetivo desse trabalho foi investigar a influência de diversas variáveis sobre o tempo de tratamento. MÉTODOS: foram examinados 70 casos clínicos, de pacientes adultos, com bom resultado final, coletados em clínicas de três ortodontistas experientes, cujo acervo total inicial era de 4.723 prontuários. A influência das variáveis idade, sexo, padrão facial, severidade inicial da má oclusão (medida por meio do índice PAR), relação sagital de caninos, tipo de braquetes (estético ou metálico), exodontias, faltas às consultas e "quebras" de aparelho, sobre o tempo de tratamento (variável dependente), foram avaliadas por meio da análise de regressão linear múltipla, seguida do método Stepwise, com p < 0,05. RESULTADOS: a quantidade de faltas (R² = 14,04%, p < 0,0001) e o número de "quebras" do aparelho (R² = 29,71%, p = 0,0037) tiveram influência significativa na variação do tempo de tratamento, sendo essas duas variáveis juntas capazes de prever 43,75% (R² total) da variação no tempo de tratamento. Outros fatores, como a relação de caninos ao início do tratamento, o tipo de braquete usado (metálico ou cerâmico), exodontias, a idade ao início do tratamento, a severidade inicial da má oclusão, o sexo do paciente e o padrão facial não tiveram influência significativa sobre o tempo de tratamento. CONCLUSÃO: a duração do tratamento ortodôntico em adultos, quando realizado por ortodontistas experientes, sofre influência, principalmente, de fatores associados à colaboração do próprio paciente. Entretanto, diversos fatores não incluídos nesse estudo podem contribuir para a variação na duração do tratamento ortodôntico.