Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts (R) total joint prostheses Part II - Airway changes and stability

The purpose of this study was to evaluate the anatomical changes and stability of the oropharyngeal airway and head Posture following TMJ reconstruction and mandibular advancement with TMJ Concepts custom-made total joint prostheses and maxillary osteotomies with counter-clockwise rotation of the maxillo-mandibular complex. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). The lateral cephalograms of 47 patients were analyzed to determine surgical and post-surgical changes of the oropharyngeal airway, hyoid bone and head posture. Surgery increased the narrowest retroglossal airway space 4.9 mm. Head Posture showed flexure immediately after surgery (-5.6 +/- 6.7 degrees) and extension long-term post surgery (1.8 +/- 6.7 degrees); cervical curvature showed no significant change. Surgery increased the distances between the third cervical vertebrae and the menton 11.7 +/- 9.1 mm and the third cervical vertebrae and hyoid 3.2 +/- 3.9 mm, and remained stable. The distance from the hyoid to the mandibular plane decreased during surgery (-3.8 +/- 5.8 mm) and after surgery (-2.5 +/- 5.2 mm), Maxillo-mandibular advancement with counter-clockwise rotation and TMJ reconstruction with total joint prostheses produced immediate increase in oropharyngeal airway dimension, which was influenced by long-term changes in head posture but remained stable over the follow-up period.

Early cephalometric characteristics in Class III malocclusion

OBJECTIVE: Early identification of craniofacial morphological characteristics allows orthopedic segmented interventions to attenuate dentoskeletal discrepancies, which may be partially disguised by natural dental compensation. To investigate the morphological characteristics of Brazilian children with Class III malocclusion, in stages I and II of cervical vertebrae maturation and compare them with the characteristics of Class I control patients. METHODS: Pre-orthodontic treatment records of 20 patients with Class III malocclusion and 20 control Class I patients, matched by the same skeletal maturity index and sex, were selected. The craniofacial structures and their relationships were divided into different categories for analysis. Angular and linear measures were adopted from the analyses previously described by Downs, Jarabak, Jacobson and McNamara. The differences found between the groups of Class III patients and Class I control group, both subdivided according to the stage of cervical vertebrae maturation (I or II), were assessed by analysis of variance (ANOVA), complemented by Bonferroni's multiple mean comparisons test. RESULTS: The analysis of variance showed statistically significant differences in the different studied groups, between the mean values found for some angular (SNA, SNB, ANB) and linear variables (Co - Gn, N - Perp Pog, Go - Me, Wits, S - Go, Ar - Go). CONCLUSION: Assessed children displaying Class III malocclusion show normal anterior base of skull and maxilla, and anterior positioning of the mandible partially related to increased posterior facial height with consequent mandibular counterclockwise rotation.

Avaliação cefalométrica da posição do osso hióide em crianças respiradoras bucais

MATERIAL E MÉTODOS: em função das relações anatomofuncionais do osso hióide com o complexo craniofacial, realizou-se avaliação cefalométrica da posição do osso hióide em relação ao padrão respiratório. A amostra consistiu de 53 crianças, gênero feminino, com idades médias de 10 anos, sendo 28 respiradoras nasais e 25, bucais. As medidas cefalométricas horizontais, verticais e angulares foram utilizadas com a finalidade de determinar a posição do osso hióide. Estabeleceu-se uma comparação entre os grupos por meio do teste t de student, bem como correlação de Pearson entre as variáveis. RESULTADOS: Observou-se que não ocorreram diferenças estatísticas significativas para a posição mandibular e posição do osso hióide e o tipo do padrão respiratório. No Triângulo Hióideo, o coeficiente de correlação de 0,40 foi significativo entre AA-ENP (distância entre vértebra atlas e espinha nasal posterior) e C3-H (distância entre a terceira vértebra cervical e osso hióide) demonstrando uma relação positiva entre os limites ósseos do espaço aéreo superior e inferior. Para as medidas cranianas sugeriu-se uma relação entre a posição do osso hióide com a morfologia mandibular. CONCLUSÃO: Os resultados permitiram concluir que o osso hióide mantém uma posição estável, provavelmente, para garantir as proporções corretas das vias aéreas e não depende do padrão respiratório predominante.

Long-term effectiveness and treatment timing for bionator therapy

The aim of the present investigation was to provide information about the long-term effects and optimal timing for class-II treatment with the Bionator appliance. Lateral cephalograms of 23 class-II patients treated with the Bionator were analyzed at three time periods: T1, start of treatment; T2, end of Bionator therapy; and T3, long-term observation (after completion of growth). T3 includes a phase with fixed appliances. The treated sample was divided into two groups according to their skeletal maturity as evaluated by the cervical vertebral maturation (CVM) method. The early-treated group (13 subjects) initiated treatment before the peak in mandibular growth, which occurred after completion of Bionator therapy. The late-treated group (10 subjects) received Bionator treatment during the peak. The T1-T2, T2-T3, and T1-T3 changes in the treated groups were compared with changes in control groups of untreated class-II subjects by nonparametric statistics (P < .05). The findings of the present study on Bionator therapy followed by fixed appliances indicate that this treatment protocol is more effective and stable when it is performed during the pubertal growth spurt. Optimal timing to start treatment with the Bionator is when a concavity appears at the lower borders of the second and the third cervical vertebrae (CVMS 11). In the long term, the amount of significant supplementary elongation of the mandible in subjects treated during the pubertal peak is 5.1 mm more than in the controls, and it is associated with a backward direction of condylar growth. Significant increments in mandibular ramus height also were recorded.

Alterações da densidade mineral óssea em vértebras de ratos wistar submetidos à ausência de carga nos membros pélvicos

The suspension of rats by the tail model is used to investigate the behavior of bone in animals unable to move around. Bone is an adaptative tissue that develops in structure and function, among other factors, in response to mechanical forces applied to it and metabolic demands that it will suffer. The absence of mechanical forces and deformation of bone that occurs causes a decrease in calcium deposition in the absence of stimuli on osteoblasts and osteocytes, favoring the action of osteoclasts, making bones weak and brittle. Therefore, the mechanical action is necessary to stimulate local bone response and thus provide growth and remodeling. The aim of this study was to evaluable by radiographic densitometry, the tail suspension for 15 and 36 days alter the bone mineral density of cervical vertebrae (C3), thoracic (T6) and lumbar (L1 and L3) of Wistar rats. Thirty Rattus norvegicus albinus, adult, male, Wistar strain, average body mass ± 350g, were divided into 3 groups: control (n = 10) - not suspended; S15 (n = 10) - suspended for 15 days and S36 (n = 10) - suspended for 36 days. For densitometric analysis vertebrae were radiographed, scanned, digitized and analyzed by the computer program ImageJ®. There was a statistically significant increase in bone mineral density in group S15, probably by the restlessness of the animals to the suspension, with a decrease in group S36, and this hypothetically is linked to the accommodation of the rats, concluding that the tail suspension altered bone mineral density in first time with a decrease over time.

Densidade mineral óssea de vértebras de ratos wistar suspensos pela cauda por 15 e 36 dias

Pós-graduação em Ciência Animal - FMVA

Morfologia das 3ª e 4ª vértebras cervicais representativa do surto de crescimento da adolescência

Pós-graduação em Odontologia - FOA

Comparação das razões lineares das vértebras cervicais por tomografia computadorizada de feixe cônico (TCFC)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo da relação entre a análise de maturação das vértebras cervicais por meio de medidas em radiografias cefalométricas laterais e a curva de crescimento ósseo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Resistência mecânica e alterações radiográficas na distração e estabilização intervertebral usando plug de poliuretana de mamona ou polimetilmetacrilato

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Alterações do tecido mole, espaço faríngeo e estabilidade após avanço maxilo-mandibular xom rotação anti-horária e prótese total de ATM

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Desenvolvimento e análise de um método de avaliação de maturação óssea por meio de medidas das vértebras cervicais em radiografias cefalométricas laterais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Correlação entre a maturação óssea das vértebras cervicais com a maturação óssea de mão e punho e com a mineralização dentária pelo método radiográfico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo radiográfico da relação entre os principais métodos de avaliação da idade óssea e dentária com a idade cronológica quando aplicados à leucodermas e xantodermas brasileiros

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação longitudinal do crescimento craniofacial de indivíduos classe II tratados e não tratados

Pós-graduação em Ciências Odontológicas - FOAR