Mudanças dento-esquelétics naturais e decorrentes do tratamento ortopédico da má oclusão de Classe II

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Desgaste superficial do esmalte dental após microabrasão in vitro

The aim of this study was to investigate the enamel wear permanent teeth after plastic stick or low speed rubber cup microabrasion. Ten permanent molars were selected to evaluate enamel wear which were sectioned into mesial and distal halves. Each half of the molars was randomly assigned to one of two experimental groups (n = 10) according to the enamel microabrasion technique: plastic stick (GE) or rubber cup (GT). In both the groups, the enamel was submitted to 10 applications of an abrasive paste comprised of 35% phosphoric acid and pumice powder. The paste was applied for 20 seconds under a pressure of 30 g using the instrument defined for each group (plastic stick or rubber cup). The specimens were evaluated under a stereomicroscope connected to a computer. The enamel wear no was statistically different between GE and GT, which presented a mean wear of 304.74 µm (21.20%) and 338.35 µm (22.75%). In conclusion, superficial enamel wear was seen for both the groups, independent of the technique used for the accomplishment of the microabrasion.

Facial type measurements influence on transverse dimensions of normal occlusion arches

Objective – To correlate facial type measurements of Caucasian individuals with transverse dimensions of normal occlusion arches. Methods – Twenty-one pairs of dental models were selected according to the following inclusion criteria: presence of all permanent teeth from 1 st molar to 1 st molar; normal occlusion; no prosthetic crowns; no previous orthodontic treatment and 2 mm or less of crow- dings or spacings. The cephalometric measurements of lateral cephalometric X-ray of the same individuals were taken and tabulat ed. To evaluate the repetition of arch measurements, paired Student’s t-test and Pearson's correlation coefficient were used. The r elationship between the measurements was analysed by using the Pearson’s correlation. Results – The repetition of the measurements showed high correlation and no systematic error. In the comparison between the measurements, a moderate negative correlation was observed b et- ween facial axis angle and the measurements Upper and Lower 6-6, whereas a positive correlation was observed between dentition height and the latter. Conclusion – It was observed a negative correlation between facial axis angle and upper and lower inter-molar distance as well as a positive correlation between dentition height and upper and lower inter-molar distance.

Avaliação do índice de Litle em indivíduos que utilizaram o aparelho funcional T4K

The study aimed to assess the degree of dental crowding correction on the lower anterior region of patients treated with T4k functional appliance using Little’s irregularity index. Twenty caucasian patients of both gender (10 female and 10 male) were selected. They featured malocclusion Class I and II in mixed dentition, with chronological age between 5.7 and 11 years. The treatment lasted from 1 year and 11 months up to 3 years and 11 months. Lower anterior crowding was measured using Little’s irregularity index. Measurements were obtained on study models achieved before and after functional orthopedic therapy, using a digital caliper in millimeters and placed parallel to the occlusal plane. Overjet and overbite measurements were also performed using a caliper. Results demonstrated that the therapy provided significant decrease in overjet (average = 1.55 mm) and also in the irregularity index (average = 1.23 mm). There was a nonsignificant raise in overbite. There was no relation between the studied variables and the treatment period or even with the patient’s age in the beginning of the therapy. The treatment with T4k resulted on reduction and improvement of dental crowding.

Eficiência do aparelho Herbst bandado na correção da Classe II divisão 1 -relato de caso

The current reports the case of a young patient with malocclusion Class II division 1 on permanent dentition treated in two stages, rthopedics and orthodontics, respectively. At first, the banded Herbst appliance was used duringa 7 months period, followed by a T4K appliance, Trainer for Kids used as retention, and on the second stage the corrective Orthodontics was performed. The results showed the acquirement of a Class I dental relationship, which was kept stable, with excellent intercuspation, even after 5 years of the removal of the Herbst appliance, as well as the correction of the overjet and the reduction of the facial profile convexity. It can be concluded that the Herbst appliance was very efficient in correcting the Class II malocclusion, long term, also providing a very favorable effect on the facial profile.

Estudo em telerradiografia em norma de 45º no tratamento da classe II com aparelho de Herbst

The aim of this retrospective study was to evaluate mandibular and maxillary changes induced by the use of Herbst applianceand by natural growth through oblique cephalometric radiographs in children with Class II division 1 malocclusion with mandibular retrusion. A sample of 49 individuals with age ranging from 8 to 10 years old (before growth peak) with Class II division 1, were into two groups: Herbst treated group (n=24) and control group (n=25). Both groups were paired for gender and chronological age. Statistical analysis was performed through Student’s t test. The Herbst appliance promoted the Class II correction in a 7 months period by mesialization of lower permanent first molars and distalization of upper permanent first molars. The Herbst appliance had no influence over the mandibular structure or the mandibular length. It was concluded that early treatment with Herbst appliance corrected the Class II malocclusion by means of dentoalveolar changes.

Infra-oclusão de molares decíduos: diagnóstico e tratamento

Infraocclusion of deciduous molars is defined by total or partial periodontal ligament absence and characterized by the cementum or dentin anatomical fusion with alveolar bone. This study aims to report an ankylosis clinical case, the implications and treatments management options in the deciduos dentition.

Alterações dimensionais em pacientes submetidos à expansão rápida da maxila com aparelho do tipo Haas

The maxillary atresia is a alteration in the transverse dimension that can result in a unilateral or bilateral crossbite. For correction of atresia of the upper dental arch appliances with the intent to expand the arch of orthopedic or orthodontic manner are used, obtaining across-compatibility between the dental arches. The purpose of this study was to evaluate the dimensional changes of the maxillary in patients in the mixed dentition with atresia in the upper dental arch, using occlusal radiographs taken before, after rapid maxillary expansion and after removal of the appliance. Methods: the sample consisted of 35 patients who used the appliance type conventional Haas, in the mixed dentition, according to the standard protocol for installation, activation, containment and removal of the appliances rapid maxillary expansion. Results: the results confirm that the suture opening occurs in greater quantities in the anterior (4.3 mm) than posterior to (3.74 mm), representing a triangular opening of 7 degrees on average with the posterior opening 87% of the quantity of anterior opening. The molars region expanded about 5 mm, and the base bone 3.7 mm, representing a 74% bone expansion of the expansion teeth.

Aparelho de Thurow modificado e aparelho ortodôntico fixo no tratamento da classe II com mordida aberta anterior

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.

Avaliação das alterações dentárias e esqueléticas induzidas pelo uso do aparelho de Herbst no tratamento da classe II na dentadura mista: Revisão sistemática

Objective: evaluate the immediate dental and skeletal changes induced by the Herbst appliance on early treatment of Angle´s Class II malocclusion. Material and Method: several electronic databases such as Scopus, Pub Med, Medline, Cochrane Library, Lilacs and Scielo were searched. The abstracts that fullfilled the selection criteria were selected and those that did not provide enough information about these criteria were selected but the final decision of including them or not on the research, was taken after the complete reading of the article. The selection criteria were: clinical studies with Class II individuals, both male and female, with initial age of 7 to 10 years, treated with the Herbst appliance that analysed the dental and/or skeletal changes evaluated on lateral cephalometric radiographs; researches where the treatment performed did not involve extractions or surgical interventions; studies that included patients without syndromes or health concerns and articles published in English or Portuguese. Results and Conclusions: five articles were selected. The articles showed that significant changes happened in the mandibular sagittal lenght, on facial convexity angle, on maxillo-mandibular relationship, on retroclination of the upper incisors and on distal movement of the upper molars, on proclination of the lower incisors and on extrusion of the lower molars. The appliance exerted a limited effect on the anterior relocation of the maxillary complex and on facial heights. However, more studies about the performance of the Herbst appliance on early treatment of Class II are needed.

Efeitos esqueléticos e dentários decorrentes da expansão rápida maxilar

This study evaluated the maxillary transversal changes caused by the rapid maxillary expansion (RME) accomplished by Hyrax appliance. Sixteen children from both genders were selected and treated, with ages between 7.7 to 10.8 years, who presented unilateral or bilateral posterior crossbite. Postero-anterior radiographs were taken at the beginning of the treatment, end and post-retention period. The treatment promoted an average opening of 8.8 mm of IMD (intermolar distance), 2.33 mm of IAD (interapex distance) and none of IID (interincisal distance). At the end of retention period, relapse was observed, with a decrease of 4.3 mm of IMD, 1.23 mm of IAD, a non-significant enlargement of IID (0,38 mm).These results confirm the significant influence of Hyrax appliance on transverse dimensions, represented by enlargement of IMD and IAD and its effectiveness to solve posterior crossbites.

Extração seriada: considerações clínicas

The early malocclusion treatment has increased interest of orthodontic community. Among these is the serial extraction that harmonizes the differences between the amount of dental material and permanent deficiency of supporting bone. The technique is applied in mixed dentition through a predetermined sequence of extractions between deciduous and permanent teeth, in order to reach spontaneous immediately alignment of remaining permanent teeth with a minimum orthodontic mechanics. It will be reported a case where the serial extraction was performed in a growing patient with biprotrusion, Class I malocclusion and severe crowding. All functional and aesthetics goals were reached.

Ertty System®: distalização segmentar

Introduction: Ertty System® is an intraoral system of biomechanical forces to move teeth anteroposteriorly. The application of forces on this system results in the distalization of the molar and all lateral segment in the side to be distalized, including premolars and canine, resulting in alveolar bone remodeling. This system is indicated to correct uni- or bilateral maxillary dental Class II malocclusion in permanent dentition both in children and adults. It is contraindicated in case of skeletal asymmetries, protrusion of maxillary and mandibular teeth, skeletal Class II and Class II subdivision malocclusions with mandibular midline deviation. This study describes Ertty System® and presents two clinical cases treated using this system. The two female patients presented with Class II malocclusion subdivision and maxillary midline deviation. Results: It was achieved correct alignment and leveling, Class I dental relation and correction of upper midline. Conclusion: The success and stability of results confirmed diagnosis and treatment adequacy.

Otimização do tracionamento de canino impactado pela técnica do arco segmentado: relato de caso clinico

Upper canines impaction are considered the second most frequent and are associated to important esthetics and functional limitations. Among the treatment strategies described in the literature the most commonly used are the extraction of the primary canines and the surgical exposure followed by orthodontic traction, that requires an adequate interdisciplinary approach. The aim of this case report is to draw the attention of the clinician to the possibility of adapting the segmented arch technique to manage a canine impaction clinical case.

Tratamento da má oclusão de classe II, divisão 1, na dentadura mista com apareljo extrabucal removivel

Extraoral appliances represent an alternative for correction of Class II malocclusions. The application of external force leads to tooth movement and influence the growth of the maxillomandibular complex. This article aims to present the removable headgear as an adjuvant in the treatment of Class II division 1 in the mixed dentition.