Análise tomográfica da articulação temporomandibular no tratamento com Herbst em adulto jovem

Class II malocclusion features a high prevalence in Brazil, being considered as a routine in orthodontic clinics. A number of appliances are shown in the literature in order to correct Class II malocclusion with mandibular retrusion. Herbst´s fixed functional appliance, idealized by Emil Herbst (1905) and reintroduced, in the 1980´s, by Hans Pancherz is highlighted for maintaining the mandible continuously advanced, showing a shorter active treament time, an immediate esthetic impact on the facial profile, as well as requiring no patient´s commitment. Recent researches indicate the use of this appliance in individuals after pubertal growth surge. The aim of the present study is to show the orthodontics practitioner the option to use this appliance so as to treat Class II in individuals after the growth surge, obtaining satisfactory outcomes and further Class II correction.

Estabilidade oclusal a longo prazo de Classe II, divisão 1, após tratamento com extração de pré-molares

Patients are looking for esthetic and functional changes when seeking orthodontic treatment and expect the remaining of a stable occlusion. Occlusion stability is one of the goals of the orthodontist; however, dental relationships changes in long-term can occur leading to a relapse of the treatment. Teeth and shape of arches tend to return to the original form, been the retention phase important after the appliance removal, even after several years of post-treatment. This article approaches a submission of a clinical case of Class II division 1 treated with extraction of premolars analyzing its long-term stability.

Modificação de forma e dimensões dos arcos superior e inferior obtidas em modelos de estudo após expansão rápida da maxila com o aparelho hyrax

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.

Integração ortodontia e dermatologia na busca da excelência na estética bucal

In recent years the number of adult Patients who seek esthetic treatments has increased. Among the patients main concern, lip augmentation has increased, and this procedure has been very well performed and studied by dermatologists and plastic surgeons. Although Orthodontics can achieve good esthetic results through teeth and jaw proper positioning it is a time consuming approach and it discloses some anatomical and biological limitations. Dermatology may be an excellent alternative to enhance orthodontic results through lip augmentation. The aim of this paper is to discuss some dermatology techniques currently available to augment the lips as well as describe a case report highlighting the need for interdisciplinary approach to enhance facial esthetics goals.

Necessidade de ancoragem do grupo A e o controle biomecanico da mola T pré-ativada por curvatura para o fechamento de espacos

Contemporary orthodontics has sought, beyond the esthetic, occlusal and functional goals, treatments even faster and with less visits to the orthodontist — especially in patients that require dental extractions in which the generated space becomes a nuisance. The segmented arch technic (SAT), by the use of a "T" loop spring, has provided such results within these requirements. Therefore, this study aimed to appraise and demonstrate the confection, activation and biomechanical control of "T" loop spring, in the group with high anchorage necessity (group A), for retraction of anterior teeth; as well as to present a case report, with high anterior retraction necessity, treated with "T" loop spring.

Tratamento ortodôntico da agenesia de incisivo lateral superior com envolvimento de fratura radicular de incisivo central superior

Patients with agenesis of maxillary lateral incisor must have in your planning functional and aesthetic considerations, important to the success of the treatment, regardless of whether the choice of treatment is closing or opening and maintenance of space for rehabilitation with prosthesis. This choice will depend on factors such as skeletal and tooth structure and profile. Children and adolescents are the group of individuals most exposed to trauma and fracture of the maxillary lateral incisor due to the activities they perform. Proper diagnosis and good treatment are essential to the success of the treatment. This article aims to report a case of agenesis of the maxillary lateral incisor along with the involvement of a root fracture of the maxillary central incisor. The orthodontic treatment was successfully finished with a favorable prognosis for the fractured incisor to stay in a esthetic and functional position.

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.

Tratamiento quirúrgico de mesiodents en odontopediatría

Supernumerary teeth are a relatively frequent disorder of odontogenesis that can interfere with the development of the germs teeth. This pathology is most common in the maxillary anterior area, called mesiodens, and their prevalence is generally reported to occur more frequently in male than female, in a ratio of 2:1. The aim of this article was to report the clinical procedures performed in the Clinic of Pediatric Dentistry at the Araraquara School of Dentistry when the presence of two mesiodens, radiographically shown, caused retention of permanent anterior teeth, resulting in esthetic and funcional disturb. All the surgical procedures, etiology and the importancy of the early diagnostic for the appropriate treatment was detailed described.

Implant-supported rehabilitation after treatment of atrophic mandibular fractures: report of two cases

Objective The objective of this article is to present options of rehabilitation with dental implants in two cases of severely atrophic mandibles (<10 mm) after rigid internal fixation of fractures. Patients and method Two patients who sustained fractures in severely atrophic mandibles with less than 10 mm of bone height were treated by open reduction and internal fixation through a transcervical access. Internal fixation was obtained with 2.4-mm locking reconstruction plates. The first patient presented satisfactory bone height at the area between the mental foramens and after 2 years, received flapless guided implants in the anterior mandible and an immediate protocol prosthesis. The second patient received a tent pole iliac crest autogenous graft after 2 years of fracture treatment and immediate implants. After 5 months, a protocol prosthesis was installed in the second patient. Results In both cases, the internal fixation followed AO principles for load-bearing osteosynthesis. Both prosthetic devices were Branemark protocol prosthesis. The mandibular reconstruction plates were not removed. Both patients are rehabilitated without complications and satisfied with esthetic and functional results. Conclusion With the current techniques of internal fixation, grafting, and guided implants, the treatment of atrophic mandible fractures can achieve very good results, which were previously not possible.

Tratamento multidisciplinar: relato de casos clínicos

Introduction: Adult patients are more prone to periodontal disease mainly caused by poor plaque control. In these patients, orthodontic movement is not contraindicated, but it is necessary to evaluate their periodontal status so that we can establish the appropriate treatment plan. Objective: The objective of this article is to describe and discuss the clinical cases of severely periodontally compromised individuals in need of oral rehabilitation. Methods: The study consisted of orthodontic treatment of two cases with periodontal involvement. After clinical and radiographic examinations, the cases were analyzed by a multidisciplinary team of Orthodontics, Periodontics and Prosthodontics, in order to provide the patient with the best possible esthetic, functional and stability outcomes. Periodontal treatment consisted of supra and subgingival scaling prior to orthodontic treatment, and regular maintenance performed on a quarterly basis throughout orthodontic movement. Activation was carried out every 45 to 50 days, with light forces. Retention remains to the present day, even after completion of the rehabilitation. Conclusion: Multidisciplinary oral rehabilitation treatment yields satisfactory results. The interaction between Orthodontics and Periodontics reveals that patients with reduced, but healthy periodontium, can receive orthodontic treatment as long as the forces applied do not exceed patient's biological limits.

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.

A combined approach for the treatment of resorbed fresh sockets allowing immediate implant restoration: a 2-year follow-up

Introduction: The demand for optimal esthetics has increased with the advance of the implant dentistry and with the desire for easier, safer and faster technique allowing predictable outcomes. Thus, the aim of this case report was to describe a combined approach for the treatment of a periodontally compromised tooth by means of atraumatic tooth extraction, immediate flapless implant placement, autogenous block and particulate bone graft followed by connective tissue graft and immediate provisionalization of the crown in the same operatory time. Case Report: A 27-year-old woman underwent the proposed surgical procedures for the treatment of her compromised maxillary right first premolar. The tooth was removed atraumatically with a periotome without incision. A dental implant was inserted 3 mm apical to the cement-enamel junction of the adjacent teeth enabling the ideal tridimensional implant position. An osteotomy was performed in the maxillary tuber for block bone graft harvesting that allowed the reconstruction of the alveolar buccal plate. Thereafter, an autogenous connective tissue graft was placed to increase both the horizontal and vertical dimensions of the alveolar socket reaching the patient functional and esthetic expectations. Conclusion: This treatment protocol was efficient to create a harmonious gingival architecture with sufficient width and thickness, maintaining the stability of the alveolar bone crest yielding excellent aesthetic results after 2-years of follow-up. We suggest that this approach can be considered a viable alternative for the treatment of periodontally compromised tooth in the maxillary esthetic area enhancing patient comfort and satisfaction.

Importância do tratamento estético periodontal na reabilitação protética

Gingival recession is a common deformity that affects a large number of people. This condition is frequently associated with esthetic complains and may lead to dental hypersensitivity. Thus, various surgical procedures have been proposed to provide root coverage. Since the 1950s, free and pedicle gingival grafts have been greatly used for treating gingival recession. However, after the 1985 Miller gingival recession classification, and with the development of other appropriated techniques that use subepithelial connective tissue grafts, gingival recession treatments have resulted in more predictable outcomes, especially with respect to Class I and II sites, i.e., in the absence of interproximal bone loss. This article reported the importance of aesthetical periodontal treatment in the prosthetic rehabilitation of a patient with a class I gingival recession with 3 mm of vertical extension in the superior canine. The treatment plan consisted of root coverage using subepithelial connective tissue graft (SCTG) associated with construction of new prosthesis.

Correlation between pH and surface structural changes on human enamel submitted to different tooth whitening agents

The intense valuation of an esthetic pleasant smile guided the dentistry to bleached tooth due the popularity of whitening treatments. The consequence of it is an increasing interest in searching the effect of peroxides in hard dental tissues. The aim of this work was to analyze qualitatively in vitro the human enamel after three different bleaching treatments: Opalescence PF 10%, White Class 7.5% and Opalescence Xtra Boost 38%, correlating the structural changes in the surface of the enamel with its respective pH. A total of 40 sound human pre-molars were randomly divided into four groups of 10 elements, which had been immersed in artificial saliva during all the experiment. Bleaching protocols followed the recommendations of the respective manufacturers. Each bleached sample and control group were submitted to a scanning electronic microscopy analysis and compared with one another. Bleaching agents used in this experiment had modified the morphologic aspect of the surface of the dental enamel; however, it did not have correlation between the degrees of severity of the alterations and pH. There is a correlation between hydrogen peroxide concentration and changes in the enamel, where G4 showed more severe alterations, followed for G3 and G2.

Planning and clinical strategy in direct composite restorations

Patients are seeking increasingly the expertise of dental surgeons for esthetic dental improvement. The dental surgeons should know the restorative materials and techniques in order to optimize the clinical practice and to obtain satisfactory results. Also the dentist should know the average heights and widths of the anterior teeth to detect the esthetic disharmony and to eliminate it for reproducing the correct dental anatomy. Thus, this study aimed to describe a clinical case report of direct restoration using the palatal barrier technique.