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.

Tratamento da má oclusão de classe II com aparelho Jasper Jumper

The Jasper Jumper appliance was developed as a fixed orthopedic device that is connected to the upper and lower leveling arches to promote the Class II correction by restricting the maxillary growth (headgear effect), mandibular growth inducement (activator effect) and dentoalveolar changes.

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.

AVALIAÇÃO DAS ALTERAÇÕES DENTOESQUELÉTICAS DECORRENTES DO TRATAMENTO DA MALOCLUSÃO DE CLASSE II COM O APARELHO FORSUS POR MEIO DE TOMOGRAFIA COMPUTADORIZADA

Este estudo teve como objetivo avaliar cefalometricamente as alterações dentoesqueléticas decorrentes do tratamento da maloclusão de Classe II, divisão 1, com o aparelho Forsus®, por meio de Tomografia Computadorizada de Feixe Cônico (TCFC). O grupo avaliado foi composto por 10 pacientes, sendo 7 do sexo masculino e 3 do sexo feminino, com idade média de 16,1 anos, maloclusão com severidade mínima de 1/2 Classe II, trespasse horizontal mínimo de 5 mm, padrão facial meso ou braquifacial. Estes jovens se encontravam no estágio IV ou V de maturação óssea, verificada pelas vértebras cervicais. O tempo de uso do aparelho Forsus foi de 7,16 meses (média), período de avaliação compreendido entre a aquisição da primeira teleradiografia gerada através da TCFC (T1 - pré-Forsus) e da segunda teleradiografia (T2 - pós-Forsus). Para análise estatística foi utilizado o teste-t pareado. Os resultados mostraram um pequeno crescimento mandibular que, juntamente com uma diminuição do SNA levaram a uma melhora da relação maxilomandibular. Houve uma rotação no sentido anti-horário da mandíbula e do plano oclusal no sentido horário. Os incisivos superiores foram retruídos, verticalizados e extruídos e os molares superiores distalizaram por inclinação. Houve vestibularização, protrusão e intrusão dos incisivos inferiores, além de mesialização e extrusão dos molares inferiores. Desta maneira, conclui-se que o aparelho Forsus foi efetivo na correção da maloclusão de Classe II, propiciando maiores alterações dentoalveolares do que esqueléticas.(AU)

Effects of cervical headgear and edgewise appliances on growing patients

Maxillary basal bone, dentoalveolar, and dental changes in Class II Division 1 patients treated to normal occlusion by using cervical headgear and edgewise appliances were retrospectively evaluated. A sample of 45 treated patients was compared with a group of 30 untreated patients. Subjects were drawn from the Department of Orthodontics, Araraquara School of Dentistry, Brazil, and ranged in age from 7.5 to 13.5 years. The groups were matched based on age, gender, and malocclusion. Roughly 87% of the treated group had a mesocephalic or brachicephalic pattern, and 13% had a dolicocephalic pattern. Cervical headgear was used until a Class I dental relationship was achieved. Our results demonstrated that the malocclusions were probably corrected by maintaining the maxillary first molars in position during maxillary growth. Maxillary basal bone changes (excluding dentoalveolar changes) did not differ significantly between the treated and the untreated groups. Molar extrusion after the use of cervical headgear was not supported by our data, and this must be considered in the treatment plan of patients who present similar facial types. (Am J Orthod Dentofacial Orthop 2001;119:531-9).

Short-term treatment effects produced by the herbst appliance in the mixed dentition

This prospective clinical investigation evaluates the dentoalveolar and skeletal cephalometric changes produced by the Herbst appliance during treatment of mixed dentition patients with Class II division 1 malocclusion. Thirty individuals (15 male and 15 female individuals; initial mean age nine years 10 months) were treated with the Herbst appliance for a period of 12 months. For comparison, the records of 30 untreated Class II children (15 boys, 15 girls; initial mean age nine years eight months) were followed without treatment for a period of 12 months. The results indicated that the treatment effects produced in the mixed dentition patients were primarily dentoalveolar in nature. The mandibular incisors were tipped labially, and the maxillary incisors were retruded; a significant increase in mandibular posterior dentoalveolar height occurred, and there was a restriction in the vertical development of the maxillary molars. There was no difference in the forward growth of the maxilla between the two groups. In comparison with the controls, however, the Herbst treatment produced a modest but statistically significant increase in total mandibular length. This increase in total mandibular length, however, was less than that observed in adolescent Herbst patients in other studies. © 2005 by The EH Angle Education and Research Foundation, Inc.

Occurrence, extension, and severity of gingival margin alterations after orthodontic treatment.

To assess the occurrence, extension, and severity of gingival margin alterations in a sample of youth after orthodontic treatment. Records from 209 Caucasian adolescents (118 female and 91 male) before and after orthodontic treatment were selected. Patients presented a mean age at the beginning of orthodontic treatment of 11.20 ± 1.86 years and a final mean age of 14.72 ± 1.83 years. Class I and II patients with mandibular incisors and canines that were completely erupted and with spacing or crowding not exceeding 4 mm were evaluated. The presence of gingival recession on the labial surface of the mandibular anterior teeth was evaluated in intraoral photographs and casts made before and after treatment. The proportion of patients with gingival recession after treatment was statistically higher than at the beginning (P<.001). After orthodontic treatment, gingival recession was not present in any of the teeth for 63.6% of the patients; in 29.2% of the patients, recession was present in at least 1 tooth. In terms of severity, the majority of affected teeth (47%) presented gingival recession less than 2 mm and in 2% more than 4 mm. It may be concluded that alterations in the gingival margin, especially gingival recession, occur in patients after orthodontic therapy, but the extent and severity of this finding are low. COPYRIGHT © 2007 BY QUINTESSENCE PUBLISHING CO, INC.

Electromyographic evaluation of the upper lip according to the breathing mode: A longitudinal study

The present study aimed at analyzing and comparing longitudinally the EMG (electromyographic activity) of the superior orbicularis oris muscle according to the breathing mode. The sample, 38 adolescents with Angle Class II Division 1 malocclusion with predominantly nose (PNB) or mouth (PMB) breathing, was evaluated at two different periods, with a two-year interval between them. For that purpose, a 16-channel electromyography machine was employed, which was properly calibrated in a PC equipped with an analogue-digital converter, with utilization of surface, passive and bipolar electrodes. The RMS data (root mean square) were collected at rest and in 12 movements and normalized according to time and amplitude, by the peak value of EMG, in order to allow comparisons between subjects and between periods. Comparison of the muscle function of PNB and PMB subjects at period 1 (P1), period 2 (P2) and the variation between periods (Δ) did not reveal statistically significant differences between groups (p < 0.05). However, longitudinal evaluation of the muscle function in PNB and PMB subjects demonstrated different evolutions in the percentage of required EMG for accomplishment of the movements investigated. It was possible to conclude that there are differences in the percentage of electric activity of the upper lip with the growth of the subjects according to the breathing mode.

Cephalometric evaluation of surgical mandibular advancement

The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6°. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23° (from 8.1° to 4.9°). Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm), and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm). It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM) or indirectly to it (ANB, AOBO and OJ).

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.

Avaliação das modificações dentárias decorrentes da utilização do aparelho pêndulo

Pós-graduação em Odontologia - FOA

Efectos de los aparatos propulsores mandibulares fijos en la articulación temporomandibular

Fixed mandibular propulsion appliances are an alternative for the treatment of Class II malocclusion in individuals with mandibular deficiency. Since they are fixed appliances, said devices keep the mandible in an anterior-forced position during rest and during all mandibular functions. When a propulsive appliance is used, the lower jaw is displaced forward and downward. This movement leads to a new position of the condyle, which can, ultimately affect the normal functioning of the temporomandibular joint (TMJ). The aim of this paper was to review effects of fixed mandibular propulsive appliance on TMJ. Inclusion criteria considered studies on animals or humans using TMJ radiography, computed tomography, and magnetic resonance imaging. Studies confirm a favorable relation between condyle and glenoid fossa following treatment with fixed mandibular propulsion appliances.

Avaliação das dimensões e relacionamento dos arcos dentários após tratamento com Bionator de Balters

The deficiency of data in the literature took us to evaluate the Bionator of Balters appliance in the alterations of the dimensions and the relationship of the dental archs in children with malocclusion Class II, division 1 of Angle. The experimental group was constituted by 36 pairs cast Caucasians patients, aged between 7 years and 10 months - 11 years and 8 months, being 10 females and 8 males. The Levene´s test showed statistical evidences of likeness among the groups. Statistical analysis was preceded and showed significant alterations (p < 0,005) in the variable indicatives of maxillary first molars' distance, overjet, upper arch total length, upper arch anterior length, right molar relationship, left molar relationship, right canine relationship and left canine relationship. On the other hand, there wasn't significant alteration related to the lower arch and maxillary intercanines distance. The Balters' Bionator appliance had a favorable effect in the improvement of the correction of the malocclusion in Class II (foremost in molars and canines relationship) and transversal increase of the upper arch, mainly in the posterior area of arch.