Fechamento de diastemas utilizando restaurações diretas de resina composta

Os diastemas contribuem para a quebra de harmonia dos dentes, comprometendo a beleza do sorriso; os incisivos superiores são os dentes que mais se destacam no sorriso, sendo muito importante a simetria e harmonia entre eles. Para o fechamento dos diastemas, durante muito tempo, as alternativas clínicas foram o emprego da Ortodontia e das próteses fixas. Atualmente, com a evolução dos sistemas adesivos e das resinas compostas, é possível reproduzir as características dos dentes com uma técnica simples, previsível, sem desgaste da estrutura dentária, reversível, com menor custo, proporcionando um resultado satisfatório e imediato. O propósito do presente artigo é apresentar três casos clínicos de fechamento de diastemas generalizados associados ou não a outras alterações que comprometem o sorriso do paciente.

Diastemas: reestablishment of an attractive smile

A healthy and attractive smile is very valued in today s society. Yet this requires better aesthetic and cosmetic solutions from dental surgeons.The present paper presents a case report of diastema closure using an association of tooth movement induced by orthodontic elastics,dental cosmetics and resin-bonded prosthesis. The female patient L.B.A.J., aged 19 years, visited the Integrated Clinic of Araçatuba DentalSchool UNESP mainly complaining of missing teeth and poor esthetics. After anamnesis, clinical and radiographic examination revealedhypodontia of the maxillary right and left first premolars, abnormal maxillary right lateral incisor shape and diastema between the maxillaryright lateral incisor and canine and between the maxillary left lateral incisor and canine. Planning was done which included indication ofdiastema closure with composite resin restoration and metal-free resin-bonded prosthesis, with a structure made of Vectris (Ivoclar VivadentInc., Amherst, NT, USA). The option for dental cosmetics associated with resin-bonded prosthesis after movement with orthodontic elasticsresulted in an excellent aesthetic outcome of low cost and short treatment duration.Indexing terms: composite resins; diastema; fixed resin bonded partial denture.

Freqüência de anquiloglossia em uma comunidade indígena brasileira

Objective: This study aimed to assess the prevalence of ankyloglossia in people of different age groups living in the native Brazilian community of Umutina, in the municipality of Barra do Bugres/Mato Grosso. Methods: The sample consisted of 291 native Brazilians who underwent clinical examination. Results: Ankyloglossia was observed in 108 (37.11%) individuals. There was a greater prevalence of ankyloglossia among males, with 57 cases (43.8%) against 51 cases (31.7%) in females. Age distribution was done after analyzing the hierarchical grouping, resulting in three age groups: 1- to 20-year-olds, 21- to 45-year-olds and 46- to 99-year-olds. Ankyloglossia was more prevalent in the youngest group, with 65 cases (40.6%). Conclusion: Although there is a high rate of ankyloglossia among the individuals who live in the Umutina Reservation, ankyloglossia does not seem responsible for the changes associated with phonation, mastication, presence of diastema and periodontal problems, since these changes were infrequent and generated no complaints.

Estudio de las caracteristicas de oclusión de niños de 12 años del municipio de Cáceres, Mato Grosso, Brasil

The aim of this study was to evaluate the occlusal condition of 12 year-old children examined by the Oral Health Brazil 2003 Project in Cáceres city. The sample consisted of 170 children, boys and girls, selected at random among 20 schools that took part in this project. It was used for the analysis of the occlusal condition the Dental Aesthetic Index (DAI), as manual of basic epidemic rising in Oral Health extolled by the World Health Organization which describes the occlusal conditions in relation to dentition, space and occlusion of the permanent dentition. It was observed that the prevalence of the normal occlusion and of the malocclusion were, respectively, 21.18% and 78.82%. This last one was present due to the tooth crowding (74.93%), spacing in the incisor segment (23.88%), diastema (17.17%), anterior maxillary misalignment (58.95%) and anterior mandibular (61.19%), excessive overjet (11.94%), negative overjet (4.47%), open bite (1.5%) and molar relationship Class II or III (26.87%). It was concluded that the studied sample presents a high index of factors to compose the malocclusion.

Maxillary incisors mesiodistal angulation changes in patients with orthodontically treated anterior superior diastemas

OBJECTIVE: The aims of this study were to describe the patterns of maxillary incisor angulation in patients with upper interincisive diastemas, to evaluate angulation changes with treatment and posttreatment period, and to assess whether there are association between incisor angulation and interincisive diastema relapse. METHODS: The sample comprised 30 Class I or Class II patients with at least one pretreatment anterior diastema of 0.77 mm or greater after eruption of maxillary permanent canines. Data were obtained from panoramic radiographs at pretreatment, posttreatment and at least 2 years post-retention. RESULTS: Incisors presented a mesial tipping tendency after treatment, but only lateral incisors showed significant changes between pre and posttreatment stages. CONCLUSION: Regarding post-retention period, no changes were found. Finally, no relation was found between diastema relapse and maxillary incisor axial angulation.

Facts and myths regarding the maxillary midline frenum and its treatment: a systematic review of the literature

OBJECTIVE To systematically review the current literature on the maxillary midline frenum and associated conditions and complications, as well as the recommended treatment options. METHOD AND MATERIALS A detailed MEDLINE database search was carried out to provide evidence about the epidemiology, associated pathologies, and treatment options regarding the maxillary frenum. Of the 206 initially identified articles, 48 met the inclusion criteria. RESULTS The maxillary frenum is highly associated with a number of syndromes and developmental abnormalities. A hypertrophic frenum may be involved in the etiology of the midline diastema. There is also a tendency by orthodontists to suggest posttreatment removal of the frenum (frenectomy). Studies on the cause of gingival recession due to the maxillary frenum are inconclusive. An injured frenum in combination with other traumas and doubtful history might point to child abuse. The involvement of hyperplastic frena in the pathogenesis of peri-implant diseases remains uncertain. There seems to be a clinical interest regarding lasers for surgery for treatment of maxillary frena. The superiority of laser treatment in relation to conventional surgical methods has not yet been demonstrated in the literature. CONCLUSION A maxillary frenum is a clinical symptom in numerous syndromic conditions and plays a role in the development of the median midline diastema. Nevertheless, the contribution to gingival recession and peri-implant diseases in the region of the maxillary incisors is rather controversial. Laser techniques are reported as the method of choice for the surgical removal of frena; however, this needs to be substantiated by appropriate prospective controlled studies.

Reabilitação biomimética na zona estética: a propósito de um caso clínico

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz