Longitudinal study on skeletal changes during and after bionator therapy using metallic implants

Aim: To demonstrate the magnitude and direction of skeletal changes in the maxilla and mandible during and after the use of bionator, as well as their rotations. Methods: Partial superimposition on the maxilla and mandible on the metallic implants and total superimposition on the cranial base were performed at three periods, T1 before bionator therapy, T2 after bionator therapy, and T3 5.68 years after T2. Results: There was total clockwise maxillary rotation and counterclockwise mandibular rotation, in the North American technique, throughout the study period, as well as extensive remodeling on the condylar region, especially in vertical direction and on the gonial region in horizontal direction. Conclusions: The total maxillary rotation seemed to be significantly affected by therapy than the mandible. There was a clear change in the direction of condylar remodeling compared to the period of bionator therapy and posterior bionator therapy. Considering the entire study period, it was observed that intra-matrix rotation of the maxilla and mandible masked their total rotation, causing minimum changes in the matrix rotation.

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.

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.

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.

A utilização do enxerto ósseo autógeno para tratamento de lesão de furca grau II

Destruction of bone and periodontal ligament as a result of periodontal disease can lead to anatomical defects in the furcation area. Treatment of these lesions is a major challenge to the clinician. Periodontal instruments have limited access to this area and plaque and calculus removal from root surfaces are extremely difficult. For proper treatment planning a number of factors must be taken into consideration to achieve immediate and long term success. Surgical therapy associated with bone grafts may be a viable option in the treatment of class II furcation defects, aiming to restore lost tissues. The aim of this paper is to report a clinical case where a simplified surgical approach with the use of autogenous graft was used to treat a class II furcation defect Twelve months after the surgery, an increase in clinical attachment level and pocket depth reduction resulted in a complete closure of the furcation lesion.

Cuspal movement related to different polymerization protocols

Objective: The aim of this study to investigate the effects of different polymerization protocols on the cuspal movement in class II composite restorations. Materials and methods: Human premolar teeth were prepared with class II cavities and then restored with composite and three-step and two-step etch-and-rinse adhesive systems under different curing techniques (n = 10). It was used a lightemittingdiode curing unit and the mode of polymerization were: standard (exposure for 40 seconds at 700 mW/cm2), pulse-delay (initial exposure for 6 seconds at 350 mW/cm2 followed by a resting period of 3 minutes and a final exposure of 37 seconds at 700 mW/cm2) and soft-start curing (exposure 10 seconds at 350 mW/cm2 and 35 seconds at 700 mW/cm2). The cuspal distance (µm) was measured before and after the restorative procedure and the difference was recorded as cuspal movement. The data were submitted to two-way ANOVA and Bonferroni test (p < 0.05). Results: The type of adhesive system did not influenced the cuspal movement for all the curing methods. Standard protocol showed the highest values of cuspal movement and was statistically different from the pulse-delay and soft-start curing modes. Conclusion: Although the cuspal displacement was not completely avoided, alternative methods of photocuring should be considered to minimize the clinical consequences of composites contraction stress.

Desordens temporomandibulares em usuários de prótese parcial removível: prevalência de acordo com a classificação de Kennedy

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Transposition burst of mariner-like elements in the sequenced genome of Rhodnius prolixus

Transposable elements (TEs) are widespread in insect´s genomes. However, there are wide differences in the proportion of the total DNA content occupied by these repetitive sequences in different species. We have analyzed the TEs present in R. prolixus (vector of the Chagas disease) and showed that 3.0% of this genome is occupied by Class II TEs, belonging mainly to the Tc1-mariner superfamily (1.65%) and MITEs (1.84%). Interestingly, most of this genomic content is due to the expansion of two subfamilies belonging to: irritans himar, a well characterized subfamily of mariners, and prolixus1, one of the two novel subfamilies here described. The high amount of sequences in these subfamilies suggests that bursts of transposition occurred during the life cycle of this family. In an attempt to characterize these elements, we performed an in silico analysis of the sequences corresponding to the DDD/E domain of the transposase gene. We performed an evolutionary analysis including network and Bayesian coalescent-based methods in order to infer the dynamics of the amplification, as well as to estimate the time of the bursts identified in these subfamilies. Given our data, we hypothesized that the TE expansions occurred around the time of speciation of R. prolixus around 1.4 mya. This suggestion lays on the Transposon Model of TE evolution, in which the members of a TE population that are replicative active are present at multiple loci in the genome, but their replicative potential varies, and of the Life Cycle Model that states that when present-day TEs have been involved in amplification bursts, they share an ancestral copy that dates back to this initial amplification.

Estudo da estabilidade da cirurgia do tipo sagital da mandíbula com vista a correção de deformidades faciais

This research evaluated the surgical stabilily in patients with mandibular prognathism and retrognathism in which was used sagital split technic to correct those detormities. Twelve patients were selected from the clinic of only one experienced surgeon. Six patients presenter a Class III 6 a Class II molar relationship. A comparative cefalometric analysis using linear and angular measurements was performed of pre-surgery, imediate pós-surgery and 1 year follow-up. The following conclusions were obtained. 1 The Dal Pont sagital split technic modified by Epker to correct mandibular prognathisn and retroghnatism is a stable technic and must be indicated to correct those deformities. 2 Small relapses are easily corrected by the post-surgical orthodontic treatment. 3 A small over correction is advised in cases of large mandibular advancements or set bascks. 4 In those cases which a large amount of mandibular retrusion on advancement need to be performed, a combination of maxillary and mandibular surgery should be used. Rigid fixation technic is also indicated in those cases

Morphometric analysis of long-term dentoskeletal effects induced by treatment with Balters bionator

Objective: To evaluate the long-term effects of the standard (Class II) Balters bionator in growing patients with Class II malocclusion with mandibular retrusion by using morphometrics (thin-plate spline [TPS] analysis). Materials and Methods: Twenty-three Class II patients (8 male, 15 female) were treated consecutively with the Balters bionator (bionator group). The sample was evaluated at T0, start of treatment; T1, end of bionator therapy; and T2, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T0); at posttreatment, 12 years 3 months (T1); and at long-term follow-up, 18 years 2 months (T2). The control group consisted of 22 subjects (11 male, 11 female) with untreated Class II malocclusion. Lateral cephalograms were analyzed at the three time points for all groups. TPS analysis evaluated statistical differences (permutation tests) in the craniofacial shape and size between the bionator and control groups. Results: TPS analysis showed that treatment with the bionator is able to produce favorable mandibular shape changes (forward and downward displacement) that contribute significantly to the correction of the Class II dentoskeletal imbalance. These results are maintained at a long-term observation after completion of growth. The control group showed no statistically significant differences in the correction of Class II malocclusion. Conclusions: This study suggests that bionator treatment of Class II malocclusion produces favorable results over the long term with a combination of skeletal and dentoalveolar shape changes.

O momento oportuno para a abordagem ortodontica no tratamento da classe II

Because it still brings polemic among the professionals, it was mention once more, in this literature review, the theme that aims to define the appropriate timing to approach the bad occlusions of Class II, and also when it would the right opportunity to treat them, in way that would convey to the patient consistent, stable results in a long term. These are important aspects to be taken into consideration by orthodontists, either by those who defend the early treatment or by those who defend the late treatment. Therefore, the present study aims to aid the clarification of daily doubts regarding this aspect.

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.

Extensive structural change of the envelope protein of dengue virus induced by a tuned ionic strength: conformational and energetic analyses

The Dengue has become a global public health threat, with over 100 million infections annually; to date there is no specific vaccine or any antiviral drug. The structures of the envelope (E) proteins of the four known serotype of the dengue virus (DENV) are already known, but there are insufficient molecular details of their structural behavior in solution in the distinct environmental conditions in which the DENVs are submitted, from the digestive tract of the mosquito up to its replication inside the host cell. Such detailed knowledge becomes important because of the multifunctional character of the E protein: it mediates the early events in cell entry, via receptor endocytosis and, as a class II protein, participates determinately in the process of membrane fusion. The proposed infection mechanism asserts that once in the endosome, at low pH, the E homodimers dissociate and insert into the endosomal lipid membrane, after an extensive conformational change, mainly on the relative arrangement of its three domains. In this work we employ all-atom explicit solvent Molecular Dynamics simulations to specify the thermodynamic conditions in that the E proteins are induced to experience extensive structural changes, such as during the process of reducing pH. We study the structural behavior of the E protein monomer at acid pH solution of distinct ionic strength. Extensive simulations are carried out with all the histidine residues in its full protonated form at four distinct ionic strengths. The results are analyzed in detail from structural and energetic perspectives, and the virtual protein movements are described by means of the principal component analyses. As the main result, we found that at acid pH and physiological ionic strength, the E protein suffers a major structural change; for lower or higher ionic strengths, the crystal structure is essentially maintained along of all extensive simulations. On the other hand, at basic pH, when all histidine residues are in the unprotonated form, the protein structure is very stable for ionic strengths ranging from 0 to 225 mM. Therefore, our findings support the hypothesis that the histidines constitute the hot points that induce configurational changes of E protein in acid pH, and give extra motivation to the development of new ideas for antivirus compound design.

Left cardiac sympathetic denervation for treatment of symptomatic systolic heart failure patients: a pilot study

To evaluate the feasibility, safety, and potential beneficial effects of left cardiac sympathetic denervation (LCSD) in systolic heart failure (HF) patients. In this prospective, randomized pilot study, inclusion criteria were New York Heart Association (NYHA) functional class II or III, left ventricular ejection fraction (LVEF) 40, sinus rhythm, and resting heart rate 65 b.p.m., despite optimal medical therapy (MT). Fifteen patients were randomly assigned either to MT alone or MT plus LCSD. The primary endpoint was safety, measured by mortality in the first month of follow-up and morbidity according to pre-specified criteria. Secondary endpoints were exercise capacity, quality of life, LVEF, muscle sympathetic nerve activity (MSNA), brain natriuretic peptide (BNP) levels and 24 h Holter mean heart rate before and after 6 months. We studied clinical effects in long-term follow-up. Ten patients underwent LCSD. There were no adverse events attributable to surgery. In the LCSD group, LVEF improved from 25 6.6 to 33 5.2 (P 0.03); 6 min walking distance improved from 167 35 to 198 47 m (P 0.02). Minnesota Living with Heart Failure Questionnaire (MLWHFQ) score physical dimension changed from 21 5 to 15 7 (P 0.06). The remaining analysed variables were unchanged. During 848 549 days of follow-up, in the MT group, three patients either died or underwent cardiac transplantation (CT), while in the LCSD group six were alive without CT. LCSD was feasible and seemed to be safe in systolic HF patients. Its beneficial effects warrant the development of a larger randomized trial. Trail registration: NCT01224899.

Molecular characterization of a mariner-like element in the Atta sexdens rubropilosa genome

Mobile elements are widely present in eukaryotic genomes. They are repeated DNA segments that are able to move from one locus to another within the genome. They are divided into two main categories, depending on their mechanism of transposition, involving RNA (class I) or DNA (class II) molecules. The mariner-like elements are class II transposons. They encode their own transposase, which is necessary and sufficient for transposition in the absence of host factors. They are flanked by a short inverted terminal repeat and a TA dinucleotide target site, which is duplicated upon insertion. The transposase consists of two domains, an N-terminal inverted terminal repeat binding domain and a C-terminal catalytic domain. We identified a transposable element with molecular characteristics of a mariner-like element in Atta sexdens rubropilosa genome. Identification started from a PCR with degenerate primers and queen genomic DNA templates, with which it was possible to amplify a fragment with mariner transposable-element homology. Phylogenetic analysis demonstrated that this element belongs to the mauritiana subfamily of mariner-like elements and it was named Asmar1. We found that Asmar1 is homologous to a transposon described from another ant, Messor bouvieri. The predicted transposase sequence demonstrated that Asmar1 has a truncated transposase ORF. This study is part of a molecular characterization of mobile elements in the Atta spp genome. Our finding of mariner-like elements in all castes of this ant could be useful to help understand the dynamics of mariner-like element distribution in the Hymenoptera.