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.

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.

Cariogenicidade do leite materno: mito ou evidência científica

Introduction: Breast-feeding has stood out as health care measure and is part of the Government’s National Health Policy, involving dental professionals. However, it has been suggested that breast milk could be a risk factor for the development of early childhood caries. Objective: The purpose of this report was to search for scientific evidence that would support or refute the statement that breastfeeding is associated with the development of early childhood caries. Method: Medline and SciELO databases were consulted to retrieve studies, ranging from laboratory investigations to epidemiological surveys, which relate breastfeeding to dental caries. The key words ‘breast-feeding’ and ‘dental caries’ were used on the reference search. There was no scientific evidence that could demonstrate a clear relationship between breast milk and cariogenicity. This is attributed to fact that dental caries is a multifactorial disease that is susceptible to multiple confusing factors, among which the early introduction of sucrose to the infant’s diet and late introduction of oral hygiene habits. The dentist should encourage exclusive breast-feeding because, in addition to the undeniable benefits to the child’s physical and psychological health, it contributes to a harmonic facial growth and prevents the development of atypical deglutition and malocclusions, in combination with early introduction of oral hygiene habits and noncariogenic diet. Conclusion: There is no scientific evidence to demonstrate an association between breast-feeding and early childhood caries.

Lateral cephalometric diagnosis of asymmetry in Angle Class II subdivision compared to Class I and II

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Reabsorção condilar progressiva: revisão de literatura

The progressive condylar resorption is a irreversible complication that can result in malocclusion and facial deformity that can happen especially in postoperative orthognathic surgery of mandibular advancement or combined surgery. Predominantly affect young women, bearers of malocclusions of skeletal class II and with incidence of temporomandibular disorders prior to surgical treatment. Its exact etiology and pathogenesis remain unclear. The purpose of this article is to make a literature review of the last 10 years on the progressive condylar resorption. For this, we used the Medline database for articles in the English language. Then, 13 articles were found, evaluated and compared on predisposing factors, etiology, diagnosis and clinical management.

Princípios de redução das fraturas panfaciais: revisão de literatura

Are called panfacial fractures when the upper, middle and lower facial thirds present fractures concurrently. In clinical practice, came to imply the involvement of two facial thirds. Panfacial fractures are usually accompanied by other systemic lesions that impair the patient's life and therefore require primary treatment. Almost invariably are associated with damage to soft tissues and severe losses of bone structures which may lead to severe facial deformations and malocclusions. The panfacial fractures treatment is complex because often there isn’t a stable bone structure to guide the reduction of various fractures. Several orders of treatment have been proposed, but they are variations of the two classical approaches "bottom to top and inside-out" and "top to bottom and out-inside". The aim of this paper is to discuss the principles of management and panfacial fractures treatment, emphasizing the sequence of fracture reduction and highlighting its indications, advantages and disadvantages, through literature review and reports of surgical clinic cases. We conclude that the exact sequence of fracture reduction is not as important as developing a treatment plan that allows accurate positioning of the fractured segments.

Pistas diretas para o tratamento de mordida cruzada posterior

The malocclusions are one focus of discussions in public health, due to which it is necessary to incorporate correction procedures that are inexpensive, easy to perform and which can be made in health services. Planas Direct Tracks meet such characteristics which make them advantageous for the crossbite correction. The aim of this study was to present a case in which correction of unilateral crossbite was performed with the resources available in a public clinic. This is a 6 year-old patient who presented functional unilateral crossbite in canines and posterior teeth. A cross decreased maxillary arch leading to a condition of unilateral posterior crossbite was detected. Occlusal adjustments were performed in canine and posterior teeth; however it was not enough to restore the occlusal balance. It was decided to prepare Planas Direct Tracks in canines, allowing functional balance, which prevented masticatory movement alteration during the growth phase and malocclusion correction. Controls were performed every six months to evaluate the patient's progress and whether or not new occlusal adjustments were necessary. Monitoring and treatment were conducted for 5 years, until stabilization of the permanent dentition ensuring treatment. It is concluded that Planas Direct Tracks were effective for the correction of unilateral posterior crossbite. So, it is essential to note that this procedure can be performed in public services.

Tratamento compensatorio da má oclusnao de classe lll: revisão de literatura

Class III malocclusion is less common occlusal relationship, covering less than 5% of the population. There are various forms of treatment in Class III malocclusion. Depending on how the form is expressed Class III and age of the patient, the therapy may be orthopedic and orthodontic surgical orthodontics. The objective was to review the literature of the last 10 years about ways to compensatory treatment of Class III malocclusion. Several articles were published between 04/2003 and 04/2013 in the Pubmed database from the keyword "Class III malocclusion". However, only 19 articles that addressed the compensatory treatment of Class III were selected. Based on the selected items it was concluded that the treatment of Class III malocclusions in children before the peak of pubertal growth has better prognosis with greater effects orthopedic and orthodontic minor effects. The ideal treatment option for this condition is the Rapid maxillary expansion associated with maxillary protraction of the same. The treatment of Class III malocclusion in young people after the peak of pubertal growth is doubtful prognosis. You can opt to treat rapid maxillary expansion and maxillary protraction of the same or fixed appliance, however, orthopedic effects can be the same or smaller than the orthodontic effects, depending on the age of the patient. Depending on the degree of Class III malocclusion in adults, the treatment will consist of dental compensations or orthognathic surgery.

Treatment effects of bonded spurs associated with high-pull chincup therapy in the treatment of patients with anterior open bite

Introduction: The aim of this prospective clinical study was to investigate the cephalometric changes produced by bonded spurs associated with high-pull chincup therapy in children with Angle Class I malocclusion and anterior open bite. Methods: Thirty patients with an initial mean age of 8.14 years and a mean anterior open bite of -3.93 mm were treated with bonded spurs associated with chincup therapy for 12 months. An untreated control group of 30 subjects with an initial mean age of 8.36 years and a mean anterior open bite of -3.93 mm and the same malocclusion was followed for 12 months for comparison. Student t tests were used for intergroup comparisons. Results: The treated group demonstrated a significantly greater decrease of the gonial angle, and increase in overbite, palatal tipping of the maxillary incisors, and vertical dentoalveolar development of the maxillary and mandibular incisors compared with the control group. Conclusions: The association of bonded spurs with high-pull chincup therapy was efficient for the correction of the open bite in 86.7% of the patients, with a 5.23-mm (SD, +/- 1.69) overbite increase. (Am J Orthod Dentofacial Orthop 2012;142:487-93)

Combined effect of anterior malocclusion and inadequate lip coverage on dental trauma in primary teeth

Objectives: The main objective of this study was to investigate whether the interaction of malocclusion (open bite or increased overjet) combined with inadequate lip coverage strengthens its association with traumatic dental injury (TDI) in the primary teeth of preschool children compared to the presence of malocclusion alone. Subjects and methods: A cross-sectional survey was conducted with 376 children aged 3659 months who attended the National Day of Childrens Vaccination. Presence of TDI, tooth discoloration, and sinus tract were evaluated in the children. Variables associated with occlusion were also evaluated. A Poisson regression analysis was performed to verify the association between the explanatory variables and TDI as well as possible interactions among the variables. Then, the prevalence ratio was calculated. Results: The prevalence of TDI was 27.7%. The maxillary central incisor was the most affected tooth, without differences between the right and left sides. Boys had more dental trauma than girls (P = 0.04). The most common TDI was crown fracture restricted to the enamel (58.4%). Children with a combination of anterior open bite or increased overjet and inadequate lip coverage presented a higher prevalence of TDI than when the malocclusions were presented alone (P < 0.05). The same trends were observed when we included, in the final adjusted model, increased overjet instead of open bite. Conclusions: Anterior malocclusions of primary teeth such as increased overjet and anterior open bite are statistically significantly associated with dental trauma only when inadequate lip coverage is also present.

Association between parental guilt and oral health problems in preschool children

Parents may feel guilty about their children's oral problems, which can affect their quality of life. The aim of this study was to assess the presence of parental guilt and its association with early childhood caries (EGG), traumatic dental injuries (TDI) and malocclusion (AMT) in preschool children. All 2 to 5 year-old children (N = 305), and their parents, seeking dental care at the University of Sao Paulo Dental School one-week Screening Programme, were asked to participate in the study, and 260 agreed. Children were examined by two calibrated dentists, and their parents answered a socioeconomic and ECOHIS questionnaire; the question on guilt was used as the dependent variable. Regression analyses examined the association between parental guilt and EGG, TDI, AMT and socioeconomic factors. A total of 35.8% of parents felt guilty. This was only associated with caries severity. No association was found between guilt and TDI, AMT or socioeconomic factors. EGG was present in 63.8% of the children; the mean (+/-sd) dmf-t score was 7.29 (+/-2.78). Thus, the number of parents feeling guilty increases with the increase of their children's dental caries severity. Parental guilt is related to caries but is not associated with TDI or AMT.

Dentoalveolar comparative study between removable and fixed cribs, associated to chincup, in anterior open bite treatment

Objective: The aim of this prospective study was to compare the dentoalveolar effects produced by two types of palatal crib, removable (Rpc+C) and fixed (Fpc+C), combined with chincup in growing patients with anterior open bite. Material and Methods: Each group comprised 30 patients, in the mixed dentition phase, with similar cephalometric characteristics and skeletal ages. Group 1 (Rpc+ C) presented initial mean age of 8.3 years and mean anterior open bite of 4.0 mm. Group 2 (Fpc+C) presented initial mean age of 8.54 years and mean anterior open bite of 4.3 mm. The evaluation period comprised 12 months between initial (T1) and second lateral radiograph (T2). The T2-T1 changes were compared cephalometrically in the 2 groups using the non-paired t-test. Results: Vertical changes in the posterior dentoalveolar region were similar between the groups (about 1 mm) and no significant differences were found in molar mesialization. The Fpc+C group had in average 1.6 mm more improvement of the overbite as a result of greater maxillary incisor extrusion (1.3 mm). Patients in this group also presented less lingual tipping of maxillary incisors and more mandibular incisors uprighting. Conclusions: The Fpc+C combination was more efficient in the correction of the negative overbite mainly due to greater extrusion of the maxillary incisors. However, the Rpc+C appliance promoted better upper and lower incisor inclination, resulting in a more adequate overjet.

Prevalence of long face pattern in brazilian individuals of different ethnic backgrounds

Conclusions: Black individuals had greater prevalence of long face pattern, followed by Brown, White and Yellow individuals. The prevalence of long face pattern was 14.06% in which 13.39% and 0.68% belonged to moderate and severe subtypes, respectively.

The influence of asthma onset and severity on malocclusion prevalence in children and adolescents

OBJECTIVE: The influence of asthma, its severity levels and onset time on malocclusion occurrence were investigated. METHODS: The sample was composed by 176 children/adolescents, of both genders, aged 3 to 15 years, that were divided in two groups. The asthma group (AG) enrolled 88 children/adolescents that were seen at the Breathe Londrina Program. The asthma-free group (AFG) enrolled 88 preschool and school children recruited in 2 public schools. Malocclusion diagnosis was made according to WHO criteria (OMS, 1999). RESULTS: A higher prevalence in malocclusions in asthmatic patients in mixed dentition was observed when compared to controls (p<0.05). On the other hand, these results were not observed for deciduous (p>0.05) and permanent dentition (p>0.05). A significant association was seen between asthma onset time and marked maxillary overjet (p<0.05), and open bite (p<0.05) in the mixed dentition, being both conditions more common among those that have presented the symptoms of asthma prior to 12 months of age. CONCLUSION: The results of this study indicate that the early manifestation of asthma at first year of life can cause dentofacial changes. Therefore, the prompt diagnostic of the illness, as well as the establishment of a proper therapy could improve the symptoms and chronic complications of asthma and also reduce its impact on craniofacial development.