Tratamento da classe II divisão 2 com aparelho de Herbst após o pico de crescimento puberal

Patients with Class II division 2 malocclusion and mandibular retrusion have limited treatment options after the growth peak, such as surgical-orthodontic treatment or mandibular advancement devices. Among bite-jumping devices, the Herbst appliance allows greater increase of mandibular growth since it does not require patient compliance and allows continuous use. This case report presents the treatment of a Class II division 2 malocclusion in a patient after growth peak, performed in two stages. The first stage included the upper incisors proclination and overjet increase with multibracket appliance to benefit next stage. The second stage involved mandibular advancement using Herbst appliance aiming to correct the Class II molar relationship. The treatment resulted in a stable occlusion with periodontal health, normal functions and facial aesthetics improvement. Dental and skeletal changes arising from treatment could be assessed by cephalometric analysis and superimposition of pretreatment and post-treatment cephalometric tracings. Antero-posterior discrepancy was corrected by means of dental movement as well as by mandibular growth increment stimulated by the Herbst appliance.

External apical root resorption in retracted incisors

AIM: To evaluate the occurrence of external apical root resorption (EARR) in the incisors after anterior retraction in corrective orthodontic treatment with first premolar extractions and whether it was related with the type of root apex movement and its inclination. METHOD: The maxillary and mandibular incisors of 22 patients (12 to 25 years of age; 9 males and 13 females) were treated with fixed appliances and premolar extraction. EARR was defined as the difference in root length before and after incisal retraction on periapical radiographs. Distortion of radiographic images and changes due to incisal tipping were controlled for. Pre- and post-incisal retraction lateral cephalometric radiographs established the relationship between EARR and the tipping of the incisors, along with the vertical, horizontal, and total movement of the root apex. RESULTS: There was significant EARR (1.51 to 2.37 mm) during incisor retraction, but this was not related to the movement or the tipping of the root apex of almost all teeth. It was observed that after the retraction stage, EARR occurred in all evaluated incisors, but it was more significant (P < .05) in the mandibular right lateral incisor. CONCLUSION: The EARR that did occur was unrelated to movement or tipping of the root apex, except for the vertical root apex movement of the mandibular left central incisor and the inclination of the maxillary right lateral incisor.

Alterações dimensionais em pacientes submetidos à expansão rápida da maxila com aparelho do tipo Haas

The maxillary atresia is a alteration in the transverse dimension that can result in a unilateral or bilateral crossbite. For correction of atresia of the upper dental arch appliances with the intent to expand the arch of orthopedic or orthodontic manner are used, obtaining across-compatibility between the dental arches. The purpose of this study was to evaluate the dimensional changes of the maxillary in patients in the mixed dentition with atresia in the upper dental arch, using occlusal radiographs taken before, after rapid maxillary expansion and after removal of the appliance. Methods: the sample consisted of 35 patients who used the appliance type conventional Haas, in the mixed dentition, according to the standard protocol for installation, activation, containment and removal of the appliances rapid maxillary expansion. Results: the results confirm that the suture opening occurs in greater quantities in the anterior (4.3 mm) than posterior to (3.74 mm), representing a triangular opening of 7 degrees on average with the posterior opening 87% of the quantity of anterior opening. The molars region expanded about 5 mm, and the base bone 3.7 mm, representing a 74% bone expansion of the expansion teeth.

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.

Aparelho de Thurow modificado e aparelho ortodôntico fixo no tratamento da classe II com mordida aberta anterior

This work had aim to present two clinical cases with open bite Class II malocclusion that treated in the phase of the mixed dentition with the modified Thurow appliance and in the permanent dentition with fixed appliance. The dentoskeletal effects of these appliances were carefully analyzed with the aid of metallic implants inserted in both maxilla and mandible. The correction of the malocclusion and the improvement of the skeletal, dental and facial relationship were observed in both cases. The modified Thurow appliance followed by fixed-appliance as a two-phase treatment protocol revealed to be an effective treatment approach for the two young people that initially presented a Class II division 1 malocclusion associated to anterior open bite presented.

Camuflagem ortodôntica com dispositivos de ancoragem temporários ou cirurgia ortognática: parâmetros para a decisão

The polemical discussion between orthodontic therapeutic and surgical approaches with relation to borderline cases receives a new impulse with the emergence of temporary anchorage devices. This branch of Orthodontics has brought new treatment perspectives, but it has still been applied empirically, while the various factors involved in determining and conducting the treatment planning are neglected. The objective of the present study is to identify the several factors to be considered in both forms of treatment in order to provide the orthodontist with information that may contribute for the correct decision.

Degradação de forças dos elasticos intermaxilares ortodônticos sintéticos

This study aimed to evaluate the force degradation of synthetic elastics over time using dynamic biomechanical tests in order to find clinical parameters of what size of elastic and frequency of exchange should be used in orthodontic therapy. It was used 240 elastics of Dental Morelli, sizes 1/8", 3/16", 1/4 "and 5/16", medium force, divided in four groups. In each group was measured forces at different times, from immediate to 72 hours after immersion in water at 37°C and incubated stretched to 600% of its initial inner diameter. Tensile tests were performed on a universal testing machine EMIC DL2000 submerged in distilled water maintained at 37°C. Data were analyzed using SPSS version 16.0, by the Analysis of Variance (One-Way) with Tukey´s post test. There was a greater increase in pattern of force decay of immediate measurement until 24 hours in all sizes of synthetic elastics, from which it was observed a decrease in force progressively smaller, with the exception of 5/16´´ elastic with a maximum force decay occurred at 12h. It was concluded that: the elastic synthetic Dental Morelli suffered significant force degradation over time, with reduction of approximately 70% of the initial force during 24 hours of stretching, followed by a progressively smaller decrease; the amount of stretch for a ideal force in intermaxillary therapies depends on the distance between the points of attachment of elastic, being necessary to consult the tables to choose the size, force and frequency of replacement.

Efeito da escovação dentária no manchamento de braquetes estéticos cerâmicos

Objective: this study aimed to analyze the in vitro effect of brushing on the color stability of ceramic brackets immersed in dye solutions. Materials and Methods: seven ceramic brackets of four commercial brands were tested: two monocrystalline and two polycrystalline. The parameters of color were obtained by spectrophotometer before and after 21 days of immersion of the brackets in coffee, red wine, Coca-Cola, black tea and artificial saliva. Another group of brackets of each brand were also immersed in the same solutions and for an equal time to the previous group, but with intervals of daily brushing performed by a toothbrushing machine (Mavtec). The data were evaluated by analysis of variance, multiple comparison tests for means and Student's t-test. Results: the mean color change of the brackets without brushing ranged from 0.46 to 7.61, while in the group with brushing these means ranged from 0.36 to 2.50. The staining still remained noticeable (change of color greater than 3.7) for all brackets when immersed in black tea. Conclusion: daily brushing helped significantly in the color stability of ceramic brackets, maintaining the color change to levels considered not visible to the human eye, except for the solution of black tea in which the staining remained relevant.

Efeitos esqueléticos e dentários decorrentes da expansão rápida maxilar

This study evaluated the maxillary transversal changes caused by the rapid maxillary expansion (RME) accomplished by Hyrax appliance. Sixteen children from both genders were selected and treated, with ages between 7.7 to 10.8 years, who presented unilateral or bilateral posterior crossbite. Postero-anterior radiographs were taken at the beginning of the treatment, end and post-retention period. The treatment promoted an average opening of 8.8 mm of IMD (intermolar distance), 2.33 mm of IAD (interapex distance) and none of IID (interincisal distance). At the end of retention period, relapse was observed, with a decrease of 4.3 mm of IMD, 1.23 mm of IAD, a non-significant enlargement of IID (0,38 mm).These results confirm the significant influence of Hyrax appliance on transverse dimensions, represented by enlargement of IMD and IAD and its effectiveness to solve posterior crossbites.

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.

Extração seriada: considerações clínicas

The early malocclusion treatment has increased interest of orthodontic community. Among these is the serial extraction that harmonizes the differences between the amount of dental material and permanent deficiency of supporting bone. The technique is applied in mixed dentition through a predetermined sequence of extractions between deciduous and permanent teeth, in order to reach spontaneous immediately alignment of remaining permanent teeth with a minimum orthodontic mechanics. It will be reported a case where the serial extraction was performed in a growing patient with biprotrusion, Class I malocclusion and severe crowding. All functional and aesthetics goals were reached.

Meaw modificado: apresentação da técnica para correção das mordidas abertas e na finalização dos tratamentos ortodônticos

This study presents a new treatment technique, that uses TMA archwires with standardized curvatures, associated to intermaxillary elastics, that can do both offer satisfactory results in short period of the treatment time in the open bites cases and in the finishing procedures of the orthodontic treatment.

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.

Parâmetros de força ideal aplicada aos principais movimenetos ortodônticos

The orthodontic movement is a result of the system of forces application and it depends on the response of periodontal tissues to this system. The forces must have a magnitude considered ideal, to has maximum response of tissue without pain or root resorption, and keep the health of the periodontal ligament, during all the tooth movement. Therefore, it seems adequate by means of an available literature to estimate parameters of ideal force, for different types of movements; with intention of assisting the orthodontists in optimum control of the tooth movement and thus to diminish the possibility to generate deleterious effects.

Sistema Essix MTM: uma alternativa estética para a movimentação

The increased interest in orthodontics by adults has led companies to develop new treatment alternatives that use less visible and more aesthetic orthodontic appliances. The aesthetic aligners stand out among the treatment options that attend these expectations. This paper presented some relevant aspects of these devices, as well as two cases treated with Essix MTM (Dentsply) system, in which all aesthetic and functional objectives proposed treatment have been achieved. The results of this study support the idea that, when properly indicated, aesthetic aligners are a viable treatment option within the clinical routine of the orthodontist.