Occurrence of skeletal malocclusions in Brazilian patients with dentofacial deformities

Este estudo avaliou a ocorrência de más oclusões esqueléticas apresentadas pelos pacientes do Centro de Pesquisa e Tratamento das Deformidades Bucofaciais (CEDEFACE), na cidade de Araraquara, SP, Brasil. Foram avaliados prontuários de 381 pacientes com deformidades dentoesqueléticas, que fizeram tratamento combinado ortodôntico-cirúrgico no período entre 2000 e 2006. Após a seleção da amostra (método de conveniência), baseado nos dados da documentação pré e pós-cirúrgica, o número de pacientes foi reduzido para 171. Para classificação do levantamento, considerou-se a discrepância ântero-posterior (Classe I, II e III), raça, idade, gênero, ausência ou presença de assimetria, excesso vertical maxilar e biprotrusão maxilar, além de determinar em qual base óssea o procedimento cirúrgico foi realizado. As documentações dos pacientes foram analisadas por um examinador previamente calibrado pelo processo de repetição até que o método fosse considerado adequado (correlação intraclasse >0,94). A idade média dos pacientes foi de 23,59 anos (DP 6,93), a maioria do gênero feminino (102 pacientes) e leucoderma (160 pacientes). A má oclusão mais prevalente foi a Classe III (81 pacientes). A assimetria, o excesso maxilar vertical e biprotrusão maxilar estavam presentes em 54, 33, e 7 pacientes, respectivamente. Na maioria dos casos, as cirurgias para correção de deformidades dentoesqueléticas foram combinadas, envolvendo os dois maxilares. Com base nos resultados, conclui-se que a Classe III foi a deformidade esquelética mais prevalente e a Classe I a menos prevalente. em geral, a prevalência de deformidades esqueléticas foi maior entre as mulheres e a maioria dos pacientes apresentou uma combinação de problemas maxilares e mandibulares, o que interfere diretamente na decisão sobre o plano de tratamento mais adequado. Houve uma maior incidência de assimetria na Classe III esquelética; o excesso vertical ocorreu de forma semelhante na Classe II e III e a biprotrusão teve baixa incidência entre as más oclusões avaliadas.

Effect of continuous and pulsed therapeutic ultrasound in the appearance of local recurrence of mammary cancer in rats

Purpose: Ultrasound (US) therapy is an elect rot hermotherapeutic modality that uses US energy to provoke physical and chemical alterations. US therapy has been widely used in physical therapy. However in clinical practice, it is contra-indicated in cancer patients due to the possibility of exacerbating tumor growth.Methods: Sixty-eight female Sprague-Dawley rats bred in UNIFAE vivarium were studied. At 50 days of age, 7, 12-dimetylbenz(a)anthracene (7, 12-DMBA) was administered to 35 rats by gastric gavage to induce mammary cancer After 90 days the mammary glands of the rats belonging to the group with mammary cancer induction and stimulated by US were removed. Animals received either continuous or pulsed US. US waves were generated at a frequency of 1 MHz during 10 days, with an intensity dose of 0.5 W in the continuous group, and 0.9 W (duty cycle: 20%) in the pulsed group.Results: Among the rats treated with continuous US, 44.4% developed local recurrence, while among the rats treated with pulsed US, 22.2% had local tumor recurrence (p < 0.05). No evidence of distant metastases was shown in any of the rats studied.Conclusion: The use ofcontinuous and pulsed therapeutic US promoted the development of local recurrence of mammary cancer in female Sprague-Dawley rats in the postoperative period.

Health-related quality of life and depression in patients with dentofacial deformity

Introduction: Patients with dentofacial deformities present difficulties at work and in social adaptation. At the same time, they often appear depressed, and as a consequence, the psychosocial aspects of surgery play an important role. The aim of this study was to investigate the effects that depression causes in the quality of life of patients with dentofacial deformity. Material and methods: Filthy patients were recruited 1 year before undergoing orthognathic surgery and correlated oral and general health with the presence and absence of depression. In order to accomplish this, these patients received an adapted questionnaires of quality of life and Beck Depression Inventory to fill out. Fisher's test was applied, with a significance level of 5 %. Intercooled Stata version 9.0 was used to analyze data. Results: Among the eight domains of quality of life, there were three associated with depression status: vitality (p < 0.001), social aspects (p = 0.011), and mental health (p = 0.008). Discussion: There is growing interest in the impact of dentofacial deformity conditions on patients' quality of life. The scientific literature has discussed the social aspects of these deformities and showed that untreated patients had low self-esteem and suffered social restrictions before making the orthodontic and surgical treatments. This study concluded that the depression interferes significantly in vitality, social aspects of the individual, and mental health and, at the same time, emphasizes that the orthognathic surgery aims to not only restore esthetics and function to the patient but also improve the quality of life. © 2012 Springer-Verlag.

Six-year follow-up of maxillary anterior rehabilitation with forced orthodontic extrusion: Achieving esthetic excellence with a multidisciplinary approach

Orthodontic extrusion with multidisciplinary treatment can provide predictable outcomes in selected situations, reducing the costs and the adaptation times of gingival tissues after implant integration. Forced orthodontic extrusion is strongly related to interactions of teeth with their supportive periodontal tissues. This article reports a case of orthodontic extrusion of the maxillary incisors for later implant rehabilitation in a patient with periodontal disease. Slow forces were applied for 14 months. After this time, the teeth were extracted, and the implants were placed on the same day. Also in the same session, the provisional crown was fabricated for restoration of the anterior maxillary interdental papillae loss and for gingival contouring. Clinical and radiographic examinations at the 6-year follow-up showed successful tooth replacement and an improved esthetic appearance achieved by this multidisciplinary treatment. The decision to perform orthodontic extrusion for implant placement in adult patients should be multidisciplinary. Copyright © 2013 by the American Association of Orthodontists.

A influência da perda bilateral do primeiro molar inferior permanente na morfologia dentofacial - um estudo cefalométrico

OBJETIVO: avaliar as alterações cefalométricas em pacientes com perda bilateral do primeiro molar inferior permanente. MÉTODOS: foram analisadas 68 telerradiografias laterais de pacientes de consultórios particulares. A amostra foi dividida em dois grupos pareados quanto ao sexo e idade - 34 indivíduos sem perdas (grupo controle) e 34 com perda bilateral do primeiro molar inferior permanente (grupo com perda). Foram excluídos da amostra pacientes que haviam perdido outros dentes que não o primeiro molar inferior, casos de agenesia e pacientes com menos de 16 anos de idade. Buscou-se avaliar somente indivíduos que tivessem relatado a perda há pelo menos 5 anos. RESULTADOS: demonstraram que a perda bilateral do primeiro molar inferior permanente leva ao suave fechamento do ângulo GnSN (P=0,05), um giro anti-horário do plano oclusal (P=0,0001), uma suave diminuição da altura facial anteroinferior (P=0,05), uma acentuada inclinação lingual (P=0,04) e retrusão dos incisivos inferiores (P=0,03). Por outro lado, a perda bilateral do primeiro molar inferior permanente não foi capaz de influenciar a relação maxilomandibular no sentido anteroposterior (P=0,21), a quantidade de mento (P=0,45), a inclinação dos incisivos superiores (P=0,12) e a posição anteroposterior dos incisivos superiores (P=0,46). CONCLUSÃO: a perda bilateral dos primeiros molares inferiores é capaz de produzir alterações marcantes no posicionamento dos incisivos inferiores e no plano oclusal, além de uma suave redução vertical da face.

Agenesia de incisivo lateral superior permanente e a morfologia dentofacial: um estudo cefalométrico

A agenesia dental é a anomalia de número mais freqüente na dentição permanente e o incisivo lateral superior permanente (ILSP) é um dos dentes mais acometidos por essa condição. O objetivo deste estudo foi analisar a influência da agenesia de ILSP sobre a morfologia dentofacial. A amostra consistiu de 100 telerradiografias da cabeça, em norma lateral, de indivíduos de ambos os gêneros, na fase de dentição permanente, com idades variando de 11 a 25 anos (média de 14.3), que foram divididos em dois grupos pareados individualmente segundo o gênero e a idade: um grupo de 50 casos de agenesia uni ou bilateral de ILSP e outro grupo sem agenesia dental, o grupo controle. As telerradiografias laterais foram traçadas e as medidas angulares e lineares foram comparadas entre os dois grupos, através do teste “t” de Student. Os resultados obtidos mostraram que os dois grupos não diferiram significantemente quanto à direção de crescimento facial. A maxila e a mandíbula mostraramse na mesma disposição sagital, quando avaliadas isoladamente em relação à base craniana, e com comprimentos semelhantes nos dois grupos. Entretanto, a convexidade facial mostrou-se significantemente reduzida no grupo com agenesia, medida através do ângulo NAP (P=0.008), bem como a relação maxilo-mandibular entre si, medida pelo ângulo ANB (P=0.017). As alterações mais significantes foram observadas nos incisivos superiores e inferiores, que apresentaram redução significante na inclinação axial e protrusão (P<0.05), com conseqüente aumento do ângulo nasolabial, no grupo com agenesia. Esses resultados permitem concluir que a agenesia de ILSP está associada a alterações na morfologia dentofacial.

Midpalatal suture maturation: Classification method for individual assessment before rapid maxillary expansion

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Orofacial functions and quality of life in oral health in subjects with dentofacial deformity

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The importance of the lifelike esthetic appearance of all-ceramic restorations on anterior teeth

The success of rehabilitation will not depend on just clinical procedures. A proper dental technique (ceramist) is required as well as the respect for some biomimetic principles to obtain the desired final result. This study has the purpose of describing a prosthetic rehabilitation with laminate veneers and all-ceramic crowns of a patient unsatisfied with a previous esthetic treatment because of the negligence of some biomimetic principles. A 45-year-old female patient was admitted to the dental clinic complaining about the lifelike appearance of her all-ceramic restorations. Before the fabrication of new restorations, a mock-up was conducted to verify the patient's satisfaction. A ceramist conducted all the fabrication process so that surface characterizations could be visually verified and the lifelike appearance of natural tooth could be reproduced. After the cementation procedure, the patient reported being satisfied with the lifelike appearance of the new restorations. Based on the clinical findings of the present case report, it can be concluded that the reproduction of the lifelike esthetic appearance of natural teeth and the visualization of the final results before definitive procedures are essential to obtain the clinical success.

On an energy exchange process and appearance of chaos in a non-ideal portal frame dynamical system

In this paper, we consider non-ideal excitation devices such as DC motors with restrictenergy output capacity. When such motors are attached to structures which needexcitation power levels similar to the source power capacity, jump phenomena and theincrease in power required near resonance characterize the Sommerfeld Effect, actingas a sort of an energy sink. One of the problems often faced by designers of suchstructures is how to drive the system through resonance and avoid this energy sink.Our basic structural model is a simple portal frame driven by a num-ideal powersource-(NIPF). We also investigate the absorption of resonant vibrations (nonlinearand chaotic) by means of a nonlinear sub-structure known as a Nonlinear Energy Sink(NES). An energy exchange process between the NIPF and NES in the passagethrough resonance is investigated, as well the suppression of chaos.

Influence of root canal sealer on the radiographic appearance of filling voids in maxillary single-rooted teeth

Objective: This study compared the influence of three epoxy resin-based sealers with distinct radiopacities on the observers' ability to detect root canal filling voids during radiographic analysis. Material and methods: The root canals of 48 extracted maxillary canines were prepared and divided into three groups. Each group was laterally condensed with one sealer (AH Plus (TM), Acroseal (R) or a non-radiopaque sealer), and a longitudinal void was simulated in half of the specimens from each group (n = 8). Buccolingual radiographs were obtained and randomly interpreted for voids by a radiologist and an endodontist in a blinded fashion. Teeth were cut and inspected under a microscope to confirm the position of void. Differences in sensitivity and specificity between groups and examiners were compared using the Fisher's Exact and McNemar tests, respectively (alpha = 0.05). Results: Significantly lower sensitivity levels (p<0.05) were observed in the coronal portion of fillings performed with both radiopaque sealers. Specificity values for Acroseal (R) were significantly higher (p<0.05) in the coronal and apical portions of fillings. Conclusion: The type of root canal sealer can affect the observers' ability to detect root canal filling voids during radiographic analysis of upper single-rooted teeth.

Masticatory efficiency in class II and class III dentofacial deformities

Masticatory efficiency may be impaired in individuals with dentofacial deformities. The objective of the present study was to determine the condition of masticatory efficiency in individuals with dentofacial deformities. 30 patients with class II (DG-II) and 35 patients with class III (DG-III) dentofacial deformity participated in the study, all had an indication for orthognathic surgery. 30 volunteers (CG) with no alterations of facial morphology or dental occlusion and with no signs or symptoms of temporomandibular joint dysfunction also participated. Masticatory efficiency was analysed using a bead system (colorimetric method). Each individual chewed 4 beads, one at a time, over 20 s measured with a chronometer. The groups were compared in term's of masticatory efficiency using analysis of variance (ANOVA), with the level of significance set at P < 0.05. Masticatory efficiency was significantly greater in CG (P < 0.05) than in DG-II and DG-III in all chewing tasks tested, with no significant difference between DG-II and DG-III (P > 0.05). It was observed that the presence of class II and class III dentofacial deformity affected masticatory efficiency compared to CG, although there was no difference between DG-II and DG-III.

Anatomical and radiographic appearance of the capuchin monkey thoracic cavity (Cebus apella)

The capuchin monkey is widespread both north and south of the Legal Amazon and in the Brazilian cerrado. Ten clinically healthy capuchin monkeys were submitted to an anatomical and radiographic study of their thoracic cavities. The radiographic evaluation allowed the description of biometric values associated with the cardiac silhouette and thoracic structures. Application of the VHS (vertebral heart size) method showed positive correlation (P<0.05) with depth of the thoracic cavity, as well as between the body length of vertebrae T 3, T 4, T 5 and T 6 and the cardiac length and width. The lung fields showed a diffuse interstitial pattern, more visible in the caudal lung lobes and a bronchial pattern in the middle and cranial lung lobes. The radiographic examination allowed preliminary inferences to be made concerning the syntopy of the thoracic structures and modifiication of the pulmonary patterns and cardiac anatomy for the capuchin monkey.

Chewing time and chewing strokes in different dentofacial deformities

PURPOSE: To verify whether the number of chewing strokes and the chewing time are influenced by dentofacial deformities in habitual free mastication. METHODS: Participants were 15 patients with diagnosis of class II dentofacial deformity (GII), 15 with class III (GIII), and 15 healthy control individuals with no deformity (CG). Free habitual mastication of a cornstarch cookie was analyzed, considering the number of chewing strokes and the time needed to complete two mastications. Strokes were counted by considering the opening and closing movements of the mandible. The time needed to consume each bite was determined using a digital chronometer, started after the placement of the food in the oral cavity and stopped when each portion was swallowed. RESULTS: There were no differences between groups regarding both the number of strokes and the chewing time. However, with regards to the number of strokes, CG and GII presented a significant concordance between the first and the second chewing situation, which was not observed in GIII. The analysis of time showed significant concordance between the first and second chewing situation in CG, reasonable concordance in GII, and discordance in GIII. CONCLUSION: Dentofacial deformities do not influence the number of chewing strokes or the chewing time. However, class III individuals do not show uniformity regarding these aspects.