Aparelho extrabucal como recurso auxiliar para alinhamento e nivelamento no tratamento orto cirúrgico de má oclusão classe III esquelética

When well indicated, the orthodontic surgical approach is the ideal treatment mean for Skeletal Class III adult patients. To improve facial esthetic results from orthognatic surgery, the leveling and alignment of maxillary dental arch must be achieved with minimal inclination and projection or even retro-inclination of anterior upper teeth. During a pre-surgical phase of 12 months, headgear bilateral force of 150 g/F was applied to the upper molars of a 22 years old male compliant patient with Class III skeletal malocclusion, to provide an upper teeth control of mesial tipping and projection during alignment and leveling. The ideal occlusal parameters required for surgical procedure were achieved without dental extractions permitting a total treatment period of 37 months. The outcomes remained stable over 3 years follow up after the removal of the appliance. The results indicate that, although headgear use depends greatly on patient compliance, when well indicated it is an interesting alternativetopromote dentaldecompensationon pre-surgical period, in order to allow surgical correction of skeletal Class III malocclusion.

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.

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.

Avaliação das dimensões e relacionamento dos arcos dentários após tratamento com Bionator de Balters

The deficiency of data in the literature took us to evaluate the Bionator of Balters appliance in the alterations of the dimensions and the relationship of the dental archs in children with malocclusion Class II, division 1 of Angle. The experimental group was constituted by 36 pairs cast Caucasians patients, aged between 7 years and 10 months - 11 years and 8 months, being 10 females and 8 males. The Levene´s test showed statistical evidences of likeness among the groups. Statistical analysis was preceded and showed significant alterations (p < 0,005) in the variable indicatives of maxillary first molars' distance, overjet, upper arch total length, upper arch anterior length, right molar relationship, left molar relationship, right canine relationship and left canine relationship. On the other hand, there wasn't significant alteration related to the lower arch and maxillary intercanines distance. The Balters' Bionator appliance had a favorable effect in the improvement of the correction of the malocclusion in Class II (foremost in molars and canines relationship) and transversal increase of the upper arch, mainly in the posterior area of arch.

Dimensões do corredor bucal e sua relação com a distância inter pré-molar e intercomissural

The objective of the study was to analyze the size of buccal corridor during the smile of individuals from 10 to 19 years of age and to determine whether there is a relationship among buccal corridor, inter premolar distance, inter commissure width. Standard digital frontal photographs in posed broad smiles and dental casts were taken of a sample of 150 individuals divided into 5 age groups of 30 individuals: 10-11 years old (G1), 12-13 years old (G2), 14-15 years old (G3), 16-17 years old (G4), 18-19 years old (G5). Distances among the cusps of superior first premolars and buccal corridors were measured for subsequent comparisons using the Image Tool 3.0 program. Data was analyzed using Anova. The SNK test and Tamhane test were applied. The mean values of the buccal corridor ranged from 4.00-to 10.69 mm on the right side and from 4.06 to 11.43 mm on the left side. In percentage related with intercomissure width each side of the buccal corridor ranged from 7.46 to 16.47% on the right side and from 7.58% to 17.61% on the left side. Buccal corridors were different between genders and increased with age. Males have bigger buccal corridors than females, but there is no difference between gender when calculated as a percentage related with the inter commissure width. The inter premolar width is significantly correlated with inter commissure widths of female individuals 14-15 years old and 18-19 years old, and with the right linear buccal corridor of males and females aged 14-15 years old.

Aplicação clínica da mola T do grupo B para retração dos dentes anteriores

A TAS (Técnica do Arco Segmentado) representa uma alternativa à mecânica de deslizamento, muitas vezes dificultada pela incerteza da quantidade de força de atrito envolvida em cada sistema de forças utilizado. Nesse contexto, sabe-se que poucos cursos de Ortodontia no Brasil têm ensinado efetivamente a filosofia e o modo de trabalhar com a TAS. Portanto, este trabalho procura elucidar a forma de raciocínio das relaçÕes entre força e momento manipuladas na TAS, bem como mostrar a forma de confecção e utilização de mola "T" do grupo B, onde objetiva-se a movimentação recíproca dos segmentos posterior e anterior e, por fim, apresentar um caso clínico tratado com esse tipo de mecânica.

Confecção e montagem do set-up ortodôntico

Diagnosis and planning stages are critical to the success of orthodontic treatment, in which the orthodontist should have many elements that contribute to the most appropriate decision-making. The orthodontic set-up is an important resource in the planning of corrective orthodontics therapy. It consists of the repositioning of the teeth previously removed from the study dental casts and reassembled on its remaining basis. When properly made, the set-up allows a three-dimensional preview of problems and limitations of the case, assisting in decision-making regarding tooth extractions in cases with problems of space, amount of anchorage loss extent and type of tooth movement, discrepancy of dental arch perimeter, discrepancy of inter-arch tooth volume, among others, indicating the best option for treatment. This paper outlines the most important steps for its confection, an evaluation system and its application in the preparation of orthodontic treatment planning.

Extração de incisivo inferior: uma alternativa no tratamento da classe III

The correction of a Class III malocclusion in adult patients is one of the major challenges in orthodontics due to facial deformities occurring during the unfavorable growth of this kind of pattern, as well as the treatment options capable of producing facial changes aesthetically acceptable and adequate for today's beauty standards. One acceptable alternative treatment is the removal of a lower incisor. For a Class III correction through a lower incisor extraction a thorough analysis and planning must be carried out by taking into consideration the amount of overjet and overbite, periodontal condition of the teeth and the possibility of obtaining a good dental occlusion with acceptable facial aesthetics. Will be presented two case reports of patients presenting an anteroinferior crowding, Class III malocclusion condition. The treatment through a lower incisor extraction and the reasons why this treatment was adopted will be discussed.

Montagem e confecção do set up ortodôntico

Diagnosis and planning stages are critical to the success of orthodontic treatment, in which the orthodontist should have many elements that contribute to the most appropriate decision-making. The orthodontic set-up is an important resource in the planning of corrective orthodontics therapy. It consists of the repositioning of the teeth previously removed from the study dental casts and reassembled on its remaining basis. When properly made, the set-up allows a three-dimensional preview of problems and limitations of the case, assisting in decision-making regarding tooth extractions in cases with problems of space, amount of anchorage loss extent and type of tooth movement, discrepancy of dental arch perimeter, discrepancy of inter-arch tooth volume, among others, indicating the best option for treatment. This paper outlines the most important steps for its confection, an evaluation system and its application in the preparation of orthodontic treatment planning.

Necessidade de ancoragem do grupo A e o controle biomecanico da mola T pré-ativada por curvatura para o fechamento de espacos

Contemporary orthodontics has sought, beyond the esthetic, occlusal and functional goals, treatments even faster and with less visits to the orthodontist — especially in patients that require dental extractions in which the generated space becomes a nuisance. The segmented arch technic (SAT), by the use of a "T" loop spring, has provided such results within these requirements. Therefore, this study aimed to appraise and demonstrate the confection, activation and biomechanical control of "T" loop spring, in the group with high anchorage necessity (group A), for retraction of anterior teeth; as well as to present a case report, with high anterior retraction necessity, treated with "T" loop spring.

Tratamento ortodôntico da agenesia de incisivo lateral superior com envolvimento de fratura radicular de incisivo central superior

Patients with agenesis of maxillary lateral incisor must have in your planning functional and aesthetic considerations, important to the success of the treatment, regardless of whether the choice of treatment is closing or opening and maintenance of space for rehabilitation with prosthesis. This choice will depend on factors such as skeletal and tooth structure and profile. Children and adolescents are the group of individuals most exposed to trauma and fracture of the maxillary lateral incisor due to the activities they perform. Proper diagnosis and good treatment are essential to the success of the treatment. This article aims to report a case of agenesis of the maxillary lateral incisor along with the involvement of a root fracture of the maxillary central incisor. The orthodontic treatment was successfully finished with a favorable prognosis for the fractured incisor to stay in a esthetic and functional position.

Tratamento ortodôntico lingual individualizado com o sistema Incognito

Introduction: The orthodontic treatment using lingual brackets has been desired by adult patients for esthetic factors. In this paper it is described the clinical steps of an orthodontic treatment using Incognito™ system, individualized lingual brackets and archwires designed by CAD/CAM technology. Methods: The presented case describes the treatment of a patient with mesofacial growth pattern,Class I malocclusion, with mandibular crowding and diastema between the upper central incisors, treated using 100% individualized lingual brackets. Results: After treatment, the molar relation of Class I was kept, the spaces between upper central incisors were closed and mandibular crowding corrected. Conclusion: This case report demonstrated the efficiency of the new method for lingual orthodontic treatment.

Resistência ao cisalhamento de bráquetes fotopolimerizados com arco de plasma, LED e luz halógena utilizando diferentes tempos

This study evaluated in vitro the shear bond strength of brackets bonded with xenon plasma arc light, light-emitting diode (LED) and conventional halogen light using different curing times. Brackets were bonded to the buccal surface of 60 human maxillary premolars allocated to five groups. In groups 1 and 2, the resin was cured with the plasma arc for three and six seconds (s), respectively; in groups 3 and 4, the LED was used for five and ten s, respectively; and in group 5, the halogen light was used for 40 s. The specimens were stored in water for 24 hours and subjected to a shear force until bracket failure. The debonding pattern was classified according to the adhesive remnant index (ARI). The results were assessed by Anova and the SNK post-hoc test. No differences were detected among groups 2, 4 and 5, which showed higher averages than groups 1 and 3, which were not different between themselves. The ARI scores showed no differences among the three types of light sources in all times tested. Plasma arc and LED lights can be used with shorter curing times, within certain limits, than conventional halogen light for bonding orthodontic brackets, without decreasing bond strength.

Resina composta indireta como alternativa funcional e estética em reabilitações protéticas

Due to mechanical and aesthetic improvement properties, continuous fiber-reinforced composites have been developed to replace the metal framework in fixed partial dentures becoming an interesting alternative to conventional treatments. A male patient, 57 years old, attended at Fixed Partial Denture Clinic of Araraquara Dental School - UNESP, complaining about upper right first molar absence. After clinical examination, it was observed: upper right second molar with amalgam restoration and periodontal bone reduction and upper right second premolar unsatisfactory treated. Following the clinical conditions and the patient expectations, it was decided to use a fiber-reinforced composite resin to make a three-element fixed bridge. The patient showed full satisfaction with the aesthetic and functional results. The case has been followed up for 60 months.