Apresentação de um método experimental de traumatismo dentoalveolar em ratos para realização de experimentos de movimentação dentária induzida

Pós-graduação em Odontologia - FOA

Avaliação do nível de conhecimento de um grupo de ortodontistas sobre o traumatismo dentoalveolar e a movimentação ortodôntica em dentes traumatizados

Pós-graduação em Odontologia - FOA

A comparison of skeletal, dentoalveolar and soft tissue characteristics in white and black Brazilian subjects

OBJECTIVE: This study aimed to compare skeletal, dentoalveolar and soft tissue characteristics in white and black Brazilian subjects presenting normal occlusions. MATERIAL AND METHODS: The sample comprised the lateral cephalograms of 106 untreated Brazilian subjects with normal occlusion, divided into two groups: Group 1- 50 white subjects (25 of each gender), at a mean age of 13.17 years (standard deviation 1.07); and Group 2- 56 black subjects (28 of each gender), at a mean age of 13.24 years (standard deviation 0.56). Variables studied were obtained from several cephalometric analyses. Independent t tests were used for intergroup comparison and to determine sexual dimorphism. RESULTS: black subjects presented a more protruded maxilla and mandible, a smaller chin prominence and a greater maxillomandibular discrepancy than white subjects. Blacks presented a more horizontal craniofacial growth pattern than whites. Maxillary and mandibular incisors presented more protruded and proclined in black subjects. The nasolabial angle was larger in whites. Upper and lower lips were more protruded in blacks than in whites. CONCLUSIONS: The present study found a bimaxillary skeletal, dentoalveolar and soft tissue protrusion in black Brazilian subjects compared to white Brazilian subjects, both groups with normal occlusion. Upper and lower lips showed to be more protruded in blacks, but lip thickness was similar in both groups.

Management of a complex dentoalveolar trauma: a case report

This paper describes the case of a 12-year-old male patient who presented a severe lateral luxation of the maxillary central incisors due to a bicycle fall. Treatment involved suture of the soft tissues lacerations, and repositioning and splinting of the injured teeth, followed by endodontic treatment and periodontal surgery. After a 2-year follow-up, clinical and radiographic evaluation revealed that the incisors presented satisfactory esthetic and functional demands.

Influência da proporção entre as alturas do ramo mandibular e dentoalveolar posterior na inclinação do plano mandibular

OBJETIVO: avaliar a existência de correlação entre a proporção da altura do ramo mandibular (AR) com a altura dentoalveolar posterior total (ADAPT) e a inclinação do plano mandibular (PM). MÉTODOS: dois examinadores avaliaram 81 telerradiografias laterais de pacientes, com idades a partir de 18 anos, do arquivo do curso de especialização em Ortodontia e Ortopedia Facial da Faculdade de Odontologia da UFBA. As radiografias foram digitalizadas, os pontos marcados e as medidas obtidas através do programa Radiocef 1.0. Mediu-se a inclinação do plano mandibular para caracterizar o padrão vertical da face e dividir as radiografias em três grupos: grupo de face normal (GN), de 22º a 28º, de face curta (GC), menor que 22º, e de face longa (GL), maior que 28º. A inclinação do plano palatino serviu como critério de exclusão, sendo que valores abaixo de -2,5° ou acima de 3,5º foram excluídos. Desta forma, 46 telerradiografias laterais totalizaram a amostra. RESULTADOS: a AR diferiu entre GC e GL, porém não houve diferença estatisticamente significante para as alturas dentoalveolares posteriores. Houve baixa correlação entre a AR e a ADAPT nos grupos, no entanto, a correlação da proporção entre essas alturas com a inclinação do PM mostrou-se estatisticamente significante e negativa. CONCLUSÃO: este é um fator a ser levado em consideração na avaliação do PM, quando do diagnóstico e tratamento das displasias verticais dentofaciais.

Masticatory muscle activity in children with a skeletal or dentoalveolar open bite

Forty-five children (31 boys and 14 girls), aged 6-11 years, were included in the study, 15 with a skeletal anterior open bite (SAOB), 15 with a dentoalveolar anterior open bite (DAOB), and 15 with a normal occlusion (CG), defined by clinical evaluation and lateral cephalograms. EMG recordings of the temporal and masseter muscles were performed under maximal voluntary clenching and during chewing. Analysis of variance was used for inter-group analysis, followed by the Tukey post hoc test. A Student`s t-test for paired data was used for intra-group analysis. There were statistically significant differences among the three groups (P < 0.05), with the mean EMG being highest in the CG and lowest in children with a SAOB. The percentage EMG activity during chewing in relation to that during maximal voluntary clenching was more than 100 per cent in the SAOB group. The CG and DAOB groups presented higher EMG activity during clenching compared with chewing (P < 0.001), as well as a greater difference between tasks. In the SAOB group, the neuromuscular system appeared to have a lower capacity to produce EMG activity according to the task, while that in the DAOB group suggests that their functional capacity during growth should also be carefully observed.

Management of a multiple dentoalveolar trauma in permanent dentition with avulsion of a canine: A 4-year follow-up

Traumatic dental injuries are relatively frequent accidents that typically involve teeth in the maxillary anterior segment. The emergency treatment and the clinical decisions must be efficiently made at the time of injury, and there is a need for long-term follow-up because of the high incidence of complications. The aim of this article was to present the emergency and rehabilitation treatments of a multiple dentoalveolar trauma in the permanent dentition involving different extensions of enamel-dentin crown fracture, pulp exposure, and the avulsion of a canine. The treatment outcomes are reported up to the 4-year follow-up, and the clinical approaches and their rationale are discussed.

Lésion du fond d'oeil séquellaire d'un traumatisme obstétrical: à propos d'un cas [Retinal lesion due to an obstetrical traumatism: a case report].

The authors report a case of unilateral, stable, localized, and well-circumscribed choriocapillaris atrophy associated with retinal pigment epithelium dispersion and atrophy. The anterior segment was normal. Facial examination revealed a homolateral malar hypoplasia. The other eye was normal. The electrophysiologic study did not confirm pigmentary degeneration of the retina. The patient's history included a difficult delivery using obstetrical forceps. The authors review the main ocular lesions secondary to birth trauma. In this case, they favored a traumatic chorioretinal lesion secondary to an obstetrical traumatism. In this context, progressive facial hemiatrophy is the main differential diagnosis.

What kind of relationships between the evolution of pain, beliefs and bio-psycho-social complexity after a locomotor traumatism?

Introduction: Pain and beliefs have an influence on the patient's course in rehabilitation, pain causes fears and fears influence pain perception. The aim of this study is to understand pain and beliefs evolutions during rehabilitation taking into account of bio-psycho-social complexity.Patients and methods: 631 consecutive patients admitted in rehabilitation after a musculoskeletal traumatism were included and assessed at admission and at discharge. Pain was measured by VAS (Visual Analogical Scale), bio-psycho-social complexity by Intermed scale, and beliefs by judgement on Lickert scales. Four kinds of beliefs were evaluated: fear of a severe origin of pain, fear of movement, fear of pain and feeling of distress (loss of control). The association between the changes in pain and beliefs during the hospitalization was assessed by linear regressions.Results: After adjustment for gender, age, education and native language, patients with a decrease in pain during rehabilitation have higher probability of decreasing their fears. For the distress feeling, this relationship is weaker among bio-psycho-socially complex patients (odds-ratio 1.22 for each decreasing of 10mm/100 VAS) than among non-complex patients (OR 1.47). Patients with a pain decrease of 30% or more during hospitalization have higher probability of seeing their fears decrease, this relationship being stronger in complex patient for fear of a severe origin of pain.Discussion: The relationships between evolution of pain and beliefs move in the same direction. The higher a patient feels pain, the less they could be able to modify their dysfunctional beliefs. When the pain diminishes of 30% or more, the probability to challenge the beliefs is increased. The prognostic with regard to feeling of distress and fear of a severe origin of pain, is worse among bio-psycho-socially complex patients.

Lower incisor dentoalveolar compensation and symphysis dimensions among Class I and III malocclusion patients with different facial vertical skeletal patterns

Objective: To compare lower incisor dentoalveolar compensation and mandible symphysis morphology among Class I and Class III malocclusion patients with different facial vertical skeletal patterns. Materials and Methods: Lower incisor extrusion and inclination, as well as buccal (LA) and lingual (LP) cortex depth, and mandibular symphysis height (LH) were measured in 107 lateral cephalometric x-rays of adult patients without prior orthodontic treatment. In addition, malocclusion type (Class I or III) and facial vertical skeletal pattern were considered. Through a principal component analysis (PCA) related variables were reduced. Simple regression equation and multivariate analyses of variance were also used. Results: Incisor mandibular plane angle (P < .001) and extrusion (P  =  .03) values showed significant differences between the sagittal malocclusion groups. Variations in the mandibular plane have a negative correlation with LA (Class I P  =  .03 and Class III P  =  .01) and a positive correlation with LH (Class I P  =  .01 and Class III P  =  .02) in both groups. Within the Class III group, there was a negative correlation between the mandibular plane and LP (P  =  .02). PCA showed that the tendency toward a long face causes the symphysis to elongate and narrow. In Class III, alveolar narrowing is also found in normal faces. Conclusions: Vertical facial pattern is a significant factor in mandibular symphysis alveolar morphology and lower incisor positioning, both for Class I and Class III patients. Short-faced Class III patients have a widened alveolar bone. However, for long-faced and normal-faced Class III, natural compensation elongates the symphysis and influences lower incisor position.

Estudio comparativo entre Lip Bumper modificado con escudos laterales y el Lip Bumper simple para lograr la expansión transversal dentoalveolar mandibular

Tesis ( Maestría en Ciencias Odontológicas con Especialidad en Ortodoncia) U.A.N.L.

Dentists' level of knowledge of the treatment plans for periodontal ligament injuries after dentoalveolar trauma

This study investigated the level of knowledge held by dentists about the possible treatment plan procedures for periodontal ligament injuries after dentoalveolar trauma. A 5-item self-applied questionnaire was prepared with questions referring to the professional profile of the interviewees and to the treatment plan they would propose for periodontal ligament injuries secondary to dentoalveolar trauma. The questionnaires were filled out by 693 dentists attending the 23rd Annual Meeting of the Brazilian Society for Dental Research, and the data obtained were subjected to descriptive analysis. Either the chi-square test or Fisher's exact test was applied to assess associations among variables, at a 5% level of significance. The results revealed that dentists experienced difficulty in establishing a treatment plan for subluxation, and for extrusive, lateral and intrusive luxations. In general, holding a dental specialty degree had no influence on the knowledge about treatment plan procedures for the most severe injuries. It could be concluded that the dentists participating in this study, whether specialists or not, did not have sufficient knowledge to treat most of the periodontal ligament injuries resulting from dentoalveolar trauma adequately.

Importance of Clinical Examination in Dentoalveolar Trauma

Dental injuries are often the result of direct trauma. The most affected teeth are the upper incisors, and the most frequent lesions are coronal fractures, contusions, and lip and alveolar mucosa lacerations. The objective of this study was to draw attention to the importance of the correct management of cases of crow fractures associated with soft tissue lacerations when the fragment is not located. This is a clinical case of crown fracture, the fragment of which remained lodged inside the lip. After fragment removal, the clinical case showed a satisfactory repair emphasizing the importance of a meticulous clinical examination to achieve a correct diagnosis and an appropriate treatment plan, which is essential for a favorable prognosis.

Avaliação da inclinação dentoalveolar e dimensões do arco superior em mordidas cruzadas posteriores tratadas com aparelho expansor removível e fixo

OBJETIVO: avaliar as diferenças produzidas nas dimensões e forma de arco pelos tratamentos com aparelho expansor fixo tipo Hyrax e aparelho expansor removível tipo Placa de Hawley com parafuso expansor palatino centralizado. MATERIAL E MÉTODOS: foram selecionados modelos de estudo iniciais e finais de 31 crianças portadoras de mordida cruzada posterior, de ambos os gêneros, de origem étnica diversa e na fase da dentadura mista, tratadas nos cursos de Graduação e Pós-Graduação em Ortodontia do Departamento de Clínica Infantil da Faculdade de Odontologia de Araraquara - UNESP. Destas crianças, 15 foram tratadas com uso do aparelho expansor fixo tipo Hyrax e as demais 16 crianças foram tratados com expansão rápida da maxila efetuada com o aparelho expansor fixo. Foram realizadas medidas das distâncias intercaninos e intermolares, da inclinação do processo alveolar e inclinação dentária nas imagens escaneadas do arco superior e do contorno do palato, obtido com auxílio de um template ajustável e do programa de análises Radiocef Studio. RESULTADOS E CONCLUSÕES: os resultados indicam uma mudança significante nas distâncias intercaninos e intermolares em ambos os grupos e uma inclinação dentária e do processo alveolar para vestibular significante no grupo tratado com o aparelho expansor fixo. A expansão conseguida pelo aparelho expansor fixo foi aproximadamente o dobro da promovida pelo aparelho expansor removível.

Análise do conhecimento dos cirurgiões dentistas sobre plano de tratamento das injúrias do ligamento periodontal após traumatismo dentoalveolar

O diagnóstico preciso e a elaboração de um plano de tratamento adequado podem constituir uma tarefa bastante complexa, especialmente nos traumatismos dentoalveolares, pois necessitam de uma abordagem multidisciplinar e conhecimento sobre o processo de reparo após o traumatismo. O objetivo do trabalho foi analisar o conhecimento dos cirurgiões dentistas sobre plano de tratamento das injúrias do ligamento periodontal após traumatismo dentoalveolar. Para tanto, a partir de um questionário, foram abordadas perguntas referentes ao perfil dos profissionais entrevistados e conduta frente às injúrias do ligamento periodontal (concussão, subluxação, luxação extrusiva, luxação lateral e luxação intrusiva) ocasionadas por traumatismo dentoalveolar. Seiscentos e noventa e três cirurgiões dentistas que participaram da 23ª Reunião Anual da SBPqO (2006) responderam o questionário e os dados obtidos foram submetidos à análise descritiva, enquanto o teste estatístico foi aplicado para demonstrar as freqüências e o nível de significância entre as variáveis (Teste qui-quadrado ou Teste Exato de Fisher). De acordo com os resultados obtidos, grandes dificuldades foram encontradas com relação ao plano de tratamento das luxações extrusiva, lateral e intrusiva. De maneira geral, a especialidade não influenciou na elaboração de planos adequados para as injúrias mais complexas. Foi possível concluir que os cirurgiões dentistas não apresentam conhecimento suficiente para tratar de maneira adequada as injúrias mais severas do ligamento periodontal após traumatismo dentoalveolar