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Bistaffa AGI, Belomo-Yamaguchi L, de Castro Ferreira Conti AC, Oltramari PVP, de Almeida MR, de Almeida-Pedrin RR, Fernandes TMF. Dental arch changes comparison between Expander with Differential Opening, Hyrax-type and Haas-type expanders: A prospective clinical study. Orthod Craniofac Res 2023; 26:468-475. [PMID: 36571153 DOI: 10.1111/ocr.12629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/05/2022] [Accepted: 12/17/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Compare changes in arch form after RME achieved by Expander with Differential Opening (EDO), Hyrax-type and Haas-type expanders. MATERIALS AND METHODS Dental models were obtained from 61 patients aged 7-11 years before expansion (T1) and 6 months after the active phase when the appliances were removed (T2). The groups were formed according to the expander used: EDO (n = 18, mean age: 9.46 ± 0.82 years), Hyrax-type (n = 22, mean age: 9.62 ± 1.57 years) and Haas-type (n = 21, mean age: 9.29 ± 1.05 years). The expander`s activation protocol consisted of 7 mm, except for EDO`s anterior screw, which was 9 mm. The measurements of upper and lower intercanine distance, inter-first permanent molar, arch perimeter and length, maxillary canine and first-permanent molar inclination, and palatal depth were performed using the OrthoAnalyzer 3D software. Intergroup comparisons of T1 and between changes (T2-T1) were performed using ANOVA followed by Tukey. RESULTS In the upper intercanine distance EDO provided a greater increase than Haas-type. In the distance between upper fist permanent molars EDO showed higher values than Haas-type and Hyrax-type. In the lower intercanine distance and maxillary arch length, Haas-type promoted higher increase than EDO. CONCLUSIONS The EDO promoted greater transverse changes in anterior region than Haas-type and greater transverse changes in posterior region of the maxilla than both conventional expanders. The appliance used for RME influences dental arch changes after treatment; therefore, it is recommended to individualize the choice of expander depending on the clinical necessity of each case.
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Bistaffa AGI, Belomo-Yamaguchi L, Almeida MRD, Conti ACDCF, Oltramari PVP, Fernandes TMF. Immediate skeletal effects of rapid maxillary expansion at midpalatal suture opening with Differential, Hyrax and Haas expanders. Dental Press J Orthod 2023; 27:e2220525. [PMID: 36790245 DOI: 10.1590/2177-6709.27.6.e2220525.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 11/24/2021] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE The aim of this study was to test the null hypothesis that there is no difference at the midpalatal suture opening after rapid maxillary expansion (RME) using Expander with Differential Opening (EDO), Hyrax-type and Haas-type expanders. METHODS Occlusal radiographs of 52 patients (19 males and 33 females; average age= 9.46?1.20 years) treated with RME were divided into three groups, according to the expander used: EDO (n=17), Hyrax-type (n=21) and Haas-type (n=14). The evaluated variables were: A) Distance between the maxillary central incisors at the incisal edge; B) Distance between the alveolar ridges at the midpalatal suture; C) Suture opening at 10-mm distance from the crest to posterior, at the midpalatal suture; D) Suture opening at 20-mm distance from the crest to posterior, at the midpalatal suture; and E) Suture opening at 30-mm distance from the crest to posterior, at the midpalatal suture. To assess the normality of variables, the Shapiro-Wilk test was performed. For intergroup comparison, ANOVA with a significance level of 5% was used. RESULTS At the region A, Hyrax-type (4.66 mm) and EDO (4.87 mm) groups presented larger openings than the Haas-type group (3.43 mm). In regions B and C, EDO showed a statistically significant greater opening than the Haas-type group. In region D, a smaller opening of the midpalatal suture was observed in the Haas-type group, compared to the Hyrax-type and EDO groups. CONCLUSIONS EDO and Hyrax-type produced greater immediate skeletal effects, compared with Haas-type, but these differences were about 1 mm and might not be clinically significant.
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Santos LLD, Conti ACDCF, Fernandes TMF, Garlet GP, Almeida MRD, Oltramari PVP. Influence of anxiety and catastrophizing on pain perception in orthodontic treatment and its association with inflammatory cytokines. Braz Oral Res 2023; 37:e010. [PMID: 36629593 DOI: 10.1590/1807-3107bor-2023.vol37.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/02/2022] [Indexed: 01/11/2023] Open
Abstract
Pain is common in orthodontic treatment, is subject to individual variation, and is associated with anxiety and stress, which can potentially become catastrophizing. The aim of the present study was to determine the variability of pain response after the insertion of orthodontic separators and to assess the association of pain levels with dental anxiety, catastrophizing, tooth sensitivity, and genetic expression of cytokines. To this end, 70 patients of both genders were divided into two equal groups according to the elastomeric separator used: G1 (Dentaurum) and G2 (Orthometric). Two separators were inserted in the mesial and distal sides of the lower right first molar. Participants were instructed to rate the level of pain at T0 (before insertion), T1 (just after insertion), and T2 (24 hours after insertion) on a visual analog scale. The gingival crevicular fluid was collected at T0 and T2. The levels of anxiety, catastrophizing, tooth sensitivity, and cytokine expression were also assessed. Statistical analysis was performed with the Fisher-Freeman-Halton, chi-squared, Spearman's correlation, and dependent and independent t tests (α=5%). Pain intensity was higher at T2 than at T1, in both groups (P<.05). An association was established (P<.05) between pain intensity at T1 and catastrophizing, and at T2 with anxiety and catastrophizing. Within-group differences in cytokine expression were found between T0 and T2. There was no correlation between cytokine expression and pain levels, anxiety, catastrophizing, and sensitivity at T2. Tooth separation produced variable pain levels, which were influenced by anxiety and catastrophizing, however, pain level was not correlated with increased cytokine expression.
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Affiliation(s)
- Lucineide Lima Dos Santos
- Universidade Norte do Paraná - Unopar, Dental School, Department of Orthdontics, Londrina, PR, Brazil
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Rosa WGN, de Almeida-Pedrin RR, Oltramari PVP, de Castro Conti ACF, Poleti TMFF, Shroff B, de Almeida MR. Total arch maxillary distalization using infrazygomatic crest miniscrews in the treatment of Class II malocclusion: a prospective study. Angle Orthod 2023; 93:41-48. [PMID: 36126679 DOI: 10.2319/050122-326.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/01/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To evaluate treatment effects in Class II patients using infrazygomatic crest (IZC) miniscrews (MS). MATERIALS AND METHODS A prospective sample of 25 adolescents (14 females and 11 males; mean age: 13.6 ± 1.5 years) who underwent maxillary dentition distalization treatment with IZC MSs were recruited. Lateral cephalograms and digital models at the beginning of treatment (T1) and after Class II molar correction (T2) were obtained. To compare cephalometric and digital model changes, paired t-test and Wilcoxon test were used. A significance level of 5% was used. RESULTS All patients achieved Class II molar correction over a mean period of 7.7 ± 2.5 months. The IZC MS therapy provided 4 mm of distalization; there was 1.2 mm of intrusion of the first molar with 11.2° distal tipping. The maxillary incisors were retracted 4.7 mm and tipped lingually 13.4°. Overjet and overbite showed a reduction of 3.6 mm and 2.4 mm, respectively. The occlusal plane rotated clockwise 2.8°. The upper lip was retracted by 1 mm and the nasolabial angle increased 5.1°. There was an increase in the interpremolar and intermolar distances. CONCLUSIONS Total arch distalization of the maxillary dentition using IZC MS was effective in the treatment of Class II malocclusions.
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Bistaffa AGI, Belomo-Yamaguchi L, Almeida MRD, Conti ACDCF, Oltramari PVP, Santana MCB, Fernandes TMF. Differential Maxillary Expander as an Alternative Device for Early Treatment of Posterior Crossbite: Case Report. J Health Scie 2022. [DOI: 10.17921/2447-8938.2022v24n1p02-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractRapid maxillary expansion (RME) is the protocol of choice for early treatment of transverse malocclusions and it is achieved with fixed expanders that produce heavy forces to achieve midpalatal suture opening. One third of patients with maxillary constriction have a greater transversal deficiency at the intercanine width than at the intermolar. The aim of this article is to present a protocol for early treatment of posterior crossbite with the use of the expander with differential opening (EDO) for RME. It is a new appliance to perform RME and its main advantage would be to allow the expansion individualization. EDO was proposed aiming to promote greater expansion on the anterior rather than on the posterior region. A 9 year-old female sought treatment. The interceptive treatment plan was based on using EDO for RME. The post-expansion orthopedic response showed an opening of 7.5 mm between the maxillary central incisors, at the level of the incisal edge. It was observed an opening of 4.8mm in the midpalatal suture. The opening at a distance of 10 mm and 20 mm from the crest to posterior at the midpalatal suture were 3.9mm and 2.8mm. The upper intercanine distance showed an increase of 9.31 mm. The upper intermolar distance had increased 8.04 mm. The upper arch perimeter showed a difference from 74.02 mm to 80.11 mm . And the upper arch length, from 29.83 mm to 31.56 mm. The posterior crossbite was 2 mm overcorrected. Early diagnosis and treatment of posterior crossbite has a very favorable prognosis.
Keywords: Palatal Expansion Technique. Interceptive Orthodontics. Malocclusion.
Resumo A expansão rápida da maxila (ERM) é a técnica de escolha para o tratamento precoce das más oclusões transversais e é ativada com expansores fixos que produzem forças pesadas para possibilitar a abertura da sutura palatina mediana. Um terço dos pacientes com atresia maxilar apresenta uma maior deficiência transversal na região intercaninos do que na região intermolares. O objetivo desse artigo é apresentar um protocolo de tratamento precoce para a mordida cruzada posterior utilizando o expansor maxilar Diferencial (EMD) para realizar a ERM. EMD é um novo dispositivo que pode ser empregado para realização da ERM e sua principal vantagem seria permitir a individualização da expansão. EMD foi proposto para proporcionar maior expansão na região anterior do que na região posterior da maxila. Uma menina de 9 anos de idade buscou tratamento. O plano de tratamento interceptativo proposto foi ERM utilizando o dispositivo EMD. A resposta ortopédica pós-expansão mostrou uma abertura de 7,5 mm entre os incisivos centrais superiores, ao nível da borda incisal. Foi observada uma abertura de 4,8 mm na sutura palatina mediana. A abertura a uma distância de 10 mm e 20 mm da crista para posterior na sutura palatina mediana foi de 3,9 mm e 2,8 mm. A distância intercaninos superior apresentou aumento de 9,31 mm. A distância intermolares superiores aumentou 8,04 mm. O perímetro do arco superior apresentou diferença de 74,02 mm para 80,11 mm. E o comprimento do arco superior, de 29,83 mm para 31,56 mm. A mordida cruzada posterior foi sobrecorrigida em 2 mm. O diagnóstico precoce e o tratamento da mordida cruzada posterior tem um prognóstico muito favorável.
Palavras-chave: Técnica de Expansão Palatina. Ortodontia Interceptora. Má Oclusão.
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Bocato JR, Pacheco DP, Toma M, Navarro RL, Fernandes TMF, Conti ACDCF, Almeida MRD, Oltramari PVP. Differential Diagnosis of Skeletal Class II: Orthodontic-Surgical Approach with Surgery First. J Health Scie 2021. [DOI: 10.17921/2447-8938.2021v23n4p257-263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractOrthodontic-surgical treatment with the “Surgery First Approach” provides immediate facial aesthetic improvements and significantly reduces the patient's orthodontic treatment time, avoiding the transient worsening of the facial profile due to dental decompensation that occurs in surgical cases. Thus, this clinical case describes the retreatment of a 22-year-old female leukoderma patient, whose main complaint was related to the proclination of upper and lower incisors. The patient used a mio-relaxing plate for 30 days, which evidenced the skeletal mandibular deficiency and the ½ bilateral Class II malocclusion. Orthognathic surgery first approach associated with the extraction of the 4 premolars was chosen considering the patient’s aesthetic demand. The use of a mio-relaxing plate in the diagnostic stage was essential for the real diagnosis of mandibular deficiency and the technique employed made it possible to conclude the treatment avoiding aesthetic commitment, with excellent results.
Keywords: Malocclusion, Angle Class II. Orthognathic Surgery. Orthodontics, Corrective.
ResumoO tratamento ortodôntico-cirúrgico por meio do benefício antecipado proporciona melhorias estéticas faciais imediatas e reduz de maneira significativa o tempo de tratamento ortodôntico do paciente, evitando a piora transitória do perfil facial devido à descompensação dentária que ocorre em casos cirúrgicos. Assim, este caso clínico descreve o retratamento de uma paciente com 22 anos de idade, leucoderma, sexo feminino, que apresentava queixa principal relacionada à inclinação vestibular dos dentes anteriores. Após uso de placa miorrelaxante por 30 dias, verificou-se a presença de Classe II esquelética com deficiência mandibular e ½ Classe II dentária bilateral. Considerando a demanda estética da paciente, optou-se pela abordagem ortodôntico-cirúrgica com Benefício Antecipado associada à extração de 4 pré-molares para correção da inclinação dentária anterior. O uso da placa miorrelaxante foi fundamental para o diagnóstico real da deficiência mandibular e a técnica empregada possibilitou concluir o tratamento evitando o comprometimento estético pré-cirúrgico, com obtenção de excelentes resultados.
Palavras-chave: Maloclusão Classe II de Angle. Cirurgia Ortognática. Ortodontia Corretiva.
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Dias FA, Oltramari PVP, Almeida MRD, Conti ACDCF, Almeida RRD, Fernandes TMF. Stability of early anterior open bite treatment: a 2-year follow-up randomized clinical trial. Braz Dent J 2021; 32:116-126. [PMID: 34755786 DOI: 10.1590/0103-6440202103509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/05/2021] [Indexed: 11/21/2022] Open
Abstract
This 2-year-follow up study compared and evaluated the stability of early anterior open bite (AOB) treatment based on different appliances. Children from 7 to 10 years with Angle Class I, AOB larger than 1.0 mm and fully erupted maxillary and mandibular permanent central incisors were eligible. The initial sample was 99 patients distributed, by simple randomization, into four groups: BS (bonded spurs), CC (chincup), FPC (fixed palatal crib) and RPC (removable palatal crib). Cephalometric analysis was performed at baseline (T1), final (T2) and 2-year post-treatment (T3) by taking the overbite measurements as the main outcome. Blinding was possible to cephalometric analysis. At T3, with dropouts, there were 63 individuals, being BS (n=15; overbite 0.19 mm; 11.54 years; 10 female (F)/5 male (M)); CC (n=11; overbite -0.19 mm; 11.41 years; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 years; 15 F/6 M) and; RPC (n=16; overbite 0.73 mm; 11.67 years; 6 F/10 M). Changes in dentoskeletal variables and breaking deleterious oral habits during the follow up were statically analyzed with p<.05. Mandibular skeletal linear measurements and vertical dental components have gradually increased with age, manly at pubertal growth spurt and at the establishment of permanent dentition after treatment. Incisor teeth extrusion had impact on AOB correction and stability in 4 groups, which recorded a 1.15 mm-improvement of overbite after treatment (T3-T2). The experimental appliances were effective with stable results, being FPC the device recorded the highest AOB correction and the lowest patient withdrawal rate.
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Dourado GB, Volpato GH, de Almeida-Pedrin RR, Pedron Oltramari PV, Freire Fernandes TM, de Castro Ferreira Conti AC. Likert scale vs visual analog scale for assessing facial pleasantness. Am J Orthod Dentofacial Orthop 2021; 160:844-852. [PMID: 34593260 DOI: 10.1016/j.ajodo.2020.05.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/01/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This study aimed to compare the 2 most commonly used methods for assessing facial pleasantness, the Likert scale and the visual analog scale (VAS). METHODS For assessing facial pleasantness, an album was assembled containing the front and profile view facial photographs of 10 patients (5 females, 5 males) who sought orthodontic treatment representing each of the different sagittal and vertical facial discrepancies (straight profile, convex profile, concave profile, long faces, and short faces). The facial pleasantness of the patients was judged by 3 groups of 90 evaluators (47 females and 43 males): 30 orthodontists (mean age, 32.41 years), 30 oral maxillofacial surgeons (mean age, 36.83 years), and 30 laypeople (mean age, 36.83 years). The evaluators judged the facial pleasantness using VAS and a 5-point Likert scale. At the end of the evaluation, the evaluators completed a questionnaire about their preferred scale. Analysis of variance and Tukey and Kruskal-Wallis tests were used to compare the data from VAS and Likert scale, respectively. The Spearman correlation coefficient was used to estimate the correlation between the 2 scales. Fisher transformation and z-statistic were used to estimate the correlation among the evaluator groups. In all tests, a 5% statistical significance level was adopted. RESULTS Both scales presented similar answers; only VAS values for the scores of pleasant and very pleasant according to the Likert scale could not be distinct. Most evaluators preferred the Likert scale as they found it easier to convey their opinion than VAS. CONCLUSIONS Although both scales can be used to assess facial pleasantness, the Likert scale seems more appropriate as the evaluators preferred it because of its simplicity.
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Toyokawa-Sperandio KC, Conti ACDCF, Fernandes TMF, Almeida-Pedrin RRD, Almeida MRD, Oltramari PVP. External apical root resorption 6 months after initiation of orthodontic treatment: A randomized clinical trial comparing fixed appliances and orthodontic aligners. Korean J Orthod 2021; 51:329-336. [PMID: 34556587 PMCID: PMC8461388 DOI: 10.4041/kjod.2021.51.5.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/10/2021] [Accepted: 03/26/2021] [Indexed: 11/28/2022] Open
Abstract
Objective To compare the magnitude of external apical root resorption (EARR) 6 months after starting orthodontic treatment using orthodontic aligners (OAs) and fixed appliances (FAs). Methods This parallel randomized clinical trial included 40 patients randomized into two groups OA group (n = 20, 160 incisors) and FA group (n = 20, 160 incisors). For evaluation of the tooth length, periapical radiographs and standardized linear measurements of the maxillary and mandibular incisors were acquired before (T0) and 6 months after treatment initiation (T1). EARR was calculated through the difference in length between the two time points (T1–T0). Statistical comparisons were performed by means of using t-tests, chi-squared test and covariance analysis (a = 5%). Results Rounding of the root apex was observed in both groups; the resorption involved 2.88% of the root length, so 97.12% of the tooth length remained intact. Intragroup comparisons between the two time points revealed a significant difference, with (T1–T0) ranging from −0.52 to −0.88 mm in the FA group and from −0.52 to −0.85 mm in the OA group. In the intergroup comparisons, only tooth #21 presented a statistically significant difference (OA −0.52 ± 0.57 mm, FA −0.86 ± 0.60 mm); however, the overall differences between groups were not clinically relevant, ranging from 0.03 to 0.35 mm. Conclusions OA and FA treatment resulted in a similar degree of EARR in the maxillary and mandibular incisors at 6 months after treatment initiation. However, the amount of resorption was small and does not impair tooth longevity.
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Bocato JR, Cheffer Nory FM, Francisco JR, Conti ACDCF, Fernandes TMF, Almeida MRD, Pedrin RRDA, Oltramari PVP. Interdisciplinary Orthodontic Treatment to Reestablishment Smile Function and Aesthetics. J Health Scie 2021. [DOI: 10.17921/2447-8938.2021v22n3p167-172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractExtrusive tooth movements are an important resource in orthodontic treatment and allow the manipulation of teeth and periodontal tissues. They can be performed quickly or slowly, depending on the patient’s need. Rapid extrusion is indicated for cases in need of prosthetic preparation or restoration, where the bone and gingival tissues are intact, such as horizontal and oblique fractures, coronary or external root resorption, iatrogenic perforations (trepanations) and the presence of subgingival caries. The aim of this study is to describe the treatment of a patient who had a coronary fracture of the right upper central incisor, with a limit located 1 mm above the level of the bone crest. Rapid orthodontic extrusion was performed, to restore biologic distances and allow the preparation for prosthesis. It started with partial differentiated bonding of a fixed orthodontic appliance to the upper arch, to allow for a 3mm orthodontic extrusion. At the end of the extrusion, periodontal surgery was performed to increase the clinical crown and endodontic treatment. After these procedures, the case was concluded with the fixed prosthesis installation. The realization of an integrated planning allowed the restoration of aesthetics, with preservation of the functional periodontal limits for the patient. Keywords: Tooth Movement Techniques. Orthodontic Extrusion. Crown Lengthening. ResumoOs movimentos dentários extrusivos constituem um recurso importante no tratamento ortodôntico e permitem a manipulação dos dentes e dos tecidos periodontais. Eles podem ser realizados de forma rápida ou lenta, dependendo da necessidade do paciente. A extrusão rápida está indicada para casos com necessidade de preparo protético ou restauração, onde os tecidos ósseo e gengival encontram-se íntegros, tais como fraturas horizontais e oblíquas, reabsorções coronárias ou radiculares externas, perfurações iatrogências (trepanações) e presença de cárie subgengival. O objetivo deste trabalho é descrever o tratamento de uma paciente que apresentava fratura coronária do incisivo central superior direito, com limite localizado 1mm acima do nível da crista óssea. Realizou-se extrusão ortodôntica rápida, com a finalidade de restabelecer as distâncias biológicas e permitir o preparo para prótese. Iniciou-se com colagem diferenciada parcial de aparelho ortodôntico fixo no arco superior, para permitir a extrusão ortodôntica de 3mm. Ao término da extrusão, realizou-se cirurgia periodontal para aumento da coroa clínica e tratamento endodôntico. Após esses procedimentos, o caso foi finalizado com a instalação da prótese fixa. A realização de um planejamento integrado permitiu o restabelecimento da estética, com preservação dos limites periodontais funcionais para a paciente.Palavras-chave: Técnicas de Movimentação Dentária. Extrusão Ortodôntica. Aumento da Coroa Clínica.
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Rossato PH, Bayer LB, Almeida RRD, Conti ACDCF, Fernandes TMF, Oltramari PVP. Clinical complications during early treatment of anterior open bite. Braz Oral Res 2021; 35:e081. [PMID: 34231768 DOI: 10.1590/1807-3107bor-2021.vol35.0081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/19/2020] [Indexed: 11/21/2022] Open
Abstract
The object of this study was to compare the clinical complications of 4 different appliances used in the early treatment of anterior open bite (AOB), and to test the null hypothesis that there is no difference in the number of complications among the appliances. Records from 99 Class I malocclusion patients with AOB treated using bonded spurs, BS, n = 25; chin cup, CC, n = 25; fixed palatal crib, FPC, n = 25; and removable palatal crib, RPC, n = 24) were examined. The total number and frequency of clinical complications that occurred over 12 months were described and compared by using chi-square and Kruskal-Wallis tests (Dunn's post-test) (α = 5%, CI = 95%). The incidence of clinical complications was 66.7%, comprising: breakage, bond failure, maladjustment, allergy, soft-tissue lesion, loss of removable appliance and abandonment. Eighteen patients gave up treatment; this occurred more frequently in the groups with removable appliances. Regarding the total number of complications per patient, Group BS exhibited a significantly higher number than the other groups (p < 0.0001). A low frequency of complications (1 to 3) was found in the groups, except for Group BS, in which 8% of the patients presented moderate frequency (4 to 6). In terms of appliance types (fixed or removable), there was no difference in the incidence of complications (p > 0.094). The null hypothesis was rejected, since the BS group exhibited the highest total number and frequency of complications. There was no difference between fixed and removable appliances in terms of incidence of clinical complications, although more patients using removable appliances abandoned their treatment.
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Affiliation(s)
- Paulo Henrique Rossato
- Universidade Norte do Paraná - Unopar, School of Dentistry, Department of Orthodontics, Londrina, PR, Brazil
| | - Letícia Batista Bayer
- Universidade Norte do Paraná - Unopar, School of Dentistry, Department of Orthodontics, Londrina, PR, Brazil
| | - Renato Rodrigues de Almeida
- Universidade Norte do Paraná - Unopar, School of Dentistry, Department of Orthodontics, Londrina, PR, Brazil
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de Araújo MC, Bocato JR, Berger SB, Oltramari PVP, de Castro Ferreira Conti AC, de Almeida MR, Freire Fernandes TM. Perceived pain during rapid maxillary expansion in children with different expanders. Angle Orthod 2021; 91:484-489. [PMID: 33621314 DOI: 10.2319/092820-829.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate and compare the intensity of pain caused by rapid maxillary expansion (RME) with two expanders: Hyrax and Haas type, in growing patients. MATERIALS AND METHODS Thirty-nine patients (23 girls and 16 boys) with an average age of 9.3 years (SD = 1.39 years) were randomized into two groups and treated with Hyrax- and Haas-type expanders. In both groups, initial activation of the expander screw was one full turn on the first day followed by 2/4 of a turn two times a day (morning and night) for 7 days. Inclusion criteria were patients presenting with a posterior crossbite or maxillary atresia between 7 and 12 years old. To evaluate the intensity of pain during the active phase of the treatment, a combination of the Numerical Rating Scale and Wong-Baker Faces Pain Scale was used. Mann-Whitney test was used to compare the two treatment groups. RESULTS There was significant inverse correlation between days following insertion and pain. During the expansion period, 100% of the children reported some pain. Hyrax expander subjects reported greater pain than those treated with the Haas-type expander only on the first day. The level of pain remained greater in girls throughout treatment. CONCLUSIONS Pain was reported regardless of the type of expander and was higher in the Hyrax group only on the first day of activation.
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Damasceno Melo PE, Bocato JR, de Castro Ferreira Conti AC, Siqueira de Souza KR, Freire Fernandes TM, de Almeida MR, Pedron Oltramari PV. Effects of orthodontic treatment with aligners and fixed appliances on speech. Angle Orthod 2021; 91:711-717. [PMID: 34037699 DOI: 10.2319/110620-917.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 03/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate effects of orthodontic treatment with aligners and conventional fixed appliances on production of speech. MATERIALS AND METHODS This was a parallel, randomized clinical trial. Patients with Angle Class I malocclusion, moderate crowding, and no speech impairment were randomly allocated to two groups: patients with orthodontic aligners (OAs; n = 20; mean age = 23.60 ± 5.65 years) and those with conventional fixed appliances (n = 20; mean age = 20.56 ± 4.51 years) and treated at the University of North Parana's clinic in Londrina, Brazil. Evaluation of speech production was performed semiobjectively by a speech therapist (myofunctional orofacial examination) and subjectively (self-assessment) at five time points: baseline, immediately after insertion of appliances, and subsequently at 3, 30, and 180 days after insertion. For intergroup comparison, independent t, χ2, Fisher exact, and Mann-Whitney tests were used; for intragroup comparison, the Friedman test was applied (α = 5%). RESULTS In the semiobjective evaluation, patients with OAs exhibited a change in production of speech production, compared with patients with fixed appliances, immediately and 3 days after insertion of appliances (P < .001). Thirty days after insertion, the groups were similar (P = .487), an outcome that was unchanged at 180 days. However, in the self-assessments, patients in both groups reported significant speech difficulties immediately and 3 days after insertion of appliances, but such impairment was no longer perceived at 30 days or 180 days. CONCLUSIONS Although the speech therapist identified changes in speech production at the start of treatment in the OA group only, patient self-assessments demonstrated that orthodontic treatment, regardless of the type of appliance used, interfered with their perception of speech.
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Abstract
The aim and objective of this study is to report the recurrence of the treatment of the anterior open bite after 5 years of treatment. A female patient aged 8 years 6 months old had a negative vertical crossing of -4.7 mm. Early treatment with a fixed palatal grid was performed for 1 year. At the end of the treatment, the vertical overpass was 1.1 mm and after 2 years of control, the vertical overpass remained positive with 1.7 mm showing the stability of the treatment. After 5 years, and due to the sucking and lingual interposition habit, there was a recurrence of the open bite. Interdisciplinary follow-up is extremely important to eliminate the factors responsible for the origin of deleterious habits, thus solving the changes resulting from these habits and providing long-term stability. How to cite this article: Justulin AF, Rossato PH, Conti ACCF, et al. Relapse of Anterior Open Bite: A Case Report. Int J Clin Pediatr Dent 2021;14(1):140-144.
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Affiliation(s)
- Aline F Justulin
- Department of Orthodontics, University of North Paraná, Londrina, Brazil
| | - Paulo H Rossato
- Department of Orthodontics, University of North Paraná, Londrina, Brazil
| | - Ana CCF Conti
- Department of Orthodontics, University of North Paraná, Londrina, Brazil
| | - Marcio R Almeida
- Department of Orthodontics, University of North Paraná, Londrina, Brazil
| | | | - Thais MF Fernandes
- Department of Orthodontics, University of North Paraná, Londrina, Brazil
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Mendonça DLD, Almeida-Pedrin RR, Pereira NC, Oltramari PVP, Fernandes TMF, Conti ACDCF. The influence of text messages and anxiety on pain perception and its impact on orthodontic patients routine. Dental Press J Orthod 2020; 25:30-37. [PMID: 33206826 PMCID: PMC7668061 DOI: 10.1590/2177-6709.25.5.030-037.oar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 07/06/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This prospective study aimed at assessing the effects of anxiety and a follow-up text message on pain perception after the installation of fixed orthodontic appliances and its impact on the patients' routine. METHODS The sample of this study consisted of 103 orthodontic patients, 40 males and 63 females (mean age 20.5 years), distributed in two groups: G1 (n=51), including control patients that did not receive any post-procedure communication; and G2 (n=52), including patients that received a structured text message. In baseline phase, the patients completed a questionnaire to assess their level of anxiety prior to treatment. Pain was assessed by using 100-mm visual analog scale (VAS) in baseline and ten times prospectively in predetermined time points. VAS was also applied to assess the patient's routine alterations caused by the pain. All data were analyzed using ANOVA, Tukey, Mann-Whitney, t-test, chi-square and Spearman's correlation tests. All statistical tests were performed with significance level of 5%. RESULTS Low-level and high-level anxiety was observed in 42.7% and 7.8% of the patients, respectively. Statistically significant correlation was observed between anxiety and pain (p< 0.05). Maximum mean pain intensity was detected in the second treatment day (G1=36.9mm and G2=26.2mm) and was significantly higher in G1. Nearly 53% of the patients in G1 reported alterations in the routine (18.8mm), while in G2 the percentage rate reached 28.8% (9.9mm) (p=0.013). CONCLUSIONS Anxious patients report more pain after the installation of orthodontic appliances. Text messages were effective to reduce pain levels and to decrease the negative effects on patients' daily routine.
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Casteluci CEVF, Oltramari PVP, Conti PCR, Bonjardim LR, de Almeida-Pedrin RR, Fernandes TMF, de Almeida MR, de Castro Ferreira Conti AC. Evaluation of pain intensity in patients treated with aligners and conventional fixed appliances: Randomized clinical trial. Orthod Craniofac Res 2020; 24:268-276. [PMID: 33058419 DOI: 10.1111/ocr.12431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/23/2020] [Accepted: 10/07/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This randomized clinical trial aimed to compare the pain intensity in patients treated with orthodontic aligners and conventional fixed appliances. SETTING AND SAMPLE POPULATION This study was a randomized clinical trial. The sample comprised 39 patients randomly allocated into 2 groups: OA (orthodontic aligners, n = 20) and FA (Fixed Appliance, n = 19). MATERIAL AND METHODS The pain intensity was measured by the visual analogue scale (VAS) in the following periods: T0 (baseline), T1 (seven days after appliance placement) and seven days after each return on the first (T2), third (T3) and sixth (T4) months. The following variables were also investigated in the baseline: conditioned pain modulation, anxiety levels, hypervigilance and catastrophizing. The VAS measurements between groups were compared by the Mann-Whitney test. Comparisons between periods within each group were performed by the Friedman test. Data regarding catastrophizing and hypervigilance were compared by the t test. All tests were applied at a significance level of 5%, with 95% confidence interval. RESULTS Both groups presented similar levels of anxiety, hypervigilance, catastrophizing and conditioned pain modulation. Both groups did not differ concerning the pain intensity in all periods. The intragroup evaluation revealed statistical differences between days in the FA group at all moments evaluated, for the OA group, similar findings between days were found for the T1 evaluation; however, at the 6-month period (T4), the pain levels varied over these days without statistical difference. Higher levels of pain were observed in the first seven days after appliance placement. CONCLUSION The pain intensity, usually mild, was not influenced by the appliance design, although different patterns of reported pain seem to occur between groups.
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Affiliation(s)
| | | | - Paulo César Rodrigues Conti
- Department of Prosthodontics, Bauru School of Dentistry, Bauru Orofacial Pain Group, University of São Paulo, São Paulo, Brazil
| | - Leonardo Rigoldi Bonjardim
- Section of Head and Face Physiology, Department of Biological Sciences, Bauru School of Dentistry, Bauru Orofacial Pain Group, University of São Paulo, São Paulo, Brazil
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Fernandes TMF, Conti ACCF, Oltramari PVP. Letter to the Editor. Angle Orthod 2020; 90:745-746. [DOI: 10.2319/0003-3219-90.5.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Rossato PH, Kaneshima EN, Domingues F, Fernandes TMF, Berger SB, Oltramari PVP. Do fluorescent agents alter the mechanical strength of orthodontic adhesives? An in vitro and clinical study. Prog Orthod 2020; 21:4. [PMID: 32037477 PMCID: PMC7008105 DOI: 10.1186/s40510-020-0304-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/06/2020] [Indexed: 12/28/2023] Open
Abstract
Background Fluorescent agents are added to orthodontic adhesives with the aim of making them visible under ultraviolet (UV) light, which ensures the complete, safe removal of remnants after orthodontic treatment. However, it is necessary to evaluate if the mechanical strength of these materials is maintained. Therefore, this study evaluated whether the addition of fluorescent agents influences the shear bond strength and clinical performance of a UV light-sensitive adhesive system. Methods This study consisted of two stages: (1) In vitro phase: 40 human teeth were selected, divided at random into 2 groups (n = 20), according to the adhesive system used: UV group—adhesive with fluorescent agent, and control group—conventional adhesive. A shear bond strength test was performed using a DL 2000 universal testing machine, at a speed of 0.5 mm/min. The accessories were removed and an evaluation of the Adhesive Remnant Index (ARI) was carried out. (2) Clinical phase: 8 patients were selected and had their appliances bonded using the split-mouth design (160 teeth) with the same tested adhesive systems (UV, n = 80; control, n = 80). The patients were monitored for bonding failure for a period of 24 months. Statistical analysis was performed using the Independent t test, chi-squared tests, and Mann-Whitney test, at a level of significance of 5% and confidence interval of 95%. Results Regarding the in vitro phase, the shear bond strength test yielded similar results in the two groups (p > 0.05) and the ARI showed statistically significant differences between the groups with a score of 1 being the most frequent ARI for both groups (70%). In addition, there was no clinical difference in terms of bonding failure between the groups (p > 0.05). Conclusion The addition of fluorescent elements does not alter the mechanical strength and performance of the orthodontic adhesive and represents a viable alternative for clinical application.
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Affiliation(s)
- Paulo Henrique Rossato
- Department of Oral Health, IFPR, Federal Institute of Parana (IFPR), Londrina, Brazil.,Department of Orthodontics, UNOPAR (University of North Parana), Londrina, Brazil
| | | | - Fábio Domingues
- Department of Orthodontics, UNOPAR (University of North Parana), Londrina, Brazil
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Vasconcelos JDB, Pacheco DP, Scwhertner J, De Almeida MR, Conti ACDCF, Oltramari PVP, Fernandes TMF, De Almeida RR. Correction of Anterior Open Bite Malocclusion with the Association of Removable Palatal Crib and Chincup. J Health Scie 2019. [DOI: 10.17921/2447-8938.2019v21n5p434-436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractAnterior open bite affects the child population by approximately 20%, with great aesthetic-functional impairment due to dental-skeletal changes, which may involve the presence of posterior crossbite. The objective was to present the anterior open bite correction associated with posterior crossbite with the use of a removable palatal crib. Patient during the mixed dentition phase presented an anterior open bite caused by a pacifier sucking habit and secondary lingual interposition. The treatment protocol consisted of the use of removable expander with palatal crib and nocturnal use of the chincup. The anterior open bite was corrected, and the best transverse relation of the arches was obtained. The precocious treatment using the palatal crib associated to the chincup allows to achieve favorable results in the resolution of the anterior open bite. Keywords: Open Bite. Malocclusion. Orthodontics, Interceptive. ResumoA mordida aberta anterior acomete a população infantil em aproximadamente 20%, com grande comprometimento estético-funcional em decorrência das alterações dentoesqueléticas, podendo envolver a presença de mordida cruzada posterior. O objetivo do estudo foi apresentar a correção da mordida aberta anterior associada à mordida cruzada posterior com a utilização de grade palatina removível. Paciente em fase de dentadura mista, apresentava mordida aberta anterior ocasionada por um hábito de sucção de chupeta e interposição lingual secundária. O protocolo de tratamento consistiu na utilização de expansor removível com grade palatina e uso noturno da mentoneira. A mordida aberta anterior foi corrigida e melhor relação transversal dos arcos foi obtida. O tratamento precoce utilizando grade palatina associada à mentoneira permite alcançar resultados favoráveis na resolução da mordida aberta anterior. Palavras-chave: Mordida Aberta. Má Oclusão. Ortodontia Interceptora.
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Didier VF, Almeida-Pedrin RR, Pedron Oltramari PV, Freire Fernandes TM, Lima Dos Santos L, Cláudia de Castro Ferreira Conti A. Influence of orthodontic appliance design on employment hiring preferences. Am J Orthod Dentofacial Orthop 2019; 156:758-766. [PMID: 31784009 DOI: 10.1016/j.ajodo.2018.12.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 12/01/2018] [Accepted: 12/01/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The objective of this study was to evaluate the extent to which different types of orthodontic appliances influence the hiring process of an individual applying for a customer service position. METHODS A total of 7 images were created for 2 adult models: 1 male and 1 female. One image was produced without orthodontic appliances, and 6 simulated the use of orthodontic appliances, including a conventional metallic appliance with a gray elastic ligature, a conventional metallic appliance with blue elastic ligature, a conventional appliance with a transparent elastic ligature, a self-ligating metal appliance, a self-ligating esthetic appliance, and a clear aligner. A photo album was designed for each model and delivered, along with a questionnaire, to individuals in charge of job interviews and hiring. These evaluators included 236 individuals, divided into 4 groups according to age and gender: males between 18-35 years (M), males over 35 years (M > 35), females between 18-35 years (F), and females over 35 years (F > 35). The evaluators quantified the chance of hiring the models using a Visual Analogue Scale. The Mann-Whitney test was used to compare the evaluators according to gender and age. The Wilcoxon test was used to compare the models according to gender. The Kruskal-Wallis and Dunn post hoc tests were used to compare the appliances according to design. A 5% significance level was used for all tests. RESULTS The clear aligner group showed the highest likelihood of being hired, followed by the group without orthodontic appliances, the groups with esthetic appliances (ie, conventional appliance with a transparent elastic ligature, and self-ligating esthetic appliance), and the groups with metallic appliances (ie, self-ligating metal appliance, conventional metallic appliance with gray elastic ligature, and conventional metallic appliance with blue elastic ligature). CONCLUSIONS Assuming all other qualifications of the applicants are equivalent, the use of an orthodontic appliance may influence job interviews. The better the esthetics of the appliance, the higher the likelihood of the individual being hired.
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Dias FA, Dos Santos LL, De Almeida MR, Conti ACDCF, Oltramari PVP, Fernandes TMF, De Almeida RR. Supranumerário: a Importância do Tratamento Ortodôntico Precoce. J Health Scie 2019. [DOI: 10.17921/2447-8938.2019v21n2p112-114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractThe presence of supernumeraries may lead to irruptive problems, such as impacted teeth, functional and aesthetic disorders. The present study describes two clinical cases, with anterior teeth eruption disorders caused by additional dental elements, treated early. Patients presented with aesthetic involvement, with delay in the emergence of the upper incisors. The clinical and radiographic examinations detected the presence of obstacles to the teeth eruption. Early treatment with 2x4 appliance was realized, followed by final corrective orthodontics. After restoration of the dimension for retained teeth, there was spontaneous eruption in clinical case 1 and need of traction in clinical case 2. When patients reached the complete permanent dentition, a corrective phase was performed with the objective of detailing the dental occlusion and finishing the treatment. The early diagnosis of teeth impacted and supernumerary, provide the achievement of adequate occlusion and positive aesthetic of patients, with good prognosis, avoiding psychological and functional problems caused by absence of anterior teeth. Keywords Interceptive Orthodontics. Supernumerary Tooth. Ectopic Tooth Eruption. ResumoA presença de supranumerários pode ocasionar problemas irruptivos, como impacção de dentes, desordens funcionais e estéticas. O presente trabalho descreve dois casos clínicos abordados precocemente, com alterações na irrupção de dentes anteriores devido a presença de supranumerários. Os pacientes apresentavam queixas estéticas, com atraso no aparecimento dos incisivos superiores. Os exames clínico e radiográfico detectaram a presença de barreiras irruptivas. Realizou-se tratamento precoce com auxílio da mecânica 4x2, seguido pela ortodontia corretiva final. Após etapa de restabelecimento da dimensão para os dentes retidos, houve irrompimento espontâneo no caso clínico 1 e necessidade de tracionamento no caso clínico 2. Quando pacientes atingiram a dentição permanente completa, realizou-se uma fase corretiva com o objetivo de detalhamento da oclusão dentária e finalização do tratamento. O diagnóstico precoce de impacção dentária e detecção de supranumerários favoreceu a restituição de oclusão adequada e estética dos pacientes, com prognóstico muito favorável, evitando problemas psicológicos e funcionais provocados pela ausência de dentes anteriores. Palavras-chave: Ortodontia interceptora. Dente supranumerário. Erupção ectópica de dente.
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Dias FA, Assis Urnau FD, Pedron Oltramari PV, Lupion Poleti M, Rodrigues de Almeida M, Freire Fernandes TM. Stability of early treatment of anterior open bite: clinical performance of bonded lingual spurs. J Orthod 2019; 46:68-73. [DOI: 10.1177/1465312519827601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Anterior open bite (AOB) is a malocclusion that generates aesthetic, speech, feeding and psychological issues, a fact that emphasises the importance of conducting early treatments to fix the disorder. Finger-sucking, pacifiers and oral habits are the main aetiological factors of AOB; thus, it is necessary to apply interceptive treatments focused on correcting and improving bite stability during childhood in order prevent the need of undergoing advanced therapy. The aim of this article is to present the early diagnosis of aetiological factors causing severe AOB and the interceptive treatment based on the use of bonded lingual spurs for one year. Results showed excellent bite stability after two years of follow-up; in other words, the proper treatment applied for the recommended growth and developmental periods enabled case stability.
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Affiliation(s)
- Flaviana Alves Dias
- Former Graduate Student, University of Northern Parana (UNOPAR), Londrina, Brazil
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Kaneshima EN, Berger SB, Fernandes TMF, Navarro MFDL, Oltramari PVP. Using UV light for adhesive remnant removal after debonding of orthodontic accessories. Braz Oral Res 2018; 32:e47. [PMID: 30281682 DOI: 10.1590/1807-3107bor-2018.vol32.0047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 08/13/2018] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to assess the effect of a UV light-based auxiliary illumination on adhesive remnant (AR) removal after orthodontic debonding. Sixty human molars were divided according to the adhesive used for bonding: O-opaque; LF-low fluorescence; and HF-high fluorescence. After debonding, the teeth were subdivided according to the AR removal method: No UV light or With UV light. After AR removal, the teeth were polished. Direct visual analysis, scanning electron microscopy (SEM) and time quantification for AR removal analyses were performed (Fisher-Freeman-Halton, Fisher's exact, chi-square trend, ANOVA, and independent t-tests; α = 5%). Concerning the adhesives, there was no significant difference among direct visual, SEM and time analyses for AR removal (p ≥ 0.05). Regarding AR removal methods, a similarity among the subgroups was verified for direct visual and SEM analyses (p≥0.05). However, a significant trend was verified for the with UV light method to produce greater marks, and the no UV light method, to produce a greater rate of samples with AR before polishing (p = 0.015). AR removal with light was significantly quicker in comparison with the no UV light method (p < 0.0001). The use of UV light may aid orthodontists in removing AR more thoroughly and in less time. However, they should receive special training to apply this technology, and should never dismiss the final polishing procedure.
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Affiliation(s)
| | | | | | - Maria Fidela de Lima Navarro
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
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Conti ACDCF, Oltramari PVP, Navarro RDL, de Almeida MR. Examination of temporomandibular disorders in the orthodontic patient: a clinical guide. J Appl Oral Sci 2009; 15:77-82. [PMID: 19089105 PMCID: PMC4327217 DOI: 10.1590/s1678-77572007000100016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2006] [Accepted: 02/12/2007] [Indexed: 02/07/2023] Open
Abstract
The possible association between orthodontic treatment and temporomandibular disorders (TMD) is a topic of great interest in the current literature. The true role of orthodontic therapy on the etiology of TMD, however, is still uncertain. From the clinical prospective, a thorough examination of the stomatognathic system is always necessary in order to detect possible TMD signs and symptoms prior to the beginning of the orthodontic therapy. Caution should be exercised when planning, performing and finalizing orthodontics, especially in patients who with history of signs and symptoms of TMD. The clinician must always eliminate patient's pain and dysfunction before initiating any type of orthodontic mechanics. Muscle incoordination, unstable disc-condyle relationship and bone alterations are usual TMD conditions that can interfere with the presenting occlusal relationship. This article reviews these aspects and presents a detailed clinical guide for the examination of the orthodontic patient, considering aspects related to facial pain and dysfunction.
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Garib DG, Navarro RDL, Francischone CE, Oltramari PVP. Rapid maxillary expansion using palatal implants. J Clin Orthod 2008; 42:665-671. [PMID: 19075382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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de Lima Navarro R, Oltramari PVP, Sant'Ana E, Henriques JFC, Taga R, Cestari TM, Conti PCR, Cunha FQ, Santos CF. Histological and molecular temporomandibular joint analyses after mandibular advancement surgery: study in minipigs. ACTA ACUST UNITED AC 2008; 106:331-8. [DOI: 10.1016/j.tripleo.2008.01.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Revised: 01/15/2008] [Accepted: 01/23/2008] [Indexed: 12/21/2022]
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Oltramari PVP, de Lima Navarro R, Henriques JFC, Taga R, Cestari TM, Janson G, Granjeiro JM. Evaluation of bone height and bone density after tooth extraction: an experimental study in minipigs. ACTA ACUST UNITED AC 2007; 104:e9-16. [DOI: 10.1016/j.tripleo.2007.06.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2006] [Revised: 06/06/2007] [Accepted: 06/21/2007] [Indexed: 11/26/2022]
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Oltramari PVP, de Lima Navarro R, Henriques JFC, Taga R, Cestari TM, Ceolin DS, Janson G, Granjeiro JM. Orthodontic movement in bone defects filled with xenogenic graft: An experimental study in minipigs. Am J Orthod Dentofacial Orthop 2007; 131:302.e10-7. [PMID: 17346582 DOI: 10.1016/j.ajodo.2006.07.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Revised: 07/01/2006] [Accepted: 07/01/2006] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In this study, we investigated whether it is possible to orthodontically move a tooth into an adjacent bone defect previously filled with xenogenic grafting material, with emphasis on the reactions of the tooth roots and adjacent tissues. METHODS Six minipigs were used. In each animal, 4 defects were created at the mesial aspects of the maxillary and mandibular first permanent molars; the defects on the right were filled with the xenograft (test side), and the opposite defects (control side) were filled with blood clots and allowed to heal spontaneously. Three months later, orthodontic appliances were placed in each quadrant to allow mesial bodily movement of the first permanent molars. When the teeth were moved about halfway into the defect spaces, the animals were killed, and the areas of interest were harvested. The mesial roots of the first molars and adjacent tissues were histologically and morphometrically evaluated. The volume density of bone tissue, the percentage of root resorption, and the bone height were evaluated with image analysis software. RESULTS Data analysis showed that (1) the percentage of root resorption was smaller (P = .0359) for the test group (4.16%) compared with the control (6.52%); (2) there was no statistically significant differences between groups concerning the volume density of neoformed bone (P >.05); (3) the bovine bone matrix was almost totally replaced by structured bone tissue; (4) the test group had a statistically significant smaller bone height loss (2.18 mm, P = .0018) than the control group (3.26 mm). CONCLUSIONS Based on these results, it was concluded that teeth can be moved into areas of bone defects previously filled with xenograft.
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Oltramari PVP, Conti ACDCF, Navarro RDL, Almeida MRD, Almeida-Pedrin RRD, Ferreira FPC. Importance of occlusion aspects in the completion of orthodontic treatment. Braz Dent J 2007; 18:78-82. [PMID: 17639207 DOI: 10.1590/s0103-64402007000100017] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2006] [Accepted: 11/20/2006] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study was to address the therapeutic goals regarding the static and functional occlusion in the completion of orthodontic treatment. For such purpose, a study population comprising 20 female treated Class II malocclusion subjects with an initial mean age of 11 years underwent a two-phase treatment (orthopedics and orthodontics). The patients were diagnosed in centric relation and were treated according to the six keys for normal occlusion and functional occlusal parameters (centric relation, vertical dimension, lateral and anterior guidances, occlusal contacts and direction of forces applied on the teeth). After removal of fixed mechanics, retainers were installed and maintained for two years. Five years after orthodontic completion, the occlusal stability of the patients was evaluated regarding molar relationship and overjet, measured in dental casts. All subjects maintained the normal molar relationship and correct overjet achieved at the end of treatment, indicating a fair level of occlusal stability. The importance of the criteria of the ideal functional occlusion to ensure a better stability after completion orthodontic treatment will be discussed in detail in this paper. In addition, some clinical situations in which localized adjustments are indicated for occlusal refinement will be described.
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de Almeida MR, de Almeida RR, Conti ACDCF, Navarro RDL, Correa GDO, de Oliveira CA, Oltramari PVP. Long-term stability of an anterior open-bite malocclusion treated in the mixed dentition: a case report. J Appl Oral Sci 2006; 14:470-5. [PMID: 19089250 PMCID: PMC4327302 DOI: 10.1590/s1678-77572006000600015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Revised: 11/30/2006] [Accepted: 12/14/2006] [Indexed: 11/21/2022] Open
Abstract
A clinical case with anterior open-bite, treated in the mixed dentition, is presented. This approach demonstrates one of the possible approaches of treatment, which is capable of interfering with growth and redirecting its vectors. Orthodontic and orthopedic methods were used, consisting of slow maxillary expansion, through a fixed palatal crib soldered in a bi-helix appliance, and high-pull traction on the mandible for 16 hours a day. After eight years of follow-up, stable outcomes were accomplished. These results may be explained by the fact that treatments were performed at the appropriate period of development, thus establishing perioral muscular equilibrium, matching the final period of facial growth. The combination of orthodontic and orthopedic treatments was necessary to prevent the need of further orthognathic surgery treatment.
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Francischone CE, Oltramari PVP, Vasconcelos LW, Francischone AC, Capelozza Filho L, Henriques JFC. Treatment for predictable multidisciplinary implantology, orthodontics, and restorative dentistry. Pract Proced Aesthet Dent 2003; 15:321-6; quiz 328. [PMID: 12830772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Multidisciplinary treatment has improved the clinician's ability to restore patients with partial anodontia using implant, orthodontic, and restorative disciplines for aesthetics and functionality. When considering biological principles and--in particular--patient anxiety, the use of a combination treatment approach may facilitate predictable success. When partial anodontia is evident, the primary rehabilitative options include fixed prostheses, recontouring of teeth, or placement of a single implant. This article discusses treatment planning for restoration of partial bilateral anodontia and illustrates the implant placement in association with orthodontic and restorative procedures.
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