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The aim of this retrospective cross-sectional investigation was to perform a 3D analysis of craniofacial morphology of patients with unilateral cleft lip and palate (UCLP) at two stages of skeletal maturation. Cone-beam computed tomography (CBCT) scans of 52 UCLP patients (34 prepubertal; 18 pubertal) were collected from an outpatient referral center for the treatment of craniofacial deformities. In total 15 multiplanar craniofacial landmarks were identified, 3D virtual surface models were created, and 13 variables were measured to assess the 3D Euclidean distances between landmarks and spatial position of the landmarks in the projected X, Y and Z components. Maxillary and mandibular pitch (clockwise, counterclockwise) rotation relative to the cranial base was also evaluated. The significance level was set at 5%. Maxillary retrusion value relative to the cranial base was higher and statistically significant greater (p = 0.028) in pubertal (SNA, 77.4° ± 6.2; N-ANS Y, 3.3 mm ± 3.1) than in prepubertal patients (SNA 81.0° ± 5.2; N-ANS Y, 5.8 mm ± 2.7). The posterior cranial base length (S-Ba Y) was significantly longer (p = 0.013) in pubertal (20.7 mm ± 3.4) than in prepubertal patients (18.4 mm ± 2.7). The upper facial height (N-ANS Z) was significantly greater (p = 0.01) in pubertal (46.9 mm ± 4.5) than in prepubertal patients (43.4 mm ± 3.0). Prepubertal and pubertal UCLP patients presented distinct patterns of craniofacial morphology, mainly in the sagittal component of the maxilla and in the posterior cranial base length. Pubertal patients had greater maxillary retrusion and posterior cranial base length.

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Abstract The aim of this retrospective cross-sectional investigation was to perform a 3D analysis of craniofacial morphology of patients with unilateral cleft lip and palate (UCLP) at two stages of skeletal maturation. Cone-beam computed tomography (CBCT) scans of 52 UCLP patients (34 prepubertal; 18 pubertal) were collected from an outpatient referral center for the treatment of craniofacial deformities. In total 15 multiplanar craniofacial landmarks were identified, 3D virtual surface models were created, and 13 variables were measured to assess the 3D Euclidean distances between landmarks and spatial position of the landmarks in the projected X, Y and Z components. Maxillary and mandibular pitch (clockwise, counterclockwise) rotation relative to the cranial base was also evaluated. The significance level was set at 5%. Maxillary retrusion value relative to the cranial base was higher and statistically significant greater (p = 0.028) in pubertal (SNA, 77.4° ± 6.2; N-ANS Y, 3.3 mm ± 3.1) than in prepubertal patients (SNA 81.0° ± 5.2; N-ANS Y, 5.8 mm ± 2.7). The posterior cranial base length (S-Ba Y) was significantly longer (p = 0.013) in pubertal (20.7 mm ± 3.4) than in prepubertal patients (18.4 mm ± 2.7). The upper facial height (N-ANS Z) was significantly greater (p = 0.01) in pubertal (46.9 mm ± 4.5) than in prepubertal patients (43.4 mm ± 3.0). Prepubertal and pubertal UCLP patients presented distinct patterns of craniofacial morphology, mainly in the sagittal component of the maxilla and in the posterior cranial base length. Pubertal patients had greater maxillary retrusion and posterior cranial base length.

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A expansão rápida da maxila é um procedimento rotineiramente utilizado para aumentar a dimensão transversa do arco superior. Diversos disjuntores já foram descritos para esta finalidade. Com o intuito de amenizar ou eliminar efeitos colaterais verticais de disjuntores bandados, foi desenvolvido o disjuntor com cobertura oclusal. Este artigo tem o objetivo de descrever uma técnica laboratorial que aperfeiçoa a confecção do disjuntor com cobertura oclusal, bem como ilustrar sua aplicação clínica na correção de severa deficiência transversa associada à dimensão vertical aumentada.

Rapid maxillary expansion is routinely used in Orthodontics to increase the transverse dimension of the maxillary arch. Different types of expanders have been described in the literature. The bonded expander was introduced as an attempt to minimize or eliminate the vertical side effects often registered with the traditional banded expanders. The purpose of this article is to describe a laboratory technique that facilitates the bonded expander fabrication and to illustrate its clinical application to correct a severe transverse maxillary deficiency associated with an increased vertical dimension.

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OBJECTIVE: Orthodontic tooth movement (OTM) is achieved by alveolar bone remodelling induced by mechanical loading. Whilst interleukin-1 (IL-1) is directly involved in OTM, the role of interleukin-1 receptor antagonist (IL-1Ra), a naturally occurring IL-1 antagonist, is not completely defined. Therefore, the aim of this study was to investigate the effects of IL-1Ra on OTM. METHODS: An orthodontic appliance was placed in C57BL6 mice treated with vehicle or IL-1Ra (10 mg/kg/day). OTM and TRAP-positive osteoclasts were evaluated after 12 days of mechanical loading and the levels of cytokines on periodontal tissues were analysed by ELISA after 12 and 72 h. RESULTS: Mice treated with IL-1Ra showed diminished OTM and decreased numbers of TRAP-positive osteoclasts. In line with this, lower levels of IL-1ß and TNF-α, and higher levels of IL-10, were observed on periodontal tissues of IL-1Ra-treated mice in relation to the vehicle-treated group. CONCLUSION: The present study suggests that IL-1Ra downregulates OTM, probably by its anti-inflammatory actions.

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O perfil dos pacientes que procuram tratamento ortodôntico mudou nas últimas décadas. O número de pacientes adultos e idosos do sexo feminino cresceu consideravelmente. Esta mudança na demanda trouxe desafios biológicos para o atendimento ortodôntico, por muitas vezes tratarem-se de pacientes com alterações sistêmicas ou sob uso de medicamentos controlados. Dentre estes, podese citar a deficiência de estrógeno e a osteoporose, comuns nessa faixa etária, e que podem interferir na movimentação dentária ortodôntica (MDO). Esta revisão de literatura se propõe a descrever os aspectos biológicos da movimentação ortodôntica e a identificar como a deficiência de estrógeno e a osteoporose podem interferir na remodelação óssea e, consequentemente, na MDO. Este artigo objetiva ainda alertar o ortodontista da importância de se avaliar cuidadosamente a condição sistêmica dos pacientes com possível deficiência de estrógeno/osteoporose, para um correto diagnóstico e elaboração do plano de tratamento.

An increasing number of adult patients are seeking for orthodontic treatment in the last decades, especially postmenopausal women. This represents a biological challenge for the orthodontic treatment, since these patients more often present systemic disorders or are routinely using controlling medication. Among them, estrogen deficiency and osteoporosis are commonly reported in elderly women. This review article elucidates the biological aspects of orthodontic tooth movement, emphasizing how the estrogen deficiency may interfere with this process. This literature review suggests that estrogen deficiency and the use of drugs for osteoporosis treatment may alter the bone remodeling and, consequently, the orthodontic tooth movement. The orthodontist must be aware of the patient’s systemic condition to better elaborate the correct treatment plan.

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