RESUMEN

OBJECTIVE: To assess the impact of treatment with orthodontic aligners (OA) on oral health-related quality of life (OHRQoL) in patients with trisomy 21 (T21) compared to non-syndromic patients. MATERIALS AND METHODS: The sample consisted of 30 patients, both sexes, aged between 11 and 35 years, divided into two groups: T21 (n = 10, patients with T21, treated prospectively) and CONTROL (n = 20, control group, non-syndromic patients, from the Orthodontic Laboratory of UNOPAR). In both groups, patients were treated with Invisalign orthodontic aligners (Align Technology), following the same treatment parameters. Participants, assisted by their caregivers, when necessary, answered Oral Health Impact Profile (OHIP-14) instrument and the patient's guardians answered the Oral Health Scale for People with Down's syndrome (OHDS) instrument, before (T0) and after 30 (T1), 180 (T2), and 365 (T3) days from the start of treatment. Friedman tests with Bonferroni correction and Mann-Whitney tests were used (p < .05). RESULTS: For the OHDS instrument, it was observed that for the eating and communication domains and an overall score, the treatment with OA positively impacted the lives of T21 patients (p < .05). Regarding the OHIP-14 instrument, the intragroup evaluation showed that in the CONTROL group, there was no significant difference between the evaluated times; while for the T21 group, there was a significant positive impact (p < .05). CONCLUSION: The results showed that the treatment with aligners positively impacted the OHRQoL of T21 patients, and these results were perceived by caregivers, mainly in relation to issues related to eating and communication.

RESUMEN

Resumo Durante a dentadura mista pode-se observar uma série de distúrbios do desenvolvimento que devem ser tratados a fim de devolver ao paciente uma oclusão normal ou minimizar o tratamento corretivo futuro. A perda precoce de dentes decíduos pode ocasionar alterações significativas na oclusão como a perda de perímetro do arco, o que prejudica a irrupção fisiológica dos dentes permanentes. O objetivo deste trabalho é apresentar o manejo de espaços durante a dentadura mista por meio de alinhadores ortodônticos, no qual foi diagnosticada a perda prematura de um dente decíduo no período intertransitório da dentadura mista. O tratamento, realizado com alinhadores ortodônticos, foi planejado para: verticalização do primeiro molar permanente, recuperação do espaço reduzido devido à perda do segundo molar decíduo, expansão sequencial dos arcos superior e inferior, correção da mordida profunda e alinhamento e nivelamento dos incisivos superiores e inferiores. Para obtenção dos resultados propostos, foram utilizadas 3 sequências de alinhadores. Os resultados demonstram que os alinhadores ortodônticos representam uma alternativa viável para a intervenção oportuna em pacientes com perda prematura de dentes decíduos e redução de espaço para dentes permanentes. Ainda, permitem a correção simultânea de outras alterações oclusais, o que confere eficiência ao tratamento interceptor (AU)

Abstract During the mixed dentition, a series of developmental disorders can be observed that must be treated to return the patient to a normal occlusion or to minimize future comprehensive treatment. Early loss of deciduous teeth can cause significant changes in occlusion, such as loss of arch perimeter, which impairs the physiological eruption of permanent teeth. This clinical report aims at presenting the management of spaces during the mixed dentition by means of orthodontic aligners, in which the premature loss of a deciduous tooth was diagnosed in the inter-transitional phase of the mixed dentition. The treatment, carried out with orthodontic aligners, was planned for: verticalization of the first permanent molar, recovery of the reduced space due to the loss of the second deciduous molar, sequential expansion of the upper and lower arches, correction of the deep bite and alignment and leveling of the upper and lower incisors. To obtain the proposed results, 3 sequences of aligners were used. The results demonstrated that orthodontic aligners represent an alternative for early intervention in patients with premature loss of deciduous teeth and reduced space for permanent teeth. Furthermore, they allow the simultaneous correction of other occlusal alterations, which makes the early treatment efficient. (AU)

Asunto(s)

RESUMEN

Resumo Dentre as dificuldades observadas durante o tratamento com os alinhadores ortodônticos, destaca-se a abertura da mordida posterior. Esta intercorrência pode ser causada pela intrusão não programada de dentes posteriores superiores e/ou inferiores, principalmente molares, e ocorre de forma mais frequente em pacientes braquifaciais. O objetivo deste trabalho foi apresentar um caso clínico tratado com alinhadores ortodônticos em que se observou a intrusão não planejada de molares, com necessidade de correção em fase de tratamento ativo. Como recursos para fechamento da mordida posterior, utilizaram-se levantes de mordida nos incisivos superiores, correção do torque dos molares superiores e inserção de attachments de extrusão nos dentes posteriores. Houve correção completa após 2 sequências de refinamento com alinhadores adicionais. Recomenda-se atenção aos pacientes braquifaciais e à expansão dentária com inclinação vestibular excessiva dos dentes posteriores. A inserção de levantes de mordida e controle de torque nos dentes posteriores podem minimizar os efeitos negativos da técnica (AU)

Abstract Among the difficulties observed during treatment with orthodontic aligners, the opening of the posterior bite stands out. This complication can be caused by unplanned intrusion of upper and/or lower posterior teeth, mainly molars, and occurs more frequently in horizontal patients. The objective of this study was to present a clinical case treated with orthodontic aligners in which unplanned intrusion of molars was observed, in need of correction in the active treatment phase. As resources for closing the posterior bite, bite lifts were used on the upper incisors, torque correction on the upper molars, and insertion of extrusion attachments on the posterior teeth. There was complete correction after 2 refinement sequences with additional aligners. Attention is recommended for horizontal patients and dental expansion with excessive buccal tipping of the posterior teeth. The insertion of anterior build-ups and torque control on the posterior teeth can minimize the negative effects of the technique. (AU)

Asunto(s)