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INTRODUCTION: In Orthodontics and Facial Orthopedics, the timing of treatment onset may be critical and individual analysis should be applied to promote a favorable treatment planning. In this study, individual analysis of midpalatal suture (MS) and palatal measurements were performed in teenagers and young adult patients treated with rapid maxillary expansion (RME). DESCRIPTION: Twenty-six patients submitted to RME with a tooth-supported appliance (Hyrax) were evaluated. The inclusion criteria were: minimum age of 14 years, presenting all posterior teeth, diagnosed with transverse maxillary discrepancy, and with a clinical indication for maxillary expansion. The pretreatment CBCT scans of these patients were assessed to obtain the stages of MS maturation (MSM); density ratio (MSD); and palatal length, thickness (anterior, intermediate and posterior) and sagittal area. RESULTS: The maturation stages present were C, D or E; the density ranged from 0.6 to 1, and lower density (MSD < 0.75) and higher density (MSD ≥ 0.75) groups were determined. Individuals with higher MSD presented smaller sagittal area, compared to the lower density group. Individuals in D and E MSM stages presented smaller sagittal area and intermediate thickness, compared to stage C. CONCLUSIONS: Smaller palatal sagittal area was observed in the high MSD groups and in the stages D and E of MSM.

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ABSTRACT Introduction: In Orthodontics and Facial Orthopedics, the timing of treatment onset may be critical and individual analysis should be applied to promote a favorable treatment planning. In this study, individual analysis of midpalatal suture (MS) and palatal measurements were performed in teenagers and young adult patients treated with rapid maxillary expansion (RME). Description: Twenty-six patients submitted to RME with a tooth-supported appliance (Hyrax) were evaluated. The inclusion criteria were: minimum age of 14 years, presenting all posterior teeth, diagnosed with transverse maxillary discrepancy, and with a clinical indication for maxillary expansion. The pretreatment CBCT scans of these patients were assessed to obtain the stages of MS maturation (MSM); density ratio (MSD); and palatal length, thickness (anterior, intermediate and posterior) and sagittal area. Results: The maturation stages present were C, D or E; the density ranged from 0.6 to 1, and lower density (MSD < 0.75) and higher density (MSD ≥ 0.75) groups were determined. Individuals with higher MSD presented smaller sagittal area, compared to the lower density group. Individuals in D and E MSM stages presented smaller sagittal area and intermediate thickness, compared to stage C. Conclusions: Smaller palatal sagittal area was observed in the high MSD groups and in the stages D and E of MSM.

RESUMO Introdução: Em Ortodontia e Ortopedia Facial, o momento de início do tratamento pode ser crítico, e uma análise individual deve ser aplicada para promover um planejamento de tratamento favorável. No presente estudo, foram realizadas a avaliação individualizada da sutura palatina mediana (SPM) e medições no palato de adolescentes e adultos jovens tratados com expansão rápida da maxila (ERM). Descrição: Foram avaliados vinte e seis pacientes submetidos à ERM com aparelho dentossuportado (Hyrax). Os critérios de inclusão foram: idade mínima de 14 anos, apresentando todos os dentes posteriores, diagnosticado com discrepância transversa da maxila e com uma indicação clínica para expansão maxilar. A tomografia computadorizada de feixe cônico (TCFC) pré-tratamento desses pacientes foi avaliada para obter os estágios de maturação da SPM (MSPM), densidade da SPM (DSPM), comprimento do palato, espessura (anterior, intermediária e posterior) e área sagital. Resultados: Os estágios de maturação presentes foram C, D ou E; a densidade variou de 0,6 a 1, e foram determinados grupos de baixa (DSPM < 0,75) e alta densidade (DSPM ≥ 0,75). Indivíduos com maior DSPM apresentaram menor área sagital, em comparação com o grupo de densidade mais baixa. Indivíduos nos estágios D e E de MSPM apresentaram menor área sagital e espessura intermediária, comparados aos indivíduos no estágio C. Conclusão: Uma menor área sagital palatina foi observada nos grupos de alta DSPM e nos estágios D e E de MSPM.

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OBJECTIVE: To evaluate the evidence reporting gene expression array data of human in vitro cultured periodontal ligament cells (PDLCs) submitted to static mechanical loading compared to a control group. DESIGN: Systematic searches were performed in MEDLINE/PubMed, Scopus, Web of Science, Virtual Health Library, The Cochrane Library and the System for Information on Grey Literature in Europe up to June 2019. A narrative synthesis was performed to summarize differentially expressed genes (DEGs). These were grouped according to the culture method (2D or 3D), force type (compression or tension) and observation time. Additionally, gene ontology (GO) analysis was performed using the Database for Annotation Visualization and Integrated Discovery. The risk of bias (RoB) and certainty of evidence (CoE) were assessed using a modified CONSORT checklist and the GRADE tool, respectively. RESULTS: Of eight studies included (all rated as having moderate RoB), only two provided the complete list of DEGs and four studies performed GO, gene network or pathways analysis. "Cell proliferation", "cell-cell signaling", "response to hypoxia and to mechanical stimulus" were among the significantly enriched biological processes in 3D-cultured compressed PDLCs (moderate CoE); while "collagen catabolic process", "extracellular matrix organization" and "cell proliferation" were associated with DEGs of 3D-cultured PDLCs submitted to tension (very low CoE). Biological processes significantly enriched in 2D-cultured PDLCs under compression were "extracellular matrix organization", "canonical glycolysis" and "glycolytic process" (very low CoE). CONCLUSION: Genes such as NR4A2, NR4A3, NAMPT, PGK1, and REDD1 are suggested as novel biomarkers for orthodontic tooth movement. Limited amount of evidence on the complete gene expression profile and the high heterogeneity in methodologies make it impossible to obtain definite conclusions. New studies following standardized and well-designed in vitro model and reporting complete gene expression datasets are needed.

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Objective: Our aim wasto analyze the reliability of midpalatal suture maturationassessment in females in the final growth period using cone-beam computedtomography (CBCT) by an undergraduate student in two time periods (intra-examiner) and compared to an orthodontist (inter-examiner). Methods: Fortypretreatment CBCT images of 14 to 19-year-old females were selected. Imageswere oriented in the InVivo Dental 5.1 software. Axial slices were selected either bya researcher (preselected slices ­ suture-PS) or by the examiners (free scanningand slice selection ­ suture-FS) and each image was classified according to itsmidpalatal suture maturation stage. The examiners analyzed all imagesindividually and twice, with a two-week interval between sessions. The weightedkappa coefficient according to Landis and Kock was used to assess intra- andinter-examiner agreement. Results: The Kappa intra-examiner of theundergraduate student was 0.824 for suture-PS and 0.692 for suture-FS, and theorthodontist was 0.919 and 0.695, respectively. Inter-observer agreement washigher for suture-PS (>0.479) than for suture-FS (>0.300). Conclusion: The intra-observer kappa coefficient was very good for the undergraduate student, similarto the orthodontist. However, inter-examiner agreement was not good, indicatinga need for development in the method training.

Objetivo: Avaliar a confiabilidade da classificação dos estágios de fusão da suturapalatina mediana em adolescentes do sexo feminino através de tomografiacomputadorizada cone beam (TCCB) por aluno da graduação em dois tempos(intraexaminador) e comparado a um ortodontista (interexaminador). Métodos:Foram selecionadas tomografias de 40 meninas na faixa etária de 14 a 19 anos feitaspreviamente ao tratamento ortodôntico. No software InVivo Dental 5.1 as imagens dacabeça foram orientadas de forma padronizada. Os cortes axiais desejados foramselecionados por um pesquisador ou por cada examinador e cada imagemresultante foi classificada quanto ao estágio de fusão da sutura palatina mediana.Os operadores realizaram todas as classificações duas vezes com intervalo de duassemanas entre as sessões, cada um individualmente. O coeficiente kappa ponderadode acordo com Landis e Kock foi utilizado para avaliar a concordânciaintraexaminador e interexaminador. Resultados: O kappa intraexaminador doaluno da graduação foi de 0,824 pra cortes pré-selecionados e 0,692 para osorientados por ele mesmo, e do ortodontista foi de 0,919 e 0,695, respectivamente.O coeficente kappa entre eles foi 0,479 e 0,300. Conclusão: Apesar do aluno degraduação ser mais inexperiente, sua concordância intraexaminador foi muitoboa, semelhante à do ortodontista. No entanto, a concordância entre eles não foiboa, demonstrando necessidade de aprimoramento no treinamento do método.

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