RESUMEN
This article aims to assess whether alterations of oral functions (AOF) are associated with malocclusion (MO)'s type and severity. Cross-sectional study of a representative sample of 332 adolescents aged 12 years in São Luís-MA, Northeastern Brazil. MO criteria included Angle's classification, Dental Aesthetic Index, and other morphological problems. The AOF were evaluated by breathing, phonation, chewing, and swallowing. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic and multinomial regression analyses (α=5%). Mouth breathing was associated with defined (OR=3.84; 95%CI=1.45-10.12), disabling (OR=4.34; 95%CI=1.99-9.49), and class III (OR=4.15; 95%CI=1.19-14.54) MO. Phonation problems were associated with defined (OR=2.01; 95%CI=1.02-4.39), disabling (OR=3.04; 95%CI=1.55-5.96), and Class II (OR=2.02; 95%CI=1.28-3.18) MO. Chewing disorders were associated with posterior crossbite (PCB) (OR=2.32; 95%CI=1.12-4.82). Swallowing disorders were associated with Class III MO (OR=5.66; 95%CI=1.35-23.71), PCB (OR=6.13; 95%CI=2.76-13.62), and posterior open bite (OR=4.53; 95%CI=1.72-8.92). Breathing and phonation alterations are associated with MO in anterior arch segments, while chewing and swallowing disorders, in the posterior segments.
Asunto(s)
Maloclusión , Adolescente , Estudios Transversales , Deglución , Humanos , Maloclusión/epidemiología , Masticación , PrevalenciaRESUMEN
Abstract This article aims to assess whether alterations of oral functions (AOF) are associated with malocclusion (MO)'s type and severity. Cross-sectional study of a representative sample of 332 adolescents aged 12 years in São Luís-MA, Northeastern Brazil. MO criteria included Angle's classification, Dental Aesthetic Index, and other morphological problems. The AOF were evaluated by breathing, phonation, chewing, and swallowing. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic and multinomial regression analyses (α=5%). Mouth breathing was associated with defined (OR=3.84; 95%CI=1.45-10.12), disabling (OR=4.34; 95%CI=1.99-9.49), and class III (OR=4.15; 95%CI=1.19-14.54) MO. Phonation problems were associated with defined (OR=2.01; 95%CI=1.02-4.39), disabling (OR=3.04; 95%CI=1.55-5.96), and Class II (OR=2.02; 95%CI=1.28-3.18) MO. Chewing disorders were associated with posterior crossbite (PCB) (OR=2.32; 95%CI=1.12-4.82). Swallowing disorders were associated with Class III MO (OR=5.66; 95%CI=1.35-23.71), PCB (OR=6.13; 95%CI=2.76-13.62), and posterior open bite (OR=4.53; 95%CI=1.72-8.92). Breathing and phonation alterations are associated with MO in anterior arch segments, while chewing and swallowing disorders, in the posterior segments.
Resumo O objetivo deste artigo é avaliar se alterações das funções orais (AFO) estão associadas ao tipo e gravidade da maloclusão (MO). Estudo transversal com amostra representativa de 332 adolescentes de 12 anos em São Luís-MA, Nordeste do Brasil. Critérios de MO incluíram Classificação de Angle, Índice de Estética Dental e outros problemas morfológicos. As AFO foram avaliadas por respiração, fonação, mastigação e deglutição. Odds ratios (OR) e intervalos de confiança de 95% (IC95%) foram calculados em análises de regressão logística e multinomial (α=5%). Respiração oral foi associada com MO definida (OR=3,84; IC95%=1,45-10,12), incapacitante (OR=4,34; IC95%=1,99-9,49) e classe III (OR=4,15; IC95%=1,19-14,54). Problemas de fonação foram associados às MO definidas (OR=2,01; IC95%=1,02-4,39), incapacitantes (OR=3,04; IC95%=1,55-5,96) e Classe II (OR=2,02; IC95%=1,28-3,18). Alterações na mastigação foram associadas à mordida cruzada posterior (MCP) (OR=2,32; IC95%=1,12-4,82). Deglutição atípica foi associada à MO Classe III (OR=5,66; IC95%=1,35-23,71), MCP (OR=6,13; IC95%=2,76-13,62) e mordida aberta posterior (OR=4,53; IC95%=1,72-8,92). Alterações de respiração e fonação estão associadas às MO nos segmentos anteriores do arco, enquanto as de mastigação e deglutição, nos segmentos posteriores.
Asunto(s)
Humanos , Adolescente , Maloclusión/epidemiología , Prevalencia , Estudios Transversales , Deglución , MasticaciónRESUMEN
This article reports the case of a 24-year-old man with a large anterior open bite, mild mandibular crowding, increased overjet, no passive lip sealing, and Angle Class I malocclusion. The treatment results were achieved by mandibular molar intrusion using 1.8 × 8.5-mm mini-implants (C-implants) inserted between the mandibular first and second molars bilaterally. A 2.5-mm molar intrusion and open-bite closure occurred within 8 months. The multiloop edgewise archwire technique helped to intrude the posterior teeth. Total treatment time was 20 months. Fifty months postretention records are also presented. The patient achieved a suitable occlusion and satisfactory facial esthetics at the end of treatment and at the 50-month retention check.
Asunto(s)
Implantes Dentales , Mandíbula , Mordida Abierta/terapia , Métodos de Anclaje en Ortodoncia/métodos , Alambres para Ortodoncia , Técnicas de Movimiento Dental/métodos , Adulto , Cefalometría/métodos , Oclusión Dental , Estética Dental , Humanos , Labio/anatomía & histología , Masculino , Maloclusión Clase I de Angle/diagnóstico por imagen , Maloclusión Clase I de Angle/terapia , Mandíbula/diagnóstico por imagen , Modelos Dentales , Diente Molar , Mordida Abierta/diagnóstico por imagen , Métodos de Anclaje en Ortodoncia/instrumentación , Diseño de Aparato Ortodóncico , Sobremordida/diagnóstico por imagen , Sobremordida/terapia , Planificación de Atención al Paciente , Satisfacción del Paciente , Radiografía Panorámica , Rotación , Técnicas de Movimiento Dental/instrumentación , Resultado del Tratamiento , Dimensión Vertical , Adulto JovenRESUMEN
The objective of this study was to evaluate the impact of malocclusion on the quality of life (QOL) of adolescents in Brazil. We carried out a cross-sectional study in a sample population of 1015 schoolchildren aged 12 to 15 years from São Luís, Maranhão, Brazil. The explanatory variable was malocclusion, evaluated on the basis of the normative need or the adolescent's self-perceived need for dental treatment. Normative need for dental treatment was determined by professional diagnosis, made on the basis of Angle's classification, the Dental Aesthetic Index, and other morphological deviations (e.g., posterior crossbite, posterior open bite, and deep overbite). We analyzed the impact of malocclusion on the QOL using the Portuguese version of the Oral Health Impact Profile-14. Associations were estimated by using the prevalence ratio (PR) in Poisson regression analysis, with hierarchized modeling. An alpha of 5% was adopted as the criterion for statistical significance. The QOL of adolescents was impacted by malocclusion, classified by a normative need for treatment according to the Dental Aesthetic Index (PR = 1.27; 95% confidence interval [CI] = 1.03-1.56) or by the self-perceived need for treatment (PR = 2.54; 95% CI = 1.81-3.56). Certain sociodemographic variables, including the head of the family (PR = 1.52; 95% CI = 1.02-2.23), greater educational level of the head of the family (PR = 0.32; 95% CI = 0.17-0.61), and female sex (PR = 1.40; 95% CI = 1.05-1.89), had negative associations with QOL. We conclude that malocclusion has a negative impact on the QOL of adolescents, associated with socioeconomic conditions and the cosmetic effects of malocclusion.
RESUMEN
This study compared adolescents' self-perceived need for orthodontic treatment with the normative need for such treatment and investigated associations between socioeconomic and demographic variables and self-perceptions of dental malocclusion. This cross-sectional study involved 1015 schoolchildren aged 12-15 years in São Luís, Maranhão, Brazil. The following data were collected using a questionnaire and an orthodontic examination card: demographic and identifying data, socioeconomic data, educational levels of family, household income, economic classification criteria, and self-reported skin color behavioral data, and oral health data. Normative occlusal condition was examined using the Angle classification and Dental Aesthetic Index (DAI). Data were analyzed using the chi-squared test (to analyze differences in the frequency distribuition of qualitative variables) and Poisson regression (to stimate associations between the perceived need of orthodontic treatment and study covariates), with a 5% significance level. Schoolchildren's self-perceived need for orthodontic treatment was associated with sex (p = 0.022) and the normative need for treatment (p = 0.004). Among socioeconomic, demographic, and oral health variables, only sex [prevalence ratio (PR) = 1.15; 95% confidence interval (95%CI) = 1.04-1.28; p = 0.009] and the normative need for orthodontic treatment (PR = 1.19; 95%CI = 1.08-1.32; p < 0.001) were associated with the perception of malocclusion, with female adolescents reporting a greater need for orthodontic treatment. Female adolescents seems to be more sensitive to oral health problems. The results suggest that the DAI score might reflect a self-perceived need for orthodontic treatment and the Angle classification might overestimate the orthodontic treatment need.
Asunto(s)
Indice de Necesidad de Tratamiento Ortodóncico/métodos , Maloclusión/diagnóstico , Evaluación de Necesidades , Autoimagen , Adolescente , Factores de Edad , Brasil , Niño , Estudios Transversales , Estética Dental , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Salud Bucal , Distribución de Poisson , Factores Sexuales , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
Abstract This study compared adolescents' self-perceived need for orthodontic treatment with the normative need for such treatment and investigated associations between socioeconomic and demographic variables and self-perceptions of dental malocclusion. This cross-sectional study involved 1015 schoolchildren aged 12-15 years in São Luís, Maranhão, Brazil. The following data were collected using a questionnaire and an orthodontic examination card: demographic and identifying data, socioeconomic data, educational levels of family, household income, economic classification criteria, and self-reported skin color behavioral data, and oral health data. Normative occlusal condition was examined using the Angle classification and Dental Aesthetic Index (DAI). Data were analyzed using the chi-squared test (to analyze differences in the frequency distribuition of qualitative variables) and Poisson regression (to stimate associations between the perceived need of orthodontic treatment and study covariates), with a 5% significance level. Schoolchildren's self-perceived need for orthodontic treatment was associated with sex (p = 0.022) and the normative need for treatment (p = 0.004). Among socioeconomic, demographic, and oral health variables, only sex [prevalence ratio (PR) = 1.15; 95% confidence interval (95%CI) = 1.04-1.28; p = 0.009] and the normative need for orthodontic treatment (PR = 1.19; 95%CI = 1.08-1.32; p < 0.001) were associated with the perception of malocclusion, with female adolescents reporting a greater need for orthodontic treatment. Female adolescents seems to be more sensitive to oral health problems. The results suggest that the DAI score might reflect a self-perceived need for orthodontic treatment and the Angle classification might overestimate the orthodontic treatment need.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Autoimagen , Evaluación de Necesidades , Indice de Necesidad de Tratamiento Ortodóncico/métodos , Maloclusión/diagnóstico , Factores Socioeconómicos , Brasil , Distribución de Poisson , Factores Sexuales , Conocimientos, Actitudes y Práctica en Salud , Salud Bucal , Estudios Transversales , Encuestas y Cuestionarios , Factores de Edad , Estética DentalRESUMEN
A mordida cruzada posterior é caracterizada pela deficiência do arco superior e relação anormal transversal entre os dentes posteriores superiores e inferiores. Algumas vezes, assimetrias dos arcos superior ou inferior estão presentes. A má oclusão de Classe III, mesmo sendo considerada uma doença de baixa prevalência, é caracterizada pela maxila retraída em relação à mandíbula. Quando as duas más oclusões estão presentes no indivíduo, a complexidade do tratamento ortodôntico exigido é proporcional ao grau de severidade da má oclusão. O presente trabalho apresenta o tratamento de uma paciente de 22 anos e 5 meses de idade, que procurou tratamento ortodôntico com a queixa principal de apinhamento na região anterior inferior. Ao exame clínico, observou-se que a paciente apresentava perfil labial côncavo, assimetria facial, giroversões, apinhamento inferior, mordida cruzada posterior unilateral esquerda, desvio da linha média dentária inferior e má oclusão Classe III com subdivisão direita. Para a correção desta má oclusão complexa foi utilizada a técnica multiloop edgewise archwire (MEAW). Durante o tratamento, o arco superior foi expandido e o arco inferior contraído. Ao fim do tratamento, foi observado restabelecimento da oclusão e da estética.
Posterior cross bite is characterized by the deficiency of the upper arch and abnormal relationship between upper and lower posterior teeth. Sometimes, asymmetries in the upper or lower arch are present. Class III malocclusion, despite considered a low-prevalence disease, is characterized by the retraction of the maxilla in relation to the mandible. When these both malocclusions are present in the same individual, the complexity of the required orthodontic treatment is proportional to the severity of malocclusion. This paper presents the treatment of a patient, 22 years old, who looked foward for orthodontic treatment with the chief complaint of crowding in the lower anterior region. During examination it was verified that the patient had a concave profile lip, facial asymmetry, rotations, anterior mandibular crowding, left unilateral posterior cross bite, lower dental midline shift and Class III malocclusion with right subdivision. In order to correct dental occlusion the multiloop technique edgewise archwire (MEAW) was used. During the treatment, the maxillary arch was expanded and the lower arch was contracted. At the end of treatment occlusion and aesthetics were restored.
Asunto(s)
Humanos , Femenino , Asimetría Facial , Ortodoncia CorrectivaRESUMEN
A mordida aberta anterior é uma das más oclusões mais difíceis de tratamento devido a sua complexidade. A terapêutica adotada depende da idade do paciente, da gravidade da má oclusão e da etiologia. As técnicas podem variar desde a correção através da modificação dentoalveolar até o tratamento ortodôntico cirúrgico. O presente trabalho tem por finalidade apresentar a técnica Multiloop Edgewise Archwire (MEAW), através de um caso clínico de um paciente adulto com mordida aberta esquelética. A técnica MEAW mostrou-se eficiente no tratamento da mordida aberta anterior esquelética, no entanto é importante que o ortodontista tenha consciência da limitação da técnica, levando em consideração a queixa principal e a expectativa do paciente.
The anterior open bite malocclusions that most concerns the dentist due to its complexity. Adopted therapy depends on the age of the patient, the severity of malocclusion and its etiology. The techniques can vary from the correction by dentoalveolar amendment to surgical orthodontic treatment. The present work aims at presenting the Multiloop Edgewise Archwire technique (MEAW) through a clinical case of an adult patient with skeletal open bite. MEAW technique proved to be efficient in the treatment of skeletal anterior open bite however, it is important that the orthodontist has awareness of technical limitation, taking into consideration patients chief complaint and expectation.