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BACKGROUND: To compare dentoskeletal changes produced by the maxillary splint headgear and cervical headgear appliance during the early phase of Class II treatment, specially the initial overjet and upper incisors position. SUBJECTS AND METHODS: In this retrospective study, 28 Class II patients treated with the maxillary splint headgear (MSG, mean age 10.1 ± 1.9 years) and 28 Class II patients treated with cervical headgear (CHG, mean age 9.5 ± 1.9 years) were evaluated before and after treatment. Statistical comparisons between the two groups for cephalometric measurements at T1 and for T2-T1 changes were performed by means of independent sample t tests. RESULTS: The MSG showed a significantly greater reduction of the overjet in comparison to the CHG (- 2.4 mm and - 0.7 mm, respectively) and a significantly greater maxillary incisor uprighting (- 1.8 mm and 0.4 mm, respectively). In the MSG, overjet correction was due mainly to mandibular advancement (3.5 mm), while the correction of molar relationship (3.9 mm) was 64% skeletal and 36% dentoalveolar. In the CHG, the overjet correction was also more skeletal, due to mandibular growth (1.8 mm), while correction of molar relationship (3.5 mm) was 63% dentoalveolar and 37% skeletal. CONCLUSIONS: Both groups showed favorable skeletal mandibular changes, which was more significant in the MSG. Regarding tooth movement, the maxillary splint headgear was more effective in uprighting upper incisors and reducing the overjet than cervical headgear appliance.
Asunto(s)
Aparatos de Tracción Extraoral , Maloclusión Clase II de Angle , Cefalometría , Niño , Humanos , Maxilar , Estudios Retrospectivos , Férulas (Fijadores) , Técnicas de Movimiento DentalRESUMEN
This case study describes the retreatment and long-term follow-up care of a patient with a medical history of 2 heart surgeries and a Class II malocclusion that included a severe anteroposterior skeletal discrepancy characterized by mandibular deficiency. The patient's initial orthodontic camouflage treatment was poorly performed and failed to correct the maxillofacial disorders. In this article, we report the successful retreatment with a surgical-orthodontic protocol and include the 5-year follow-up records showing stable results. Guidelines for the stratification of cardiac risk are included.
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Enfermedad Coronaria/complicaciones , Maloclusión Clase II de Angle/cirugía , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Adulto , Cefalometría/métodos , Atención Dental para Enfermos Crónicos , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Maloclusión Clase II de Angle/terapia , Avance Mandibular/métodos , Osteotomía Sagital de Rama Mandibular/métodos , Sobremordida/cirugía , Sobremordida/terapia , Técnica de Expansión Palatina/instrumentación , Planificación de Atención al Paciente , Retratamiento , Retrognatismo/cirugía , Retrognatismo/terapia , Técnicas de Movimiento Dental/métodos , Resultado del TratamientoRESUMEN
OBJECTIVE: To assess changes in oral health-related quality of life (OHQoL) in children undergoing fixed orthodontic treatment and compare it to that of two groups not receiving treatment. MATERIALS AND METHODS: Two hundred eighty-four subjects aged 12-15 years were followed for 2 years; 87 were undergoing treatment at a university clinic (TG), 101 were waiting for treatment at this clinic (WG), and 96 were attending a public school and had never sought treatment (SG). OHQoL was assessed using the Oral Health Impact Profile (OHIP-14). All subjects were examined and interviewed at baseline (T1), 1 year later (T2), and 2 years later (T3). OHIP-14 scores were analyzed using negative binomial regression in generalized estimating equations for correlated data. RESULTS: During the follow-up period, the WG and TG OHIP-14 scores showed a statistically significant increase and decrease, respectively (P < .001). At T1, the TG had an OHIP-14 score that was 1.9 times higher than that of the SG; however at T3, the TG score was 60% lower than the initial score of the SG. Adjusting for age, gender, dental health status (DMFT), socioeconomic position, malocclusion severity, and self-perceived esthetics did not change the effect of orthodontic treatment on OHQoL. CONCLUSION: Fixed orthodontic treatment in Brazilian children resulted in significantly improved OHQoL after 2 years.
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Estética Dental/psicología , Maloclusión/terapia , Aparatos Ortodóncicos Funcionales , Calidad de Vida/psicología , Adolescente , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maloclusión/psicología , Estudios Prospectivos , Análisis de Regresión , Autoimagen , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
OBJECTIVE: To make a brief description of the Surgery-First approach, where surgery is performed prior to orthodontic movement. MATERIALS AND METHODS: Three clinical cases involving this type of treatment are reported. The cases presented here show different approaches, providing clinicians with an idea of how to plan this type of treatment. RESULTS: The cases presented satisfactory results that are similar to results of the conventional technique, once a well-designed treatment plan was conducted. CONCLUSIONS: The Surgery-First approach is a viable technique; however, collaborative and careful planning by the orthodontists and surgeons is needed. When well planned, the results of the Surgery-First approach are similar to those of conventional surgical-orthodontic treatment.
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Maloclusión de Angle Clase III/cirugía , Adolescente , Adulto , Citas y Horarios , Cefalometría , Femenino , Humanos , Relaciones Interprofesionales , Masculino , Maloclusión de Angle Clase III/terapia , Ortodoncia Correctiva , Procedimientos Quirúrgicos Ortognáticos , Planificación de Atención al Paciente , Adulto JovenRESUMEN
OBJECTIVES: To compare the sliding resistance forces produced by polycarbonate self-ligating brackets with esthetic archwires. MATERIALS AND METHODS: Samples of Opal, Oyster and conventional Blonde brackets were tested each one with 30 segments of .018x.025-in wires. The archwires were slipped at 8mm/min for 40 seconds with an universal testing machine. Two way ANOVA with Bonferroni correction were used. RESULTS: Blonde brackets presented the highest sliding resistance, followed in decreasing order by Oyster and Opal. The TP Shiny Bright Wire produced the highest surface friction, while the lowest was observed for Imagination archwires (except for Opal brackets where the TP Pearltone Wire achieved the best performance). CONCLUSIONS: Self-ligating system is more effective to reduce the sliding force resistance than conventional brackets. Esthetic stainless steel archwires produce less friction resistance than those without surface treatment. Polycarbonate self-ligating brackets are more effective to reduce the frictional forces than esthetic archwires with surface treatment.
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Aleaciones Dentales/química , Materiales Dentales/química , Diseño de Aparato Ortodóncico , Soportes Ortodóncicos , Alambres para Ortodoncia , Polímeros/química , Acero Inoxidable/química , Análisis del Estrés Dental/instrumentación , Fricción , Vidrio/química , Humanos , Ensayo de Materiales , Modelos Anatómicos , Estrés Mecánico , Propiedades de Superficie , Resistencia a la Tracción , Factores de TiempoRESUMEN
OBJECTIVE: The aim of this study was to assess resistance to sliding of stainless steel passive self-ligating brackets with 0° and 2.5° angulations and to compare them to active self-ligating brackets at zero angulation. The hypothesis to be tested was that passive self-ligating brackets produce lower frictional forces than active self-ligating brackets. METHODS: Twenty five 0.022 x 0.028-in slot maxillary canine brackets were divided into 5 groups of 5 brackets: Damon SL II (Ormco, CA, USA) self-ligating bracket and Gemini (3M/Unitek, CA, USA) conventional bracket with angulation of 0 and 2.5° and a group of Speed 2 (American Orthodontics, WI, USA) active clip self-ligating system with zero angulation. Twenty five segments of stainless steel 0.020-in archwire (TP Orthodontics, IN, USA) were tested and each bracket/wire interface was evaluated at 4 successive points during sliding. Overall, 100 frictional values were analyzed by parametric analysis of variance and Bonferroni tests. RESULTS AND CONCLUSION: Frictional tests were performed with an Emic DL 10000 testing machine (Emic, Brazil) with a load cell of one kilogram. Passive self-ligating brackets produced lower frictional forces than active self-ligating brackets (p < 0.01). Under angulation, brackets with a slide mechanism produced higher friction than the same brackets under zero angulation (p < 0.01). Nevertheless, the slide system under angulation produced smaller friction values than conventional brackets tied with elastomeric ligatures in 0° tests.
OBJETIVO: avaliar a fricção apresentada por braquetes autoligáveis de aço inoxidável com sistema passivo de tampa deslizante sob angulação de 0 grau e 2,5 graus, e comparar o comportamento desse grupo sob angulação nula com o de um grupo de braquetes autoligáveis com sistema ativo de tampa resiliente. MÉTODOS: foram utilizados 25 braquetes de caninos superiores, divididos em 5 grupos - braquetes autoligáveis passivos Damon SL II sob angulação de 0 grau e de 2,5 graus; braquetes convencionais Gemini amarrados com ligaduras elásticas sob as mesmas angulações; e um grupo formado pelo sistema ativo Time 2, sob angulação nula. A hipótese a ser testada é se artefatos autoligáveis com sistema de tampa passiva são mais efetivos no controle da fricção do que dispositivos contendo coberturas ativas. O tracionamento foi realizado segundo emprego de 25 segmentos de fio de aço inoxidável 0,020" na máquina de ensaios EMIC DL 10000 com célula de carga de 2,0kg. Cada conjunto braquete/fio foi responsável pela geração de quatro corpos de prova, totalizando-se 100 leituras. As comparações entre médias dos valores foram realizadas através da Análise de Variância (one-way ANOVA) com correções pelo coeficiente de Bonferroni. RESULTADOS E CONCLUSÃO: as médias de fricção encontradas confirmaram a hipótese em teste, de que o sistema de braquetes Damon SL II é mais eficiente no controle do atrito do que o sistema de tampa ativa sob angulação de 0 grau (p<0,01). Quando submetidos a angulações de 2,5 graus, a fricção aumentou significativamente (p<0,01), porém mantendo-se ainda muito inferior aos patamares evidenciados no grupo de braquetes convencionais amarrados com ligaduras elásticas.
RESUMEN
INTRODUCTION: The aim of this prospective evaluation was to assess changes in esthetic self-perception of Brazilian adolescents who were receiving fixed orthodontic treatment during a 2-year period. METHODS: The treatment group consisted of 92 patients, ages 12 to 15 years, treated at the Rio de Janeiro State University orthodontic clinic. The control group consisted of 226 untreated adolescents; 124 subjects were waiting for treatment at this clinic, and 102 subjects were attending public school and had never undergone or sought treatment. The index of orthodontic treatment need was used to assess malocclusion severity, esthetic status (measured by an orthodontist), and esthetic self-perception. All subjects were interviewed 3 times during the study: at baseline; 1 year after placement of the fixed appliance for the treatment group and 1 year after the first interview for the school and waiting groups; and 2 years after placement of the fixed appliance for the treatment group and 2 years after the first interview for the school and waiting groups. The index of orthodontic treatment need scores were analyzed by using negative binomial regression in generalized estimating equations for correlated data. RESULTS: During the follow-up period, the treatment group's esthetic self-perception scores had a statistically significant decrease (P <0.01), the waiting group's scores had an increase (P = 0.08), and the school group's scores were stable (P = 0.79). At baseline, the treatment group had an esthetic self-perception score of 96% (risk ratio = 1.96; 95% confidence interval, 1.70-2.26) higher than the school group, but at the final interview, the treatment group's score was 20% lower (risk ratio = 0.81; 95% confidence interval, 0.68-0.96) than the initial score of the school group. Age; sex; the index of decayed, missing, and filled teeth; and socioeconomic position did not affect the adolescents' esthetic self-perceptions at follow up, but malocclusion severity and the group had a significant interaction. CONCLUSIONS: Fixed orthodontic treatment in patients 12 to 15 years of age significantly improved their esthetic self-perceptions.
Asunto(s)
Conducta del Adolescente , Estética Dental/psicología , Indice de Necesidad de Tratamiento Ortodóncico , Maloclusión/psicología , Ortodoncia Correctiva/psicología , Autoimagen , Adolescente , Niño , Índice CPO , Femenino , Humanos , Entrevistas como Asunto , Modelos Lineales , Masculino , Maloclusión/terapia , Aparatos Ortodóncicos , Ortodoncia Correctiva/instrumentación , Estudios Prospectivos , Clase SocialRESUMEN
INTRODUCTION: Studies in the dental literature do not yet provide conclusive evidence for the functional and psychosocial benefits of orthodontic treatment. In this cross-sectional study, we aimed to assess the oral health-related quality of life of young Brazilian adults, aged 18 to 30 years, who had completed orthodontic treatment compared with untreated subjects waiting for treatment. METHODS: The subjects were recruited at a state-funded university clinic. The sample comprised 100 patients in the retention phase of orthodontic treatment for more than 6 months (treated group) and 100 persons who were seeking orthodontic treatment and were still on a waiting list (nontreated group). Data were collected by using the oral health impact profile, the index of orthodontic treatment need (malocclusion severity and esthetic impairment), the Brazilian economic classification criteria (socioeconomic status), and the index of decayed, missing, and filled teeth (oral health status). Statistical analyses were performed by using chi-square and Fisher exact tests and negative binomial regression. RESULTS: The mean oral health impact profile scores were 3.1 (SD ± 2.99) and 15.1 (SD ± 8.02) in the treated and nontreated groups, respectively. The most frequent impacts in the treated and nontreated groups were "painful aching" and "been self-conscious," respectively. Comparisons between the groups were controlled for malocclusion severity, clinician-assessed esthetic impairment, age, sex, socioeconomic status, and oral health status. Nontreated young adults had mean oral health impact profile scores 5.3 times higher than did the treated subjects. CONCLUSIONS: Young Brazilian adults who received orthodontic treatment had significantly better oral health-related quality of life scores in the retention phase, after treatment completion, than did nontreated subjects.
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Maloclusión/psicología , Salud Bucal , Ortodoncia Correctiva/psicología , Calidad de Vida , Adolescente , Adulto , Distribución de Chi-Cuadrado , Estudios Transversales , Índice CPO , Femenino , Humanos , Indice de Necesidad de Tratamiento Ortodóncico , Masculino , Modelos Estadísticos , Análisis de Regresión , Perfil de Impacto de Enfermedad , Clase Social , Listas de Espera , Adulto JovenRESUMEN
OBJETIVO: o objetivo do presente trabalho foi determinar a força de atrito estático entre braquetes de aço inoxidável autoligados com sistema de fechamento resiliente e fios ortodônticos redondos e retangulares do mesmo material. MÉTODOS: empregaram-se 30 braquetes referentes aos caninos superiores divididos em 6 grupos formados por braquetes autoligados Smartclip, In-Ovation R e convencionais Gemini amarrados com ligaduras elásticas. A hipótese testada neste trabalho foi quanto à possibilidade dos braquetes autoligados ativos serem suscetíveis à elevação da força de atrito com o aumento e alteração da secção transversal dos fios ortodônticos. Os ensaios foram realizados com tração de 30s em fios de aço inoxidável 0,020" e 0,019"X0,025" na máquina de ensaios Emic DL 10000, com uma célula de carga de 20 newtons. Cada conjunto braquete/fio foi responsável pela geração de quatro corpos de prova, totalizando 120 leituras. As comparações entre as médias foram realizadas através da Análise de Variância (one way ANOVA) com correções pelo coeficiente de Bonferroni. RESULTADOS E CONCLUSÃO: os braquetes autoligados apresentaram maior força de atrito do que os braquetes convencionais amarrados com ligaduras elásticas. O grupo Smartclip foi o mais efetivo no controle do atrito (p<0,01). A hipótese em teste, influência da forma da seção transversal do fio na força de atrito, foi confirmada, uma vez que os fios de secção retangular 0,019"X0,025" apresentaram maior força de atrito ao serem tracionados do que os fios redondos 0,020" (p<0,01). O sistema Smartclip foi mais efetivo mesmo quando o tracionamento de fios retangulares foi comparado com o ensaio de braquetes In-Ovation R conjugados a fios redondos (p<0,01).
OBJECTIVES: The purpose of this study was to assess the surface friction produced by self-ligating stainless steel brackets equipped with a resilient closure system and compare the friction generated during traction of round and rectangular orthodontic wires made from the same material. METHODS: Thirty maxillary canine brackets were divided into six groups comprising SmartClip and In-Ovation R self-ligating brackets, and conventional Gemini brackets tied with elastomeric ligatures. This investigation tested the hypothesis that self-ligating brackets are susceptible to increases in friction that are commensurate with increases and changes in the cross-section of orthodontic wires. Traction was performed with the aid of thirty segments of 0.020" and 0.019" x 0.025" stainless steel wires in an EMIC DL 10000 testing machine with a 2N load cell. Each set of bracket/wire generated four samples, totaling 120 readings. Comparisons between means were performed using analysis of variance (one way ANOVA) corrected with the Bonferroni coefficient. RESULTS AND CONCLUSION: The self-ligating brackets exhibited lower friction than conventional brackets tied with elastomeric ligatures. The SmartClip group was the most effective in controlling friction (p <0.01). The hypothesis under test was confirmed to the extent that the traction performed with rectangular 0.019" x 0.025" cross-section wires resulted in higher friction forces than those observed in the 0.020" round wire groups (p<0.01). The SmartClip system was more effective even when the traction produced by rectangular wires was compared with the In-Ovation R brackets combined with round wires (p<0.01).
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Soportes Ortodóncicos , Fricción , Alambres para Ortodoncia , Acero Inoxidable , OrtodonciaRESUMEN
This case report describes the orthodontic treatment for a young female, aged 18 years 4 months, with a Class III malocclusion on the right side, with a combination of a posterior and anterior crossbite. Two rigid orthodontic mini-implants were placed in the retromolar region in order to move the entire lower arch distally with nickel-titanium coil springs. In addition, a Pendex appliance was used to create space and to improve the arch form and the transverse relationship. The active treatment period was 17 months. Normal overjet and overbite were obtained, and facial balance was improved. Although the cephalometric superimposition has demonstrated the effects of dental compensation, the final dental and facial results were satisfactory and stable after the second year in retention.
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Estética Dental , Maloclusión de Angle Clase III/terapia , Métodos de Anclaje en Ortodoncia/instrumentación , Aparatos Ortodóncicos , Ortodoncia Correctiva/métodos , Adolescente , Cefalometría , Implantes Dentales , Femenino , Humanos , Técnica de Expansión PalatinaRESUMEN
OBJECTIVE: To test the null hypothesis was that there is no difference in the mean shear bond strength of indirectly bonded lingual brackets prepared with or without sandblasting prior to acid etching. MATERIALS AND METHODS: Forty extracted human premolars were obtained and randomly divided into two groups of 20 each: group I (control), phosphoric acid and indirect bonding with Maximum Cure and Phase II (Reliance, Itasca, Ill); and group II, sandblasting with 50 µm aluminum oxide (Microetcher, Danville Engineering, Danville, Calif) prior to etching and indirect bonding. All products were used according to the manufacturer's instructions. Instron universal testing machine was used to apply an occlusogingival shear force directly onto the enamel-bracket interface at a speed of 0.5 mm/min. The groups were compared using unpaired Student's t-test. Kaplan-Meir survival plots and log-rank test were done to compare the survival distribution between the two groups. RESULTS: Mean (SD) shear bond strength for group I was 13.17 (4.33) MPa and for the group II was 16.42 (5.41) MPa. Significant difference was observed in the bond strengths of the two groups evaluated (P = .048). However, the log-rank test demonstrated that clinical performance of the groups evaluated was not significantly different (P = .091). The adhesive remnant index (ARI) was significantly higher when using sandblasting prior to acid etching than in the control group (P = .011). CONCLUSIONS: Intraoral sandblasting prior to enamel etching increased the bond strength of lingual brackets, but the clinical performance of the groups was not significantly different.
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Recubrimiento Dental Adhesivo , Aparatos Ortodóncicos , Abrasión Dental por Aire , Esmalte Dental , Grabado Dental , Análisis del Estrés Dental , Humanos , Estimación de Kaplan-Meier , Diseño de Aparato Ortodóncico , Resistencia al Corte , Propiedades de SuperficieRESUMEN
AIM: To evaluate the frictional forces generated by ceramic- (Opal, Ultradent) and glass-fiber-reinforced polycarbonate self-ligating brackets (Oyster, Gestenco) and compare the effectiveness of these ligatureless systems with glass-fiber-reinforced polycarbonate conventional brackets (Blonde, Gestenco). The hypothesis is that there is no difference between frictional forces generated by ceramic- and glass-fiber-reinforced polycarbonate self-ligating and glass-fiber-reinforced polycarbonate conventional brackets. METHODS: Twelve preadjusted 0.022 3 0.028-inch maxillary canine brackets were tested, divided into three groups: Opal, Oyster, and Blonde. Frictional tests were conducted with the Emic DL 10000 testing machine with a 20 N loadcell for 40 seconds at a 0.5 cm/min speed. Each bracket-wire combination was tested five times. The data generated were analyzed by parametric analysis of variance (one-way ANOVA) and Bonferroni tests. RESULTS: Analysis of variance indicated significant differences for the three groups (P<.01). The frictional forces of the Oyster glass-fiber-reinforced polycarbonate self-ligating brackets were significantly lower (37.0 ± 8.9 cN) than those of the Opal ceramic-reinforced polycarbonate self-ligating brackets (49.5 ± 10.1 cN), while the Blonde glass-fiber-reinforced conventional bracket frictional forces were 105.8 ± 6.4 cN. CONCLUSION: Oyster glass-fiber-reinforced polycarbonate brackets produced less friction than Opal ceramic-reinforced polycarbonate brackets. The polycarbonate ligatureless system showed significantly lower frictional forces compared to Blonde conventional polycarbonate brackets tied with elastomeric ligatures. The study rejected the initial hypothesis because there are significant differences of frictional forces among the tested systems.
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Diseño de Aparato Ortodóncico , Soportes Ortodóncicos , Cemento de Policarboxilato/química , Cerámica/química , Aleaciones Dentales/química , Análisis del Estrés Dental/instrumentación , Elastómeros/química , Fricción , Vidrio/química , Humanos , Ensayo de Materiales , Alambres para Ortodoncia , Acero Inoxidable/química , Estrés Mecánico , Propiedades de SuperficieRESUMEN
INTRODUCTION: The aim of this study was to assess oral health-related quality of life (OHQOL) in adolescents who sought orthodontic treatment. A comparison between these adolescents and their age-matched peers who were not seeking orthodontic treatment provided an assessment of the role of OHQOL in treatment seeking. METHODS: The sample consisted of 225 subjects, 12 to 15 years of age; 101 had sought orthodontic treatment at a university clinic (orthodontic group), and 124, from a nearby public school, had never undergone or sought orthodontic treatment (comparison group). OHQOL was assessed with the Brazilian version of the short form of the oral health impact profile, and malocclusion severity was assessed with the index of orthodontic treatment need. RESULTS: Simple and multiple logistic regression analysis showed that those who sought orthodontic treatment reported worse OHQOL than did the subjects in the comparison group (P <0.001). They also had more severe malocclusions as shown by the index of orthodontic treatment need (P = 0.003) and greater esthetic impairment, both when analyzed professionally (P = 0.008) and by self-perception (P <0.0001). No sex differences were observed in quality of life impacts (P = 0.22). However, when the orthodontic group was separately evaluated, the girls reported significantly worse impacts (P = 0.05). After controlling for confounding (dental caries status, esthetic impairment, and malocclusion severity), those who sought orthodontic treatment were 3.1 times more likely to have worse OHQOL than those in the comparison group. CONCLUSIONS: Adolescents who sought orthodontic treatment had more severe malocclusions and esthetic impairments, and had worse OHQOL than those who did not seek orthodontic treatment, even though severely compromised esthetics was a better predictor of worse OHQOL than seeking orthodontic treatment.
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Estética Dental/psicología , Maloclusión/psicología , Salud Bucal , Aceptación de la Atención de Salud/psicología , Calidad de Vida/psicología , Adolescente , Estudios de Casos y Controles , Niño , Femenino , Humanos , Masculino , Maloclusión/clasificación , Maloclusión/terapia , Valores de Referencia , Índice de Severidad de la Enfermedad , Ajuste SocialRESUMEN
OBJECTIVES: To investigate the interrelationships between factors involved in orthodontic treatment seeking by children aged 12-15 years. SETTING: State funded orthodontic clinic at the Faculty of Dentistry of the Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil, and a nearby public school. SUBJECTS AND METHODS: One hundred and ninety-four adolescents aged 12-15 years took part in the study; 92 had sought orthodontic treatment at UERJ (orthodontic group) and 102 were from a nearby public school and had never undergone or sought orthodontic treatment (comparison group). Each participant underwent a comprehensive oral examination, and both parent and child were questioned about who had initiated the orthodontic referral. OUTCOMES: Normative need assessed with IOTN DHC; clinician and self-perceived aesthetic perception assessed with IOTN AC, previous caries experience was determined using the decayed, missing and filled teeth index (DMFT) and WHO diagnostic criteria. The 'Brazil Economic Classification Criteria' was used to classify the socioeconomic status. Intra-examiner repeatability and inter-examiner agreement were assessed with kappa statistics. Univariate and multiple logistic regression analyses were used to investigate the association between orthodontic treatment seeking (dependent variable) and the independent variables (i.e. aesthetic impairment, malocclusion severity, socioeconomic status, gender, age and DMFT). RESULTS: Univariate analyses showed that self-perceived aesthetics (P<0.001), examiner-assessed aesthetics (P = 0.01) and treatment need (P<0.001), socioeconomic status (P<0.001) were significantly associated with orthodontic treatment seeking, but gender (P = 0.22) and DMFT (P = 0.41) were not. Multiple logistic regression analyses showed that poor self-perceived aesthetics (OR = 16.7; 95% CI: 4.17-61.9), more severe malocclusion (OR = 3.4; 95% CI 1.64-7.14) and better socioeconomic position (OR = 39.1; 95% CI: 5.47-280.54) significantly influenced the decision to seek orthodontic treatment. CONCLUSIONS: Concern about dental appearance and the desire for treatment, together with normative orthodontic need, should be carefully assessed by dentists before referring patients to specialized orthodontic care in publicly-funded clinics. In a publicly-funded oral health care system, self-perceived orthodontic treatment need is the key to establishing treatment priority.
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Servicios de Salud Dental/economía , Estética Dental/psicología , Maloclusión/psicología , Ortodoncia Correctiva/estadística & datos numéricos , Aceptación de la Atención de Salud , Adolescente , Niño , Índice CPO , Femenino , Financiación Gubernamental , Humanos , Modelos Logísticos , Masculino , Variaciones Dependientes del Observador , Oportunidad Relativa , Ortodoncia Correctiva/economía , Derivación y Consulta , Autoevaluación (Psicología) , Factores SocioeconómicosRESUMEN
OBJECTIVE: To evaluate the success of osseointegrated implants under immediate prosthetic and orthodontic forces after a follow-up period of at least 2 years. MATERIALS AND METHODS: The sample included 20 titanium implants which were used as orthodontic and prosthetic anchorage of immediately loaded single-crowns on a total of 13 patients. A 40 N initial torque was considered the minimum for inclusion in the sample. All implants received screwed provisional crowns immediately after surgery. The implants were randomly divided into two groups: the control group (9 implants) and the immediate orthodontic loading group (11 implants). A healing period of 4 months was observed before orthodontic loads were applied to the control group implants. For the immediate orthodontic loading group, orthodontic forces were applied within 24 hours. The maximum orthodontic force applied in both groups was 200 g. After 6 months of orthodontic movement, clinical and radiographic evaluations were obtained. Implants were considered successful when favorable results were obtained in all evaluations. RESULTS: After a 2-year follow-up, the success rates were 90.9% and 88.9%, respectively, in the orthodontic loading group and the control group. Each group had one failure. CONCLUSION: Shortening the healing period for the application of orthodontic forces did not seem to affect the success of osseointegrated implants used as anchorage.
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Implantes Dentales de Diente Único , Métodos de Anclaje en Ortodoncia/instrumentación , Adulto , Fenómenos Biomecánicos , Coronas , Pilares Dentales , Materiales Dentales/química , Prótesis Dental de Soporte Implantado , Restauración Dental Provisional , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Soportes Ortodóncicos , Cierre del Espacio Ortodóncico/instrumentación , Oseointegración/fisiología , Estudios Prospectivos , Estrés Mecánico , Factores de Tiempo , Titanio/química , Técnicas de Movimiento Dental/instrumentación , Torque , Resultado del Tratamiento , Adulto JovenRESUMEN
AIM: To evaluate longitudinally the cephalometric changes in the facial profile of young adults. METHODS: The sample was composed of 27 individuals of both genders who presented with Class I and normal occlusion; the initial mean age was 21.2 years. After a mean period of 7.2 years, patients were re-evaluated. All measurements were carried out via digitalized lateral cephalometric radiographs. One calibrated operator identified the cephalometric landmarks. Software was used to take linear and angular values; the mean dimensions were used for data. The evaluated measurements were nasal depth, soft pogonion thickness, upper and lower lip thickness, upper and lower lip position in relation to the esthetic plane of Ricketts, facial convexity including the nose, and facial convexity excluding the nose. The paired t test was used to evaluate the changes. RESULTS: Data indicate that the nose depth increased by a mean of 1.07 mm. The soft pogonion thickness and the lower lip thickness increased a mean of 0.51 mm and 0.55 mm, respectively, and the facial convexity excluding the nose decreased 0.72 degrees. Only the facial convexity including the nose was different between the genders, with greater values for the male subjects. CONCLUSIONS: Facial profile changes throughout the third decade of life; in the present study, these changes were statistically significant for nose depth, observed in both sexes.
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Oclusión Dental , Cara/anatomía & histología , Adulto , Cefalometría/métodos , Mentón/anatomía & histología , Femenino , Estudios de Seguimiento , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Incisivo/anatomía & histología , Labio/anatomía & histología , Estudios Longitudinales , Masculino , Mandíbula/anatomía & histología , Maxilar/anatomía & histología , Hueso Nasal/anatomía & histología , Nariz/anatomía & histología , Factores SexualesRESUMEN
INTRODUÇÃO: os braquetes autoligáveis foram, inicialmente, idealizados com objetivo de otimização do tempo de atendimento clínico. Por dispensar qualquer tipo de amarração, inúmeras vantagens foram atribuidas a este sistema, com a redução da fricção superficial na interface braquete/fio ortodôntico. Com esta redução, são necessárias forças de menor intensidade para o estabelecimento da movimentação dentária, realizada, assim, de uma forma mais rápida e eficiente. Em decorrência da maior demanda estética por parte dos pacientes, os braquetes autoligáveis começaram a ser confeccionados em policarbonato, promovendo ganhos estéticos únicos, quando em comparação a seus anólogos metálicos. OBJETIVO: realizar uma revisão de literatura sobre o sistema de braquetes autoligáveis estéticos.
INTRODUCTION: The self-ligating system was introduced aiming the reduction of chair time. Once this system does not need any ligation form, several advantages were observed, such as the reduction on superficial friction in couple bracket/ orthodontic wire, and the reduction on the force level that is necessary to establish the orthodontic tooth movement. The growing demands of aesthetic patients induced the self-ligating system to be made of polycarbonate material, resulting in unique aesthetic advantages when compared with the metallic form of this system. AIM: The objective of this paper was to proceed with a literature review about aesthetic self-ligating brackets.
Asunto(s)
Soportes Ortodóncicos/tendencias , Estética Dental , Materiales Dentales , FricciónRESUMEN
The purpose of this in vitro study was to evaluate the influence of a new self-etching primer (Adper Prompt L-pop; 3M ESPE, St Paul, Minn) on shear bond strength of orthodontic brackets. Forty extracted human premolars were obtained and randomly divided into two groups of 20 each: group 1 (control), phosphoric acid + Transbond XT primer (3M Unitek, Monróvia, Calif) and group 2, Adper Prompt L-pop. Transbond XT adhesive paste (3M Unitek) was used in both groups for bracket bonding. All products were used according to the manufacturer's instructions. Instron Universal Testing Machine was used to apply an occlusal shear force directly onto the enamel-bracket interface at a speed of 0.5 mm/min. The groups were compared using Student's t-test. Mean results and standard deviation for the groups were: group 1 = 16.23 MPa (4.77), group 2 = 13.56 MPa (4.31). No significant difference was observed in the bond strengths of the two groups evaluated (P = .069). However, the adhesive remnant index was significantly less when conditioning the enamel with Adper Prompt L-pop compared with phosphoric acid (P = .0003). The results suggest no difference in bond strength whether a conventional etching and primer or Adper Prompt L-pop is used. The amount of adhesive on the enamel after debonding was significantly less when using Adper Prompt than when using phosphoric acid. These results indicated that Adper Prompt is potentially adequate for orthodontic bonding needs.
Asunto(s)
Recubrimiento Dental Adhesivo , Soportes Ortodóncicos , Cementos de Resina/química , Grabado Ácido Dental/métodos , Esmalte Dental/ultraestructura , Humanos , Ensayo de Materiales , Ácidos Fosfóricos/química , Resistencia al Corte , Estrés Mecánico , Propiedades de SuperficieRESUMEN
The aim of this study was to evaluate the influence of a self-etching primer (SEP) (Transbond Plus SEP, 3M Unitek, Monrovia, Calif) on shear bond strength of adhesive uncoated and precoated Victory brackets (3M Unitek). The sample group consisted of 23 patients, with four premolars each, equally divided in four different groups. Brackets were bonded in vivo by the same operator using a split-mouth random technique: group 1, 37% phosphoric acid + primer + composite + conventional Victory bracket; group 2, 37% phosphoric acid + primer + precoated Victory bracket; group 3, SEP + composite + conventional bracket; group 4, SEP + precoated bracket. After 30 days, premolars were extracted for orthodontic reasons and a Universal Instron Machine was used to apply an occlusal shear force directly to the enamel-bracket interface at a speed of 0.5 mm/min. The groups were compared using two-way analysis of variance. Mean results and standard deviation for the groups were: group 1 = 11.60 +/- 2.65 Mpa, group 2 = 9.79 +/- 2.71 Mpa, group 3 = 10.75 +/- 2.67 Mpa, and group 4 = 10.31+/- 2.70 Mpa. No difference was observed between the conventional etching and primer or SEP (P = .948). However, significant differences in bond strength were present between the uncoated and precoated brackets (P = .032). Considering the values required to withstand normal orthodontic forces (8-9 Mpa), it could be concluded that the SEP combined with adhesive precoated brackets showed adequate shear bond strength and may be suitable for clinical use.