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BACKGROUND: Facial advancement represents the essence of the surgical treatment of syndromic craniosynostosis. Frontofacial monobloc distraction is an effective surgical approach to correct midface retrusion although someone consider it very hazardous procedure. The authors evaluated a group of patients who underwent frontofacial monobloc distraction with the aim to identify the advancement results performed in immature skeletal regarding the midface morphologic characteristics and its effects on growth. METHODS: Sixteen patients who underwent frontofacial monobloc distraction with pre- and postsurgical computed tomography (CT) scans were evaluated and compared to a control group of 9 nonsyndromic children with CT scans at 1-year intervals during craniofacial growth. Three-dimensional measurements and superimposition of the CT scans were used to evaluate midface morphologic features and longitudinal changes during the craniofacial growth and following the advancement. Presurgical growth was evaluated in 4 patients and postsurgical growth was evaluated in 9 patients. RESULTS: Syndromic maxillary width and length were reduced and the most obtuse facial angles showed a lack in forward projection of the central portion in these patients. Three-dimensional distances and images superimposition demonstrated the age did not influence the course of abnormal midface growth. CONCLUSION: The syndromic midface is hypoplastic and the sagittal deficiency is associated to axial facial concavity. The advancement performed in mixed dentition stages allowed the normalization of facial position comparable to nonsyndromic group. However, the procedure was not able to change the abnormal midface architecture and craniofacial growth.

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The purpose of this study was to evaluate patient acceptance and perception of pain with regard to orthodontic mini-implants. The study was conducted on 58 individuals undergoing orthodontic treatment, who had orthodontic mini-implants placed as anchorage devices. Data were collected using a questionnaire containing 6 questions evaluating perception of pain during mini-implant placement and during use, difficulty with cleaning, unaesthetic appearance, difficulty with eating and benefits observed. Data were tabulated and analyzed using Fisher and Spearman's Correlation Coefficient tests. It was found that 94.8% of the patients reported that they would be willing to undergo treatment with mini-implants again. Of the negative aspects evaluated, the most significant was discomfort during placement, while the least significant was difficulty with eating. Patients' perception of aspects related to mini-implants was shown to be independent of the quantity of these devices placed. Although the patients evaluated some aspects of mini-implants negatively, the mean score for benefits observed was very high, indicating good patient satisfaction with treatment.

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The purpose of this study was to evaluate patient acceptance and perception of pain with regard to orthodontic mini-implants.The study was conducted on 58 individuals undergoing orthodontic treatment, who had orthodontic mini-implants placed as anchorage devices. Data were collected using a questionnaire containing 6 questions evaluating perception of pain during mini-implant placement and during use, difficulty with cleaning, unaesthetic appearance, difficulty with eating and benefits observed. Data were tabulated and analyzed using Fisher and Spearman’s Correlation Coefficient tests. It was found that 94.8% of the patients reported that they would be willing to undergo treatment with mini-implants again. Of the negative aspects evaluated, the most significant was discomfort during placement, while the least significant was difficulty with eating. Patients’ perception of aspects related to mini-implants was shown to be independent of the quantity ofthese devices placed. Although the patients evaluated some aspects of mini-implants negatively, the mean score for benefits observed was very high, indicating good patient satisfaction with treatment.

O objetivo do presente estudo foi avaliar a aceitabilidade e percepção dolorosa dos pacientes em relação aos mini-implantes ortodônticos. Este estudo foi realizado com 58 indivíduos em tratamento ortodôntico que tiveram a instalação de mini-implantes ortodônticos como recurso de ancoragem. Oinstrumento de coleta de dados foi um questionário contendo 8 perguntas que avaliaram a percepção dolorosa durante a instalação e uso dos mini-implantes, dificuldade de higienização,aspecto anti-estético, dificuldade de alimentação e os benefíciosobservados. Os dados foram tabulados e analisados pelos testes de Fisher e de Coeficiente de Correlação de Spearman. Os resultados demonstraram que 94,8% dos pacientes relataram que se submeteriam novamente ao tratamento com mini-implantes.Dos aspectos negativos avaliados, o mais significante foi o incômodo e dor durante a instalação, enquanto o menos significante foi dificuldade de alimentação. A percepção dos pacientes sobre os aspectos relacionados aos mini-implantesmostrou-se independente da quantidade desses dispositivos instalados. Conclui-se que apesar da avaliação dos mini-implantes pelos pacientes ter apresentado alguns aspectos negativos, o escore médio dos benefícios observados foi bastante alto, indicando boa satisfação dos pacientes com o tratamento.

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OBJECTIVES: The aim of this study was to assess the pharyngeal airway space (PAS) in nasal and mouth-breathing children using cone beam computed tomography (CBCT). METHODS: Volume, area, minimum axial area and linear measurements (PAS-NL, PAS-UP, PAS-OccL, PAS-UT, PAS-Bgo, PAS-ML, PAS-TP) of the pharyngeal airway of 50 children (mean age 9.16 years) were obtained from the CBCT images. The means and standard deviations were compared according to sexes (28 male and 22 female) and breathers patterns (25 nasal breathers and 25 mouth breathers). RESULTS: There were no statistically significant differences (p>0.05) between all variables when compared by sexes. Comparisons between nasal and mouth breathers showed significant differences only in two linear measurements: PAS-OccL (p<0.001) and PAS-UP (P<0.05). Airway volume (p<0.001), area (p<0.001) and minimum axial area (p<0.01) had significant differences between the groups. CONCLUSIONS: The CBCT evaluation showed that pharyngeal airway dimensions were significantly greater in nasal-breathers than in mouth-breathers.

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OBJECTIVE: To evaluate a 10-year follow-up of anteroposterior and vertical maxillary changes in skeletal Class II patients treated with slow and rapid maxillary expansion methods. MATERIALS AND METHODS: The sample consisted of 70 patients divided into two groups: (1) treated with a cervical headgear with expansion of the inner bow (CHG) and (2) using a Haas-type rapid maxillary expansion appliance in conjunction with cervical headgear (RME-CHG). The CHG group consisted of 40 patients (18 males and 22 females; average age 10.6 years at pretreatment [T1], 13.6 years at posttreatment [T2], and 23.6 years at postretention [T3]). The RME-CHG group consisted of 30 patients (14 males and 16 females; average age 10.4 years at T1, 14.0 years at T2, and 24.6 years at T3). The profiles of SNA and SN-PP angles showed no significant differences in either group at T1, T2, and T3 phases. RESULTS: For the entire sample, the profile analysis between the phases showed reduction in the SNA angle from T1-T2 and an increase from T2-T3. The SN-PP angle showed an increase from T1-T2 and a decrease from T2-T3. Treatment of skeletal Class II patients with slow and rapid maxillary expansions was efficient and stable over the long-term. CONCLUSIONS: The profiles of SNA and SN-PP at T1, T2, and T3 achieved with slow and rapid maxillary expansions were clinically equivalent.

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Este relato mostra tratamento Ortodôntico efetuado em paciente portador de Classe II, Divisão 1, de Angle, com sobremordida profunda e agenesía do incisivo lateral superior esquerdo, em que o espaço foi fechado ortodonticamente e o canino ocupou o lugar do incisivo lateral. Os procedimentos adotados possibilitaram a obtenção de estética agradável e relação oclusal normal. A linha mediana não apresentou desvio ao término do tratamento e a discrepância vertical foi devidamente corrigida

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