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El desarrollo craneofacial es un proceso complejo con diversos factores involucrados. Cuando las maloclusiones son de origen esqueletal pueden generar una relación ortognática (clase I), retrognática (clase II) o prognática (clase III) de la mandíbula respecto de la maxila. Esta configuración está estrechamente relacionada con la base del cráneo donde la silla turca ha sido estudiada con este fin debido a su origen ectomesenquimático (Dasgupta et al., 2018) y sus relaciones anatómicas. Diversos estudios se han realizado para dilucidar esta relación y este trabajo busca aportar a la discusión comparando las características de la silla turca entre las maloclusiones esqueletales a través de telerradiografías laterales. El estudio se realizó mediante 52 placas radiográficas de individuos de entre 18 a 24 años con igual número de sujetos masculinos y femeninos, 15 de clase I, 7 de clase II y 30 de clase III. Se realizó la medición digital del área radiográfica de la silla turca y se clasificó morfológicamente mediante las categorías de Axelsson et al. (2004). Se utilizó coeficiente de correlación intraclase con un 95 % de confianza arrojando un valor de 0,88 para el área de la silla turca, 0,89 para el ángulo ANB y de 0,70 para el valor Wits demostrando una excelente fiabilidad del observador. Con un 95 % de confianza la prueba exacta de Fisher evidenció una asociación significativa (p = 0,029) entre las variaciones morfológicas de la ST y la clase esqueletal siendo más frecuentes en clase III. La prueba H de Kruskal Wallis no arrojó diferencias significativas (p=0,550) en las medianas del área selar entre las clases esqueletales. Las variaciones morfológicas parecen ser más relevantes que las variaciones anatómicas en esta asociación. Se requieren nuevos estudios en población chilena con un mayor número de casos.

SUMMARY: Craniofacial development is a complex process with several factors involved. When malocclusions have a skeletal origin, they can generate an orthognathic (class I), retrognathic (class II) or prognathic (class III) relationship of the mandibular bone respect to the maxilla. This configuration is closely related to the base of the skull where the sella turcica has been studied for this purpose due to its ectomesenchymal origin (Dasgupta et al., 2018) and its anatomical relationships. Several studies have been conducted to elucidate this relationship and this work seeks to contribute to the discussion by comparing the characteristics of the sella turcica among skeletal malocclusions through lateral teleradiographies. The study was conducted using 52 radiographic plates of individuals between 18 and 24 years old with an equal number of male and female subjects, 15 class I, 7 class II and 30 class III. The radiographic area of the sella turcica was digitally measured and morphologically classified using the categories of Axelsson et al. (2004). An intraclass correlation coefficient was obtained with 95 % confidence, yielding a value of 0.88 for the sella turcica area, 0.89 for the ANB angle and 0.70 for the Wits value, demonstrating excellent observer reliability. With 95 % confidence, Fisher's exact test showed a significant association (p = 0.029) between the morphological variations of the ST and the skeletal class, being more frequent in class III. The Kruskal Wallis H test did not show significant differences (p=0.550) in median sellar area between skeletal classes. Morphological variations seem to be more relevant than anatomical variations in this association. New studies are required in the Chilean population with a greater number of cases.

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OBJECTIVE: To compare tooth inclinations in different sagittal skeletal patterns and transverse maxillary relationships three-dimensionally. METHODS: A cross-sectional study carried out with 132 three-dimensional digital models in the complete permanent dentition divided into six groups (n=22); three groups with maxillary atresia: G1- skeletal class I, G2- skeletal class II and G3-skeletal class III; three groups without maxillary atresia: G4- skeletal class I; G5- skeletal class II and G6- skeletal class III. The comparison between the skeletal pattern was performed by the non-parametric tests of Kruskal Wallis and Dunn and between the groups by the non-parametric test of Mann Whitney. RESULTS: Subjects with skeletal class II and maxillary atresia had a greater lingual inclination of the maxillary teeth than those with class I and III; Subjects with skeletal class II without atresia had a less lingual inclination of the mandibular molars than the other classes (p<0.05). The maxillary premolars showed no variation in dental inclination with atresia, independent of the skeletal class in G1, G2, and G3 (p>0.05). The mandibular premolars showed that the groups without atresia G4, G5, and G6 presented no significant difference (p>0.05). Lower premolars in skeletal class III malocclusion individuals with atresia had a more negative inclination than the others. CONCLUSION: There is a difference in the inclination of posterior teeth between individuals with and without maxillary atresia and skeletal classes I, II, and III.

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Objetivo: Analizar la literatura actual referente a los procesos de la determinación social y la presencia de maloclusiones dentales. Materiales y métodos: Revisión narrativa, que utilizó bases científicas como PubMed, Google Académico, ResearchGate, Scielo, Elsevier, LILACS y Semantic Scholar, usando pala-bras clave "Maloclusiones", "Determinación social de la salud", "Clase social", "Epidemiología crítica", "Salud Oral". Se incluyeron artículos actuales (últi-mos 5 años) y clásicos relevantes, libros y encues-tas nacionales de salud. Resultados: Se encontró literatura que no toma propiamente el concepto de determinación social, pero si responde a las varia-bles, clase social, género y etnia. Adicionalmente, no se encontró una tendencia clara de la prevalencia de maloclusiones y los procesos críticos de la deter-minación social. Conclusiones: La historicidad de la reproducción social podría influir en la presencia de maloclusiones dentales, sin embargo, no existen es-tudios sobre ello, por lo que, surge la necesidad de investigaciones que utilicen la metodología de la epi-demiología crítica asociada a las maloclusiones (AU)

Aim: To analyze the current literature on the processes of social determination and the presence of dental malocclusions. Materials and methods: Narrative review, using scientific databases such as PubMed, Google Scholar, ResearchGate, Scielo, Elsevier, LILACS and Semantic Scholar, using keywords "Malocclusions", "Social determination of health", "Social class", "Critical epidemiology", "Oral health". Current articles (last 5 years) and relevant classics, books and national health surveys were included. Results: Literature was found that does not properly take the concept of social determination, but it does respond to the variables social class, gender and ethnicity. In addition, no clear trend was found on the prevalence of malocclusion and the critical processes of social determinants. Conclusions: The historicity of social reproduction could influence the presence of dental malocclusions, however, there are no studies on this regard, so there is a need for research using the methodology of critical epidemiology associated with malocclusions (AU)

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Objetivo: evaluar la calidad de vida en pacientes que se encuentran en la primera fase de tratamiento de ortodoncia, ofrecido por un programa de docencia-servicio de educación superior en la ciudad de Medellín. Métodos: se realizó un estudio transversal analítico en los pacientes atendidos en el servicio de ortodoncia. La muestra estuvo compuesta por un total de 104 pacientes. Se empleó un cuestionario estructurado de 12 ítems para evaluar información sociodemográfca. Para estudiar la calidad de vida relacionada con la salud bucal (CVRSB), la cual fue medida con el OHIP-14 (Oral Health Impact Profle 14) validado en el idioma español y datos clínicos tomados en el momento de la consulta odontológica. Resultados: el promedio de edad de los participantes fue de 25,7 ± 12,1 años, edad mínima de 12 y máxima de 60. Se encontraron diferencias estadísticamente signifcativas en los mayores de 30 años y con estudios superiores, principalmente en la extensión y la severidad del impacto en la calidad de vida. Respecto al OHIP-14, el mayor impacto lo presentaron aquellos con apiñamiento severo (8,1 RIC=13), mordida borde a borde (8,0 RIC=6) y relación molar clase III (9,0 RIC=10), con diferencias estadísticamente signifcativas. Conclusiones: este estudio permitió evidenciar que, en general, el impacto en la calidad de vida del OHIP-14 en los pacientes fue bueno durante la primera fase del tratamiento y que las diferencias están relacionadas con la edad, nivel de escolaridad y características oclusales, tales como apiñamiento, overbite y relación molar.

Objective: To evaluate the quality of life in patients with orthodontic treatment in the frst phase of treatment who consult in a higher education teaching-service program in the city of Medellín. Methods: An analytical cross-sectional study was conducted in the patients treated in the orthodontic service. The sample consisted of a total of 104 patients. A 12-item structured questionnaire was used with sociodemographic information, regarding quality of life related to oral health (QOLHR), which was measured with the OHIP-14 (Oral Health Impact Profle 14) validated in the Spanish language and clinical data taken at the time of the dental consultation. Results: The average age of the participants was 25.7 ± 12.1 years, with a minimum age of 12 and a maximum of 60. Statistically signifcant diferences were found in those over 30 years of age and with higher education, mainly in the extension and severity of impact on quality of life. Regarding OHIP-14, the greatest impact was presented by those with severe crowding (8.1 IQR=13), edge-to-edge bite (8.0 IQR=6) and class III molar relationship (9.0 IQR=10), with Statistically signifcant diferences. Conclusions: This study made it possible to show that in general the impact of the quality of life of OHIP-14 in patients was good in the frst phase of treatment and that the diferences are related to age, level of education and its dimensions with occlusal characteristics such as such as crowding, overbite and molar relationship of the patients reported during orthodontic treatment.

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Asthma is a public health problem that has been widely described, but little has been reported about its effects on dental occlusions. The aim of this study was to compare the alterations of normal occlusions in asthmatic children and those without the disease. The study included 186 patients between 5 and 12 years old, divided into two groups. The first group included patients with a previous diagnosis of asthma given by a specialist, which was confirmed by using the International Study of Asthma and Allergies in Childhood questionnaire. The second group included patients without the disease. All patients underwent a clinical examination to determine the presence of occlusion alterations in the sagittal, transverse, and vertical planes. Subsequently, chi-squared tests were performed to compare the variables between the groups. A significant association was found between asthma and the variables studied here: alterations in the sagittal plane (chi2 = 7.839, p = 0.005), alterations in the vertical plane (chi2 = 13.563, p < 0.001), alterations in the transverse plane (Fisher's F p < 0.001), and oral habits (chi2 = 55.811, p < 0.001). The results suggest that asthmatic patients are more likely to develop malocclusions, especially anterior open bite and posterior crossbite. These conditions are typically related to mouth breathing, which is common in asthmatic patients.

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RESUMEN Introducción: las caries dentales y las maloclusiones son preocupaciones para pacientes y profesionales de la estomatología por su incidencia a nivel mundial, por las manifestaciones bucales que desencadenan y por la alteración estética del paciente. Objetivo: identificar la incidencia de caries, maloclusión y caries-maloclusión en adolescentes de 7mo grado de la Escuela Secundaria Básica "XXX Aniversario de la Batalla de Guisa" del municipio Bayamo. Métodos: se realizó una investigación descriptiva transversal en los adolescentes de 7mo grado en el período de enero de 2017 a diciembre de 2018 con un universo de 142 estudiantes. Resultados: se reveló que el sexo masculino tuvo una incidencia de 85,71% de afectación por caries dental, la maloclusión incidió en el 43,10 % en el sexo femenino; la incidencia de caries-maloclusión en la población objeto de estudio, fue de 29,31 % y 27,38 % según el sexo femenino y masculino respectivamente. Conclusiones: se determinó la incidencia de la caries dental, maloclusiones y caries-maloclusión las cuales tuvieron una alta incidencia en la población adolescente.

ABSTRACT Introduction: dental caries and malocclusions are concerns for patients and dental professionals due to their worldwide incidence, due to the oral manifestations that they trigger and due to the aesthetic alteration of the patient. Objective: to identify the incidence of caries, malocclusion and caries-malocclusion in 7th grade adolescents from the Basic Secondary School "XXX Anniversary of the Battle of Guisa" of the Bayamo municipality. Methods: a cross-sectional descriptive research was carried out in the 7th grade adolescents in the period from January 2017 to December 2018 with a universe of 142 students. Results: it was revealed that the male sex had an incidence of 85.71% of affectation by dental caries, the malocclusion affected 43.10% in the female sex; the incidence of caries-malocclusion in the population under study was 29.31% and 27.38% according to the female and male sex, respectively. Conclusions: the incidence of dental caries, malocclusions and caries-malocclusion was determined, which had a high incidence in the adolescent population.

RESUMO Introdução: a cárie e as maloclusões são uma preocupação dos pacientes e profissionais da odontologia devido à sua incidência mundial, pelas manifestações bucais que desencadeiam e pela alteração estética do paciente. Objetivo: identificar a incidência de cárie, má oclusão e má oclusão cárie em adolescentes da 7ª série do Ensino Médio Básico "XXX Aniversário da Batalha de Guisa" do município de Bayamo. Métodos: foi realizada uma pesquisa descritiva transversal realizada com adolescentes da 7ª série no período de janeiro de 2017 a dezembro de 2018 com um universo de 142 alunos. Resultados: revelou-se que o sexo masculino teve uma incidência de 85,71% de acometimento por cárie dentária, a má oclusão afetou 43,10% no sexo feminino; a incidência de maloclusão cárie na população em estudo foi de 29,31% e 27,38% de acordo com o sexo feminino e masculino, respectivamente. Conclusões: foi determinada a incidência de cárie dentária, maloclusões e má oclusão cárie, as quais tiveram alta incidência na população de adolescentes.

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Treacher Collins Syndrome (TCS) is a genetic disorder with predominantly autosomal dominant inheritance, associated with different mutations in specific genes. This review aimed to evaluate the facial, temporomandibular, zygomatic and bucco-dental phenotype in TCS individuals, and describe surgical and non-surgical solutions for each case in order to improve the quality of life of these individuals. A review of the literature on the craniofacial characteristics of the TCS was carried out, using the PICO strategy, and then a systematic search method was performed in Medline, Scopus, LILACS and SCIELO databases, identifying articles of impact and relevance until 10 June 2020, 240 articles were recovered and only 35 fulfilled the selection criteria. We found the main craniofacial and oral morphological characteristics of these individuals, and the possible functional alterations inducing repercussion in the stomatognathic apparatus. Among other characteristics, the most representative include hypoplasia in the zygomatic and mandibular complex, which can cause difficulty in breathing and feeding. In some cases, cleft palate and malocclusions such as anterior open bite may lead to Angle's Class II malocclusion, sometimes causing problems in the temporomandibular joint. In conclusion, individuals with TCS have specific craniofacial features including maxillary hypoplasia, altered orbital zones, mandibular retrognathia, and temporomandibular disorders. Oral deformities produce to a higher prevalence of caries and calculus formation because of poor hygiene due to the malformations present in these patients.

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Introducción: La aplicación y el análisis del índice de Bolton es necesario para establecer un plan de tratamiento correcto en pacientes con maloclusiones dentarias. Los especialistas en formación deben adquirir y aplicar este conocimiento para el desarrollo adecuado de su práctica profesional. Objetivo: Evaluar las necesidades de aprendizaje en residentes de ortodoncia sobre el uso y la interpretación del índice de Bolton y sus factores potencialmente determinantes. Métodos: Estudio descriptivo de corte transversal con enfoque cualitativo-cuantitativo, mediante encuestas anónimas y entrevistas no estructuradas a residentes y profesores del departamento de ortodoncia de la Facultad de Estomatología de La Habana, durante el curso 2017-2018. Resultados: Los residentes encuestados presentaron conocimientos insuficientes sobre el índice de Bolton. Su aplicación no fue sistemática en la educación en el trabajo y las mayores deficiencias se observaron en segundo y tercer años. Los factores potencialmente determinantes revelados resultaron la falta de uniformidad y la exigencia a los estudiantes en la evaluación de los docentes. Conclusiones: Los residentes de ortodoncia deben elevar su nivel de conocimiento sobre el análisis del índice de Bolton e incrementar su aplicación práctica mediante un sistema evaluativo más exigente y metódico(AU)

Introduction: Application and analysis of the Bolton index is necessary to establish a correct treatment plan in patients with dental malocclusions. Training specialists must acquire and apply this knowledge for the proper development of their professional practice. Objective: To assess the learning needs of Orthodontics residents regarding the use and interpretation of the Bolton index and its potentially determining factors. Methods: Descriptive and cross-sectional study with a qualitative-quantitative approach, using anonymous surveys and non-structured interviews with residents and professors of the Department of Orthodontics at the Dental School in Havana, during the academic year 2017-2018. Results: The surveyed residents showed insufficient knowledge about the Bolton index. Its application was not systematic in education at work. The greatest deficiencies were observed in the second and third academic years. The potentially determining factors revealed were lack of uniformity and professors' being demanding for student evaluation. Conclusions: Orthodontics residents should increase their level of knowledge about analysis of the Bolton index and increase its practical application through a more demanding and methodical evaluation system(AU)

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OBJECTIVE: This study aimed to compare cranial base linear and angular measurements between individuals with skeletal open bite and different sagittal skeletal relationships. MATERIALS AND METHODS: This observational and cross-sectional study included 101 lateral radiographs of young Latin-American individuals with skeletal open bite that met the inclusion criteria and were collected from a private radiological centre. Three groups were formed. Groups 1, 2 and 3 included individuals with skeletal open bite (negative overbite and FMA>30°) and Class I (n=31), II (n=35) and III (n=35) sagittal skeletal relationship, respectively. The anterior and posterior cranial bases (SN and SBa), and cranial base angles (BaSN and ArSN) were measured. Groups were compared with one-way analysis of variance and post-hoc Scheffé tests. The influence of predictor variables on the cranial base were evaluated with linear regressions (α=0.05). RESULTS: The cranial base angles were significantly smaller (approximately 3° to 5°) in the skeletal open bite Class III group (BaSN=127.97°± 5.86°, ArSN=120.19°±6.12°) when compared with the other groups. BaSN angle, Class I versus Class III (p<0.001) and Class II versus Class III (p<0.001). ArSN angle, Class I versus Class III (p=0.005) and Class II versus Class III (p=0.026). Multiple linear regressions showed that sex had a significant influence on both cranial base dimensions with men showing larger values than women. CONCLUSIONS: Skeletal open bite Class III individuals show a smaller cranial base angle than Skeletal open bite Class I or II individuals.

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ABSTRACT Objective: The present study aims at using cone beam computed tomography (CBCT) to analyze the maxillomandibular characteristics present in adults with mandibular asymmetries and different sagittal jaw relationships. Methods: 360 patients were selected and divided into three groups (Class I, Class II, and Class III), with 120 individuals per group. The groups were then subdivided according to the intensity of lateral deviation of the gnathion point, into: 1) relative symmetry, 2) moderate asymmetry, and 3) severe asymmetry. Three planes of reference were established in the CBCT images and several measurements were taken to compare the bilateral skeletal differences between the intensities of asymmetry for the different sagittal jaw relationships. Results: When the groups were compared by the intensity of asymmetry, significant differences among patients with relative symmetry and moderate to severe asymmetry were found. This was especially noticed for severe asymmetry, suggesting that the deviation of the chin did not constitute the only morphological alteration for these patients, especially because a series of measurements showed significant bilateral differences. When comparing sagittal jaw relationships, the only significant finding was the vertical positioning of the gonion between Class II and III patients with severe asymmetry. Conclusions: When comparing the three sagittal jaw relationships with the same intensity of asymmetry, most maxillofacial aspects were quite similar. The only difference was found for patients with severe asymmetry, as the individuals with Class II showed greater bilateral difference in the vertical positioning of the gonion, when compared to patients with Class III.

RESUMO Objetivo: o presente estudo teve como objetivo analisar, por meio de tomografia computadorizada de feixe cônico (TCFC), as características esqueléticas maxilomandibulares presentes em adultos com diferentes graus de assimetria mandibular e diferentes relações esqueléticas sagitais. Métodos: foram selecionados 360 pacientes, os quais foram divididos em três grupos, com 120 indivíduos cada (Classe I, Classe II e Classe III). Cada grupo foi, ainda, subdividido de acordo com a intensidade do desvio lateral do mento: 1) simetria relativa; 2) assimetria moderada; e 3) assimetria severa. Três planos de referência foram estabelecidos nas imagens de TCFC e várias medidas foram realizadas, sendo comparadas as diferenças esqueléticas bilaterais existentes entre os graus de assimetria em cada grupo, nas diferentes relações esqueléticas sagitais. Resultados: quando comparados os grupos pelos graus de assimetria, existiram diferenças significativas entre pacientes com simetria relativa e pacientes assimétricos, especialmente para a assimetria severa, sugerindo que o desvio do mento não constitui a única alteração morfológica para esses pacientes, especialmente porque uma série de medidas apresentou diferenças bilaterais significativas. Quando comparadas as relações sagitais entre si, não foram encontradas diferenças significativas, exceto para o posicionamento vertical do gônio entre as Classe II e III na assimetria severa. Conclusão: ao comparar a mesma intensidade de assimetria entre as diferentes relações esqueléticas sagitais, pouca diferença pôde ser observada. A única diferença encontrada foi em pacientes com assimetria severa, na qual os indivíduos com Classe II apresentaram maior diferença bilateral no posicionamento vertical do gônio, quando comparados àqueles com Classe III.

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Introducción: Los pacientes con el Síndrome de clase II división 2, además de presentar clínicamente una relación de molares y caninos en disto-oclusión, muestran una retroinclinación de los incisivos centrales superiores con proinclinación de los laterales y sobremordida profunda, lo cual puede llegar a convertirse en un factor de riesgo que provoca disfunción temporomandibular. Objetivo: Identificar la relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular. Material y Métodos: Se realizó una revisión bibliográfica automatizada en las bases de datos de los sistemas MEDLINE, PubMed, Hinari y Google; se utilizó un total de 17 artículos. Desarrollo: Por las características clínicas de la oclusión en los pacientes con este síndrome, el rango de movimiento mandibular está limitado, y produce un efecto traumático que se relaciona con una posición de los cóndilos desplazados hacia atrás e intruidos en la fosa glenoidea. Este desplazamiento más distal produce la presión del espacio retrodiscal ricamente inervado y sería causa de inflamación de los tejidos circundantes y afectación de la función de la articulación por elongación de los ligamentos discales o adelgazamiento del disco que afecta el complejo cóndilo-disco. Conclusiones: Los estudios consultados muestran la relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular, dada las características clínicas presentes en este síndrome, que afectan el funcionamiento de la articulación temporomandibular y que al sobrepasar las capacidades adaptativas del paciente producen la disfunción en la misma(AU)

Introduction: Patients with Syndrome type II division 2 malocclusions, besides presenting a clinically established relationship between molars and canines in a distal occlusion, show a retro-inclination of the upper front teeth with pro-inclination of the lateral incisors and a deep overbite, which can result in a risk factor of temporomandibular dysfunction. Objective: To identify the relationship between Syndrome type II division 2 malocclusions and the temporomandibular dysfunction. Material and Methods: A bibliographic review was carried out through a search of databases such as MEDLINE, PubMed, Hinari, and Scholar Google. A total of 17 articles were used. Development: Because of the clinical characteristics of the occlusion in the patients with this syndrome, the range of jaw movement is limited, producing a traumatic effect that is related with a position of the condyles displaced backward and with glenoid fossa intrusion. This more distal displacement produces the pressure of the richly innervated retrodiscal tissue, which could be the cause of inflammation of the surrounding tissues and the affectation of the joint function due to an elongation of the discal ligaments or a thinning of the disc affecting the disc-condyle complex. Conclusions: The studies conducted demonstrate the relationship between the Syndrome type II division 2 and the temporomandibular joint dysfunction, given the clinical characteristics that are present in this syndrome, which affect the functioning of the temporomandibular joint, and produce its dysfunction when exceeding the adaptive capacities of the patient(AU)

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OBJECTIVES: Dental malocclusions in modern populations would be the result of small and weak jaws developing under low masticatory loads. We assess the validity of this by characterising the external and internal morphology of mandibles affected by class II and III malocclusions and comparing them with those from individuals with different masticatory load patterns. MATERIALS AND METHODS: CTs from up to 118 individuals exerting intensive, medium and low masticatory loads with harmonic occlusion, and from class II and III individuals, were used to compare their external shape using geometric morphometrics, as well as their internal amount and distribution of cortical bone. RESULTS: The low-load groups (harmonic, class II and III occlusion) are externally more gracile than the intense and medium load groups. But more relevant in shape variation is a marked allometric pattern, which differentiates class II (small) and III (large) mandibles. Despite gracility, the relative amount of cortical bone in the low-load groups is larger than in the remaining groups. CONCLUSIONS: There is no evidence that the modern mandible, including class II and III individuals, is intrinsically small and weak. Instead, there is a rather large degree of morphological variation, which could be linked to a lack of constraints derived from low masticatory loads. Thus, the effect of other factors such as genetics, but also basal metabolism, should be looked in more depth. CLINICAL RELEVANCE: Dental malocclusions are a common disorder whose aetiology has not been unravelled, and several to be considered in the prevention and therapy of malocclusion.

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AIM: Dental arch is a dynamic structure and its size depends on genetic and environmental factors. The aim of this study was to determine lower arch dimensions in children between 8 and 16 years with anterior open bite (AOB) and normal vertical overbite (NVO). MATERIALS AND METHODS: A cross-sectional study was performed in 132 individuals with AOB and 132 with NVO between 8 and 16 years selected from public schools. Intercanine width, arch length, intermolar and interpremolar distances, and arch perimeter of the lower arch were measured in previously digitalized models using the GOM inspection program and an optical three-dimensional scanner. RESULTS: Individuals with NVO presented smaller lower arch size with statistical differences in intercanine (P = 0.024, 95% confidence interval [CI]: 0.01, 0.02) and intermolar (P = 0.000, 95% CI: -1.76, -0.53) width and nonsignificant differences in the arch perimeter (P = 0.239, 95% CI: -1.57, 0.39) according to Mann-Whitney U-test. CONCLUSION: Individuals between 8 and 16 years of age with NVO showed smaller lower dental arch than individuals with AOB in most dimensions.

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Dental implants are a common and successful option for the rehabilitation of edentulous areas. However, there are some limitations to their use. The present clinical report describes a 5-year follow-up of maxillary rehabilitation using an attachment-retained removable partial denture (RPD) associated with fixed partial denture (FPD) units as an alternative to orthodontic treatment associated with orthognathic surgery and dental implant placement. Rehabilitation with fixed prosthodontics associated with a removable partial prosthesis was proposed. For greater precision and stability, a gold attachment was prepared. The patient was very satisfied with the rehabilitation and has been clinically followed for 5 years. In cases where the use of dental implants and/or conventional FPDs is limited or not indicate the association between an FPD and an RPD by means of attachments remains an important alternative to conventional clasp-retained RPDs.

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Introdução: O objetivo desse estudo foi avaliar quantitativamente a anatomia 3D da Base do Crânio em pacientes com padrão esquelético Classe I, II e III. Material e Método: Um estudo retrospetivo, foi realizado com as imagens de TCFC de 75 pacientes. A amostra foi dividida em três grupos de acordo com o padrão esquelético de cada individuo: Classe I, II e III. As Imagens de TCFC foram reorientadas e foi realizada a segmentação dos arquivos. Foram posicionados pontos de referência em Base do Crânio, Maxila e Mandíbula. Posteriormente, foram construídos modelos volumétricos 3D da Base do Crânio, Maxila e Mandibula. Foram realizadas medidas angulares e lineares utilizando os pontos de referência. As medidas foram utilizadas para avaliar a morfologia da base do crânio e as suas correlações em diferentes padrões esqueléticos. Analise Estatística: As diferenças entre os grupos foram testadas usando o teste de ANOVA, e as correlações foram medidas utilizando o teste de correlação de Pearson. Resultados: Ainda sem muitas diferenças estatisticamente significativas entre os grupos, foram observadas algumas diferenças menores, onde a Classe II e III se comportam como extremos e a Classe I se comporta como intermediário. Foram observadas diferenças estatisticamente significativas para a posição 3D da Fossa Mandibular (p <0.05) e o Comprimento Mandibular (p <0.05). Foram verificadas correlações entre comprimento Mandibular, comprimento Maxilar e o posicionamento mandibular com uma serie de estruturas na Base do Crânio. Conclusões: Nossos resultados sugerem que o comprimento mandibular e o posicionamento da fossa mandibular podem estar relacionados com o padrão esquelético do individuo. (AU)

Introduction: The aim of this study was to quantitatively assess 3D anatomy of CB in patients with Class I, II and II skeletal patterns. Material and Methods: This retrospective study sample was composed by CBCT scans of 75 patients. The sample was divided into three groups according to the skeletal pattern: Class I, II and III. The CBCT scans were re-oriented and segmentation was performed. Landmarks were positioned in CB, Mx and Md. 3D models of CB, Mx, and Md were constructed, and linear and angular measurements was performed. Measurements were used to evaluate the CB morphology and correlations on different skeletal patterns. Statistical Analysis: The differences among groups were tested by ANOVA test and correlation was performed by Pearson correlation test. Results: Even without many significant differences between groups, were observed some differences between groups in most of the measure, where Class II and III have a greater distance between them and Class I behaves as an intermediary. Statistically significant differences were observed for 3D position of MF (p 0.05) and mandibular length (p 0.05). Correlation between MD length, Mx and Md positioning with some structures was verified. Conclusions: Our results suggested that de Md length and MF positioning can be related with de patient skeletal pattern. (AU)

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Introducción: En su evolución, la DMD afecta el sistema estomatognático, situación no explorada en nuestro país. Objetivo: Describir características clínicas orales y asociación con edad, en pacientes con distrofia muscular de Duchenne (DMD). Pacientes y Método: Estudio descriptivo, transversal en 81 pacientes con DMD del Instituto Teletón Santiago, reclutados desde agosto a noviembre 2017, con consentimiento informado. Se efectuó examen clínico diagnóstico para determinar la presencia de caries clínicas (índice ceod/COPD), índice de higiene (Índice Green y Vermillion Simplificado), presencia de maloclusiones y asociaciones de variables orales con edad. Resultados: 65,4% de los pacientes no presentaban caries ni restauraciones, registrándose un promedio COPD = 1,7 ± 1,2 y ceod= 2,1 ± 1,6. El índice de higiene oral promedio fue de 1,9 ± 0,8 considerado como regular. 67,9% de los pacientes presentaba alguna maloclusión, existiendo una relación esta- dísticamente significativa entre presencia de mordida cruzada y grupo etario (p < 0,05). Conclusiones: La menor presencia de caries clínica en pacientes con DMD a lo referido en bibliografía para pacientes sanos, podría atribuirse a los controles periódicos odontológicos otorgados por Instituto Teletón San- tiago. El aumento de las maloclusiones con el avance de la edad, podría ser un indicador del progreso de la enfermedad, ya que los cambios en la función muscular masticatoria son dependientes del tiempo y producen aumento del ancho transversal mandibular originando las maloclusiones más prevalentes como la mordida cruzada y abierta. Palabras clave: Distrofia muscular Duchenne, caries, higiene oral, malo- clusiones.

Oral characteristics of patients with Duchenne muscular dystrophy (DMD). Descriptive study Introduction: In its evolution, Duchenne muscular dystrophy (DMD) affects the stomatognathic system, a condition that has not been studied in our country. Objective: To describe the oral clinical characteristics and age-related association in patients with DMD. Patiens and Method: Cross-sectional des- criptive study including 81 patients with DMD of Instituto Teletón Santiago, recruited from August to November 2017, with informed consent. A diagnostic clinical examination was performed to establish the presence of clinical cavities (DEFT, DMFT index), oral hygiene index (Green and Vermillion, simplified), presence of malocclusions, and age-related associations. Results: 65.4% of patients did not have caries or restorations, showing an average of DMFT = 1.7 ± 1.2, and DEFT= 2.1 ± 1.6. Average oral hygiene index was 1.9 ± 0.8.which is considered regular. 67.9% of the patients had some type of malocclusion, with a statistically significant relation between the presence of cross bite and age group (p < 0.05). Conclusions: Lower presence of clinical caries in DMD patients as referred to in bibliography for healthy patients, could be due to periodic dental controls provided by Instituto Teletón Santiago. Increased ca- ses of malocclusions with age may be an indicator of progress of the disease, because changes in the function of mastication muscles are time-dependent, and increase transverse jaw width, causing more prevalent malocclusions such as cross bite and open bite. Key words: Duchenne muscular dystrophy, caries, oral hygiene, malocclu- sions.

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Aim: To determine the need for orthodontic treatment in Ecuadorian adolescents aged 13 to 18 years in Cojitambo, 2017. Materials and methods: A cross-sectional and descriptive study was made including 140 adolescents aged 13 to 18 years, 50% males. For determining the prevalence of malocclusion, a visual clinical examination was performed to obtain the data required using the Dental Aesthetic Index (DAI). Results: 37.14% of the adolescents presented a minor malocclusion (without the need for treatment), 20% a definitivemalocclusion (need for elective treatment), 30% a severe malocclusion (highly desirable treatment) and 12.86% a very severe malocclusion (mandatory treatment). No statistically significant differences were found by sex (p =0.53) or by age (p =0.05). Conclusion: There is a higher prevalence of adolescents who had a normal occlusion without the need of orthodontic treatment and the ones with the lowest prevalence were adolescents with very severe malocclusion that needed compulsory treatment, without differences by sex or age

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Antecedentes: La corrección temprana de las maloclusiones clase II asociadas a retrognatismo mandibular se logra mediante avance mandibular sostenido y continuo que no requiera colaboración del paciente. Objetivo: Describir un caso de maloclusión tratado con un nuevo arco de adelantamiento mandibular fijo (AAMF). Descripción del caso: El AAMF se usó en una paciente de 11 años y 6 meses, clase II esquelética división 1, con retrognatismo mandibular y mordida profunda. Resultados: Al año de tratamiento había cambios estéticos y funcionales. El ángulo ANB disminuyó (6,6° a 5,0°). La longitud efectiva mandibular (Co-Gn) aumentó (96,1 mm a 103,4 mm). La inclinación de incisivos superiores pasó de 28,0° a 28,4°. Los incisivos inferiores se proinclinaron levemente (26,2° a 30,9°). Las cefalometrías después de la fase de ortodoncia mostraron medidas esqueléticas estables: ANB pasó de 5,0° a 5,1° y Co-Gn se mantuvo en 103,4°. Hubo cambios en la posición de los incisivos: superiores retroinclinaron de 28,4° a 22,5° e incisivos inferiores pasaron de 30,9° a 28,2°. Conclusión: El AAMF representa una alternativa de tratamiento en denticiones mixta y permanente temprana: Por ser fijo, permite lograr avance mandibular sostenido y continuo, sin requerir colaboración del paciente, y durante el tiempo necesario para generar cambios. Por la sencillez de su estructura (maxilar cementado solo en los primeros molares maxilares), avanza la mandíbula sin fijarse a ella cada vez que el paciente cierra la boca. Además es sencillo de elaborar, cementar, activar, limpiar y mantener en boca.

Background: Early correction of class II malocclusions associated to mandibular retrognathism is possible through sustained and continuous mandibular advancement that does not require patient collaboration. Purpose: To describe a case of malocclusion treated with a new fixed mandibular advance arch (FMAA). Case description: FMAA was applied to a 11-year-6-month-old skeletal class-II, division-1 girl with mandibular retrognathism and overbite. Results: After one-year treatment, there were functional and esthetic outcomes. ANB angle was reduced from 6.6° to 5.0°. Effective mandibular length (Co-Gn) increased (96.1 mm to 103.4 mm). Upper incisors inclinations went from 28,0° to 28,4°. Lower incisors experienced slight proinclinations (26.2° to 30.9°). Cephalograms after orthodontic treatment showed stable measures: ANB went from 5.0° to 5,1° and Co-Gn remained stable in 103.4°. Upper incisors had retroinclinations from 28.4° to 22.5° and lower incisors went from 30.9° to 28.2°. Conclusion: FMAA is a treatment alternative for mixed and early permanent dentitions for being a fixed appliance, it allows advancing mandible without requiring patient collaboration and during the necessary time to obtain changes. Because of its simple structure (cemented in the maxilla only to first molars), it advances without being fixed to the mandible every time the patient closes the mouth. In addition, it is easy to make, cement, activate, clean, and keep in mouth.

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Antecedentes: La familia constituye el espacio por excelencia para el desarrollo de la identidad humana y es el primer grupo de socialización del individuo. En ella la persona adquiere sus primeras experiencias, hábitos, valores y concepciones del mundo, incluyendo la salud. Objetivo: Analizar el estado de salud bucal de las personas en relación con el funcionamiento familiar. Métodos: Se realizó un estudio descriptivo con 84 sujetos de 20 familias pertenecientes a un consultorio odontológico del municipio Plaza de la Revolución de la ciudad de La Habana, Cuba. Los pacientes contestaron encuestas de funcionamiento familiar y hábitos bucales y recibieron evaluación clínica domiciliaria (p=0,05, Chi2). Resultados: Predominó el edentulismo (53,57 %) que fue más común en personas de familias disfuncionales. El 70,24 % tenía mala higiene bucal. La mayoría de quienes tenían buena higiene bucal (88 %) pertenecían a familias funcionales. El 51,19 % se cepillaba los dientes solo dos veces al día, principalmente en aquellos de familias disfuncionales. 22,62 % de las personas informó no consumir alimentos azucarados, la mayoría de ellos de familias funcionales. El 82,05 % acudía al estomatólogo solamente cuando tenía una urgencia y eran todos de familias disfuncionales. Conclusión: El funcionamiento familiar se asoció a la salud bucal de las personas estudiadas. Se recomienda crear programas educativos de salud bucal con un enfoque familiar.

Background: Family is the space par excellence for the development of human identity and is a person's first socialization group. People have their first experiences, habits, values, and world perceptions, including health, within the family core. Purpose: To analyze oral health status of individuals regarding family functioning. Methods: A descriptive study with 84 persons of 20 families who belonged to the dental office of the Plaza de la Revolution municipality in Havana Cuba was carried out. Patients responded family functioning and oral habits surveys and underwent at-home clinical evaluations (p=0.05, Chi2). Results: Edentulism was predominant (53.57 %) mainly among individuals from dysfunctional families. 70.24 % had poor oral hygiene; however, most of those with good oral hygiene (88.00 %) belonged to functional families. 51.19 % only brushed their teeth twice a day, mainly from dysfunctional families. 22.62 % of patients reported not consuming sugary foods, most of whom belonged to functional families. 82.05 % informed seeing the dentist only when they had an dental emergency, all of them from dysfunctional families. Conclusion: Family functioning showed association with oral health status among the individuals studied. It is advisable to create family-focused preventive oral health programs.

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OBJECTIVES: The aim of this study was to evaluate the characteristics affecting different intensities of mandibular asymmetry in skeletal Class II adults using three-dimensional images. This study is clinically relevant since it allows professionals to evaluate the morphological components related to these deformities and more carefully obtain correct diagnosis and treatment plan for such patients. METHODS: Cone-beam computed tomography data of 120 Class II patients (40 with relative symmetry, 40 with moderate asymmetry, and 40 with severe asymmetry) were imported to SimPlant Ortho Pro® 2.0 software (Dental Materialise, Leuven, Belgium). Three reference planes were established and linear measurements were performed from specific landmarks to these planes, comparing the deviated side and the contralateral side in each group, as well as the differences between groups. The correlation between midline mandibular asymmetry and other variables was also evaluated. Statistical analyses considered a significance level of 5%. RESULTS: Comparing the values obtained on the deviated side and on the contralateral side, there were significant differences for patients with moderate asymmetry and severe asymmetry. However, differences were seen more often in severe mandibular asymmetries. In those patients, there was a significant correlation of the gnathion deviation with lower dental midline deviation, difference in the lateral gonion positions, difference in the mandibular rami heights, and difference in the jugale vertical displacements. CONCLUSIONS: For skeletal Class II patients with mandibular asymmetry, some craniofacial features are related to chin deviation and require proper evaluation, including the bilateral differences in the ramus height, mandibular body length, transverse and vertical positioning of the gonion and jugale points.

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