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O objetivo deste relato de caso foi mostrar o tracionamento de caninos impactados em posições desfavoráveis numa paciente de 13 anos e 3 meses. Foram realizadas uma tomografia computadorizada e radiografia panorâmica inicial para averiguação da posição e angulação dos caninos. A tomografia mostrou o canino superior direito em posição horizontal em relação aos dentes adjacentes e localizado apicalmente, e o canino superior esquerdo, em uma angulação favorável para o tracionamento. A paciente foi encaminhada para extração dos caninos decíduos superiores direito e esquerdo. Em seguida, realizou-se a colagem do aparelho fixo superior com molas de secção aberta de aço inoxidável para obtenção do espaço suficiente para os caninos e, após, iniciou-se o tracionamento. Durante o tratamento ortodôntico, controles foram obtidos com tomografias após 11 meses de tratamento e dois anos pós-tratamento. Assim que ocorreu a irrupção parcial da coroa do canino superior direito na cavidade bucal, colou-se um botão, e com arcos de níquel titânio superelásticos, o dente foi tracionado lentamente (para não sofrer alterações de tecido mole) em direção ao arco dentário. Na finalização, a paciente utilizou elásticos intermaxilares para auxiliar o posicionamento correto no arco dentário. Os resultados obtidos foram muito satisfatórios considerando a angulação horizontal do canino superior direito na tomografia inicial, e obteve-se o correto encaixe dos dentes em Classe l de caninos com grande harmonia e estética.

The aim of this case report was to present the case of a 13.3 year old patient submitted to traction of impacted canine in a very unfavorable position. CT scan and initial panoramic radiograph were performed to determine the position and angulation of the canines. The CT scan showed tooth 13 in an apical position horizontally to the adjacent teeth. On the other hand, the tooth 23 was at a favorable angle for traction. The patient was referred for extraction of deciduous teeth 53 and 63. Then a fixed appliance with stainless steel open coil springs was installed to open space for the canines. After obtaining enough space in the arch, one closed coil spring was installed in the regions of canines to maintain the space and then start the traction. During orthodontic treatment CT scans performed at 11 months and again 2 years after treatment. As a part of the 13 crown erupted in the oral cavity, a button was installed and superelastic NiTi wire was used to slowly traction the tooth (not to suffer soft tissue changes) toward the arch. Following treatment, the patient wore intermaxillary elastics to aid in its final positioning. The obtained results were very satisfactory where in the initial CT scan tooth 13 was in an almost impossible angle for the traction to be performed. Proper occlusion of teeth in Class l canine relationship was achieved with great harmony and aesthetics.

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AIM: This controlled trial cephalometrically compared soft profile changes during orthodontic treatment with a banded Herbst appliance against a control group. METHODS: The sample consisted of late mixed dentition Class II division 1 malocclusion cases. The first group consisted of 29 consecutive patients (14 females and 15 males), selected prospectively and treated solely with a banded Herbst appliance; the second group consisted of 28 nontreated subjects (14 females and 14 males). Two lateral cephalograms were obtained from each patient at the beginning and immediately following the completion of the treatment/observation period (1 year). Soft tissue cephalometric variables were analyzed. Different t tests were used to compare the starting forms of the 2 groups and the changes that occurred after treatment (P <.05). RESULTS: The present study showed a modest decrease in the facial convexity, retrusion of the upper lip, and an improvement in the mentolabial angle. All these changes were statistically significant. The profile improvement in the Herbst group was likely because of the changes observed in the upper lip and, to a minor degree, in the lower lip and soft tissue pogonion. CONCLUSIONS: It can be concluded that the changes in the soft tissue profile produced by a banded-type Herbst appliance were statistically different from the control group, but not likely clinically significant. The direction and magnitude of the changes were similar to those reported for permanent dentition cases.

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INTRODUCTION: In this study, we cephalometrically compared changes in the dentoskeletal and soft tissues after orthodontic treatment of Class II Division 1 malocclusions between the cervical headgear (CHG) and the mandibular protraction appliance (MPA) followed by fixed appliances. METHODS: The sample consisted of 50 patients divided into 2 groups of 25 patients each (13 male, 12 female). Group 1 patients were treated with CHG and fixed appliance, and group 2 patients were treated with the MPA and fixed appliances. The patients were matched according to sex, age, treatment time, and initial cephalometric variables. The groups were compared regarding pretreatment stage and treatment changes, with t tests, at P <.05. RESULTS: The CHG group showed statistically greater restriction of the anterior displacement of the maxilla, improvement of the skeletal Class II relationship, decreased facial convexity, extrusion and distalization of the maxillary first molar, and extrusion of the mandibular incisors. The MPA group had statistically greater increases in maxillary length, mandibular protrusion, maxillary incisor retrusion, mesial displacement of the mandibular first molars, and protrusion of the lower lip. CONCLUSIONS: The changes in Class II malocclusion correction between the CHG and the MPA were that the CHG corrected the Class II malocclusion primarily through greater action on the maxillary skeletal and dentoalveolar structures as compared with the MPA, which corrected the malocclusion through greater action on the mandibular dentoalveolar structures.

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This study evaluated and compared the heights of the alveolar bone crests (AC) among orthodontic patients treated with either the simplified standard edgewise technique (group 1, n = 30), the edgewise straight-wire system (group 2, n = 30), or bioefficient therapy (group 3, n = 26). These 3 groups were compared with an untreated control group (group 4, n = 30). A comparison by sex of AC height was also conducted. The first premolars were extracted in every treated patient, and measurements were performed on bitewing radiographs taken after a mean posttreatment period of 2.17 years. The distances from the AC to the cementoenamel junction (CEJ) on the mesial and distal surfaces of the first molars and second premolars and on the distal surface of the canines were measured; the larger the distance, the greater the alveolar bone loss. The data were analyzed by 1-way analysis of variance and the Newman-Keuls test (P <.05) for comparison among the groups. Sex differences of the AC height were evaluated with the t test. All treated groups had larger, statistically significant CEJ-AC distances than the untreated group, primarily at the extraction areas. There were no consistent statistically significant differences in the areas among the treated groups. Mean distances of the CEJ-AC in boys were larger than or similar to those in girls. The patients in the treated groups showed a greater number of proximal surfaces with statistically significant differences between sexes, compared with the control subjects.

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O nível de pH é fator relevante na manutenção da saúde bucal, a sua variação induz a condições que favorecem o início ou o agravamento de lesões na mucosa e no órgão dental. Neste trabalho estudou-se os efeitos de alterações funcionais sistêmicas sobre o pH bucal em um grupo de 80 crianças (4-14 anos) e 30 adultos jovens (17-22) submetidos a tratamento dentário, exercícios físicos (15 minutos) e bochechos (1 minuto) com solução de fluoreto de sódio 0,05 por cento. Efeito sobre pH bucal da desidratação e da iluminação contínua por 7 dias foram verificados em 30 ratos albinos, machos, 90 dias de idade. Os resultados mostram que o pH em condições de repouso foi de X=7,1±0,2. No pré-operatório de tratamento dentário o pH foi de X=6,9±0,2; no período trans-operatório o pH foi de X=7,1±0,3 e no pós-operatório o pH foi de X=6,5±0,2. O valor de pH imediatamente após a realização de exercício físico foi de X=6,4±0,2, havendo gradativa elevação após repouso de 15 minutos (X=6,7±0,3), 30 minutos (X=6,9±0,2) e 45 minutos (X=7,2±0,3). Após bochecho com solução fluoretada o pH foi de X=7,1±0,1, ocorrendo diminuição naqueles indivíduos com pH bucal alcalino (8,0) e aumento naqueles com pH ácido (6,0). Nos ratos, os pH controle foi de X=9,5±0,5. A desidratação e a iluminação contínua provocaram diminuição no pH bucal (X=8,5±0,5 e X=8,9±0,2). Conclui-se que 1) o pH bucal é sensível às alterações funcionais sistêmicas; 2) s variações de pH podem ser corrigidas através de bochechos com solução fluoretada

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