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This study aimed to describe the changes produced on the occlusal plane (OP), the mandibular position and the dentoalveolar compensations of patients with distalization of the maxillary/mandibular arch assisted by mini-screws (MS). A descriptive case-series study was performed using the digital lateral cephalograms (DLC) of nine patients who underwent orthodontic treatment and required the use of MS for a complete distalization of the maxillary/mandibular arch. Records were collected at three different times (T1-T2-T3) and digitally analyzed (variables: Skeletal diagnosis; maxillary occlusal plane; position of the maxilla/mandible; and dentoalveolar changes of the distalization arch tracing the longitudinal axis of incisors/molars regarding the palatal/mandibular plane). Findings show that the OP varied from T1-T2-T3 in all cases, indicating its stepping or flattening. ODI, APDI, SNA, SNB, and ANB changed minimally in all cases, without variations in the mandibular position or in the skeletal diagnosis. Dentoalveolar measurements also showed differences between T1-T2-T3. In summary, conventional orthodontic treatment modified the OP during the first phase of treatment. Moreover, the distalization mechanics with MS changed the OP and produced dentoalveolar changes, mainly in the inclination of incisors and molars. Other measures considered in the study did not change substantially.

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OBJECTIVES: To synthesise the dentoalveolar, periodontal and skeletal changes that occur when using maxillary expansion techniques assisted by temporary anchorage devices compared to conventional protocols. METHODS: Five databases and grey literature were consulted, up to December 2023, focusing on intervention designs and excluding other type of studies. The quality assessment was conducted by using the adaptation for orthodontics of the CONSORT statement, the guidelines for reporting non-randomised studies, the RoB-2 tool, and the ROBINS-I tool. A descriptive summary and meta-analysis using RevMan 5.4 were performed. RESULTS: Nine clinical trials were included (n=377 patients, mean age 13.2±0.6) with a diagnosis of transverse maxillary deficiency. The analysed studies showed qualitative dentoalveolar and periodontal changes after expansion, which were greater on the maxillary first premolars in tooth-borne appliances. Meta-analyses for some effects were included from two studies (n=64); patients who used tooth-borne appliances had greater effects of buccal intercoronal width between the premolars with statistically significant differences (Std Mean difference 2.34; 95% CI: 0.04-4.65 p=0.05). Conversely, those patients who used bone-borne or hybrid appliances had greater effects of buccal intercoronal width between molars with statistically significant differences (Std Mean difference -0.64; 95% CI: -1.38-0.10; p=0.09). CONCLUSIONS: According to the studies analysed, all measurements increased in the intervention groups after expansion. Quantitative analyses show different findings at dentoalveolar level when tooth-borne, bone-borne or hybrid appliances are considered. Nevertheless, the results should be taken with caution due to the heterogeneity of the studies. The protocol was registered at PROSPERO (CRD42021283170), with no funding to report.

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OBJECTIVE: To evaluate the efficacy of microchips and 3D microsensors in the measurement of orthodontic forces. METHODS: Through September 2023, comprehensive searches were conducted on PubMed/MEDLINE, SCOPUS and SCIELO without restrictions. RESULTS: After removing duplicate entries and applying the eligibility criteria, 23 studies were included for analysis. All the studies were conducted in vitro, and slightly more than half of them were centred on evaluating orthodontic forces exerted by aligners. Eight utilized microchips as measurement tools, while the remaining studies made use of 3D microsensors for their assessments. In the context of fixed appliances, key findings included a high level of agreement in 3-dimensional orthodontic force detection between simulation results and actual applied forces. Incorporating critical force-moment combinations during smart bracket calibration reduced measurement errors for most components. Translational tooth movement revealed a moment-to-force ratio, aligning with the bracket's centre of resistance. The primary findings in relation to aligners revealed several significant factors affecting the forces exerted by them. Notably, the foil thickness and staging were found to have a considerable impact on these forces, with optimal force transmission occurring at a layer height of 150 µm. Furthermore, the type of material used in 3D-printing aligners influenced the force levels, with attachments proving effective in generating extrusive forces. Deliberate adjustments in aligner thickness were observed to alter the forces and moments generated. CONCLUSIONS: Microchips and 3D sensors provide precise and quantitative measurements of orthodontic forces in in vitro studies, enabling accurate monitoring and control of tooth movement.

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The purpose of this article was to describe a simple graphical driven method for determining the necessary two-vector mechanics (TVM) as an alternative solution to the ideal or single force. In orthodontics, some tooth movements are difficult to achieve, mainly because of the impossibility of getting the point of application for the necessary force system. Given two points in biomechanically accessible areas, adding together two vectors applied to those points will result in an equivalent force system. The method was developed based on previous research, 3,880 hypothetical cases were analyzed to determine the trends between the resulting forces and their relative locations. A graphical driven TVM method (GTVM) for establishing the necessary TVM is presented in a manner that combine different procedures from the traditional method that simplify the analysis and may allow the user to perform more complex orthodontic cases making easier to compare systems of force equivalents.

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A expansão rápida da maxila (ERM) representa o procedimento gold-standard para correção da deficiência transversal do arco dentário superior. Porém, a idade é fator limitante para o sucesso da ERM convencional. Recentemente, a expansão rápida da maxila assistida por mini-implantes (MARPE) ampliou o limite de idade para separação da sutura palatina mediana (SPM), permitindo a correção minimamente invasiva da atresia maxilar, em pacientes adultos. O objetivo deste artigo foi relatar um caso clínico de um paciente adulto com mordida cruzada posterior tratado com MARPE, avaliar os efeitos transversais, o reparo da sutura palatina mediana (SPM) e a estabilidade da expansão após 8 meses de contenção. Paciente de sexo masculino, de 25 anos de idade, apresentava-se com mordida cruzada posterior bilateral, má oclusão de Classe III bilateral e estágio de maturação da SPM avançado. Foi indicado o tratamento com MARPE com 4 parafusos, posicionados parassuturalmente, seguido de tratamento compensatório para Classe III. Após a fase ativa da expansão o aparelho foi mantido por 12 meses como contenção. Após os 6 meses foram removidas as hastes do expansor e foi instalado o aparelho fixo, com uso de elásticos intermaxilares O reparo completo da SPM foi observada após um período de 12 meses de contenção. Após a ortodontia corretiva, uma adequada relação oclusal de molar Classe I foi alcançada (AU)

Rapid palatal expansion (RPE) represents the gold-standard procedure for correcting transverse maxillary dental arch deficiency. However, age is a limiting factor for the success of conventional RPE. Recently, mini-implant-assisted rapid palatal expansion (MARPE) has extended the age limit for midpalatal suture (MPS) separation, allowing for minimally invasive correction of maxillary atresia in adult patients. The aim of this article was to report a clinical case of an adult patient with posterior crossbite treated with MARPE, to evaluate the cross-sectional effects, midpalatal suture (MPS) repair and expansion stability after 8 months of retention. A 25-year-old male patient presented with bilateral posterior crossbite, bilateral Class III malocclusion, and advanced PMS maturation stage. Treatment with MARPE with 4 screws, positioned parasuturally, was indicated, followed by compensatory treatment for Class III. After the active phase of expansion, the appliance was kept for 12 months as a retainer. After 6 months, the expander rods were removed and the fixed appliance was installed using inter maxillary elastics. Complete PMS repair was observed after a period of 12 months of retention. After corrective orthodontics, an adequate Class I molar occlusal relationship was achieved (AU)

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Orthodontic miniscrews are used to achieve absolute anchorage. Their insertion technique is simple but must be precise to avoid intra- and postoperative complications. This study aimed to review the literature on the role of digital technology in the precise placement of miniscrews and to describe the different stages of the insertion guide manufacturing chain. The databases used were PubMed, Science Direct, and Google Scholar, including the following English descriptors: "Orthodontic Anchorage Procedures," "Cone Beam Computed Tomography." Digital technology improves the accuracy of miniscrew placement by using 3D imaging to assess the quantity and quality of bone and the proximity of anatomical structures in the area to be implanted. By combining 3D imaging with the new techniques of 3D printing and virtual planning, the orthodontist can obtain a personalized placement guide for the patient using computer-aided design and manufacturing techniques. A digitally-assisted miniscrew insertion system is a promising technique for precise and safe miniscrew insertion but cannot be used routinely. Therefore, large-scale studies are needed to map miniscrew insertion in different areas, considering ethnicity, gender, and different anatomical characteristics.

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OBJECTIVE: To compare two methods of maxillary molar distalisation with skeletal anchorage using finite element analysis (FEA). METHODS: Two digitised models were created: the miniscrew-anchored distaliser, which consisted of a distalisation method anchored in a buccal miniscrew between the first molar and second premolar (Model 1), and the miniscrew-anchored palatal appliance, which consisted of a distalisation method anchored in a miniscrew on the anterior region of the palate (Model 2). FEA was used to simulate both methods, assessing teeth displacements and stress concentration. RESULTS: The miniscrew-anchored distaliser showed greater buccal than distal displacement of the first molar, while the opposite was observed in the miniscrew-anchored palatal appliance. The second molar responded similarly in the transverse and anteroposterior perspectives with both appliances. Greater displacements were observed at crown level than in apical regions. Greater stress concentration was observed at the buccal and cervical regions of the crown in the miniscrew-anchored distaliser and the palatal and cervical regions in the palatal appliance. The stress progressively spread in the buccal side of the alveolar bone for the miniscrew-anchored distaliser and in the palatal root and alveolar bone for the palatal appliance. CONCLUSION: FEA assumes that both appliances would promote maxillary molar distalisation. A skeletally anchored palatal distalisation force seems to provide a greater molar bodily movement with less undesirable effects. Greater stress is expected at the crown and cervical regions during distalisation, and the stress concentration in the roots and alveolar bone depends directly on the region the force was applied.

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The purpose of this research was the tomographic evaluation of the Mandibular Buccal Shelf (MBS) in orthodontic patients with different vertical growth pattern. An observational, descriptive, cross-sectional and retrospective study was conducted. Tomographic images of patients aged 14 to 40 years were observed and a database was formed with those that met the inclusion criteria. The sample size was 10 for each group according to vertical growth pattern (hypodivergent, normodivergent and hyperdivergent). Then four zones of frequent insertion of extralveolar mini-screws were selected in the MBS, taking as a reference the mesial and distal roots of the first and second mandibular molar. When comparing the characteristics of MBS between vertical growth patterns, between sexes and hemiarchs, no statistically significant differences were found. However, when the characteristics of MBS were compared according to the reference root, it was found that there were statistically significant differences. The vestibular area to the distal root of the second mandibular molar presented the highest values in terms of angulation, height and thickness. There are no significant differences in the bone characteristics of MBS according to vertical growth patterns, sexes or hemiarchs. Angulation, height and thickness progressively increase from the vestibular bone of the mesial root of the first mandibular molar to the distal root of the second molar.

El propósito de esta investigación fue la evaluación tomográfica de la placa ósea mandibular (POM) en pacientes de ortodoncia con diferente patrón de crecimiento vertical. Se realizó un estudio de tipo observacional, descriptivo, transversal y retrospectivo. Se observó imágenes tomográficas de pacientes de 14 a 40 años de edad y se formó una base de datos con las que cumplían los criterios de selección. El tamaño de muestra fue de 10 para cada grupo según patrón de crecimiento vertical (hipodivergentes, normodivergentes e hiperdivergentes). Luego se seleccionaron cuatro zonas de inserción frecuente de minitornillos extralveolares en la POM, tomando como referencia las raíces mesial y distal del primer y segundo molar mandibular. Al realizar la comparación de las características de la POM entre patrones de crecimiento vertical, entre sexos y hemiarcadas no se encontraron diferencias estadísticamente significativas. Sin embargo, cuando se comparó las características de la POM según la raíz de referencia se encontró que había diferencias estadísticamente significativas. La zona vestibular a la raíz distal de la segunda molar mandibular presento los mayores valores en cuanto angulación, altura y grosor. No existen diferencias significativas en las características óseas de la POM según patrones de crecimiento vertical, sexos o hemiarcadas. La angulación, la altura y el grosor aumenta progresivamente desde el hueso vestibular de la raíz mesial del primer molar mandibular hacia la raíz distal del segundo molar.

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OBJECTIVE: We report the orthodontic treatment of a class II malocclusion with anterior open bite and posterior crossbite in a patient with Down syndrome (DS) treated with mini-implants. METHODS: Treatment began with rapid maxillary expansion with a Haas appliance, followed by dental alignment and leveling with a fixed appliance and the correction of class II dental relationships with the use of orthodontic mini-implants associated with a sliding jig. RESULTS: The results obtained at the end of the treatment were satisfactory, with improvements in occlusion, including bite closure; maxillary expansion; and the correction of dental relationships. CONCLUSION: When well-planned, orthodontic treatment in a patient with DS achieves satisfactory results from a skeletal, occlusal, and facial perspective.

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INTRODUCTION: The intrusion of posterior teeth had been considered challenging up to the development of orthodontic mini implants. In periodontally compromised teeth, the challenge is even greater, because of the root resorption risk due to periodontal ligament over-compression. Still, the precise strategy to determine the force reduction level remains uncertain. OBJECTIVE: The objective of the study was to determine, by a finite element analysis (FEA), the force reduction needed to avoid root resorption and maintain the efficiency of orthodontic mechanics of periodontally compromised teeth similar to the sound one. METHODS: An anatomical model was constructed representing a premolar inserted into a maxillary bone. Based on the initial model (R0), three bone height loss conditions were simulated (R2 = 2 mm, R4 = 4 mm, and R6 = 6 mm). Two intrusive movements were simulated: pure intrusion (bilateral mini implant) and uncontrolled-tipping intrusion (buccal mini implant). The hydrostatic stress at the periodontal ligament was used to evaluate the risk of root resorption due to over-compression. RESULTS: For bilateral mini implant intrusion, the force had to be decreased by 16%, 32% and 48% for R2, R4 and R6, respectively. For buccal mini implant intrusion, the required reductions were higher (20%, 36% and 56%). A linear relationship between the intrusive force reduction and the alveolar bone height loss was observed in both intrusion mechanics. CONCLUSIONS: According to the FE results, 8% or 9.3% of force reduction for each millimetre of bone height loss is suggested for intrusion with bilateral or buccal mini implant, respectively. The buccal mini implant anchorage must be associated with a supplemental strategy to avoid buccal crown tipping.

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INTRODUCTION: The aim of the present study was to evaluate the thickness of the hard palate at the different angles formed by the palatal plane and the Frankfort horizontal line using computed tomography in patients with different facial patterns for planning the installation of MARPE. MATERIALS AND METHODS: The measurements were analysed in the hard palate of 106 patients. Four regions were selected passing through the mesial face, tangent at the level of the cemento-enamel junction of the premolars and molars. The bone thickness was measured from the floor of the nasal cavity to the cortical bone of the hard palate, 02 measurements with a distance of 05 mm between them (2.5 mm on each side starting from the midsagittal line) and 2 more with a distance of 7 mm between measurements (3.5 mm on each side starting from the midsagittal line). The palatal plane cant was determined based on the palatal plane and the Frankfort horizontal plane. The sagittal skeletal pattern was determined based on the ANB angle and the vertical skeletal pattern based on the SN.Go.Gn angle. RESULTS: Palatal bone thickness was greater in males than in females. Regarding the sagittal skeletal pattern, patients with Class II were found to have a thinner hard palate than Class I and Class III patients. No difference in the vertical skeletal pattern was observed between groups. Regarding the palatal plane cant, bone thickness was greater in patients with clockwise rotation. CONCLUSIONS: Careful planning should be considered in the case of female patients; patients with greater angles of the palatal plane cant and Class II patients have a smaller bone thickness.

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Resumo Objetivo: Demonstrar a confecção de um hyrax híbrido apoiado em mini-implante, para o tratamento da classe III. Caso clínico: Paciente D. B. S, sexo masculino, 07 anos de idade, com mordida anterior de topo e mordida cruzada posterior unilateral direita, apinhamento leve nos incisivos inferiores, perda precoce decorrente de cárie dos elementos dentários 54 e 64 e atresia maxilar, contribuindo para a diminuição do perímetro do arco. Discussão: Em pacientes que possuem deficiência maxilar o tratamento deve englobar a estimulação e o direcionamento maxilar através de forças ortopédicas. A terapia com a Expansão Rápida da Maxila (ERM) em associação com a Máscara Facial (MF) é o tratamento mais habitual para a má oclusão classe III sendo utilizada para o tratamento da maxila retruída e também para que se acelere o crescimento maxilar. A utilização da ancoragem esquelética como forma de tratamento precoce da classe III resulta em efeitos ortopédicos fundamentalmente maiores se comparado com o tratamento convencional, desta forma, permite que não haja deslocamento dentário provocado pela força exercida durante a protração maxilar e evitando perda de espaço no perímetro do arco. Conclusão: a ancoragem esquelética vem ampliando as fronteiras dos tratamentos ortodônticos e ortopédicos, aumentando, com isso, a época de início da terapia sem efeitos dentários adversos, sendo a modificação de um hyrax convencional para um híbrido uma opção de melhor custo benefício e biológico. (AU)

Abstract Objective: To demonstrate the construction of a mini-implant-supported hybrid hyrax for the treatment of class III. Case report: Patient DB S, male, 07 years old, with upper anterior bite and right unilateral posterior crossbite, light crowding of the lower incisors, early loss due to caries of the teeth 54 and 64 and maxillary atresia, contributing to the decrease in the perimeter of the arch. Discussion: In patients who have maxillary deficiency, treatment should include maxillary stimulation and direction through orthopedic forces. Therapy with Rapid Maxillary Expansion (RME) in association with Facial Mask (MF) is the most common treatment for class III malocclusion and is used for the treatment of retruded maxilla and also to accelerate maxillary growth. The use of skeletal anchorage as a form of early class III treatment results in fundamentally greater orthopedic effects compared to conventional treatment, thus allowing for no tooth displacement caused by the force exerted during maxillary protraction and avoiding loss of space in the perimeter of the bow. Conclusion: skeletal anchorage has been expanding the frontiers of orthodontic and orthopedic treatments, thereby increasing the time to start therapy without adverse dental effects, with the modification of a conventional hyrax to a hybrid being a more cost-effective and biological option. (AU)

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Objective: to analyze the stress distribution in a 3D model that simulates second molar mesialization using two different types of mini-implants. Material and Methods: a mandible bone model was obtained by recomposing a computed tomography performed by a software program. The cortical and trabecular bone, a lower second molar, periodontal ligament, orthodontic tube, resin cement and the mini-implants were designed and modeled using the Rhinoceros 4.0 software program. The characteristics of self-drilling orthodontic mini-implants were: one with 7 mm length, 1 mm transmucosal neck section and 1.6 mm diameter and another with 5 mm length and 1.5 mm diameter. A total of 235.161 and 224.505 elements were used for the mesh. These models were inserted into the bone block and then subjected to loads of 200 cN (centinewton). The results were calculated and analyzed by the Ansys 17.0 software program for qualitative verification through displacement and maximum principal stress maps. Results: it was possible to observe that the periodontal ligament presented low displacement and stress values. However, the physiological values presented are among those capable to provide orthodontic movement, with compression and tensile area visualization staggered between 0.1 and -0.1 MPa (megapascal). Conclusion: within the limitations of the study, the mini-implants tested showed similar results where the load on the tooth allowed dental displacement (molar mesialization), with a tendency to rotate it, theoretically allowing the second molar to take the location of the first molar. (AU)

Objetivo: analisar a distribuição de tensões em um modelo 3D que simula a mesialização do segundo molar usando dois tipos diferentes de mini-implantes. Material e Métodos: um modelo de osso mandibular foi obtido por recomposição de uma tomografia computadorizada realizada por um software. O osso cortical e trabecular, um segundo molar inferior, ligamento periodontal, tubo ortodôntico, cimento resinoso e os mini-implantes foram projetados e modelados no software Rhinoceros 4.0. As características dos mini-implantes ortodônticos auto perfurantes foram: um com 7 mm de comprimento, 1 mm de secção transmucosa e 1,6 mm de diâmetro e outro com 5 mm de comprimento e 1,5 mm de diâmetro. Para a malha, foram utilizados 235.161 e 224.505 elementos. Esses modelos foram inseridos no bloco ósseo e então submetidos a cargas de 200 cN (centinewton). Os resultados foram calculados e analisados pelo software Ansys 17.0 para verificação qualitativa por meio de mapas de deslocamento e tensões máximas principais. Resultados: foi possível observar que o ligamento periodontal apresentou baixos valores de deslocamento e tensões. Porém, os valores fisiológicos apresentados são capazes de proporcionar movimentação ortodôntica, com visualização da área de compressão e tração escalonada entre 0,1 e -0,1 MPa (megapascal). Conclusão: dentro das limitações do estudo, os mini-implantes testados apresentaram resultados semelhantes onde a carga sobre o dente permitiu o deslocamento dentário (mesialização do molar), com tendência a girá-lo, permitindo teoricamente que o segundo molar ocupe do lugar do primeiro molar (AU)

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ABSTRACT Objective: To evaluate the mechanical properties of mini-implants (MIs) manufactured from stainless steel and compare them with conventional titanium-aluminum-vanadium alloy MIs. Material and Methods: The following groups were formed: G1 (n=24), 8×1.5 mm steel MIs; G2 (n=24), 12×2.0 mm steel MIs; and G3 (n=24), 10×1.5 mm titanium MIs. The 72 MIs were inserted in the infra zygomatic crest region of the maxilla and retromolar trigone in the jaw of 10 pigs. Pull-out, insertion torque, fracture and percussion tests were performed in order to measure the tensile strength, primary stability and fracture strength of MIs. A digital torque gauge was used to measure insertion and fracture torque, a universal mechanical testing machine was used for pull-out testing and a periotest device was used to measure the micromovement of MIs. For morphological and MI component evaluation, scanning electron microscopy (SEM) was performed. D'Agostino & Pearson, Kruskal-Wallis, and Dunn post-hoc and normality tests were used. Results: G2 insertion and fracture torques were significantly higher than G1 and G3 insertion and fracture torques (p<0.05). The pull-out and percussion tests presented similar values among the groups. SEM revealed that the fracture point was predominantly on the fourth thread for steel MIs (G1 and G2) and on the seventh thread for titanium-aluminum-vanadium MIs (G3). Conclusion: The mechanical properties of stainless steel MIs are superior to those of titanium-aluminum-vanadium alloy MIs.

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ABSTRACT Objective: The aim of this randomized clinical trial was to evaluate and compare, during the first week of rapid maxillary expansion (RME), the impact caused by two types of appliances: Hyrax and Hybrid Hyrax. Methods: Forty-two patients who met the eligibility criteria (aged 11-14 years, with transverse maxillary deficiency, posterior crossbite, and presence of maxillary first premolars and first permanent molars) were selected and randomly divided into two groups: TBB GROUP (tooth-bone-borne expander), treated with Hybrid Hyrax (12 females and 9 males, mean age 13.3 ± 1.3 years), and TB GROUP (tooth-borne expander), treated with Hyrax (5 females and 16 males, mean age 13.3 ± 1.4 years). Pain and discomfort were assessed in two times: after the first day of activation (T1) and four days after, by means of the numerical rate scale and the instrument MFIQ (Mandibular Functional Impairment Questionnaire). Descriptive statistics and the Mann-Whitney test were used for comparison between groups and between sexes. A 5% significance level was adopted. Results: Both appliances had a negative impact, generating pain and discomfort, and reducing functional capacity. However, the scores obtained were of low intensity and no significant differences were observed between the groups. Considering sexes, there were statistically significant differences, with the female sex presenting higher scores for pain and functional limitation. Conclusions: Despite causing impact in pain and increase in the functional limitation, these changes were of low intensity, with no statistical difference between the groups. Females were more sensitive to the impact caused by the RME.

RESUMO Objetivo: O objetivo deste ensaio clínico randomizado foi avaliar e comparar, durante a primeira semana de expansão rápida da maxila (ERM), o impacto causado por dois tipos de aparelhos: Hyrax e Hyrax Híbrido. Métodos: Quarenta e dois pacientes que atendiam aos critérios de seleção (idade de 11 a 14 anos, com deficiência transversal da maxila, mordida cruzada posterior e presença de primeiros pré-molares e primeiros molares permanentes superiores) foram selecionados e divididos aleatoriamente em dois grupos: Grupo DOS (expansor dento-osseossuportado), tratado com Hyrax Híbrido (12 mulheres e 9 homens, idade média 13,3 ± 1,3 anos), e Grupo DS (expansor dentossuportado), tratado com Hyrax (5 mulheres e 16 homens, idade média de 13,3 ± 1,4 anos). A dor e o desconforto foram avaliados em dois momentos: após o primeiro dia de ativação (T1) e após quatro dias, por meio da escala de frequência numérica e do instrumento MFIQ (Questionário de Limitação Funcional Mandibular). A estatística descritiva e o teste de Mann-Whitney foram utilizados para comparação entre os grupos e entre os sexos. Adotou-se nível de significância de 5%. Resultados: Ambos os aparelhos tiveram impacto negativo, gerando dor e desconforto e reduzindo a capacidade funcional. No entanto, os escores obtidos foram de baixa intensidade e não foram observadas diferenças significativas entre os grupos. Considerando os sexos, houve diferenças estatisticamente significativas, com o sexo feminino apresentando maiores escores para dor e limitação funcional. Conclusões: Apesar de causar impacto na dor e aumento na limitação funcional, essas alterações foram de baixa intensidade, sem diferença estatística entre os grupos. As mulheres foram mais sensíveis ao impacto causado pela ERM.

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This study synthesized the scientific evidence concerning the main characteristics of the Temporary Anchorage Devices (TADs) used in orthodontics and reported the success-failure rates during treatment. For that means, this scoping review collected articles from previous research. A complementary search was carried out in the databases PubMed-MEDLINE, Scopus, LILACS, and EMBASE, focusing on original studies published from 2010 to 2020. We analyzed the main characteristics of the publications. As a result, 103 articles were included. Most of the research was conducted among different groups, who needed TADs principally in the maxilla and an interradicular location between the second premolar and first molar. AbsoAnchor, Dentos Inc., Daegu, Korea, was the most used brand of TADs. The most common characteristics of the devices and biomechanics were a diameter and length of 1.6 mm and 8 mm, a self-drilled system, a closed technique for placement, immediate loading, and forces that ranged between 40 and 800 g. Of the studies, 47.6% showed success rates ≥90%. In conclusion, high success rates were found for TADs, and differences were found according to sociodemographic and clinical variables. The studies showed variability in methodological design, and scientific publications were concentrated in certain countries. We recommend further scientific research on TADs using more standardized designs.

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The study evaluated the clinical changes of orthodontic mini-implants (MI) inserted for the purpose of anchoring during orthodontic treatment. The null hypotheses were: 1-that there is no correlation between proximity of the MI to the root and peri-implantitis or mobility; 2-that peri-implantitis does not interfere with mobility; 3-that the pain is not related to mobility or peri-implantitis. Forty (40) patients were selected and the MI were evaluated for each patient. MI in the upper and lower arch were evaluated for a period of approximately 6 months with relationship to the distance MI - root, peri-implantitis, mobility, biological damage and pain through the analysis of periapical radiography and clinical/periodontal evaluation. The evaluations were performed out by means of scores and a correlation was made between the variables. No statistically significant differences were found between the upper and lower arch in the variables evaluated, except for the mobility that was more present in the lower arch (p = 0.0336). There was a correlation between peri-implantitis and mobility (p = 0.0003) and between pain and mobility (p = 0.0443). However, there was no correlation between a greater degree of peri-implantitis and greater mobility (p = 0.7054). In addition, the MI placed too close to the root showed peri-implantitis (p = 0.0142). The null hypotheses were rejected because there was a positive correlation between the analyzes. The placement of MI close to the root led to greater peri-implantitis. Patients who reported pain had greater mobility of the MI and peri-implantitis led to greater mobility.

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Resumo A biprotrusão apresenta-se com grande frequência na clínica ortodôntica e os pacientes, em sua maioria, são tratados através de exodontias dos primeiros pré-molares com retração da bateria anterior, permitindo uma retração do lábio superior e melhora na estética, harmonia facial e função. Nestes casos é importante uma ancoragem eficiente dos dentes posteriores, evitando a mesialização dos mesmos. O presente estudo possui como objetivo relatar um caso clínico de retração anterossuperior com utilização de mini-implante em um paciente com biprotusão dentária. Paciente do sexo masculino, melanoderma, 21 anos, apresentava Padrão Facial I de Capelozza, simetria facial, perfil convexo, protrusão da maxila, mandíbula e dos incisivos, Classe I de Angle, apinhamento anterior e ausências dentárias dos elementos 15 e 26. Durante o planejamento, optou-se pela exodontia dos primeiros pré-molares inferiores, alinhamento e nivelamento, retração em massa das baterias anteriores superiores e inferiores e a utilização de mini-implante na região superior posterior direita onde necessitaria de ancoragem absoluta. Entre as diversas formas de ancoragem, a utilização de mini-implante, de acordo com a bibliografia especializada, é uma das melhores opções, proporcionando um tratamento ortodôntico de qualidade, com ancoragem absoluta e menor tempo. Além disso, apresenta pequeno tamanho, o que facilita a instalação e remoção. As forças empenhadas são determinadas pelo ortodontista, recebem carga imediata, possuem estética, conforto e baixo custo. Outros métodos raramente permitem uma ancoragem máxima, além de apresentarem dificuldade de higienização, desconforto e dependem da colaboração do paciente.(AU)

Abstract Biprotrusion is very common in the orthodontic clinic. Most of these patients are treated by extractions of the first premolars with retraction of the anterior arcade, allowing retraction of superior lip and an improvement in aesthetics, facial harmony and function. In these cases, it is important to have an efficiently anchor for posterior teeth, avoiding mesialization. This study aims to report a clinical case of anterosuperior retraction using a mini-implant in a patient with dental biprotusion. Patient, melanoderma, 21 years old, male, facial Pattern I, facial symmetry, convex profile, maxilla, mandible and incisors protrusion, Angle Class I, anterior crowding, and tooth absences 15 and 26. During the planning, we opted for the extraction of the first inferior premolars, alignment and leveling, retraction of anterior teeth in superior and inferior arcade, and the use of mini-implants in the superior posterior right region where it would require absolute anchorage. Among the various forms of anchorage, the use of mini-implant, according to the specialized bibliography, is one of the best options, it leads a quality orthodontic treatment, absolute anchorage in a shorter period of time. In addition, they are small in size which facilitates installation and removal. The force applied is determined by the orthodontist, they receive immediate load, they have a good aesthetics, comfort and they have low cost. Other methods rarely allow maximum anchorage, and usually present difficulties in hygiene, discomfort, and depend on the patients collaboration (AU)

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Resumo O presente estudo teve como objetivo avaliar, por meio de uma revisão sistemática da literatura, a melhor área anatômica para instalação de mini-implantes extra-alveolares na mandíbula, região do buccal shelf. A pesquisa foi realizada nas bases de dados PUBMED, SCOPUS, WEB OF SCIENCE e COCHRANE LIBRARY, de setembro de 2019 a março de 2020. A estratégia de busca incluiu termos relativos a mini-implantes extra-alveolares, ancoragem esquelética e espessura da cortical óssea mandibular e resultou em 18585 títulos/resumos, sendo nove artigos lidos integralmente. Foram selecionados cinco artigos para avaliação metodológica, após aplicação dos critérios de inclusão e exclusão. Todos os estudos foram retrospectivos e a maioria com nível de evidência moderado. Os resultados revelaram uma alta taxa de sucesso dos mini-implantes extra-alveolares (em torno de 90%) e, quanto à região anatômica, a área correspondendo à distal do segundo molar apresentou maior espessura da cortical e largura óssea. No entanto quanto mais distal ao segundo molar, maior a proximidade do nervo alveolar inferior. Foram observadas variações individuais, mas faltam evidências científicas em relação às possíveis variáveis de interferência tais como tipo de má oclusão, padrão de crescimento, tipo racial, idade e gênero. Conclui-se que os mini-implantes extra-alveolares na região do buccal shelf são recursos eficientes de ancoragem e o local mais adequado para a instalação foi a região vestibular aos segundos molares, a uma distância de 4mm a 8mm da junção cemento esmalte, com um ângulo de 700 a 900 com o plano oclusal mandibular.(AU)

Abstract The present study aimed to evaluate, through a systematic review of the literature, the best anatomical area for the installation of extra-alveolar mini-implants in the mandible, buccal shelf region. The research was conducted in the PUBMED, SCOPUS and WEB OF SCIENCE databases and COCHRANE LIBRARY from September 2019 to March 2020. The search strategy included terms related to extra-alveolar mini-implants, skeletal anchorage and thickness of the mandibular bone cortex and resulted in 18585 titles/abstracts of which nine articles were read in full. Five articles were selected for methodological evaluation after the application of the inclusion and exclusion criteria. All the studies were retrospective and most of them with a moderate level of evidence. The results revealed a high success rate of the extra-alveolar miniimplants (around 90%), and in relation to the anatomical region, the area corresponding to the distal of the second molar presented greater cortical thickness and bone width. However, the more distal to the second molar, the greater the proximity of the inferior alveolar nerve. Individual variations were observed, but scientific evidence is lacking regarding the possible interference variables, such as malocclusion type, growth pattern, racial type, age and gender It was concluded that extra-alveolar mini-implants in the buccal shelf region are efficient anchoring resources and the most appropriate place for the installation was the vestibular region to the second molars, at a distance of 4mm to 8mm from the cementoenamel junction, with angulation ranging from 70 to 90 degrees in relation to the mandibular occlusal plane. (AU)

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Resumo Esta pesquisa busca demonstrar a utilização de sistemas de ancoragem absoluta focados na instalação extra-alveolar, principalmente, nas regiões conhecidas como prateleira bucal (buccal shelf-BC) e na crista infrazigomática (Infrazygomatic Crest-IZC). Através de pesquisas realizadas em portais especializados, como o Scielo e Google Scholar, selecionou-se uma série de artigos, periódicos, monografias e dissertações especializados na área. Verificando, principalmente através das pesquisas de Chang e Almeida, as principais áreas de instalação, o tamanho recomendado dos parafusos de acordo com o tipo de instalação, quais os métodos que proporcionam maior estabilidade ao parafuso, as principais indicações de uso, os benefícios incorridos no tratamento ortodôntico, assim como as contraindicações decorrentes do estado do paciente. Observando os diversos critérios elencados, pode-se verificar diversas vantagens dos miniparafusos extra-alveolares em relação aos intra-alveolares, principalmente, com relação à estabilidade decorrida pelo sistema extra-alveolar, permitindo o uso de parafusos com maior calibre sem afetar as raízes dentárias, podendo dessa maneira inclusive realizar a retração ou a mesialização de toda uma arcada, diminuindo sobremaneira as extrações dentárias e também corrigindo as divergências do plano oclusal. (AU)

Abstract This research aims to demonstrate the use of absolute anchoring systems focused on extra-alveolar installation, especially in regions known as buccal shelf-BC and infrazygomatic crest (IZC). Through research carried out in specialized portals, such as Scielo and Google Scholar, a series of articles, journals, monographs, and dissertations specialized in the area were selected. Checking, mainly through research of Chang and Almeida, the main installation areas, the recommended size of the screws according to the type of installation, which methods provide greater stability to the screw, the main indications of use, the benefits incurred to orthodontic treatment, as well as the contraindications resulting from the patient's condition. Observing the various criteria listed, several advantages of extra-alveolar mini-screws can be verified in relation to intra-alveolar screws, especially in relation to the stability eluded by the extra-alveolar system, allowing the use of screws with greater caliber without affecting the dental roots, thus being able to perform the retraction or mesyalization of an entire arch, reducing dental extractions in the way and also correcting the divergences of the occlusal plane.(AU)

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