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Objective: This study aimed to compare the effect of ibuprofen and low intensity pulsed ultrasound (LIPUS) on the reduction of pain after the placement of initial archwire in orthodontic patients. Material and Methods: This double-blind clinical trial study was carried out on 60 female candidates for fixed orthodontic treatment referring to the Orthodontic Department of School of Dentistry in Mashhad University of Medical Sciences, Mashhad, Iran, during 2015-2016. The subjects were divided into four groups of ibuprofen, LIPUS, placebo, and mock LIPUS. A questionnaire and a rectangular and flexible cubic silicone were given to each patient to record the severity of pain based on the visual analog scale at specified time points (i.e., 2 h, 6 h, at bedtime, 2nd, 3rd, and 7th days after archwire placement) when biting the silicone block with the anterior and posterior teeth and without biting at all. Repeated measures analysis of variance was used in order to compare the pain severity at different time points. Results: The comparison of pain severity at various time points showed that the highest and lowest mean scores of pain were reported at bedtime and seven days after the intervention (p<0.001). In each of the three conditions (i.e., biting the silicone block with the anterior and posterior teeth and without biting the teeth) at six time points (i.e., 2 h, 6 h, at bedtime, 2nd, 3rd, and 7th days following archwire placement), no significant difference was observed in the severity of pain (p>0.05). Conclusion: In conclusion, LIPUS (with a frequency of 1 MHz and an intensity of 100 mW) and ibuprofen have no significant effects on reduction of the pain severity at different time points and various conditions in orthodontic patients.

Objetivo: Este estudio tuvo como objetivo comparar el efecto del ibuprofeno y el ultrasonido pulsado de baja intensidad (LIPUS) en la reducción del dolor después de la colocación del arco inicial en pacientes de ortodoncia. Material y Métodos: Este estudio de ensayo clínico doble ciego se llevó a cabo en 60 candidatas a tratamiento de ortodoncia fija referidas al Departamento de Ortodoncia de la Facultad de Odontología de la Universidad de Ciencias Médicas de Mashhad, Mashhad, Irán, durante 2015-2016. Los sujetos se dividieron en cuatro grupos: ibuprofeno, LIPUS, placebo y LIPUS simulado. Se entregó un cuestionario y un bloque de silicona cúbica rectangular y flexible a cada paciente para registrar la intensidad del dolor según la escala analógica visual en puntos de tiempo específicos (es decir, 2 h, 6 h, hora de acostarse, 2do, 3er y 7mo día después de la colocación del arco) al morder el bloque de silicona con los dientes anteriores y posteriores, y sin morder en absoluto. Se utilizó el análisis de varianza de medidas repetidas para comparar la intensidad del dolor en diferentes momentos.Resultados: La comparación de la intensidad del dolor en varios puntos de tiempo mostró que las puntuaciones medias de dolor más altas y más bajas se informaron a la hora de acostarse y siete días después de la intervención (p<0,001). En cada una de las tres condiciones (es decir, al morder el bloque de silicona con los dientes anteriores y posteriores, y sin morder) en seis momentos (2 h, 6 h, antes de acostarse 2do, 3er y 7mo día después de la colocación del arco), no se observó diferencia significativa en la severidad del dolor (p>0.05).Conclusión: En conclusión, LIPUS (con una frecuencia de 1 MHz y una intensidad de 100 mW) y el ibuprofeno no tienen efectos significativos en la reducción de la severidad del dolor en diferentes puntos de tiempo y diversas condiciones en pacientes de ortodoncia.

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Abstract Background Optimal orthodontic force results in maximum rate of tooth movement without tissue damage. Even though starting orthodontic treatment with a thicker archwire may shorten treatment duration, the evidence on the effect of using 0.018-inch NiTi as the first alignment archwire on pulpal blood flow (PBF) status is still scarce. Objectives to record PBF changes and pain scores associated with using 0.018-inch NiTi as the first alignment archwire during fixed orthodontic treatment. Methodology Patients were selected from subjects attending postgraduate orthodontic teaching clinics at Jordan University of Science and Technology. In total, forty healthy patients who exhibited mild lower arch crowding were included. A split-mouth trial design was used. Each patient received two archwire sizes at one time joined in the midline by crimpable hook and applied in the lower arch. Patients were assigned into one of two groups based on archwire sizes used. Group 1: 0.014-inch and 0.018-inch NiTi (Six males, 14 females aged 19.4±1.33 years) and Group 2: 0.016-inch and 0.018-inch NiTi (Seven males, 13 females aged 19.6±1.45 years). The archwire size group was randomly allocated with a 1:1 allocation ratio. A Laser Doppler Flowmeter was used to measure PBF at different time intervals (T0-T5). Pain scores were recorded using a visual analogue scale (VAS). A repeated measures ANOVA and a post-hoc Bonferroni comparison tests were conducted to examine differences at the different time points before and during orthodontic alignment. Results For all studied archwire sizes, PBF decreased 20 minutes after their placement. Most PBF changes occurred within 24hours and continued to decrease until 72 hours after archwire placement where the maximum reduction was reached. Eventually, normal values were reverted within 1 month. PBF changes were similar between all alignment - groups. Conclusions Initial orthodontic alignment with 0.018-inch NiTi does not cause irreversible changes to pulpal vasculature or produces higher pain scores.

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INTRODUCTION: It has been suggested that heat-activated NiTi archwires (HANT) speed up crowding alleviation. HANT wires are available with different austenite finish temperatures. OBJECTIVE: The aim of the present study was to compare the effectiveness of two alignment sequences using thermally activated archwires with different austenite activation temperatures for the correction of mandibular anterior crowding. MATERIAL AND METHODS: The following NiTi archwire sequence was used for both groups: 0.012 in (conventional NiTi), 0.018 in (heat-activated NiTi archwires), 0.016×0.022 in (heat-activated NiTi archwires) and 0.019×0.025 in (conventional NiTi). The conventional NiTi used for both groups belongs to the same commercial brand. Two different austenite activation temperatures (35°C and 37°C) were used for the heat-activated archwires. The primary outcome was the degree of crowding correction measured on study models. The secondary outcome was crowding survival time over a six-month period. This RTC included fifty-four patients that were randomly allocated to the two different archwire sequences. A Mann-Whitney test was used to compare the groups regarding crowding alleviation. A survival curve was created using the Kaplan-Meier method to illustrate the reduction of crowding over time. A Mantel-Cox log-rank test was used to compare survival times (until correction of crowding). RESULTS: No differences in crowding alleviation were identified between both groups (log-rank test; P=0.77). CONCLUSIONS: The two alignment sequences with different thermal activated archwires at 35°C and 37°C achieved similar clinical results during the correction of mandibular anterior crowding.

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Objetivo: Determinar si existen diferencias en el tamaño de los arcos de NiTi en los calibres 0.012, 0.014 y 0.016 de tres marcas comerciales. Material y métodos: Se utilizaron 180 arcos de NiTi de las marcas American Orthodontics, TD Orthodontics y OrthoPremium. La estadística descriptiva, la ANOVA y el Post Hoc se realizaron en el programa SPSS 18. Resultados: los arcos de American Orthodontics presentaron diferencias estadísticas significativas en la parte anterior y posterior. En los arcos superiores de TD Orthodontics se encontró contracción en el calibre 0.016. En los arcos superiores OrthoPremium presento una contracción en la parte anterior y en el arco inferior de los 10 a los 40mm. Al comparar las tres marcas se encontraron diferencias estadísticas significativas (p<0.05) entre ellas con las pruebas de ANOVA. Conclusiones: existen diferencias en los tamaños de los arcos superiores e inferiores de cada marca y entre ellas.

Objective: To determine if there are differences between the 0.012, 0.014 and 0.016 NiTi archwires of three brands. Material and methods: 180 NiTi archwires of the following brands were used: American Orthodontics, TD Orthodontics and OrthoPremium. Descriptive statistics, ANOVA and Post Hoc were performed in the SPSS 18 program. Results: The American Orthodontics archwires presented significant statistical differences in the anterior and posterior parts. In the TD Orthodontics upper archwires, contraction was found in the 0.016 caliber. In the upper archwires, OrthoPremium presented a contraction in the anterior part and in the lower archwire of 10 to 40mm. When comparing the three brands, significant statistical differences (p <0.05) were found between them with the ANOVA tests. Conclusions: there are differences in the sizes of the upper and lower archwires of each brand and between them.

Objetivo: determinar se existem diferenças no tamanho dos arcos de NiTi em calibres 0, 12, 0, 14 e 0, 16 de três marcas comerciais. Material e métodos: foram utilizados 180 arcos NiTi das marcas American Orthodontics, TD Orthodontics e OrthoPremium. Estatística descritiva, ANOVA e Post Hoc foram realizadas no programa SPSS 18. Resultados: os arcos da American Orthodontics apresentaram diferenças estatísticas significativas na parte anterior e posterior. Nos arcos superiores da TD Ortodontia foi encontrada contração no calibre 0, 16. Nos arcos superiores, o OrthoPremium apresentou contração na parte anterior e no arco inferior de 10 a 40mm. Ao comparar as três marcas, foram encontradas diferenças estatísticas significativas (p <0,05) entre elas com os testes ANOVA. Conclusões: existem diferenças nos tamanhos dos arcos superior e inferior de cada marca e entre eles.

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ABSTRACT: Orthodontic treatment (OT) is essential for the aesthetic and functional rehabilitation of the chewing apparatus, however it may lead to certain complications which can have a negative impact on patients' everyday lives. The study included patients of the Dental Teaching Clinic of Universidad de La Frontera who were undergoing OT for the first time, with the placement of their first orthodontic arch. To analyse the impact of the placement of the first arches on everyday activities (EDA), patients completed a questionnaire with questions relating to their oral condition, including: functional limitation, physical impairment, psychological malaise, physical pain and oral hygiene. The impact on EDAs was classified as high, moderate or low. The chisquared test, Student's t-test and Spearman's coefficient were applied, using a significance threshold of 5 %. Statistical analysis used the SPSS software, v. 22.0. The variables were analysed by sex and age-band. Difficulty in brushing their teeth, eating and speaking were the limitations on EDAs most frequently reported by the patients. Females presented higher scores than males (p=0.003), showing that they suffer a greater negative impact on EDAs than do males. The majority of the patients presented a low impact on EDAs after the placement of their first orthodontic arches. Physical pain after installation, and difficulty in adapting to the orthodontic apparatus were factors determining a negative impact on EDAs, affecting sleep, speech, eating and oral hygiene of patients after starting OT.

RESUMEN: El tratamiento ortodóntico (TO) es esencial para la rehabilitación estética y funcional del aparato masticatorio, sin embargo puede determinar algunas complicaciones que pueden impactar negativamente en la vida diaria de los pacientes. Fueron incluidos pacientes de la Clínica Odontológica Docente Asistencial de la Universidad de La Frontera que realizaban tratamiento ortodóntico por primera vez, con instalación del primer arco ortodóntico. Para análisis del impacto de la instalación de los primeros arcos en las actividades de vida diaria (AVD), los pacientes llenaron un cuestionario con preguntas relacionadas a su condición oral, incluyendo: limitación funcional, incapacidad física, incapacidad psicológica, dolor físico e higiene oral. El impacto en las AVDs fueclasificado como alto, moderado y bajo. Para análisis estadístico se utilizó el software SPSS v. 22.0. Fueron aplicadas las pruebas de chi-cuadrado, t-student y Spearman's coefficient, considerándose umbral de significación de 5 %. Para análisis estadístico se utilizó el software SPSS v. 22.0. Las variables fueron analizadas según sexos y rangos etarios. Dificultad para cepillar los dientes, para comer y hablar fueron las limitaciones en las AVDs más frecuentemente reportadas por los pacientes. Las mujeres presentaron mayores puntajes en relación a los hombres (p=0,003), lo que demostró que presentan mayor impacto negativo en las AVDs en relación a los hombres. La mayoría de los pacientes presentaron bajo impacto en las AVDs tras la instalación de los primeros arcos de ortodoncia. El dolor físico tras instalación y la dificultad en la adaptación con el aparato ortodóntico fueron factores que determinaron impacto negativo en las AVDs, afectando el sueño, el habla, la alimentación y la higiene oral de los pacientes que iniciaron el TO.

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Occasionally, orthodontists will be challenged to treat malocclusions and skeletal disharmonies, which by their complexity one might think that the only treatment alternative is the surgical-orthodontic approach. A male patient, aged 17 years old, was diagnosed with a skeletal Class III malocclusion, anterior open bite and negative overjet. An unpleasant profile was the patient's 'chief complaint' showing interest in facial aesthetics improvement. Nevertheless, the patient and his parents strongly preferred a non-surgical treatment approach. He was treated with a multiloop edgewise archwire to facilitate uprighting and distal en-masse movement of lower teeth, correct the Class III open bite malocclusion, change the inclination of the occlusal plane and obtain the consequent morphological-functional adaptation of the mandible. The Class III malocclusion was corrected and satisfactory changes in the patient's profile were obtained. Active treatment was completed in 2 years, and facial result remained stable at 2 years 6 months after debonding.

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Los brackets autoligantes han llegado para quedarse en la Ortodoncia actual. Sus beneficios en higiene, eficiencia, manejo del anclaje, expresión de la prescripción y rentabilidad por puntear algunas características, hacen que sean la elección de una gran parte de los Ortodoncistas clínicos. Los brackets auto-ligantes activos, buscan a través de su clip flexible, expresar la prescripción, sea ésta Roth, MBT, Andrews, CCO u otra. Es muy importante que el clínico conozca la aparatología, en su manejo y en su información, para estar seguro que lo que necesita para cada paciente en particular puede ser logrado con ella. Es fundamental que la prescripción adecuada, esté inscripta en el bracket indicado, muchas veces con fines comerciales ese binomio puede no funcionar de la mejor forma.

Self-ligating brackets have arrived to stay in actual Orthodontics. Its benefits, such as hygiene, efficiency, anchorage management, prescription expression and profitability, are some of the reasons why clinical orthodontists around the world have chosen them. Active self ligating brackets, with the performance of its active and flexible clip, look for the total expression of the selected prescription, regardless of this being Roth, MBT, Andrews, CCO or some other. It is very important for the clinician to know the selected appliance in perfection, not only its handling but also its prescription. This is the only way to ensure that the selected appliance will be the best option for some specific patient. It is mandatory that the indicated prescription be installed in the correct appliance. Sometimes commercial outcomes may not have the best results.

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A Ortodontial lingual aplica dois tipos de arco com mais frequência em sua técnica. Foi introduzido mais recentemente o arco reto lingual, depois de décadas utilizando o arco em forma de cogumelo. Alguns autores defendem o uso do arco reto por terem diversas vantagens em relação ao arco cogumelo. Porém, outros ainda persistem com o arco cogumelo como uma escolha ideal para a ortodontia lingual. Esse trabalho teve como objetivo levantar comparativamente e discutir algumas vantagens e desvantagens de ambas formas de arco. Pode-se concluir que há vantagens e desvantagens em cada tipo; o arco reto pode ser uma boa opção para o ortodontista que necessita facilitações práticas para exercer a técnica e o arco em forma de cogumelo pode ser mais confortável. O arco reto pode ser uma melhor opção quando se deseja melhor controle de torque na região anterior; o arco em forma de cogumelo pode ser uma melhor opção quando se deseja alinhamentos; e os procedimentos laboratoriais para a adoção do arco reto podem ser mais trabalhosos que o arco em forma de cogumelo.

There are two archwires commonly used for lingual orthodontics. The lingual straight-wire was recently introduced after decades using the mushroom archwire. Some authors defend the use of the straight-wire affirming it has several advantages over the mushroom archwire. However, several authors still persist with the mushroom archwire as an ideal choice for lingual orthodontics technique. This study aimed to discuss the advantages and disadvantages of both archwire types establishing a comparison between both of them. It was concluded that each one of them have its advantages and disadvantages. Straigh-wire can be a good option when a more precise control of torque in the anterior region is required. In the other hand the mushroom archwire can be more comfortable, and it can also be a better option when aiming to obtain alignments. Regarding the laboratory procedures the adoption of the straight-wire can be more laborious than the mushroom archwire.

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OBJECTIVE: The aim of this laboratory study is to evaluate the influence of the shape and the length limitation of superelastic nickel-titanium (NiTi) archwires on lower incisors inclination during alignment and leveling. METHODS: Metal teeth mounted on a typodont articulator device were used to simulate a malocclusion of the mandibular arch (-3.5 mm model discrepancy). Three different shapes (Standard, Accuform and Ideal) of superelastic NiTi archwires (Sentalloy, GAC, USA) were tested. Specimens were divided in two groups: Group I, with no limitation of the archwire length; and Group II, with distal limitation. Each group had thirty specimens divided into three subgroups differentiated by the archwire shape. All groups used round wires with diameters of 0.014-in, 0.016-in, 0.018-in and 0.020-in. The recording of all intervals was accomplished using standardized digital photographs with orthogonal norm in relation to median sagittal plane. The buccolingual inclination of the incisor was registered using photographs and software CorelDraw. RESULTS: The results were obtained using ANOVA and Tukey's test at a significant level of 5%. The inclination of the lower incisor increased in both groups and subgroups. The shape of the archwire had statistically significant influence only in Group I - Standard (11.76º), Ideal (5.88º) and Accuform (1.93º). Analyzing the influence of the length limitation, despite the mean incisor tipping in Group II (3.91º) had been smaller than Group I (6.52º), no statistically significant difference was found, except for Standard, 3.89º with limitation and 11.76º without limitation. The greatest incisor tipping occurred with the 0.014-in archwires.

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INTRODUÇÃO: em alguns casos, a extração de pré-molares torna-se necessária e nem sempre os espaços são completamente fechados após o alinhamento e nivelamento. O arco de dupla chave, ou Double Key Loop (DKL), é um arco retangular de aço para retração, com duas alças - uma mesial e outra distal ao canino. OBJETIVOS: este trabalho propôs-se a estudar o local onde a força é exercida, após a ativação desse arco, utilizando ativação na alça distal, ativação entre as alças e na alça distal, e ativação com Gurin®. MÉTODOS: foram montados nove modelos fotoelásticos de um arco dentário inferior, sem os primeiros pré-molares e os terceiros molares, com braquetes In-Ovation e arco DKL. O arco foi ativado e a região de incisivos, caninos e dentes posteriores foi fotografada, com interposição de filtros polarizadores de luz. RESULTADOS E CONCLUSÕES: após a análise do modelo fotoelástico, concluiu-se que a ativação com Gurin® pode produzir movimento de retração anterior com componente extrusivo; a ativação na alça distal pode produzir movimento de retração anterior sem componente extrusivo; e a ativação entre as alças e na alça distal pode produzir movimento de retração anterior com componente intrusivo.

INTRODUCTION: There are clinical situations in which the extraction of bicuspids becomes necessary and, eventually, the extraction spaces are completely closed after aligning and leveling the teeth. The Double Key Loop (DKL) is a stainless steel arch for retraction, with two loops (keys), one mesial and another distal to the canine. AIM: This study aims to study the area where the force is exerted after the activation of the distal loop, the activation of the loops among themselves and the distal loop, and the activation with Gurin®. METHODS: Nine photoelastic models of the inferior arch were made, without the first bicuspids and the third molars, with In-Ovation brackets and the DKL. With the interposition of polarizing filters, pictures of incisors canines and posterior teeth were taken, after the activation of the arch. RESULTS AND CONCLUSIONS: Based on the analysis of the photoelastic model, we concluded that the activation in the distal loop can produce an anterior retraction movement without an extrusive component, while the activation with Gurin® produces an extrusive component; besides that, the activation of the keys among themselves and the distal loop activation can produce an anterior retraction movement with an intrusive component.

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