RESUMO
OBJECTIVE(S): This study compared buccal bone thickness, dental inclinations and maxillary transverse width dimensions changes between auxiliary beta-titanium expansion arch (AEA) and miniscrew-assisted rapid palatal expansion (MARPE). MATERIALS AND METHODS: The sample consisted of 29 patients, aged between 18 and 40 years, with transverse maxillary deficiency and treated without extractions, divided into two groups: group AEA: comprised 13 individuals (initial mean age: 29.23 ± 9.13 years) treated using auxiliary beta-titanium expansion arch; group MARPE: comprised 16 patients (initial mean age: 24.92 ± 7.60 years) treated with miniscrew-assisted rapid palatal expansion. Buccal bone thickness, dental inclinations and transverse width dimensions (dental, nasal base and jugular) were measured in cone-bean computed tomographies at pre- and post-treatment stages. The variables were compared using the independent t-test. RESULTS: The buccal bone thickness was similar for both groups at the post-treatment stage. The second premolars were significantly more buccal inclined in the AEA group and the right maxillary first molars in the MARPE group. The intercanine and intermolar distances were statistically significantly greater in the MARPE group. Changes in dental arch transverse dimensions were significantly greater for the MARPE group. CONCLUSION: Both treatment protocols corrected the maxillary transverse discrepancy; however, MARPE provided greater correction.
Assuntos
Parafusos Ósseos , Tomografia Computadorizada de Feixe Cônico , Maxila , Procedimentos de Ancoragem Ortodôntica , Técnica de Expansão Palatina , Titânio , Humanos , Técnica de Expansão Palatina/instrumentação , Maxila/diagnóstico por imagem , Titânio/química , Adulto , Adolescente , Feminino , Masculino , Adulto Jovem , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico , Arco Dental/diagnóstico por imagem , Arco Dental/patologia , Dente Molar/diagnóstico por imagem , CefalometriaRESUMO
The aim of this study was to determine the differences in arch length, inter-canine distance, inter-premolar distance, intermolar distance and arch shape between dental discrepancies (crowding and spacing) in a sample of dental casts from the Afro-Colombian population of San Basilio de Palenque. An analytical, cross-sectional study was conducted on a convenience sample of 63 subjects aged 11 to 57years, of Afro-Colombian origin, with full dentition from first molar to first molar, without extensive caries or restorations, and excluding casts with defects due to loss. The differences between arch (upper and lower) variables were analyzed according to dental discrepancies. Plaster models digitalized with a TR1OS3 Mono scanner with exactitude (6.9 ± 0.9 pm) and precision (4.5 ± 0.9 pm) were analyzed with Orthonalyzer software. Statistical analyses were done on SPSS software (Version 20 for Windows) and Real Statistics. Spacing discrepancy of68.25% was found for upper arch and 66.66% for lower arch; crowding discrepancy of 19.04% for upper arch and 20.63% for lower arch, and an adequate ratio of 12.69% for both arches. No statistically significant difference (p>0.05) was found between arch parameters except for inter-premolar distance on the lower arch. The most frequent arch shape in the population was oval for both upper arch, with 76.19%, and lower arch, with 71.42%. Tooth size was larger in males than females but the difference was not statistically significant.
El objetivo de este estudio fue determinar las diferencias en longitud de arco, distancia intercanina, interpremolar, intermolar y la forma de arco entre discrepancias dentales (apiñamiento y espaciamiento), en una muestra de modelos dentales de la población afrocolombiana de San Basilio de Palenque. Se realizó un estudio analítico transversal, en una muestra por conveniencia de 63 sujetos con un rango de edad entre 11 y 57 años, de origen afrocolombiano, quienes tuvieron dentición completa de primer molar a primer molar, sin caries extensas, ni restauraciones; se excluyeron los modelos con defectos por el vaciado. Se analizaron las diferencias entre las variables de los maxilares (superior e inferior) con las discrepancias dentales. Se utilizaron modelos de yeso que fueron digitalizados con el escánerTR1OS3 Mono con una exactitud de (6.9 ± 0.9 pm) y una precisión de (4.5 ± 0.9 pm)y analizados con el software Orthonalyzer. Los análisis estadísticos se llevaron a cabo utilizando el software SPSS (Versión 20 para Windows) y Real Statistics. Se encontró una discrepancia de espaciamiento de un 68,25% para el arco superior y 66,66% en el arco inferior; y una discrepancia de apiñamiento en el arco superior de 19,04% e inferior de 20,63% y una relación adecuada de 12,69% para los dos arcos. No se encontraron diferencias estadísticamente significativas (p>0.05) en los parámetros de arco a excepción de la distancia interpremolar del arco inferior. La forma de arco más frecuente en la población fue ovalada tanto en el arco superior con un 76,19% como en el arco inferior con un 71,42%. En cuanto al tamaño dental, se presentó mayor tamaño en los hombres que en las mujeres, pero este no fue estadísticamente significativo.
Assuntos
Arco Dental/patologia , Má Oclusão/etiologia , Coroa do Dente/patologia , Adolescente , Adulto , Cefalometria/estatística & dados numéricos , Criança , Colômbia/epidemiologia , Estudos Transversais , Coroas , Diastema/etiologia , Feminino , Humanos , Masculino , Má Oclusão/epidemiologia , Má Oclusão/patologia , Maxila/patologia , Pessoa de Meia-Idade , Modelos Dentários , Odontometria/estatística & dados numéricos , Tamanho do Órgão , Adulto JovemRESUMO
The aim of this study was to determine the differences in arch length, inter-canine distance, inter-premolar distance, intermolar distance and arch shape between dental discrepancies (crowding and spacing) in a sample of dental casts from the Afro-Colombian population of San Basilio de Palenque. An analytical, cross-sectional study was conducted on a convenience sample of 63 subjects aged 11 to 57years, of Afro-Colombian origin, with full dentition from first molar to first molar, without extensive caries or restorations, and excluding casts with defects due to loss. The differences between arch (upper and lower) variables were analyzed according to dental discrepancies. Plaster models digitalized with a TR1OS3 Mono scanner with exactitude (6.9 ± 0.9 pm) and precision (4.5 ± 0.9 pm) were analyzed with Orthonalyzer software. Statistical analyses were done on SPSS software (Version 20 for Windows) and Real Statistics. Spacing discrepancy of68.25% was found for upper arch and 66.66% for lower arch; crowding discrepancy of 19.04% for upper arch and 20.63% for lower arch, and an adequate ratio of 12.69% for both arches. No statistically significant difference (p>0.05) was found between arch parameters except for inter-premolar distance on the lower arch. The most frequent arch shape in the population was oval for both upper arch, with 76.19%, and lower arch, with 71.42%. Tooth size was larger in males than females but the difference was not statistically significant.
El objetivo de este estudio fue determinar las diferencias en longitud de arco, distancia intercanina, interpremolar, intermolar y la forma de arco entre discrepancias dentales (apiñamiento y espaciamiento), en una muestra de modelos dentales de la población afrocolombiana de San Basilio de Palenque. Se realizó un estudio analítico transversal, en una muestra por conveniencia de 63 sujetos con un rango de edad entre 11 y 57 años, de origen afrocolombiano, quienes tuvieron dentición completa de primer molar a primer molar, sin caries extensas, ni restauraciones; se excluyeron los modelos con defectos por el vaciado. Se analizaron las diferencias entre las variables de los maxilares (superior e inferior) con las discrepancias dentales. Se utilizaron modelos de yeso que fueron digitalizados con el escánerTR1OS3 Mono con una exactitud de (6.9 ± 0.9 pm) y una precisión de (4.5 ± 0.9 pm)y analizados con el software Orthonalyzer. Los análisis estadísticos se llevaron a cabo utilizando el software SPSS (Versión 20 para Windows) y Real Statistics. Se encontró una discrepancia de espaciamiento de un 68,25% para el arco superior y 66,66% en el arco inferior; y una discrepancia de apiñamiento en el arco superior de 19,04% e inferior de 20,63% y una relación adecuada de 12,69% para los dos arcos. No se encontraron diferencias estadísticamente significativas (p>0.05) en los parámetros de arco a excepción de la distancia interpremolar del arco inferior. La forma de arco más frecuente en la población fue ovalada tanto en el arco superior con un 76,19% como en el arco inferior con un 71,42%. En cuanto al tamaño dental, se presentó mayor tamaño en los hombres que en las mujeres, pero este no fue estadísticamente significativo.
Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Coroa do Dente/patologia , Arco Dental/patologia , Má Oclusão/etiologia , Tamanho do Órgão , Cefalometria/estatística & dados numéricos , Estudos Transversais , Colômbia/epidemiologia , Coroas , Modelos Dentários , Diastema/etiologia , Má Oclusão/patologia , Má Oclusão/epidemiologia , Maxila/patologia , Odontometria/estatística & dados numéricosRESUMO
This study aimed to compare the linear dimensions of the dental arches of adult patients with complete unilateral cleft lip and palate (UCLP) after orthodontic and prosthetic treatment with fixed partial dentures (FPD) to patients without clefts, using 3D technology. This retrospective longitudinal study sample consisted of 35 subjects divided into two groups. Included in this sample were 15 complete UCLP individuals who had received orthodontic treatment before rehabilitation with a fixed partial denture (FG), as well as 20 patients without cleft as control group (CG). All patients were aged between 18 and 30 years. Digital dental casts were obtained in two stages: (T1) end of orthodontic treatment and (T2) one year after prosthetic rehabilitation (FG); and (T1) end of orthodontic treatment and (T2) one year after removal of the orthodontic appliance (CG). Intercanine, interfirst premolar and intermolar distances, and incisor-molar length were obtained. A precalibrated and trained examiner performed the assessments. Intergroup differences between T2 and T1 were compared between the groups using the t test or Mann-Whitney test with a significance level of 5% (p<0.05). The intercanine distance variation (T2-T1) showed statistical difference (p=0.005) increasing in the FG group and decreasing in the CG group. In the interfirst premolar distance variation, FG decreased, while CG increased with statistically significant difference (p=0.008). The intercanine distance of individuals with cleft showed stability, while that of the CG had no stability. The CG showed stability in the interfirst premolar distance, while FG had no stability. These findings showed that the FPD is capable of restricting orthodontic results, leading to a stabilization of the dental arches.
Assuntos
Fenda Labial/reabilitação , Fissura Palatina/reabilitação , Arco Dental/patologia , Prótese Dentária Fixada por Implante/métodos , Imageamento Tridimensional/métodos , Ortodontia Corretiva/métodos , Adolescente , Adulto , Pontos de Referência Anatômicos , Fenda Labial/patologia , Fissura Palatina/patologia , Feminino , Humanos , Masculino , Maxila/patologia , Aparelhos Ortodônticos , Valores de Referência , Estudos Retrospectivos , Estatísticas não Paramétricas , Resultado do Tratamento , Adulto JovemRESUMO
Abstract This study aimed to compare the linear dimensions of the dental arches of adult patients with complete unilateral cleft lip and palate (UCLP) after orthodontic and prosthetic treatment with fixed partial dentures (FPD) to patients without clefts, using 3D technology. This retrospective longitudinal study sample consisted of 35 subjects divided into two groups. Included in this sample were 15 complete UCLP individuals who had received orthodontic treatment before rehabilitation with a fixed partial denture (FG), as well as 20 patients without cleft as control group (CG). All patients were aged between 18 and 30 years. Digital dental casts were obtained in two stages: (T1) end of orthodontic treatment and (T2) one year after prosthetic rehabilitation (FG); and (T1) end of orthodontic treatment and (T2) one year after removal of the orthodontic appliance (CG). Intercanine, interfirst premolar and intermolar distances, and incisor-molar length were obtained. A precalibrated and trained examiner performed the assessments. Intergroup differences between T2 and T1 were compared between the groups using the t test or Mann-Whitney test with a significance level of 5% (p<0.05). The intercanine distance variation (T2-T1) showed statistical difference (p=0.005) increasing in the FG group and decreasing in the CG group. In the interfirst premolar distance variation, FG decreased, while CG increased with statistically significant difference (p=0.008). The intercanine distance of individuals with cleft showed stability, while that of the CG had no stability. The CG showed stability in the interfirst premolar distance, while FG had no stability. These findings showed that the FPD is capable of restricting orthodontic results, leading to a stabilization of the dental arches.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Ortodontia Corretiva/métodos , Fenda Labial/reabilitação , Fissura Palatina/reabilitação , Prótese Dentária Fixada por Implante/métodos , Imageamento Tridimensional/métodos , Arco Dental/patologia , Aparelhos Ortodônticos , Valores de Referência , Estudos Retrospectivos , Fenda Labial/patologia , Fissura Palatina/patologia , Resultado do Tratamento , Estatísticas não Paramétricas , Pontos de Referência Anatômicos , Maxila/patologiaRESUMO
INTRODUCTION: In this study, we aimed to determine the effect of maxillary and mandibular posterior space discrepancies and third molar angulations on the overbite. METHODS: Pretreatment lateral cephalograms of 131 subjects were analyzed. The sample included 83 open-bite and 48 deepbite subjects. A multiple regression analysis was used to evaluate the influence of maxillary and mandibular posterior space discrepancies and third molar angulations (predictor variables) on overbite. Correlations between posterior space discrepancy and third molar angulation, and correlations between predictor variables and dental angulation and height of posterior teeth and incisors were evaluated with the Pearson correlation coefficient. Subgroups with accentuated negative overbite and deepbite (27 open-bite, 37 deepbite) were compared with t tests. RESULTS: The multiple linear regression analysis showed a positive association of the mesial angulation of the mandibular third molar with overbite. Posterior space discrepancy was negatively associated with posterior teeth mesial angulation and dentoalveolar height. However, these associations were weak, with no clinically significant implications. The deepbite subgroup showed significantly greater mesial angulation of the mandibular third molars than did the open-bite subgroup. CONCLUSIONS: There was no clinically significant effect of posterior space discrepancies and third molar angulations on overbite and dental angulation and height of posterior teeth and incisors.
Assuntos
Incisivo/anatomia & histologia , Má Oclusão Classe II de Angle/patologia , Dente Serotino/anatomia & histologia , Sobremordida , Dente Impactado/complicações , Adolescente , Pontos de Referência Anatômicos , Brasil , Criança , Arco Dental/patologia , Feminino , Humanos , Incisivo/patologia , Modelos Lineares , Masculino , Mandíbula , Maxila , Dente Serotino/diagnóstico por imagem , Mordida Aberta , Erupção Dentária , Dente Impactado/patologiaRESUMO
OBJECTIVE: This study aimed to perform a longitudinal morphometric analysis of the alterations of the maxillary dental arches in children with cleft lip and palate before and after primary lip and/or palate surgeries using a 3-dimensional stereophotogrammetry system. STUDY DESIGN: The sample consisted of dental casts of 60 children with complete unilateral cleft lip (UCL) and complete unilateral cleft lip and palate (UCLP). Dental arches were evaluated before cheiloplasty (T1), after cheiloplasty (T2), and 1 year after palatoplasty (T3). Independent t test and Mann-Whitney U test were used for intergroup comparisons, and paired t test, Wilcoxon's test, and repeated-measures analysis of variance (ANOVA), followed by Tukey's test, were used for intragroup comparisons. RESULTS: At T1, the intercanine and intertuberosity distances in the UCLP group were statistically greater than those in the UCL group. At T2, the maxillary dimensions significantly increased, except for the intertuberosity distance in UCL. Between T1 and T3, the intercanine distance and the anterior length decreased significantly, whereas the intertuberosity distance and the total length of the palate increased significantly. CONCLUSIONS: Our results indicated that the primary lip surgery altered the development of dental arches, evidently in children with UCLP. The primary palate surgery interfered in the growth of the anterior palatal region in the UCLP group. Children with UCLP had more restricted development of the maxillary dental arch compared with children with UCL.
Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Arco Dental/crescimento & desenvolvimento , Imageamento Tridimensional , Maxila/crescimento & desenvolvimento , Fotogrametria , Pontos de Referência Anatômicos , Arco Dental/diagnóstico por imagem , Arco Dental/patologia , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Maxila/diagnóstico por imagem , Maxila/patologia , Modelos DentáriosRESUMO
The teeth become very close to each other when they are crowded, but their structures remain individualized and, in this situation, the role of the epithelial rests of Malassez is fundamental to release the EGF. The concept of tensegrity is fundamental to understand the responses of tissues submitted to forces in body movements, including teeth and their stability in this process. The factors of tooth position stability in the arch - or dental tensegrity - should be considered when one plans and perform an orthodontic treatment. The direct causes of the mandibular anterior crowding are decisive to decide about the correct retainer indication: Should they be applied and indicated throughout life? Should they really be permanently used for lifetime? These aspects of the mandibular anterior crowding and their implication at the orthodontic practice will be discussed here to induct reflections and insights for new researches, as well as advances in knowledge and technology on this subject.
Assuntos
Incisivo/patologia , Má Oclusão/etiologia , Má Oclusão/patologia , Mandíbula/patologia , Perda do Osso Alveolar , Arco Dental/anatomia & histologia , Arco Dental/patologia , Humanos , Incisivo/anatomia & histologia , Mandíbula/anatomia & histologia , Contenções Ortodônticas , Dente/patologia , Erupção Dentária , Técnicas de Movimentação DentáriaRESUMO
The purpose of this paper was to emphasize the importance of the orthodontic setup in treatment planning for skeletal Class III malocclusion correction in an adult patient with moderate lower anterior crowding and anterior crossbite associated with two supernumerary lower incisors.
Assuntos
Má Oclusão Classe III de Angle/cirurgia , Má Oclusão Classe III de Angle/terapia , Ortodontia Corretiva/métodos , Planejamento de Assistência ao Paciente , Cefalometria/métodos , Arco Dental/patologia , Arco Dental/cirurgia , Estética Dentária , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Incisivo/patologia , Má Oclusão/diagnóstico por imagem , Má Oclusão/terapia , Má Oclusão Classe III de Angle/diagnóstico por imagem , Desenho de Aparelho Ortodôntico , Braquetes Ortodônticos , Fios Ortodônticos , Ortodontia Corretiva/instrumentação , Fotografia Dentária , Radiografia Dentária , Extração Dentária , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Dente Supranumerário/terapia , Resultado do Tratamento , Adulto JovemRESUMO
ABSTRACT The purpose of this paper was to emphasize the importance of the orthodontic setup in treatment planning for skeletal Class III malocclusion correction in an adult patient with moderate lower anterior crowding and anterior crossbite associated with two supernumerary lower incisors.
RESUMO O objetivo desse artigo é enfatizar a importância do setup ortodôntico no planejamento do tratamento da má oclusão de Classe III esquelética de uma paciente adulta com apinhamento anteroinferior moderado e mordida cruzada anterior associada à presença de dois incisivos inferiores supranumerários.
Assuntos
Humanos , Feminino , Adulto Jovem , Ortodontia Corretiva/métodos , Planejamento de Assistência ao Paciente , Má Oclusão Classe III de Angle/cirurgia , Má Oclusão Classe III de Angle/terapia , Fios Ortodônticos , Ortodontia Corretiva/instrumentação , Extração Dentária , Técnicas de Movimentação Dentária/instrumentação , Processamento de Imagem Assistida por Computador/métodos , Radiografia Dentária , Cefalometria/métodos , Resultado do Tratamento , Braquetes Ortodônticos , Desenho de Aparelho Ortodôntico , Fotografia Dentária , Arco Dental/cirurgia , Arco Dental/patologia , Estética Dentária , Incisivo/patologia , Má Oclusão/terapia , Má Oclusão/diagnóstico por imagem , Má Oclusão Classe III de Angle/diagnóstico por imagemRESUMO
ABSTRACT The teeth become very close to each other when they are crowded, but their structures remain individualized and, in this situation, the role of the epithelial rests of Malassez is fundamental to release the EGF. The concept of tensegrity is fundamental to understand the responses of tissues submitted to forces in body movements, including teeth and their stability in this process. The factors of tooth position stability in the arch - or dental tensegrity - should be considered when one plans and perform an orthodontic treatment. The direct causes of the mandibular anterior crowding are decisive to decide about the correct retainer indication: Should they be applied and indicated throughout life? Should they really be permanently used for lifetime? These aspects of the mandibular anterior crowding and their implication at the orthodontic practice will be discussed here to induct reflections and insights for new researches, as well as advances in knowledge and technology on this subject.
RESUMO Os dentes ficam muito próximos quando estão apinhados, mas suas estruturas permanecem individualizadas e, nessa situação, o papel dos restos epiteliais de Malassez é fundamental para liberar o EGF. A tensigridade é um conceito chave para compreender as respostas dos tecidos submetidos às forças nos movimentos corporais, incluindo os dentes e sua estabilidade nesse processo. Os fatores da estabilidade de posição de um dente na arcada dentária — ou tensigridade dentária — devem ser considerados quando se planeja e finaliza um caso na prática clínica ortodôntica. As causas diretas do apinhamento dentário anteroinferior são determinantes para se refletir se a contenção deve ser mesmo indicada e aplicada por toda a vida e se, necessariamente, deve ser usada de forma permanente. Esses aspectos do apinhamento dentário anteroinferior e suas implicações na prática clínica serão aqui abordados para induzir reflexões e insights de novas pesquisas, bem como avanços no conhecimento e tecnologia sobre esse assunto.
Assuntos
Humanos , Incisivo/patologia , Má Oclusão/etiologia , Má Oclusão/patologia , Mandíbula/patologia , Dente/patologia , Erupção Dentária , Técnicas de Movimentação Dentária , Perda do Osso Alveolar , Contenções Ortodônticas , Arco Dental/anatomia & histologia , Arco Dental/patologia , Incisivo/anatomia & histologia , Mandíbula/anatomia & histologiaRESUMO
This study aimed to present two papers that show the alterations in the dental arch dimensions of children with cleft lip and palate before and after the primary surgeries. The first study aimed to evaluate the dimensional alterations of the dental arches of neonates with unilateral complete cleft lip and palate before and after two different primary plastic surgeries. The sample was composed of 114 dental casts of 57 children, divided into two groups: Group 1 26 neonates whose lip closure was accomplished at 3 months of life by Millard´s technique and the anterior and posterior palate closure by von Langenback's technique (VL); Group 2 31 neonates whose lip closure, nose's ala correction, and anterior palate closure were accomplished of life by Millard´s technique, Mcomb's or Skoog's technique, and vomer's flap, respectively at 3 months of life; posterior palate closure was accomplished by VL at 12 months of life. The dental casts were analyzed at two phases: (T1) pre-cheiloplasty and (T2) one year after palatoplasty. The second study aimed to evaluate morphometrically and longitudinally the alterations of the dental arch dimensions of children with cleft lip and palate. The sample was composed by digital dental casts of children with complete cleft lip (Group 1), complete cleft lip and palate (Group 2), and complete cleft palate (Group 3), obtained at pre-cheiloplasty (T1), pre-palatoplasty (T2), and one year after palatoplasty (T3). The measurements of the dental arch dimensions of both studies were performed directly on the digitized models and analyzed by Appliance Designer software. The following dimensions were obtained: intercanine distance, inter-tuberosity distance, anterior arch length, and total arch length. A previously trained and calibrated examiner performed the assessments of both studies. To verify the alterations among groups, t test and ANOVA followed by Tukey was applied. In the first study, no statistically significant differences occurred at pre-cheiloplasty. At one year after palatoplasty, Group 1 had statistically significant greater anterior-posterior arch length (P=0.002) than Group 2. This suggested that the outcomes of the different surgical techniques may cause alterations in the dental arch growth and development of neonates with cleft lip and palate. In the second study, in Group 1, the distances C-C', T-T', and I-TT' were statistically greater at T2 than at T1. In Group 2, the distances C-C' and I-CC' were smaller at T3. T-T' distance decreased and I-TT' distance increased at all phases. In Group 3, the C-C', T-T', and I-TT' distances were statistically greater at T3. The intergroup comparisons showed that C-C' and T-T' distances were statistically greater in Group 1; C-C' and I-CC' distances were statistically smaller in Group 2; and I-TT' distance was statistically greater in Group 3. The longitudinal evaluation of the changes occurred in the dental arches of children with different oral cleft types showed that cheiloplasty and palatoplasty caused the most alterations in the growth and development of the maxillary dimensions of children with complete cleft lip and palate.(AU)
O propósito deste estudo foi apresentar dois artigos que mostram as alterações das dimensões dos arcos dentários de crianças com fissura labiopalatina antes e depois das cirurgias primárias. O primeiro estudo foi proposto para avaliar as alterações dimensionais dos arcos dentários de neonatos com fissura labiopalatina antes e após a realização de duas técnicas distintas de cirurgias plásticas primárias. A amostra foi composta de 114 modelos dentários em gesso de 57 crianças, divididos em dois grupos: Grupo I 26 neonatos, fechamento do lábio realizado aos 3 meses de vida pela técnica de Millard e palato total aos 12 meses, pela técnica de von Langenback (VL); Grupo II 31 neonatos, fechamento do lábio pela técnica de Millard aos 3 meses de vida, correção de asa nasal (técnicas de Mcomb ou Skoog) e palatoplastia anterior com retalho de vômer aos 3 meses. A palatoplastia posterior foi realizada aos 12 meses pela técnica VL. Os modelos foram analisados em 2 fases: (F1) pré-queiloplastia e (F2) 1 ano pós-palatoplastia. No segundo estudo o objetivo foi realizar uma avaliação longitudinal das alterações das dimensões dos arcos dentários de crianças com fissura labiopalatina. A amostra foi composta de modelos digitais de crianças com fissura completa de lábio (Grupo 1), completa de lábio e palato (Grupo 2), e completa de palato (Grupo 3), obtidos nas fases de pré-queiloplastia (Fase 1), pré-palatoplastia (Fase 2), 1 ano póspalatoplastia (Fase 3). As medidas das dimensões dos arcos dentários nos dois estudos foram realizadas nos modelos digitalizados e analisados utilizando software Appliance Designer. As seguintes dimensões foram obtidas: distância intercaninos, distância intertuberosidade, comprimento anterior do arco dentário e comprimento total do arco. Um avaliador previamente calibrado e treinado realizou as avaliações para os dois estudos. Foi aplicado o Teste t e a Análise de Variância, seguida do Teste de Tukey. Para o primeiro estudo não houve diferença estatisticamente significante na fase pré-queiloplastia entre os grupos. Na fase 1 ano pós-palatoplastia houve diferença para o comprimento anteroposterior do arco dentário (p=0,002), entre os grupos, com valores maiores para o grupo I. Para o segundo estudo, no Grupo 1, as distâncias C-C', T-T' e I-TT' apresentaram diferença estatisticamente significante entre a F1 e F2, com aumento na F2. Para o Grupo 2, houve diferença estatisticamente significante em todas as fases avaliadas. As distâncias C-C' e I-CC' apresentaram menor valor na F3, T-T' diminuiu em todas as fases, e I-TT' aumentou em todas as fases. No Grupo 3, as distâncias C-C', T-T' e I-TT' mostraram diferença estatisticamente significante com aumento na F3. Quando avaliadas as medidas entre os grupos e fases, C-C' e T-T' mostraram um valor maior para o Grupo 1. A comparação entre F2 e F3 mostraram para as distâncias C-C' e I-CC' valor menor para o Grupo 2, e I-TT' foi maior para o Grupo 3. As avaliações longitudinais nos arcos dentários mostraram que a queiloplastia e palatoplastia causam maiores alterações de crescimento e desenvolvimento maxilares de pacientes com fissura completa de lábio e palato.(AU)
Assuntos
Humanos , Animais , Masculino , Lactente , Pré-Escolar , Fenda Labial/patologia , Fissura Palatina/patologia , Arco Dental/patologia , Pontos de Referência Anatômicos , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Modelos Dentários , Imageamento Tridimensional , Estudos Longitudinais , Valores de Referência , Fatores SexuaisRESUMO
ABSTRACT: This paper main objective is to estimate the level of association between lower anterior crowding and the presence of lower third molars on study models and panoramic dental radiographs of patients treated by the Orthodontics Postgraduate Students at the Dentistry Faculty at the University of Cartagena (Cartagena de Indias, Colombia) and also other dental and radiographs care centers in Cartagena de Indias. It was made using a cross-sectional study at the Dentistry Faculty at the University of Cartagena and others dental care centers in the city. There were 366 study models and panoramic dental radiographs selected by strict inclusion/exclusion criteria for patients. An instrument that includes age, gender, presence or absence of third molars, position of third molars according to Winter's classification, stage of formation of the third molars according to Nolla's classification, and crowding magnitude according to Harfin's classification was used. Data were analyzed based on frequency distributions and proportions; inferential analysis was performed through proportional odds model using the software package IBM SPSS Statistics v23. It was found that the patients with Nolla 6 from the right side are more likely to have mild-moderate crowding magnitude than patients with Nolla 10 on that same side. In conclusion, this research provides as main result the implication of the eruption of the lower third molars and particularly those erupting in mesioangular and horizontal positions in the anterior crowding (AA).
RESUMEN: El objetivo de este trabajo fue estimar el nivel de asociación entre el apiñamiento dentario anteroinferior y la presencia de terceros molares inferiores en modelos de estudio y radiografías panorámicas de los pacientes atendidos por estudiantes del posgrado de ortodoncia de laFacultad de Odontología de Cartagena de Indias, Colombia y también otros centros dentales y de radiografías en Cartagena de Indias. Se realizó un estudio transversal en la Facultad de Odontología de la Universidad de Cartagena y otros centros de atención odontológica de la ciudad. Se utilizaron 366 modelos de estudio y radiografías dentales panorámicas seleccionadas por estrictos criterios de inclusión / exclusión para los pacientes. Se utilizó un instrumento que incluía edad, sexo, presencia o ausencia de terceros molares, posición de los terceros molares de acuerdo con la clasificación de Winter, etapa de formación de los terceros molares de acuerdo con la clasificación de Nolla y magnitud de apiñamiento según la clasificación de Harfin. Los datos se analizaron en base a las distribuciones y proporciones de frecuencia; el análisis inferencial se realizó a través del modelo de probabilidades proporcional utilizando el software IBM SPSS Statistics v23. Se encontró que los pacientes con Nolla 6 en el lado derecho son más propensos a tener una magnitud de apiñamiento de leve a moderada en comparación a los pacientes con Nolla 10 en ese mismo lado. En conclusión, esta investigación proporciona como resultado principal la implicación de la erupción de los terceros molares inferiores y particularmente aquellos que erupcionan en posiciones mesioangulares y horizontales en el apiñamiento dentario anterior (AA).
Assuntos
Humanos , Erupção Dentária , Dente Impactado/complicações , Incisivo/patologia , Má Oclusão/etiologia , Dente Serotino/patologia , Dente Impactado/patologia , Dente Impactado/epidemiologia , Radiografia Panorâmica , Incidência , Estudos Transversais , Colômbia/epidemiologia , Arco Dental/patologia , Má Oclusão/patologia , Má Oclusão/epidemiologiaRESUMO
INTRODUCTION:: Etiology of dental crowding may be related to arch constriction in diverse dimensions, and an appropriate manipulation of arch perimeter by intervening in basal bone discrepancies cases, may be a key for crowding relief, especially when incisors movement is limited due to underlying pathology, periodontal issues or restrictions related to soft tissue profile. OBJECTIVES:: This case report illustrates a 24-year old woman, with maxillary transverse deficiency, upper and lower arches crowding, Class II, division 1, subdivision right relationship, previous upper incisors traumatic episode and straight profile. A non-surgical and non-extraction treatment approach was feasible due to the miniscrew-assisted rapid palatal expansion technique (MARPE). METHODS:: The MARPE appliance consisted of a conventional Hyrax expander supported by four orthodontic miniscrews. A slow expansion protocol was adopted, with an overall of 40 days of activation and a 3-month retention period. Intrusive traction miniscrew-anchored mechanics were used for correcting the Class II subdivision relationship, managing lower arch perimeter and midline deviation before including the upper central incisors. RESULTS:: Post-treatment records show an intermolar width increase of 5 mm, bilateral Class I molar and canine relationships, upper and lower crowding resolution, coincident dental midlines and proper intercuspation. CONCLUSIONS:: The MARPE is an effective treatment approach for managing arch-perimeter deficiencies related to maxillary transverse discrepancies in adult patients.
Assuntos
Parafusos Ósseos , Arco Dental/patologia , Má Oclusão Classe II de Angle/terapia , Técnica de Expansão Palatina/instrumentação , Fenômenos Biomecânicos , Cefalometria , Arco Dental/diagnóstico por imagem , Feminino , Humanos , Má Oclusão Classe II de Angle/diagnóstico por imagem , Desenho de Aparelho Ortodôntico , Radiografia Panorâmica , Adulto JovemRESUMO
This study aimed at monitoring the maxillary growth of children with cleft lip/palate in the first two years of life, and to evaluate the effects of primary surgeries on dental arch dimensions. The sample consisted of the three-dimensional digital models of 25 subjects with unilateral complete cleft lip and palate (UCLP) and 29 subjects with isolated cleft palate (CP). Maxillary arch dimensions were measured at 3 months (before lip repair), 1 year (before palate repair), and at 2 years of age. Student's ttest was used for comparison between the groups. Repeated measures ANOVA followed by Tukey's test was used to compare different treatment phases in the UCLP group. Paired ttest was used to compare different treatment phases in the CP group. P<0.05 was considered statistically significant. Decreased intercanine distance and anterior arch length were observed after lip repair in UCLP. After palate repair, maxillary dimensions increased significantly, except for the intercanine distance in UCLP and the intertuberosity distance in both groups. At the time of palate repair and at two years of age, the maxillary dimensions were very similar in both groups. It can be concluded that the maxillary arches of children with UCLP and CP changed as a result of primary surgery.
Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Arco Dental/crescimento & desenvolvimento , Imageamento Tridimensional/métodos , Maxila/crescimento & desenvolvimento , Fatores Etários , Análise de Variância , Pontos de Referência Anatômicos , Cefalometria , Pré-Escolar , Fenda Labial/reabilitação , Fissura Palatina/reabilitação , Arco Dental/patologia , Feminino , Humanos , Lactente , Masculino , Ilustração Médica , Valores de Referência , Fatores de Tempo , Resultado do TratamentoRESUMO
ABSTRACT Introduction: Etiology of dental crowding may be related to arch constriction in diverse dimensions, and an appropriate manipulation of arch perimeter by intervening in basal bone discrepancies cases, may be a key for crowding relief, especially when incisors movement is limited due to underlying pathology, periodontal issues or restrictions related to soft tissue profile. Objectives: This case report illustrates a 24-year old woman, with maxillary transverse deficiency, upper and lower arches crowding, Class II, division 1, subdivision right relationship, previous upper incisors traumatic episode and straight profile. A non-surgical and non-extraction treatment approach was feasible due to the miniscrew-assisted rapid palatal expansion technique (MARPE). Methods: The MARPE appliance consisted of a conventional Hyrax expander supported by four orthodontic miniscrews. A slow expansion protocol was adopted, with an overall of 40 days of activation and a 3-month retention period. Intrusive traction miniscrew-anchored mechanics were used for correcting the Class II subdivision relationship, managing lower arch perimeter and midline deviation before including the upper central incisors. Results: Post-treatment records show an intermolar width increase of 5 mm, bilateral Class I molar and canine relationships, upper and lower crowding resolution, coincident dental midlines and proper intercuspation. Conclusions: The MARPE is an effective treatment approach for managing arch-perimeter deficiencies related to maxillary transverse discrepancies in adult patients.
RESUMO Introdução: a etiologia do apinhamento dentário pode estar relacionada à constrição das arcadas dentárias em diversas dimensões, e a manipulação apropriada do perímetro da arcada, por meio da intervenção em casos de discrepâncias de base óssea, pode ser o fator chave para a dissolução do apinhamento, especialmente em casos onde a movimentação de incisivos é limitada em decorrência de problemas periodontais ou restrições relacionadas ao perfil facial. Objetivos: o presente relato de caso ilustra uma paciente de 24 anos de idade, com deficiência transversa de maxila, apinhamento das arcadas superior e inferior, má oclusão de Classe II, 1a divisão, subdivisão direita, incisivos superiores previamente traumatizados e perfil reto. A abordagem de tratamento não-cirúrgica e sem extrações foi viável devido à técnica de expansão rápida da maxila assistida por mini-implantes (MARPE, do inglês miniscrew-assisted rapid palatal expansion). Métodos: o dispositivo MARPE foi confeccionado a partir de um expansor Hyrax convencional apoiado em quatro mini-implantes. Foi adotado o protocolo de expansão lenta, com um período total de ativações de 40 dias e 3 meses de contenção. Uma mecânica de tração intrusiva apoiada em mini-implantes foi utilizada para a correção da relação de Classe II subdivisão direita, adequação do perímetro da arcada inferior e correção do desvio da linha média antes da inclusão dos incisivos centrais superiores. Resultados: os registros pós-tratamento demonstraram o aumento de 5,0 mm na distância intermolares, relação bilateral de Classe I de molares e caninos, resolução do apinhamento superior e inferior, linhas médias dentárias coincidentes e intercuspidação adequada. Conclusões: a técnica MARPE é uma abordagem de tratamento efetiva para a resolução da deficiência de perímetro das arcadas dentárias relacionada à discrepância maxilar transversa em pacientes adultos.
Assuntos
Humanos , Feminino , Adulto Jovem , Parafusos Ósseos , Técnica de Expansão Palatina/instrumentação , Arco Dental/patologia , Má Oclusão Classe II de Angle/terapia , Fenômenos Biomecânicos , Radiografia Panorâmica , Cefalometria , Desenho de Aparelho Ortodôntico , Arco Dental/diagnóstico por imagem , Má Oclusão Classe II de Angle/diagnóstico por imagemRESUMO
Purpose: The aim of this study was to evaluate the occlusal and arch form stability of self-ligating Damon System appliance treatment, after a mean period of 3 years. Methods: The sample consisted of 20 patients (10 female and 10 male) Class I malocclusion with mild to moderate crowding treated orthodontically without extractions, with a mean initial age of 14.66 years (SD +1.40), mean final age of 17.70 years (SD +1.39) and mean age at posttreatment of 20.62 years (SD +1.42). The mean treatment time was 3.03 years (S.D. +1.17) and the mean posttreatment time was 2.92 years (S.D +0.88). Initial, final and posttreatment dental casts and panoramic radiographs of each patient were evaluated. Crowding, transverse and anteroposterior arch dimensions were measured in digital models in the maxillary and mandibular dental arches. For evaluation of the occlusal stability of orthodontic treatment it was used the Objective Grading System (OGS) in dental casts and panoramic radiographs. Intragroup comparison of all variables evaluated was performed by ANOVA and Tukey test, when necessary. For OGS comparison the dependent T test were used. Intragroup comparison of all variables evaluated was performed by ANOVA and Tukey test, when necessary. For OGS comparison the dependent T test used. Results: During treatment, there was significant decrease in the Little's Irregularity Index in maxillary and mandibular arches. No statistically significant changes in the Little's Irregularity Index were found during the follow-up period after debonding in a mean period of 2.9 years. There was significant increase in all measurements of the maxillary arch width and arch length with treatment. The mandibular measurements of arch width and arch length also showed a significant increase during treatment. At posttreatment, all maxillary and mandibular measurements remained stable, with no significant relapse of arch changes. The OGS index did not show significant changes during the posttreatment period. Conclusions: Treatment with self-ligating Damon System appliances showed increase in maxillary and mandibular arch widths and lenghts, which remain stable after a mean period of 3 years posttreatment. Treatment with this system provides maxillary and mandibular incisor alignment, as defined by Little's Irregularity index, and occlusal stability, as defined by the OGS score, with stability after a mean period of 3 years posttreatment.(AU)
Objetivo: O objetivo deste estudo foi avaliar a estabilidade oclusal e a estabilidade da forma do arco em pacientes tratados com aparelho autoligável do Sistema Damon. Material e métodos: A amostra foi constituída por radiografias panorâmicas e modelos de gesso iniciais (T1), finais (T2) e pós-tratamento (T3) de 20 pacientes (10 homens e 10 mulheres) com má oclusão de Classe I, apinhamento moderado a severo, tratados ortodonticamente sem extrações. Os pacientes apresentaram idade inicial média de 14,66 anos (D.P= +1,40), idade final média de 17,70 anos (D.P= +1,39), tempo médio de tratamento 3,03 anos (D.P= +1,17), idade de pós-tratamento média de 20,62 anos (D.P= +1,42) e tempo médio de pós tratamento de 2,92 anos (D.P= +0,88). O Índice de Estabilidade Oclusal (OGS), foi avaliado por meio de modelos de gesso e radiografias panorâmicas. As medidas transversais, sagitais e o Índice de irregularidade de Little foram realizadas utilizando-se modelos de gesso que foram digitalizados com o scanner 3Shape R700 3D (3Shape A/S, Copenhagen, Dinamarca) e mensurados através do Software OrthoAnalyzerTM 3D (3Shape A / S, Copenhagen, Dinamarca). Para comparação intragrupo de todas as variáveis avaliadas entre as fases inicial (T1), final (T2) e controle (T3), ANOVA e teste de Tukey foram utilizados. Para avalição do OGS foi utilizado o teste t dependente. Resultados: No arco superior todas as medidas da forma e comprimento do arco apresentaram um aumento com o tratamento (T2-T1), com exceção do Índice de Irregularidade de Little que diminuiu significantemente com o tratamento. As medidas mandibulares da forma e comprimento do arco também tiveram um aumento significante com o tratamento, já o Índice de Irregularidade de Little diminuiu significantemente. No período pós-tratamento (T3-T2) todas as medidas maxilares e mandibulares permaneceram estáveis, não apresentando recidiva significante da forma do arco e do Índice de Irregularidade de Little. O índice OGS não apresentou alterações significantes do fim do tratamento para o controle. Conclusão: O tratamento com aparelho autoligável do Sistema Damon apresentou aumentos na forma e comprimento do arco, mantendo-se estáveis após o período de contenção. O tratamento com este Sistema promoveu o alinhamento dos incisivos tanto superiores quanto inferiores, com resultados oclusais estáveis após um período médio de 3 anos pós-tratamento.(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Arco Dental/patologia , Oclusão Dentária , Má Oclusão Classe I de Angle/terapia , Aparelhos Ortodônticos , Análise de Variância , Arco Dental/diagnóstico por imagem , Má Oclusão Classe I de Angle/diagnóstico por imagem , Desenho de Aparelho Ortodôntico , Radiografia Panorâmica , Fatores de Tempo , Resultado do TratamentoRESUMO
Abstract This study aimed at monitoring the maxillary growth of children with cleft lip/palate in the first two years of life, and to evaluate the effects of primary surgeries on dental arch dimensions. The sample consisted of the three-dimensional digital models of 25 subjects with unilateral complete cleft lip and palate (UCLP) and 29 subjects with isolated cleft palate (CP). Maxillary arch dimensions were measured at 3 months (before lip repair), 1 year (before palate repair), and at 2 years of age. Student’s ttest was used for comparison between the groups. Repeated measures ANOVA followed by Tukey’s test was used to compare different treatment phases in the UCLP group. Paired ttest was used to compare different treatment phases in the CP group. P<0.05 was considered statistically significant. Decreased intercanine distance and anterior arch length were observed after lip repair in UCLP. After palate repair, maxillary dimensions increased significantly, except for the intercanine distance in UCLP and the intertuberosity distance in both groups. At the time of palate repair and at two years of age, the maxillary dimensions were very similar in both groups. It can be concluded that the maxillary arches of children with UCLP and CP changed as a result of primary surgery.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Imageamento Tridimensional/métodos , Arco Dental/crescimento & desenvolvimento , Maxila/crescimento & desenvolvimento , Valores de Referência , Fatores de Tempo , Cefalometria , Análise de Variância , Fenda Labial/reabilitação , Fissura Palatina/reabilitação , Fatores Etários , Resultado do Tratamento , Arco Dental/patologia , Pontos de Referência Anatômicos , Ilustração MédicaRESUMO
AIMS: To evaluate changes in transverse dimensions of upper arch and thickness of the buccal bone plate in patients undergoing orthodontic treatment during the leveling phase. MATERIALS AND METHODS: Sixteen patients aged between 11 and 30 years, presenting with class I and II malocclusion, with minimum of 2 mm crowding treated without extraction, were divided into two groups: GI (n = 8), self-ligating brackets (Easyclip Aditek), and GII (n = 8), conventional preadjusted brackets (3M Unitek). The intercanines, interpremolar, and intermolar widths were measured in dental casts using a digital caliper, before (T1) and after 6 months of treatment (T2). Measurements of the thickness of the bone plate were performed by using cone-beam computed tomography (CBCT) scans and Dolphin three-dimensional program. Paired and nonpaired t tests were applied to analyze the results in and between the groups for the changes in the transversal arch dimensions and buccal bone thickness. RESULTS: In all statistical tests, the significance level was set at 5%. A nonsignificant increase in transverse dimensions and a slight reduction on thickness of the buccal bone plate were observed in both groups. CONCLUSION: The dimensional changes of transverse and thickness of the bone plate during the initial phase of treatment were similar, regardless of the bracket design. CLINICAL SIGNIFICANCE: It should be noted that the bracket design does not influence the treatment course regarding transversal dimensions and buccal bone thickness.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Arco Dental/diagnóstico por imagem , Arco Dental/patologia , Má Oclusão Classe II de Angle/terapia , Má Oclusão Classe I de Angle/terapia , Braquetes Ortodônticos , Ortodontia Corretiva/métodos , Adolescente , Adulto , Criança , Feminino , Humanos , Imageamento Tridimensional , Masculino , Ortodontia Corretiva/instrumentaçãoRESUMO
INTRODUCTION: The objectives of this study were to evaluate the prevalence and long-term behavior of extraction space reopening in patients with Class I malocclusion and to identify some associated factors. METHODS: A sample of 43 patients met the inclusion criteria. Dental casts at the onset of treatment, after treatment, and 1 and 5 years after debonding were used. Initial and final cephalometric radiographs were used to measure the amount of incisor retraction. Cochran tests were used to compare the numbers of open and closed extraction spaces after treatment and at 1 and 5 years after debonding (P <0.05). Initial incisor crowding, amounts of anterior retraction, and angulations between the canines and the second premolars were compared between patients with and without space reopening with t tests. RESULTS: Of the sample, 30.23% had extraction space reopening. The frequency of open spaces significantly increased between the final and the 1-year posttreatment dental casts and decreased between the casts at 1 and 5 years posttreatment. Patients with space reopening had less initial anterior crowding and greater amounts of mandibular incisor retraction during treatment. CONCLUSIONS: There was a high prevalence of space reopening 1 year after treatment. However, these spaces tended to decrease by 5 years after treatment.