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INTRODUÇÃO: A impacção do incisivo central superior é uma condição desafiadora para os cirurgiões-dentistas e necessita, geralmente, de uma abordagem multidisciplinar. A não irrupção deste dente pode ocorrer devido à falta de espaço na arcada dentária, às alterações de erupções dos dentes decíduos e/ou permanentes, à presença de dentes supranumerários ou lesões patológicas adjacentes, e ao denso revestimento ósseo ou excesso de tecido mole local. O planejamento adequado e tratamento precoce podem minimizar os desconfortos estéticos e funcionais do paciente, evitando interferências negativas em seu desenvolvimento biopsicossocial. OBJETIVO: Apresentar um caso clínico de tracionamento de incisivo central superior impactado com apoio em barra transpalatina modificada em paciente infantil. RELATO DE CASO: Paciente do gênero masculino, 13 anos de idade, em desconforto estético com o sorriso devido à retenção prolongada do incisivo decíduo. Nos exames de imagem, notou-se a impacção do incisivo permanente, além de uma imagem sugestiva de odontoma composto e agenesia dos incisivos laterais permanentes. No primeiro momento, foi realizado a exodontia do incisivo e canino decíduo e exérese do odontoma composto, aguardando-se a erupção espontânea do incisivo permanente. Diante da irrupção incompleta do incisivo permanente no período de 6 meses, optou-se pelo seu tracionamento por meio da colagem de um botão ortodôntico e utilização de amarrilhos apoiados em uma barra transpalatina modificada. RESULTADO: Paciente encontra-se com o incisivo permamente já erupcionado, aguardando correção ortodôntica para melhor alinhamento e nivelamento dentário. CONCLUSÃO: A barra transpalatina modificada é um importante aparato ortodôntico para o apoio do amarrilho durante o tracionamento do incisivo impactado em pacientes com impossibilidade do uso do aparelho ortodôntico fixo.

Abstract Objective: The aim of this study was to evaluate a flapless surgical technique as an alternative to traditional alveolar corticotomy used to accelerate orthodontic tooth movement (OTM). Methods: To induce OTM in Wistar rats, 40 cN of orthodontic force were applied to the maxillary left first molars. Forty rats were distributed into control groups (CG1, CG3, CG7 and CG14) and experimental groups (n= 5), in which alveolar perforations were made using a spear-shaped guide bur (EG1, EG3, EG7, EG14). Euthanasia dates were set at 1, 3, 7 and 14 days, respectively, after tooth movement began. The amount of OTM was measured with a caliper, and osteoclasts present in the periodontal ligament of the mesial root of the moved tooth were counted by means of histological evaluation (tartrate-resistant acid phosphatase staining, TRAP). Results: Although there was no difference in the amount of OTM within subgroups of corresponding experimental periods (p> 0.05), when EG14 and CG14 were compared, a larger number of osteoclasts was counted in the experimental group (p< 0.00). Conclusion: The authors concluded that flapless cortical alveolar perforations led to more intense osteoclastic activity on the fourteenth day; nevertheless, no evidence of accelerated OTM could be noted.

ABSTRACT Objective: Evaluate dental and skeletal changes resulting from the exclusive use of the cervical headgear for 15 ± 4 months in the treatment of patients with Class II division 1 malocclusion. Methods: Differences between the beginning (T1) and immediately after the end of the therapy (T2) with the cervical headgear in growing patients (Experimental Group, EG, n = 23) were examined and compared, during compatible periods, with those presented by a group of untreated individuals (Control Group, CG, n =22) with similar malocclusions and chronological age. The cephalometric variables evaluated were: ANB, GoGn.SN, AO-BO, S'-ANS, S'-A, S'-B, S'-Pog and S'-U6 (maxillary first molar). The Shapiro-Wilk and Levene tests were used to evaluate the results. Results: Significant differences were found relative to the ANB, S'-U6, AO-BO, S'-ANS, S'-A, S'-B and S'-Pog variables between T1 and T2 when comparing both groups. No statistically significant variation was found regarding the GoGn.SN angle. Conclusions: The use of cervical headgear promoted distal movement of the maxillary first molars and restricted the anterior displacement of the maxilla, without significantly affecting the GoGn.SN angle.

ABSTRACT Hypodontia is the most prevalent craniofacial malformation in mankind. It may present a wide variety of manifestations and, depending on the number and location of missing teeth, it may affect the esthetics, mastication, speech and occlusal balance. This paper discusses the therapeutic approaches to solve this condition, describing a case report with hypodontia of one mandibular lateral incisor, which treatment option included space closure at the region of hypodontia associated with composite resin restorations in the mandibular central incisors. The three-year follow-up after treatment revealed occlusal stability, adequate intercuspation in Class I relationship and excellent micro and macroesthetics.