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Objective: To understand the experiences and challenges faced by professionals working on a street team in Portugal in caring for the vulnerable population from the phenomenological perspective of Alfred Schutz., Method: Qualitative approach in the light of the theoretical framework of phenomenological Sociology, developed in a street team in the central region of Portugal from phenomenological interviews with five professionals in the months of June and July 2021. The interpretation of the results was analyzed through theoretical conceptions of Alfred Schutz's phenomenological sociology and related literature., Results: Three categories emerged: Conflicts experienced by the street team; Frustration in the daily care provided by the street team; and, Limits in the social relationship with the vulnerable population., Conclusion: The street team in Portugal faces challenges in caring for the vulnerable population served,requiring team skills for conflict mediation combined with an understanding of the influences of relationships, in social action.

Objective: To analyze how university students self-evaluate their academic performance during the COVID-19 pandemic in a public university in southern Brazil., Method: A cross-sectional study was carried out with 527 students of undergraduate courses in the health field. Descriptive statistical analyses and the chi-square test were performed to assess associations., Results: For 49.5% of participants their academic performance was insufficient; for 24.1%, sufficient; 19.40%, good; 5.90% very good; and 1.10% excellent. It was found that there was an association between the variables, course (p=0.034), form of enrollment into the institution (p=0.016) and work activity (p=0.010) in academic performance during the COVID-19 pandemic., Conclusion: Academic performance during the suspension of face-to-face classes is insufficient for many students, and groups of students from the occupational therapy course, who entered the university through the system of quotas and who work in addition to studying showed an inferior academic performance during the COVID-19 pandemic.

Objective: To evaluate the relationship between psychoactive substance use, anxiety, depression and stress by workers at a Brazilian public university., Methods: This is a cross-sectional study with a quantitative approach, carried out with 345 workers from a public higher education institution, located in a city in the interior of the state of Rio Grande do Sul, Brazil., Results: Professionals with an average age of 38.9 years, 187 (54.2%) were women, 163 (47.2%) were single, 186 (53.9%) professed the Catholic religion, 223 (64.8%) had graduate school education. Of the workers, 122 (35.4%) considered their work to be stressful. The use of alcohol in the binge pattern (monthly) and heavy episodic drinking (weekly) were higher among workers with higher levels of anxiety, depression and stress., Conclusion: The use of alcohol in its different forms, stress, depression and anxiety show particularities that must be evaluated and recognized among the worker's health problems.

Objective: To evaluate the quality of life and to analyze the epidemiological profile of people with diabetes treated in Family Health Strategies., Method: A cross-sectional study carried out with 350 people with diabetes., Results: Most people with diabetes are women, elderly, married, white, with low educational level, retired/pensioners, family income of up to two minimum wages. As the time of people with the disease increases, their quality of life decreases. People with complications from diabetes have a lower quality of life, with a statistically significant difference., Conclusion: Knowledge of the sociodemographic characteristics, clinical evaluation and quality of life of people with diabetes can improve the care process provided to this population.

Objective: To understand the reasons attributed by women to the abuse of psychoactive substances., Method: Qualitative approach of phenomenological nature. We interviewed 12 women users of psychoactive substances under treatment at the Center for Psychosocial Care alcohol and drugs in Southern Brazil. The interviews were conducted between may and june 2013. The data were interpreted in light of Alfred Schütz's Social Phenomenology., Results: The abuse of psychoactive substances is motivated by the influence of the people with whom the women have a relationship or with whom they have lived. Still, the losses and the family conflicts experienced were also a trigger for the abuse of psychoactive substances., Conclusion: Women's health care needs to meet beyond demands, since they must take into account the life history of these women.

Objective: to understand the professionals' intentions and family members' expectations about care actions developed to the relatives of users of psychoactive substances., Method: a social phenomenology approach according to Alfred Schütz, performed in a Psychosocial Care Center for Alcohol and Drugs. Interviews were performed with 13 professionals and 12 family members., Results: there is a reciprocity of perspectives between the professionals' intentions and the relatives' expectations, described by the effectiveness of the treatment of the user (typical of the action of both). The family members seek for care actions, expecting to improve the user's treatment., Final Considerations: the findings provide reflections for professionals about the health care actions and the organization of the service for the family's mental health.

Hydroxypropyl methylcellulose (HPMC) and xyloglucan (XG) crosslinked with citric acid over a range of HPMC/XG weight ratios formed sustainable blend films characterized by Fourier transform infrared spectroscopy, thermogravimetric analysis, scanning electron microscopy, tensile tests, circular dichroism and determination of inhibitory activity against Staphylococcus aureus and Escherichia coli. Both in solution and in the crosslinked films, HPMC chains lost the original ordered conformation upon interacting with XG, giving rise to an entropic gain. The highest values of tensile strength (25MPa) and Young's modulus (689MPa) occurred for the 50:50 HPMC/XG blend films. In vitro loading of gentamicin sulfate (GS) in the films amounted to 0.18±0.05 -0.37±0.05g of GS per g polymer. At pH 7.4 and 37°C, the GS release kinetics from the films fitted with the Korsmeyer-Peppas model revealed a non-Fickian release mechanism with diffusional coefficient n∼0.7. The cross-linked films of HPMC, XG and their blends loaded with GS showed outstanding antibacterial activity against Staphylococcus aureus and Escherichia coli, disclosing their potential for novel biomedical applications., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Introduction: In this retrospective study, we aimed to evaluate the effects on the facial silhouettes produced by a mandibular protraction appliance associated with corrective treatment in Class II patients., Methods: The sample consisted of 54 (27 initial and 27 final) lateral radiographs from 27 patients. Of these patients, 14 were girls and 13 were boys, with a mean initial age of 12.27 years and a mean treatment period of 2.9 years. An album containing the silhouettes of the pretreatment and posttreatment profiles based on the lateral cephalograms of the patients was prepared. Then, 60 orthodontists and 60 laypeople chose the more esthetic facial silhouette (A or B) and the amount of alterations they perceived between the 2 silhouettes, according to a visual analog scale. A paired t test was used to compare the 2 groups of evaluators with a 5% significance level., Results: Differences between the preferences regarding the pretreatment and posttreatment facial silhouettes were statistically significant for both groups. The posttreatment silhouettes were preferred by most evaluators. The visual analog scale scores showed that the lay evaluators identified greater differences between the pretreatment and posttreatment silhouettes than did the orthodontists (P <0.001)., Conclusions: Based on the evaluators' judgments, treatment with the mandibular protraction appliance had a positive effect on the facial silhouette, and the laypeople better perceived this effect., (Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

The objective of this study was to determine the prevalence and risk factors for the occurrence of endoparasitosis in dogs and cats in Espírito Santo, Brazil. For the study, 345 dogs and 160 cats were examined. Faecal samples from the animals were collected, and owners were interviewed about their handling of their animals. For the diagnosis of the infections, the Willis-Molley, simple centrifugal flotation and formalin-ether sedimentation techniques were performed. The data found in the tests were tabulated and analysed with a chi-square test (p <0.05), and calculation of odds ratios (OR) with confidence intervals of 95% were then performed to determine the association between the variables and the outcome of stool examinations. The prevalence of parasites was 59% for dogs and 54% for cats. The genus Ancylostoma was the most prevalent (45%). Supplying filtered water, not feeding raw foods, standardisation of a defecation site and cleaning up the faeces reduced the chances of developing intestinal parasites. An increased frequency of deworming was also shown to be a protective factor; specifically animals which received anthelmintic more than once a year had a lower predisposition for intestinal parasites.

Hybrid beads composed of magnetite nanoparticles (MNP) and alginate (Alg) were synthesized and coded as Alg-MNP. They were incubated in dopamine (DOPA) solution (5 g/L), at pH 7.4 and 8 °C, during 12 h, promoting the DOPA loaded magnetic beads, coded as Alg-MNP/DOPA. The release of DOPA was further evaluated in the absence and the presence of external magnetic field (EMF) of 0.4 T. The products Alg-MNP and Alg-MNP/DOPA were characterized by scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS), Fourier transform infrared vibrational spectroscopy (FTIR), UV spectrophotometry, thermogravimetric analyses (TGA), inductively coupled plasma atomic emission spectroscopy (ICP-AES) analyses and superconducting quantum interference device (SQUID) magnetometer. The magnetic and chemical properties of Alg-MNP beads were not affected by DOPA loading. The incorporation of DOPA into the beads depended on the pH and on the negative charge density. At pH 7.4 38% of DOPA were loaded into Alg-MNP beads, whereas at pH 2 or using neat Alg beads (lower charge density than Alg-MNP) the loading efficiency decreased to one third or less. In the absence of EMF, 24% of the loaded DOPA was released from Alg-MNP at pH 7.4 over a period of 26 h. The released amount increased to 33% under the stimulus of EMF. A model was proposed to explain the loading efficiency of charged drugs, as DOPA, into hybrid beads and the role played by EMF on delivery systems, where drug and matrix are oppositely charged. The results suggest that the alginate combined with magnetite nanoparticles is a promising system for release of DOPA in the presence of EMF., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: Several cationic polymers exhibit a useful antimicrobial property, however the structure-activity relationship still requires a more complete investigation. The main objective of this work is the comparison between the antimicrobial activity and toxicity of free and immobilized poly (diallyldimethylammonium) chloride (PDDA) in biocompatible poly (methylmethacrylate) (PMMA) nanoparticles (NPs)., Results: NPs synthesis by emulsion polymerization is performed over a range of [PDDA] at two methylmethacrylate (MMA) concentrations. The PMMA/PDDA dispersions are characterized by dynamic light-scattering for sizing, polydispersity and zeta-potential analysis, scanning electron microscopy (SEM), plating plus colony forming unities (CFU) counting for determination of the minimal microbicidal concentrations (MMC) against Escherichia coli, Staphylococcus aureus and Candida albicans and hemolysis evaluation against mammalian erythrocytes. There is a high colloidal stability for the cationic PMMA/PDDA NPs over a range of [PDDA]. NPs diverse antimicrobial activity against the microorganisms reduces cell viability by eight-logs (E. coli), seven-logs (S. aureus) or two-logs (C. albicans). The NPs completely kill E. coli over a range of [PDDA] that are innocuous to the erythrocytes. Free PDDA antimicrobial activity is higher than the one observed for PDDA in the NPs. There is no PDDA induced-hemolysis at the MMC in contrast to the hemolytic effect of immobilized PDDA in the NPs. Hemolysis is higher than 15 % for immobilized PDDA at the MMC for S. aureus and C. albicans., Conclusions: The mobility of the cationic antimicrobial polymer PDDA determines its access to the inner layers of the cell wall and the cell membrane, the major sites of PDDA antimicrobial action. PDDA freedom does matter for determining the antimicrobial activity at low PDDA concentrations and absence of hemolysis.

Objective: The present study assessed the maxillary dental arch changes produced by surgically assisted rapid maxillary expansion (SARME)., Methods: Dental casts from 18 patients (mean age of 23.3 years) were obtained at treatment onset (T1), three months after SARME (T2) and 6 months after expansion (T3). The casts were scanned in a 3D scanner (D-250, 3Shape, Copenhagen, Denmark). Maxillary dental arch width, dental crown tipping and height were measured and assessed by ANOVA and Tukey's test., Results: Increased transversal widths from T1 and T2 and the maintenance of these values from T2 and T3 were observed. Buccal teeth tipping also showed statistically significant differences, with an increase in all teeth from T1 to T2 and a decrease from T2 to T3. No statistically significant difference was found for dental crown height, except for left first and second molars, although clinically irrelevant., Conclusion: SARME proved to be an effective and stable procedure, with minimum periodontal hazards.

Controlling the eruption and development of dentitions is fundamental for a good oral health. The early diagnosis and adequate treatment of occasional developmental disorders are essential to achieve occlusal, functional and esthetic harmony. Abnormality is the term used for classification of alterations and is the most common developmental anomaly in humans. Even though several factors causing tooth malformations have been identified, many are still partially understood, thus requiring a more thorough study. Anyway, the available knowledge provides bases to attempt the early diagnosis of tooth abnormalities, to allow the adoption of preventive and effective therapeutic approaches.

Polypyrrole (PPy) was electropolymerized in xanthan hydrogels (XCA), resulting in electroactive XCAPPy scaffolds with (15 ± 3) wt.% PPy and (40 ± 10) μm thick. The physicochemical characterization of hybrid XCAPPy scaffolds was performed by means of cyclic voltammetry, swelling tests, Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), thermogravimetric analyses (TGA), scanning electron microscopy (SEM), atomic force microscopy (AFM) and tensile tests. XCAPPy swelled~80% less than XCA. FTIR spectra and thermal analyses did not evidence strong interaction between PPy and XCA matrix. XCAPPy presented a porous stratified structure resulting from the arrangement of PPy chains parallel to XCA surface. Under stress XCAPPy presented larger strain than neat XCA probably due to the sliding of planar PPy chains. The adhesion and proliferation of fibroblasts onto XCA and XCAPPy were evaluated in the absence and in the presence of external magnetic field (EMF) of 0.4T, after one day, 7 days, 14 days and 21 days. Fibroblast proliferation was more pronounced onto XCAPPy than onto XCA, due to its higher hydrophobicity and surface roughness. EMF stimulated cell proliferation onto both scaffolds., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Introduction: Prognosis is the main limitation of interceptive treatment of Class III malocclusions. The interceptive procedures of rapid maxillary expansion (RME) and face mask therapy performed in early mixed dentition are capable of achieving immediate overcorrection and maintenance of facial and occlusal morphology for a few years. Individuals presenting minimal acceptable faces at growth completion are potential candidates for compensatory orthodontic treatment, while those with facial involvement should be submitted to orthodontic decompensation for orthognathic surgery., Objectives: To investigate cephalometric variables that might predict the outcomes of orthopedic treatment with RME and face mask therapy (FM)., Methods: Cephalometric analysis of 26 Class III patients (mean age of 8 years and 4 months) was performed at treatment onset and after a mean period of 6 years and 10 months at pubertal growth completion, including a subjective facial analysis. Patients was divided into two groups: success group (21 individuals) and failure group (5 individuals). Discriminant analysis was applied to the cephalometric values at treatment onset. Two predictor variables were found by stepwise procedure., Results: Orthopedic treatment of Class III malocclusion may have unfavorable prognosis at growth completion whenever initial cephalometric analysis reveals increased lower anterior facial height (LAFH) combined with reduced angle between the condylar axis and the mandibular plane (CondAx.MP)., Conclusion: The results of treatment with RME and face mask therapy at growth completion in Class III patients could be predicted with a probability of 88.5%.

Introduction: This study was conducted with the aim of adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the pubertal growth spurt (PGS) curve. It also aimed to test the reliability and agreement between those methods and the method of hand and wrist radiograph when compared two by two and all together. , Methods: The sample comprised 72 radiographs, with 36 lateral radiographs of the head and 36 hand-wrist radiographs of 36 subjects with Down's syndrome (DS), 13 female and 23 male, aged between 8 years and 6 months and 18 years and 7 months, with an average age of 13 years and 10 months. , Results and Conclusions: Results revealed that adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the PGS curve is practical and useful in determining the stage of growth and development of individuals. The stages of maturation evaluated by cervical vertebrae and ossification centers observed in radiographs of the hand and wrist were considered reliable, with excellent level of agreement between the methods by Hassel and Farman as well as Baccetti, Franchi and McNamara Jr and Martins and Sakima. Additionally, results revealed an agreement that ranged between reasonable to good for the three methods used to assess the skeletal maturation, showing statistical significance.

This study aimed to explore the perception healthcare sector teachers, students and graduates from two institutions of higher learning in Rio Grande do Sul, on the generation of waste from healthcare services. It used a qualitative research approach, performed with 13 teachers, 18 students and 12 healthcare professionals, who were collected through a focus group. The main results showed there is a perception toward the importance of proper segregation and disposal of Healthcare Service Waste, also there is a lack of concern for the reduction of these wastes. Therefore, the issue requires a broader understanding of the environment, with a view of planetary sustainability, exposing needs to provide the healthcare professionals with knowledge and awareness of the importance of handling these types of waste.

Introduction: Orthodontics, just as any other science, has undergone advances in technology that aim at improving treatment efficacy with a view to reducing treatment time, providing patients with comfort, and achieving the expected, yet hardly attained long-term stability. The current advances in orthodontic technology seem to represent a period of transition between conventional brackets (with elastic modules) and self-ligating brackets systems. Scientific evidence does not always confirm the clear clinical advantages of the self-ligating system, particularly with regard to reduced time required for alignment and leveling (a relatively simple protocol), greater comfort for patients, and higher chances of performing treatment without extractions - even though the number of extractions is more closely related to patient's facial morphological pattern, regardless of the technique of choice. Orthodontics has recently and brilliantly used bracket individualization in compensatory treatment with a view to improving treatment efficacy with lower biological costs and reduced treatment time., Objective: This paper aims at presenting a well-defined protocol employed to produce a better treatment performance during this period of technological transition. It explores the advantages of each system, particularly with regards to reduced treatment time and increased compensatory tooth movement in adult patients. It particularly addresses compensable Class III malocclusions, comparing the self-ligating brackets system, in which greater expansive and protrusive tooth movement (maxillary arch) is expected, with Capelozza Prescription III conventional brackets, in which maintaining the original form of the arch (mandibular arch) with as little changes as possible is key to yield the desired results.

In this work xanthan-nanohydroxyapatite (XnHAp) and its equivalent strontium substituted (XnHApSr) were synthesized by the precipitation of nanohydroxyapatite in xanthan aqueous solution, characterized and compared to conventional hydroxyapatite particles (HAp). XnHAp and XnHApSr were less crystalline than HAp, as revealed by X-ray diffraction. Xanthan chains enriched the surface of XnHAp and XnHApSr particles, increasing the zeta potential values from -(7±1)mV, determined for HAp, to -(17±3)mV and -(25±3)mV, respectively. This effect led to high colloidal stability of XnHAp and XnHApSr dispersions and acicular particles (140±10)nm long and (8±2)nm wide, as determined by scanning electron microscopy and atomic force microscopy. XnHAp and XnHApSr particles were added to xanthan hydrogels to produce compatible nanocomposites (XCA/XnHAp and XCA/XnHApSr). Dried nanocomposites presented surface energy, Young's modulus and stress at break values comparable to those determined for bare xanthan matrix. Moreover, adding XnHAp or XnHApSr nanoparticles to xanthan hydrogel did not influence its porous morphology, gel content and swelling ratio. XCA/XnHAp and XCA/XnHApSr composites proved to be suitable for osteoblast growth and particularly XCA/XnHapSr composites induced higher alkaline phosphatase activity., (Copyright © 2014 Elsevier B.V. All rights reserved.)

In this article the molecular conformation of xanthan chains in hydrogel films was investigated by means of circular dichroism, showing substantial differences between xanthan hydrogel prepared in the absence (XNT) and in the presence of citric acid (XCA). The xanthan chains in XNT hydrogels films presented ordered conformation (helixes), while in XCA they were in the disordered conformation (coils), exposing a larger number of carboxylate groups than XNT. The large charge density in XCA hydrogels was evidenced by their behavior under variable ionic strength. Studies about the application of XNT and XCA for loading and delivering of bovine serum albumin (BSA) and lysozyme (LYZ) showed that both events are controlled by hydrogels and proteins net charge, which can be triggered by pH. The preservation of LYZ native conformation after hydrogel loading explained the substantial bactericidal activity of LYZ loaded hydrogels and enables their use as active wound dressings., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

This article reports the case of a patient with severe mandibular deficiency and crowding in the mandibular arch treated with atypical extractions of two premolars followed by mandibular advancement with the Herbst appliance. It became clear that this therapy corrected the malocclusion while improving facial.

We describe a fast and simple method to prepare composite films of magnetite nanoparticles and xanthan networks. The particles are distributed close to hybrid film surface, generating a coercivity of 27 ± 2 Oe at 300 K. The proliferation of fibroblast cells on the hybrid composites was successful, particularly when an external magnetic field was applied.

Orthodontic extrusion with multidisciplinary treatment can provide predictable outcomes in selected situations, reducing the costs and the adaptation times of gingival tissues after implant integration. Forced orthodontic extrusion is strongly related to interactions of teeth with their supportive periodontal tissues. This article reports a case of orthodontic extrusion of the maxillary incisors for later implant rehabilitation in a patient with periodontal disease. Slow forces were applied for 14 months. After this time, the teeth were extracted, and the implants were placed on the same day. Also in the same session, the provisional crown was fabricated for restoration of the anterior maxillary interdental papillae loss and for gingival contouring. Clinical and radiographic examinations at the 6-year follow-up showed successful tooth replacement and an improved esthetic appearance achieved by this multidisciplinary treatment. The decision to perform orthodontic extrusion for implant placement in adult patients should be multidisciplinary., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Objective: This retrospective study aimed to conduct a cephalometric evaluation of the skeletal, dental and soft tissue effects resulting from treatment of adult patients presenting Class II malocclusion, performed with a Mandibular Protraction Appliance (MPA) combined with a fixed orthodontic appliance., Methods: The sample consisted of teleradiographs obtained before and after treatment of 9 adult patients (initial mean age of 22.48 years) with bilateral Class II, division 1, malocclusion. Paired t test (p < 0.05) was applied to compare initial and final values., Results: t test revealed an increase in anteroinferior facial height and posterior facial height. The dental changes include: extrusion of upper incisors, buccal inclination, protrusion of lower incisors, mesialization and extrusion of mandibular molars. Regarding the soft tissue component, there was an increase in nasolabial angle in addition to upper lip retrusion., Conclusions: The effects of treating Class II malocclusion adult patients, by means of using Mandibular Protraction Appliance (MPA) combined with a fixed appliance were mostly observed in the mandibular arch, and consisted of buccal inclination, protrusion and intrusion of incisors, and mesialization and extrusion of the molars.

The aim of this study was to evaluate if upward or downward head inclination might interfere with determination of the growth stage, using cervical vertebrae maturation index (CVMI), in order to verify the accuracy of such diagnosis when radiographs are taken with errors. Forty-nine patients, 26 females and 23 males, aged 9 to 15 years, were submitted to 3 lateral cephalograms: normal (NHP), with 15° upward head inclination (NHP-Up), and with 15° downward head inclination (NHP-Down). Three examiners evaluated the CVMI on the 147 cephalograms. The agreement among examiners was higher in the evaluation of cephalograms taken in NHP. The weighted Kappa test revealed moderate to substantial agreement between NHP and NHP-Up and between NHP and NHP-Down. There was greater agreement between NHP-Up and NHP-Down. It may be concluded that the evaluation of the CVMI on cephalograms in NHP is different as compared with radiographs taken with inclinations. Both NHP-Up and NHP-Down exhibited greater disagreement in the interpretation among examiners, since the evaluation method was not designed for cephalograms with positioning errors.

In this work xanthan chains were crosslinked by esterification reaction at 165 °C either in the absence or in the presence of citric acid. Higher crosslinking density was obtained using citric acid, as evidenced by its lower swelling degree. Tensiometry, a very precise and sensitive technique, was applied to study swelling rates and diffusion mechanisms of water, which was initially quasi-Fickian, controlled by wicking properties, changing to Fickian or Anomalous, depending on hydrogel composition. Hydrogels swelling degree increased at high pH values, due to electrostatic repulsion and ester linkages rupture. Equilibrium swelling degree was affected by salts, depending on gel composition and kind of salt. Effects could be explained by interaction between ions and polymeric chains, EPA/EPD ability of water or osmotic gradient., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

This is an experience report regarding crack users following detoxification treatment, which aimed to achieve a comprehensive treatment of human beings through spirituality workshops. Cultivated and created from the inspirations of the subjects themselves, the workshops are strategies capable of encouraging a revision of attitudes and behaviors, as well as to resume life based on new values and ideals. In abstract, the workshops aim to contribute towards broadening discussions on the theme, thus supporting the revision of nursing practice in regards to detoxification treatment, in addition to highlighting the need to conduct further studies in this field.

Several etiological factors that result in dental and/or skeletal alterations make the open bite a type of malocclusion with several treatment alternatives. Corrective fixed orthodontics in conjunction with mechanical or functional orthopedics is a routine approach in correcting this problem. However, orthosurgical treatment must never be discarded for cases with skeletal involvement. This article describes a clinical case which, despite involving skeletal aspects, was treated satisfactorily using a passive bite-block appliance in conjunction with corrective fixed orthodontics.

The scope of this paper was to investigate the relationship between the nutritional status and the motor skills of the elderly registered in the Family Health Program in the urban area of Vitória de Santo Antão in the State of Pernambuco, by means of a transversal epistemological descriptive-analytical field study. The participants of this survey were 235 elders, both male and female of 60-years-old and over registered in the family health program in the urban area of the city. The nutritional status was evaluated by the body mass index and the circumference of the calf. Four motor tests were used to evaluate motor performance: Time Up&Go, Tinetti's Index, Functional Reach and Unipodal Support. The associations were checked using Spearman's correlation. The association of the nutritional status with the motor tests was statistically significant among males* or females**: (Time Up&Go rho = 0.290* / 350**; Functional Reach rho = 0.232* / 352**; Tinetti's Index rho = 243* / 363** and Unipodal Support rho = 221* / 475**. The evaluation of the results revealed an association between nutritional status and functional capacity of the elders no matter what gender; with obesity being a limiting nutritional condition to adequate performance in the tests.

Introduction: In this study, we evaluated the effects of a low-level laser on bone regeneration in rapid maxillary expansion procedures., Methods: Twenty-seven children, aged 8 to 12 years, took part in the experiment, with a mean age of 10.2 years, divided into 2 groups: the laser group (n = 14), in which rapid maxillary expansion was performed in conjunction with laser use, and the no-laser group (n = 13), with rapid maxillary expansion only. The activation protocol of the expansion screw was 1 full turn on the first day and a half turn daily until achieving overcorrection. The laser type used was a laser diode (TWIN Laser; MMOptics, São Carlos, Brazil), according to the following protocol: 780 nm wavelength, 40 mW power, and 10 J/cm(2) density at 10 points located around the midpalatal suture. The application stages were 1 (days 1-5 of activation), 2 (at screw locking, on 3 consecutive days), 3, 4, and 5 (7, 14, and 21 days after stage 2). Occlusal radiographs of the maxilla were taken with the aid of an aluminum scale ruler as a densitometry reference at different times: T1 (initial), T2 (day of locking), T3 (3-5 days after T2), T4 (30 days after T3), and T5 (60 days after T4). The radiographs were digitized and submitted to imaging software (Image Tool; UTHSCSA, San Antonio, Tex) to measure the optic density of the previously selected areas. To perform the statistical test, analysis of covariance was used, with the time for the evaluated stage as the covariable. In all tests, a significance level of 5% (P <0.05) was adopted., Results: From the evaluation of bone density, the results showed that the laser improved the opening of the midpalatal suture and accelerated the bone regeneration process., Conclusions: The low-level laser, associated with rapid maxillary expansion, provided efficient opening of the midpalatal suture and influenced the bone regeneration process of the suture, accelerating healing., (Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

The aim of this study was to analyze a possible correlation of different cephalometric measurements to define facial type and to evaluate the best measurement for diagnosis. The sample consisted of 95 lateral cephalograms of caucasian patients with normal occlusion, aged between 15 years and two months and 21 years and four months, of which 54 were male and 41 female. The facial types were divided into dolichofacial, mesofacial and brachyfacial, according to the standards stated by different authors, and a relationship among them was investigated using the Kappa and Total agreement methods. The highest agreement found was between FMA and SN.GoGn; the lowest was between SN. Gn and VERT index. According to literature review and the interpretation of the results, SN.GoGn appears to be the best measurement to define facial type.

Angle Class II malocclusions may present morphologic deviations originated from the maxilla, mandible, or both. Since its reintroduction by Pancherz, the Herbst appliance has demonstrated effectiveness in the management of patients with mandibular deficiency. Because of the intermaxillary anchorage, the action of mandibular advancement provokes simultaneous reaction of maxillary restriction, similar to high-pull headgear. This aimed of this report is to compare two cases treated in two phases. In the first interceptive phase, the transverse problem was corrected by rapid maxillary expansion, which was followed by a Herbst appliance for mandibular advancement; in the second corrective phase, the cases were finished with fixed appliances. Although Herbst appliances were used in both patients, one patient with maxillary protrusion and another with mandibular deficiency, their use targeted different types of skeletal discrepancies. This difference allowed for the comparison of treatment effects, and although both patients had their malocclusion corrected, it seems reasonable to conclude that the final outcome was more favorable for the patient with maxillary protrusion.

The aim of this study was to evaluate the shear bond strength of brackets bonded with different restorative systems and compare it with that afforded by an established orthodontic bonding system. Seventy human bicuspids were used, divided into five different groups with 14 teeth each. Whereas a specific orthodontic bonding resin (Transbond™ XT) was used in the control group, the restorative systems Charisma, Tetric Ceram, TPH Spectrum and Z100 were used in the other four groups. Seven days after bonding the brackets to the samples, shear forces were applied under pressure in a universal testing machine. The data collected was evaluated using the ANOVA test and, when a difference was identified, the Tukey test was applied. A 5% level of significance was adopted. The mean results of the shear bond strength tests were as follows: Group 1 (Charisma), 14.98 MPa; Group 2 (Tetric Ceram), 15.16 MPa; Group 3 (TPH), 17.70 MPa; Group 4 (Z100), 13.91 MPa; and Group 5 or control group (Transbond™ XT), 17.15 MPa. No statistically significant difference was found among the groups. It was concluded that all tested resins have sufficient bond strength to be recommended for bonding orthodontic brackets.

Effective orthodontic anchorage may be obtained by miniimplants inserted into the maxillary bones. However, the risk of miniimplant failure is one of the most important issues, especially the rupture of its structure referred to as fracture, mainly due to metal deficiencies. This study analyzed the internal microstructure of orthodontic mini-implants, ascertaining the composition of the metal to detect possible discontinuities from the surface to the core of the screws. Eighteen samples of mini-implants, of 3 different brands, were obtained. The samples were cold-embedded in methyl methacrylate polymer, and were sectioned both longitudinally (3 samples of each brand) and transversely (the other 3 screws of each brand). After preparation, the samples were observed using a light microscope at up to 2,000 x magnification. The results showed that the mini-implants thus analyzed were composed of an Alpha-Beta globular phase of titanium alloy, patterns A1 and A9 (in accordance with the "Technical Committee of European Titanium Producers"). The miniimplants did not present any defects such as bubbles, imperfections or fissures, in either longitudinal or transverse sections, in their internal microstructure. All samples met the requirements of international norms. Orthodontists must be aware of the metal composition and internal microstructure of mini-implants, to decrease the risk of fractures.

Introduction: The aims of this study were to evaluate the distances between the mandibular permanent teeth and the alveolar process in Brazilians with normal occlusion and to compare them with normal American values., Methods: We used 59 mandibular casts from untreated subjects who had permanent dentition and the 6 keys to normal occlusion. A computer program was used to calculate the distances between the dental reference points and the alveolar process for each tooth. The mean values were then compared to the normal values by applying the Student t test at a significance level of 0.05., Results: The results showed a progressive increase of these distances from the anterior region (incisors) to the posterior region (molars), from 0.00 to 2.49 mm. All measurements had statistically significant differences from the American sample, except for the values for canines and first premolars., Conclusions: Brazilians with normal occlusion have more lingual crown positions for the incisors, second premolars, and molars compared with Americans with normal occlusion. Although these findings were statistically significant, they are unlikely to be clinically significant., (2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Aim: To evaluate the Bolton ratios in Brazilians with natural, normal occlusions., Methods: Thirty-five dental casts of Brazilian Caucasians with a natural, normal occlusion from the files of the Postgraduate Program in Orthodontics of the Methodist University of São Paulo were scanned in three dimensions. On the scanned images, the greatest mesiodistal distance of each tooth from right first molar to left first molar was measured with Geomagic Studio 5 software. The Bolton ratios were then calculated., Results: The anterior ratio amounted to 78.66% (SD ± 2.72) and the total ratio to 91.58% (SD ± 2.20)., Conclusion: The anterior, but not the overall, ratio was significantly different from the ratio suggested by Bolton., (COPYRIGHT © 2009 BY QUINTESSENCE PUBLISHING CO, INC.)

Orthodontic treatment to improve not only tooth alignment but also facial esthetics is a given in modern society. This paper illustrates this assumption with a report of a patient with a Class I, maxillary retrusion, concave profile, and retrusion of the upper and lower lips. Maxillary expansion was followed by face mask therapy and orthodontic treatment, which significantly improved the soft tissue profile by projecting the upper lip., (© 2009 BY QUINTESSENCE PUBLISHING CO, INC.)

Objectives: To evaluate the influence of JPEG quality factors 100, 80 and 60 on the reproducibility of identification of cephalometric points on images of lateral cephalograms, compared with the Digital Imaging and Communications in Medicine (DICOM) format., Methods: The sample was composed of 30 images of digital lateral cephalograms obtained from 30 individuals (15 males and 15 females) on a phosphor plate system in DICOM format. The images were converted to JPEG with quality factors 100, 80 and 60 with the aid of software, adding up to 90 images. The 120 images (DICOM, JPEG 100, 80 and 60) were blinded and 12 cephalometric points were identified on each image by three calibrated orthodontists, using the x-y coordinate system, on a cephalometric software., Results: The results revealed that identification of cephalometric points was highly reproducible, except for the point Orbitale (Or) on the x-axis. The different file formats did not present a statistically significant difference., Conclusions: JPEG images of lateral cephalograms with quality factors 100, 80 and 60 did not present alterations in the reproducibility of identification of cephalometric points compared with the DICOM format. Good reproducibility was achieved for the 12 points, except for point Or on the x-axis.

Mandibular second molar impactions can be difficult to correct and might require surgery. A young man with an impacted mandibular right second molar was treated with a miniplate, which provided anchorage to upright the tooth. Although other devices are available, this technique appears to be predictable and quick, and has few side effects.

Introduction: Because it is important to maintain dental arch dimensions during orthodontic therapy, all possible dental arch forms must be evaluated., Methods: A mathematical method associated with a polynomial function was used to evaluate the dental arch forms of 63 mandibular models of Brazilian adolescents in the permanent dentition with normal occlusion. A bead was glued to each tooth to simulate an orthodontic accessory and help in the measurement of distances between the center of the bead to the x- and y-axes. The dental casts were digitized, and images were plotted on a computer program to obtain the sixth-degree polynomial and the graph of this function. These segments were organized into 8 groups according to the form of the anterior curve of the dental arch; these were named forms A through H. Each group was subdivided into 3 subgroups: small, medium, and large sizes., Results: Form A was the most frequently observed at 22%, whereas form G was observed in only 2% of the total sample. Forms A, B, C, D, E, and F had more curve segments in medium size, and forms G and H had more curves in small size. A mean dental arch curve was calculated; however, this form coincided with form C, which had an incidence of 10%., Conclusions: The mandibular dental arch is represented by 23 forms; thus, a normal dental arch cannot be represented by only 1 simple arch form.

Aim: To describe the dentoskeletal changes occurring during treatment of a patient with a skeletal Class III malocclusion treated for orthodontic compensation at 10 years 4 months of age., Methods: Rapid maxillary expansion was performed with a Hyrax appliance, Petit orthopedic face mask, high-pull chin cap, and bioprogressive fixed mechanics., Results: The mechanics employed yielded downward and backward mandibular rotation (3 degrees of opening of the facial axis), advancement of the maxillary incisors, and retraction of the mandibular incisors. The result was satisfactory from both esthetic and functional standpoints, providing adequate overjet and overbite, and with stability at 5 years posttreatment., Conclusion: The option for compensatory treatment of the skeletal Class III malocclusion without extractions and without orthognathic surgery might be a good option for young patients with good compliance, convergent facial pattern (brachyfacial), and with deep bite, since such occlusal characteristics allow the downward and backward mandibular rotation that is necessary for correction of this problem.

The adsorption behavior of horseradish peroxidase (HRP) onto hybrid particles of poly(methylmethacrylate) (PMMA) and carboxymethylcellulose (CMC) was investigated by means of spectrophotometry. Dispersions of PMMA/CMC particles were characterized by light scattering, zeta potential measurements and scanning electron microscopy before and after HRP adsorption. HRP adsorbed irreversibly onto PMMA/CMC particles; the adsorption isotherm showed an initial step and an adsorption plateau. The enzymatic activity of free HRP and immobilized HRP (plateau region) was monitored by means of spectrophotometry as a function of storing time. Upon adsorbing HRP there is little (up to 20%) or no reduction of enzymatic activity in comparison to that observed for free HRP in solution. After storing free HRP and HRP-covered PMMA/CMC particles for 18 days the level of enzymatic activity is kept. HRP-covered PMMA/CMC particles dispersions, which were dried and re-dispersed, retained 50% of their catalytic properties. These interesting findings were discussed in the light of a beneficial effect of a hydrated microenvironment for maintenance of enzyme conformation and activity.

Aim: To describe the treatment of a 7-year-old patient with a hyperdivergent (dolichofacial) pattern, Class II Division 1 malocclusion, and anterior open bite., Methods: Treatment was performed in 2 stages following the principles of the Ricketts bioprogressive technique and comprised early extraction of the maxillary permanent first molars and primary second molars., Results: The treatment plan established for correction of the initial malocclusion reached the orthodontic goals, providing optimal esthetics and normal function., Conclusion: Posterior dentoalveolar height, which is fundamental in diagnosis and treatment planning, should be investigated in cases with excessive vertical dimension. In addition, extraction of permanent or primary maxillary posterior teeth at an early age may be a good option for hyperdivergent patients with excessive posterior dentoalveolar height.

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

Objectives: This study evaluated new bone formation at the midpalatal suture after surgically assisted rapid maxillary expansion (SARME) by optical density analysis., Methods: The study population consisted of 18 patients, 10 males and 8 females. All patients presented maxillary atresia with posterior crossbite and were submitted to SARME. Maxillary occlusal radiographs were taken at three stages (before SARME, immediately after SARME and after 3 months). Three patients did not attend the session at the 3-month period for achievement of the occlusal radiography and thus were excluded, leading to a final sample of 15 patients. Two regions were selected and analysed at each stage. Region A measured 8 x 1 mm(2) and was located 1.2 cm from the tangent to the maxillary central incisors at the region of the midpalatal suture. Region B measured 5 x 9 mm(2) and was located 4.3 cm from the tangent to the maxillary central incisors at the region of the midpalatal suture. An aluminium scale (step wedge) with eight steps varying from 1 mm to 8 mm was adapted at the end of the films. Radiographs were taken on a Spectro 70X machine (Dabi Atlante, Ribeirão Preto, Brazil) set at 70 kVp and 10 mA with an exposure time of 1.0 s. Radiographs were scanned using a Power Look 1000 scanner (Umax, Taiwan, China) and a computer Dimension E510 (Dell Computer, Taiwan, China). Optical density analysis was performed after digitization of radiographs using the software Image Tool (UTHSCSA, San Antonio, TX)., Results: Statistical analysis of region A revealed statistically significant differences between Stages I and II (P=0.0001), Stages II and III (P=0.0001) and Stages I and III (P=0.0003). In region B, statistically significant differences were observed between Stages I and II, I and III and II and III (P=0.0018, P=0.0003 and P=0.0003, respectively)., Conclusions: Optical density analysis improves post-treatment control of SARME procedures by surgeons and orthodontists. After 3 months, new bone formation at the midpalatal suture is not complete.