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INTRODUÇÃO: A distalização sequencial por meio do sistema de alinhadores ortodônticos Invisalign® apresenta uma grande efetividade clínica, quando bem indicada. Entretanto, muitas vezes a correção de más oclusões de Classe II mais graves ou com características particulares requer o uso de dispositivos auxiliares, que potencializam ou propiciam a correção sagital adequada. OBJETIVO: Sendo assim, o intuito do presente artigo é relatar métodos auxiliares para maximizar o protocolo de distalização sequencial na maxila com Invisalign®, quer seja com o uso de recursos empregando elásticos intermaxilares, ou com diferentes meios de ancoragem esquelética.

O presente caso clínico relata o tratamento ortopédico e ortodôntico de uma má oclusão de Classe II, divisão 1, com padrão de crescimento horizontal. A paciente se apresentava no surto de crescimento puberal, com mordida cruzada vestibular dos primeiros pré-molares superiores e diastemas na arcada inferior. Os objetivos do tratamento foram corrigir a sobremordida e a sobressaliência, além de adequar a relação transversal e sagital entre as arcadas, aproveitando, para isso, o crescimento mandibular. Ao fim do tratamento, obteve-se arcadas coordenadas e uma boa intercuspidação dentária.

Background This study aimed to analyze 3-dimensional nasolabial soft tissue changes following double jaw surgery with Le Fort I maxillary advancement and relate them to underlying surgical movements. Methods Pre- and post-surgical cone-beam computed tomography images of 37 maxillomandibular surgery patients with ≥2 mm of advancement at A-point were analyzed. Lateral cephalograms were constructed to determine horizontal and vertical surgical movements and 3-dimensional facial images were created from the CBCTs to calculate linear and angular changes. Results Alar base width increased 1.9 mm, nasal tip protrusion decreased 0.74 mm, the upper lip flattened 7.71 degree and increased 0.9 mm in length, nasal tip was displaced 2.47 mm superiorly causing an increased concavity of 5.52 degree for the overall dorsal surface and 3.99 degree at the supratip break angle (SBA), nasal tip angle decreased 2.16 degree and nasolabial angle decreased 7.37 degree. Correlations were found between underlying surgical movements and nasal tip protrusion, SBA, nasolabial angle (NLA), and nasal tip elevation (NTE). Multiple linear regression equations were calculated to predict changes in SBA from horizontal change at A-point, NLA from horizontal change at B-point, and NTE from the change at A-point horizontally and U1-tip vertically. Conclusion Double jaw surgery with maxillary advancement has significant effects on nasolabial anatomy.

Objective The purpose of this study was to assess the long-term stability of rapid palatal expansion (RPE) followed by full fixed edgewise appliances. Methods This study included 67 patients treated using Haas-type RPE and non-extraction edgewise appliance therapy at a single orthodontic practice. Serial dental casts were obtained at three different time points: pretreatment (T1), after expansion and fixed appliance therapy (T2), and at long-term recall (T3). The mean duration of the T1-T2 and T2-T3 periods was 4.8 ± 3.5 years and 11.0 ± 5.4 years, respectively. The dental casts were digitized, and the computed measurements were compared with untreated reference data. Results The majority of treatment-related increases in the maxillary and mandibular arch measurements were statistically significant (p < 0.05) and greater than expected for the untreated controls. Although many measurements decreased postretention (T2-T3), the net gains persisted for all of the measurements evaluated. Conclusions The use of RPE therapy followed by full fixed edgewise appliances is an effective method for increasing maxillary and mandibular arch width dimensions in growing patients.

Introduction Our objective was to analyze the characteristics that affect skeletal Class I adults with mandibular asymmetries using cone-beam computerized tomography. Methods The sample included cone-beam computerized tomography images of 120 subjects. Asymmetry was determined by the deviation of gnathion from the midsagittal plane and classified as relative symmetry, moderate asymmetry, or severe asymmetry. Maxillary and mandibular measurements were made, and the differences between the contralateral side and the deviated side were evaluated, as well as the differences between the categories of asymmetry. Results For patients with moderate asymmetry, there were significant differences between the contralateral and deviated sides for some measuments in the transverse and vertical planes. For those with severe asymmetry, statistically significant differences were found between the sides for all measurements, except for the measuments that evaluated the position of the mandibular condyle in the transverse and sagittal directions. Furthermore, a strong correlation was found in patients with severe asymmetry, between the deviation of the mandibular dental midline and the lateral displacement of gnathion. Conclusions: Patients with relative symmetry had a bilateral balance, whereas those with moderate and severe asymmetries showed several skeletal imbalances. A great deviation of the mandibular dental midline may indicate severe skeletal asymmetry in Class I adults.

The aim of this study was to evaluate the characteristics affecting different intensities of mandibular asymmetry in skeletal Class II adults using three-dimensional images. This study is clinically relevant since it allows professionals to evaluate the morphological components related to these deformities and more carefully obtain correct diagnosis and treatment plan for such patients. Cone-beam computed tomography data of 120 Class II patients (40 with relative symmetry, 40 with moderate asymmetry, and 40 with severe asymmetry) were imported to SimPlant Ortho Pro® 2.0 software (Dental Materialise, Leuven, Belgium). Three reference planes were established and linear measurements were performed from specific landmarks to these planes, comparing the deviated side and the contralateral side in each group, as well as the differences between groups. The correlation between midline mandibular asymmetry and other variables was also evaluated. Statistical analyses considered a significance level of 5%. Comparing the values obtained on the deviated side and on the contralateral side, there were significant differences for patients with moderate asymmetry and severe asymmetry. However, differences were seen more often in severe mandibular asymmetries. In those patients, there was a significant correlation of the gnathion deviation with lower dental midline deviation, difference in the lateral gonion positions, difference in the mandibular rami heights, and difference in the jugale vertical displacements. For skeletal Class II patients with mandibular asymmetry, some craniofacial features are related to chin deviation and require proper evaluation, including the bilateral differences in the ramus height, mandibular body length, transverse and vertical positioning of the gonion and jugale points.

Objective To examine the efficacy of the magnetic retainer as compared with canine-to-canine retainers bonded to each tooth. Materials and Methods Using digital models of 39 patients who had the magnetic retainer (MagneTainer) placed at debond and 41 patients who had canine-to-canine retainers placed at debond, Little's Irregularity Index (LII), intercanine width (ICW), and a tooth size arch length discrepancy (TSALD) for the lower anterior teeth were calculated before treatment, at placement of retainers, and 2 years after placement. The groups were compared to determine if any significant differences existed. Results Significant differences within each group were seen for changes in LII and TSALD at 2 years compared with debond ( P P Conclusions There are no significant differences in the efficacy of canine-to-canine retainers bonded to each tooth and the magnetic retainer.

This study aimed to estimate the prevalence of mandibular asymmetry and investigate some associated factors. Tomographic images of 952 individuals aged from 18 to 75 years old were analyzed. The investigated outcome was mandibular asymmetry. The explanatory variables included gender, age, absence of posterior teeth, and sagittal jaw relationship of the individuals. Statistical analyses included the chi-squared and the Poisson regression with robust variance. Mandibular asymmetry was present in 17.4% of the sample (95% confidence interval 15.2-20.0). In the bivariate analysis, there was an association between the variables age and sagittal jaw relationship with mandibular asymmetry (P = 0.026 and P = 0.018, respectively). However, in the adjusted regression model, the association with age was not maintained, occurring only an association between sagittal jaw relationship and mandibular asymmetry (P = 0.045), with significant difference between individuals with skeletal Class II and skeletal Class III (P = 0.013). Mandibular asymmetry was not independently associated with sex, age, or absence of posterior teeth. The only verified independent association was between mandibular asymmetry and sagittal jaw relationship.

Objective: The present study aims at using cone beam computed tomography (CBCT) to analyze the maxillomandibular characteristics present in adults with mandibular asymmetries and different sagittal jaw relationships. Methods: 360 patients were selected and divided into three groups (Class I, Class II, and Class III), with 120 individuals per group. The groups were then subdivided according to the intensity of lateral deviation of the gnathion point, into: 1) relative symmetry, 2) moderate asymmetry, and 3) severe asymmetry. Three planes of reference were established in the CBCT images and several measurements were taken to compare the bilateral skeletal differences between the intensities of asymmetry for the different sagittal jaw relationships. Results: When the groups were compared by the intensity of asymmetry, significant differences among patients with relative symmetry and moderate to severe asymmetry were found. This was especially noticed for severe asymmetry, suggesting that the deviation of the chin did not constitute the only morphological alteration for these patients, especially because a series of measurements showed significant bilateral differences. When comparing sagittal jaw relationships, the only significant finding was the vertical positioning of the gonion between Class II and III patients with severe asymmetry. Conclusions: When comparing the three sagittal jaw relationships with the same intensity of asymmetry, most maxillofacial aspects were quite similar. The only difference was found for patients with severe asymmetry, as the individuals with Class II showed greater bilateral difference in the vertical positioning of the gonion, when compared to patients with Class III. RESUMO Objetivo: o presente estudo teve como objetivo analisar, por meio de tomografia computadorizada de feixe cônico (TCFC), as características esqueléticas maxilomandibulares presentes em adultos com diferentes graus de assimetria mandibular e diferentes relações esqueléticas sagitais. Métodos: foram selecionados 360 pacientes, os quais foram divididos em três grupos, com 120 indivíduos cada (Classe I, Classe II e Classe III). Cada grupo foi, ainda, subdividido de acordo com a intensidade do desvio lateral do mento: 1) simetria relativa; 2) assimetria moderada; e 3) assimetria severa. Três planos de referência foram estabelecidos nas imagens de TCFC e várias medidas foram realizadas, sendo comparadas as diferenças esqueléticas bilaterais existentes entre os graus de assimetria em cada grupo, nas diferentes relações esqueléticas sagitais. Resultados: quando comparados os grupos pelos graus de assimetria, existiram diferenças significativas entre pacientes com simetria relativa e pacientes assimétricos, especialmente para a assimetria severa, sugerindo que o desvio do mento não constitui a única alteração morfológica para esses pacientes, especialmente porque uma série de medidas apresentou diferenças bilaterais significativas. Quando comparadas as relações sagitais entre si, não foram encontradas diferenças significativas, exceto para o posicionamento vertical do gônio entre as Classe II e III na assimetria severa. Conclusão: ao comparar a mesma intensidade de assimetria entre as diferentes relações esqueléticas sagitais, pouca diferença pôde ser observada. A única diferença encontrada foi em pacientes com assimetria severa, na qual os indivíduos com Classe II apresentaram maior diferença bilateral no posicionamento vertical do gônio, quando comparados àqueles com Classe III.

Objectives: To estimate the prevalence of mandibular asymmetries in orthodontic and orthognathic surgery patients and to investigate demographic and skeletal factors associated with this disharmony. Materials and Methods: Cone-beam computed tomography images of 1178 individuals aged 19 through 60 years with complete dentitions were analyzed. Outcomes were classified as relative mandibular symmetry, moderate asymmetry, and severe asymmetry. Factors recorded included sex, age, side of mandibular deviation, sagittal jaw relationship, vertical skeletal pattern, angle of the cranial base, and maxillary asymmetry. Ordinal logistic regression was used to estimate simple and adjusted odds ratios (OR) for the individuals with moderate and severe mandibular asymmetry, as well as 95% confidence intervals. Results: Prevalence values of 55.2%, 27.2%, and 17.6% were observed for relative mandibular symmetry, moderate asymmetry, and severe asymmetry, respectively. An independent association with the side of mandibular deviation and the presence of maxillary asymmetry was observed, both for subjects with moderate mandibular asymmetry (left side: OR = 1.50; 95% CI: 1.01–2.24 / maxillary asymmetry: OR = 2.07; 95% CI: 1.11–3.76) and for those with severe asymmetry (left side: OR = 2.09; 95% CI: 1.27–3.44 / maxillary asymmetry: OR = 4.93; 95% CI: 2.64–9.20). Conclusions: Moderate and severe mandibular asymmetries were present in 44.8% of the sample, being associated with the side of mandibular deviation and with maxillary asymmetry.

Introduction Dens invaginatus is an anomaly of dental development in which calcified tissues, such as enamel and dentin, are invaginated into the pulp cavity. This morphologic alteration is more frequent in maxillary permanent lateral incisors and makes them more susceptible to carious lesions and pulp alterations. Methods This case report describes a patient with maxillary lateral incisors affected by dens invaginatus. The maxillary right lateral incisor had already undergone endodontic treatment, and the maxillary left one had a periapical lesion. Additionally, the patient had a Class II Division 1 malocclusion, with anterior open bite, posterior crossbite, and an impacted mandibular left second molar. Results The orthodontic treatment involved extraction of the maxillary lateral incisors and 2 mandibular premolars, resulting in proper overjet and overbite with good arch coordination and occlusal stability. Conclusions Treatment results were stable, as evaluated in a 6-year posttreatment follow-up.

Purpose To analyze components related to different degrees of mandibular asymmetry in adults with skeletal Class III using cone-beam computed tomographic (CBCT) images. Materials and Methods CBCT images from 138 patients were analyzed. Asymmetry was determined by the deviation of the gnathion point in relation to the midsagittal plane and classified as relative symmetry, moderate mandibular asymmetry, or severe mandibular asymmetry. Several maxillary and mandibular measurements were used to compare different degrees of mandibular asymmetry and the difference between measurements of the contralateral and deviated sides. Results For patients with moderate and severe mandibular asymmetry, there were statistically relevant differences between bilateral measurements of the sagittal position of the condylar heads, the transverse and sagittal positioning of the gonion, ramus height, and mandibular body length, the transverse and vertical positioning of the jugale point, including a vertical positioning of the gonion only for severe asymmetry. In patients with severe mandibular asymmetry, there was a highly relevant correlation of gnathion lateral displacement with lower dental midline displacement and with the difference in height of the mandibular rami between the deviated and contralateral sides. Conclusion In patients with skeletal Class III, not only lateral displacement of the menton but also a series of morphologic changes differed markedly for each degree of mandibular asymmetry.

Purpose: The present work consists of a comparative study of two indexes of skeletal maturation: the carpal index (SMI) and the vertebral index (CVMI) and verification of the reliability of the vertebral index in the determination of the stages of the skeletal maturation. Methods: Radiographies from the dental records of treated patients from Universidade do Sul de Santa Catarina (UNISUL) were used. The sample was composed of 158 radiographies comprising seventy-nine carpal and seventy-nine lateral cephalometric radiographies of patients of both genders between six and eighteen of age. The carpal radiographies were analyzed using Martins’ method and the lateral cephalometric, according to Baccetti, Franchi and McNamara Jr. Results: The Spearman’s correlation test results showed a significant correlation coefficient of 0.616 between SMI and CVMI and the Pearson’s test, of 0.698 for both genders (P

The term "asymmetry" is used to make reference to dissimilarity between homologous elements, altering the balance between structures. Facial asymmetry is common in the overall population and is often presented subclinically. Nevertheless, on occasion, significant facial asymmetry results not only in functional, but also esthetic issues. Under these conditions, its etiology should be carefully investigated in order to achieve an adequate treatment plan. Facial asymmetry assessment comprises patient's first interview, extra- as well as intraoral clinical examination, and supplementary imaging examination. Subsequent asymmetry treatment depends on patient's age, the etiology of the condition and on the degree of disharmony, and might include from asymmetrical orthodontic mechanics to orthognathic surgery. Thus, the present study aims at addressing important aspects to be considered by the orthodontist reaching an accurate diagnosis and treatment plan of facial asymmetry, in addition to reporting treatment of some patients carriers of such challenging disharmony. Resumo O termo assimetria é utilizado quando existe uma desigualdade entre as partes homólogas, afetando, assim, o equilíbrio entre as estruturas. A assimetria facial é comum na população, e muitas vezes se apresenta de forma subclínica. Entretanto, em alguns casos existe uma assimetria facial significativa que resulta tanto em problemas funcionais quanto estéticos. Nessas circunstâncias, a etiologia deve ser cuidadosamente investigada, para que seja possível elaborar um plano de tratamento adequado. A avaliação da assimetria facial é constituída por uma anamnese do paciente, exame clínico extra e intrabucal, além de exames complementares de imagem. O tratamento subsequente dessa assimetria depende da idade do paciente, etiologia e da magnitude da desarmonia, podendo envolver desde mecânicas ortodônticas assimétricas até a realização de cirurgia ortognática. Assim, o presente artigo busca abordar aspectos importantes para que o ortodontista possa realizar um adequado diagnóstico e plano de tratamento da assimetria facial, além de relatar o tratamento de alguns pacientes portadores dessa desafiadora desarmonia.

Introduction In this study, we investigated volumetric and dimensional changes to the pharyngeal airway space after isolated mandibular setback surgery for patients with Class III skeletal dysplasia. Methods Records of 28 patients who had undergone combined orthodontic and mandibular setback surgery were obtained. The sample comprised 17 men and 11 women. Their mean age was 23.88 ± 6.57 years (range, 18-52 years). Cone-beam computed tomography scans were obtained at 3 time points: before surgery, average of 6 months after surgery, and average of 1 year after surgery. Oropharyngeal, hypopharyngeal, and total volumes were calculated. The lateral surface and anteroposterior dimensions at the minimal axial areas for oropharyngeal and hypopharyngeal volumes and mean mandibular setback were determined. Results The mean mandibular setback was 9.93 ± 5.26 mm. Repeated measures analysis of variance determined an overall significant decrease between the means for 6 months and up to 1 year after surgery for oropharyngeal and hypopharyngeal volumes, anteroposterior at oropharyngeal, lateral surface at oropharyngeal, and anteroposterior at hypopharyngeal. No strong correlation between mandibular setback surgery and pharyngeal airway volumes or dimensions was determined. Conclusions After mandibular setback surgery, pharyngeal airway volume, and transverse and anteroposterior dimensions were decreased. Patients undergoing mandibular setback surgery should be evaluated for obstructive sleep apnea and the proposed treatment plan modified according to the risk for potential airway compromise.

OBJETIVO: avaliar o efeito da aplicação do fluoreto de sódio (NaF 1,23%) sobre a superfície de braquetes de titânio e de aço inoxidável. METODOLOGIA: foram utilizados 15 braquetes de titânio, divididos em três grupos: A) grupo controle, composto por braquetes não submetidos a qualquer tipo de tratamento; B) braquetes imersos por 60 segundos em fluoreto de sódio e lavados com 20ml de água destilada por trinta segundos; C) braquetes imersos por 60 segundos em fluoreto de sódio e posteriormente submetidos à escovação por 15 segundos, sendo então lavados com 20ml de água destilada por trinta segundos. Para efeito comparativo, foram utilizados 15 braquetes de aço inoxidável, divididos em três grupos (Grupos A1, B1, C1) e submetidos aos mesmos procedimentos descritos. Todos os braquetes, antes e após o experimento, foram avaliados por inspeção visual e analisados ao microscópio eletrônico de varredura (Philips, modelo XL 30). RESULTADOS: a inspeção visual revelou uma mudança da coloração dos braquetes de titânio submetidos ao fluoreto de sódio (grupos B e C), apresentando-se escurecidos quando comparados aos acessórios do grupo A. Os braquetes de aço inoxidável não sofreram alteração cromática em nenhum dos grupos. CONCLUSÃO: através da análise por microscópio eletrônico de varredura, não foram constatadas alterações topográficas e químicas na superfície dos braquetes de titânio, assim como nos braquetes de aço inoxidável.AIM: to assess and compare the effects of fluoride (NaF 1.23%) on titanium and stainless steel brackets. METHODS: Fifteen titanium brackets, divided in 3 groups were used: A) control group (no treatment on its surface), B) brackets immersed in NaF (60 seconds) and washed with distilled water (30 seconds), C) brackets with similar treatment to group B and submitted to brushing (15 seconds). Fifteen stainless steel brackets were used for comparative effects, divided in 3 groups, and submitted to the same described procedures. All brackets were evaluated by macroscopic (visual appearence) and scanning microscopy (Philips, model XL 30), before and after the procedures. RESULTS: titanium brackets submitted to fluoride (NaF), groups B and C, presented discoloration (matte gray color) when compared to group A. Stainless steel brackets showed no color alteration. CONCLUSION: titanium and stainless steel brackets showed no change in surface roughness or chemical components when immersed in sodium fluoride solution.

OBJETIVO: avaliar o efeito da aplicação do fluoreto de sódio (NaF 1,23%) sobre a superfície de braquetes de titânio e de aço inoxidável. METODOLOGIA: foram utilizados 15 braquetes de titânio, divididos em três grupos: A) grupo controle, composto por braquetes não submetidos a qualquer tipo de tratamento; B) braquetes imersos por 60 segundos em fluoreto de sódio e lavados com 20ml de água destilada por trinta segundos; C) braquetes imersos por 60 segundos em fluoreto de sódio e posteriormente submetidos à escovação por 15 segundos, sendo então lavados com 20ml de água destilada por trinta segundos. Para efeito comparativo, foram utilizados 15 braquetes de aço inoxidável, divididos em três grupos (Grupos A1, B1, C1) e submetidos aos mesmos procedimentos descritos. Todos os braquetes, antes e após o experimento, foram avaliados por inspeção visual e analisados ao microscópio eletrônico de varredura (Philips, modelo XL 30). RESULTADOS: a inspeção visual revelou uma mudança da coloração dos braquetes de titânio submetidos ao fluoreto de sódio (grupos B e C), apresentando-se escurecidos quando comparados aos acessórios do grupo A. Os braquetes de aço inoxidável não sofreram alteração cromática em nenhum dos grupos. CONCLUSÃO: através da análise por microscópio eletrônico de varredura, não foram constatadas alterações topográficas e químicas na superfície dos braquetes de titânio, assim como nos braquetes de aço inoxidável.

The objective of this clinical case is to suggest a treatment approach for impaction of the maxillary first permanent molars. This approach allows access to the partially erupted tooth for orthodontic bonding and utilization of loops for distalization. An important detail is the non inclusion of the primary second molar in the orthodontic mechanics, in order to reduce the risk of early loss and preserve this tooth until exfoliation.

OBJETIVO: o presente estudo teve o objetivo de avaliar as alterações esqueléticas sagitais produzidas pelo aparelho de Herbst. METODOLOGIA: foram avaliados 22 indivíduos com má oclusão de Classe II, 1ª divisão, sendo 11 do gênero masculino e 11 do gênero feminino, com média de idade de 9,01 anos (±6 meses), apresentando padrão facial Classe II, deficiência mandibular e padrão esquelético de Classe II (ANB>5º e Co-Gn-Co-SnAIM: the present study aimed at evaluating the sagittal skeletal alterations after Herbst appliance treatment. METHODS: the sample was comprised by in 22 subjects with Class II division 1 malocclusion, being 11 males and 11 females, with a mean age of 9.01 years (±06 months), who presented Class II facial pattern, mandibular deficiency and Class II skeletal pattern (ANB>5º and Co-Gn - Co-Sn

OBJETIVO: o presente estudo teve o objetivo de avaliar as alterações esqueléticas sagitais produzidas pelo aparelho de Herbst. METODOLOGIA: foram avaliados 22 indivíduos com má oclusão de Classe II, 1ª divisão, sendo 11 do gênero masculino e 11 do gênero feminino, com média de idade de 9,01 anos (±6 meses), apresentando padrão facial Classe II, deficiência mandibular e padrão esquelético de Classe II (ANB>5º e Co-Gn-Co-Sn5º and Co-Gn - Co-Sn

O crescimento corporal de crianças e adolescentes e sua relação com a aceleração do crescimento do complexo craniofacial constituem assunto de enorme interesse para o ortodontista, uma vez que a instituição de uma terapia que vise controlar o desenvolvimento maxilo-mandibular é baseada no estudo da idade esquelética do paciente e sua conseqüente maturação somática. Este estudo objetivou assim avaliar a correlação existente entre o crescimento estatural e o crescimento mandibular em 30 indivíduos com Classe II esquelética, não tratados ortodonticamente, acompanhados longitudinalmente junto ao Burlington Growth Study - Canadá. As documentações seriadas foram obtidas aos 6, 9, 12, 14 e 16 anos de idade cronológica, constando de telerradiografias de perfil e fichas clínicas com dados cadastrais. Os resultados indicaram que o pico de crescimento estatural, bem como o maior incremento médio da maioria das medidas mandibulares avaliadas, ocorreu para o gênero feminino, no período entre 9 e 12 anos, e para o gênero masculino, entre 12 e 14 anos. Além disso, foi verificado que, dentre todas as medidas analisadas, a velocidade média de incremento no comprimento da mandíbula demonstrou a correlação mais consistente com a velocidade média de crescimento em altura destes indivíduos, principalmente para o gênero masculino durante seu pico de crescimento (r=0,758).The height growth of children and teenagers, as well as its relationship with the rate of craniofacial growth, are of large interest to the orthodontist, since the indication of a therapy to control jaw development is based on the study of the skeletal age of the patient and subsequent somatic maturation. Therefore, this study aimed at evaluating the correlation between height growth and mandibular growth of 30 subjects presenting with skeletal Class II, with no orthodontic treatment, which were longitudinally followed-up through the Burlington Growth Study of Canada. The serial records were obtained at 6, 9, 12, 14 and 16 years of chronological age and comprised lateral cephalograms, clinical records and personal information. The results indicated that the height growth spurt, as well as the largest mean increase in the mandibular measurements, occurred from 9 to 12 years of age for the females and from 12 to 14 years of age for the males. Moreover, it was also observed that, among all study measurements, the rate of increase of the mandibular length demonstrated the strongest correlation with the mean rate of height growth of these individuals, specially for the males during their growth spurt (r=0,758).

OBJETIVO: o diagnóstico e o tratamento precoce do Padrão III são temas ainda muito discutidos na literatura ortodôntica. A tração reversa associada à expansão rápida da maxila constitui a abordagem mais popular e estudada, produzindo os melhores resultados no menor período de tempo. O foco deste estudo foi avaliar as mudanças gradativas ocorridas no complexo dentofacial em crianças com Padrão III de crescimento tratadas com tração reversa da maxila associada à mecânica intermaxilar. MÉTODOS: a amostra foi constituída por 10 pacientes Padrão III, com média de idade de 8 anos e 2 meses ao início do tratamento, tratados consecutivamente com aparelho expansor de Haas modificado, arco lingual modificado, elásticos intermaxilares e máscara de Petit para tração reversa da maxila por 9 meses. Foram realizadas 4 telerradiografias em norma lateral de cada paciente, uma correspondente ao início do tratamento e as demais em intervalos regulares de 3 meses (T1, T2, T3 e T4). As grandezas cefalométricas foram comparadas entre os tempos através de Análise de Variância de Medidas Repetidas, complementada pelo Teste de Comparações Múltiplas de Tukey. RESULTADOS: pôde-se observar que as alterações esqueléticas mais significativas ocorreram nos primeiros 3 meses de tratamento, sendo que, após esse período, elas se mantiveram constantes até o final do tratamento. Ocorreram poucas compensações dentárias e as alterações verticais ocorridas apresentaram significado clínico reduzido. CONCLUSÃO: a terapia empregada obteve não só uma correção do trespasse horizontal entre as arcadas, mas também uma melhora no relacionamento sagital entre as bases ósseas e na estética tegumentar. OBJECTIVE: The early diagnosis and treatment of skeletal Class III (Pattern III) is still a much debated topic in orthodontic literature. Maxillary protraction associated with rapid maxillary expansion is the most popular and widely researched approach, producing the best results in the shortest period of time. This study aimed to evaluate the gradual changes that occur in the dentofacial complex in children with Pattern III growth treated with maxillary protraction associated with intermaxillary mechanics. METHODS: The sample consisted of 10 patients with Pattern III, whose mean age was 8 years and 2 months at the beginning of treatment, consecutively treated with a modified Haas expander, modified lingual arch, intermaxillary elastics and Petit facemask for maxillary protraction during a 9-month period. Four lateral cephalograms were taken of each patient, one at the beginning of treatment and the other three at regular 3-month intervals (T1, T2, T3 and T4). Cephalometric measurements at each of the four times were compared using ANOVA variance for repeated measures and supplemented by Tukey's multiple comparisons test. RESULTS: It was observed that the most significant skeletal changes occurred in the first 3 months of treatment. After that period the changes remained constant until the end of treatment. There were few dental compensations and the vertical changes which occurred showed reduced clinical significance. CONCLUSIONS: The therapy used in this study accomplished not only the correction of overjet but also improvements in the sagittal relationship of the basal bones and in soft tissue esthetics.

AIM: The objective of this study was evaluating the prevalence of mandibular asymmetry in skeletal Class I adult patients. MATERIALS AND METHODS: The sample was composed by cone-beam computed tomography images of 250 skeletal Class I patients with age from 18 to 70 years old. The side deviation of mandibular asymmetry was evaluated (right and left), as well as the intensity of this asymmetry. People with gnathic deviation until 2mm were considered as patients with slight asymmetry; deviation between 2 and 5mm was considered moderate asymmetry and those higher than 5mm as severe asymmetries. The error calculation method was performed and there was not significant error in the measurements. To verify the association between the prevalence of mandibular asymmetry and the gender of individuals, the Χ2 was carried out and the significant level adopted was 5% (p

OBJECTIVE: This study evaluated the variations in the anterior cranial base (S-N), posterior cranial base (S-Ba) and deflection of the cranial base (SNBa) among three different facial patterns (Pattern I, II and III). METHOD: A sample of 60 lateral cephalometric radiographs of Brazilian Caucasian patients, both genders, between 8 and 17 years of age was selected. The sample was divided into 3 groups (Pattern I, II and III) of 20 individuals each. The inclusion criteria for each group were the ANB angle, Wits appraisal and the facial profile angle (G'.Sn.Pg'). To compare the mean values obtained from (SNBa, S-N, S-Ba) each group measures, the ANOVA test and Scheffé's Post-Hoc test were applied. RESULTS AND CONCLUSIONS: There was no statistically significant difference for the deflection angle of the cranial base among the different facial patterns (Patterns I, II and III). There was no significant difference for the measures of the anterior and posterior cranial base between the facial Patterns I and II. The mean values for S-Ba were lower in facial Pattern III with statistically significant difference. The mean values of S-N in the facial Pattern III were also reduced, but without showing statistically significant difference. This trend of lower values in the cranial base measurements would explain the maxillary deficiency and/or mandibular prognathism features that characterize the facial Pattern III.OBJETIVO: o presente estudo avaliou as variações da base craniana anterior (S-N), base craniana posterior (S-Ba), e ângulo de deflexão da base do crânio (SNBa) entre três diferentes padrões faciais (Padrão I, II e III). MÉTODOS: selecionou-se uma amostra de 60 telerradiografias em norma lateral de pacientes brasileiros leucodermas, de ambos os sexos, com idades entre 8 anos e 17 anos. A amostra foi dividida em três grupos (Padrão I, II e III), sendo cada grupo constituído de 20 indivíduos. Os critérios de seleção dos indivíduos para cada grupo basearam-se nos valores de ANB, Wits e ângulo do contorno facial (Gl.Sn.Pg'). Para observar se houve diferença nos valores médios de SNBa, S-N e S-Ba entre os diferentes grupos, utilizou-se a Análise de Variância One Way - ANOVA, seguida de testes post-hoc de Scheffé. RESULTADOS E CONCLUSÕES: não houve diferença estatisticamente significativa na deflexão da base do crânio entre os diferentes padrões faciais (Padrão I, II e III). Também não houve diferença significativa nos valores da base anterior e posterior do crânio entre o Padrão I e o Padrão II. Os valores médios de S-Ba apresentaram-se reduzidos no Padrão III, com diferença estatisticamente significativa. Os valores médios de S-N também se apresentaram reduzidos no Padrão III, embora sem diferença estatisticamente significativa. Essa tendência a valores reduzidos da base do crânio poderia explicar a deficiência maxilar e/ou prognatismo mandibular, características que podem estar presentes no Padrão III.

Este artigo apresenta um novo sistema de fixação para aparelhos removíveis que dispensa a confecção de grampos, sendo especialmente indicado para pacientes que apresentem dentes com pouca ou nenhuma retenção. Esse sistema de fixação, chamado GCS, utiliza attachments, fabricados a partir de botões ortodônticos, que são colados aos dentes, proporcionando excelente retenção mecânica e permitindo que os aparelhos removíveis, nesse caso um expansor, possam ser ativados como se fossem aparelhos fixos cimentados ou colados aos dentes, com a vantagem adicional de poderem ser removidos para higienização e para eventuais consertos. Também é apresentado um aparelho de contenção GCS que se encaixa aos attachments, trava o aparelho em posição e dispensa o uso de grampos, e que pode ser utilizado em praticamente todos os dispositivos ortodônticos ativos ou de contenção, aliando alta eficiência retentiva com simplicidade de construção. This study describes a new fixation system for removable appliances that does not require the fabrication of clasps and is specially recommended for patients whose teeth provide little or no retention. This fixation system, called GCS, uses attachments fabricated with orthodontic buttons bonded to the teeth. It provides excellent mechanical retention, and the removable appliances, in this case an expander, can be activated as if they were fixed appliances cemented or bonded to teeth. An additional advantage is that they may be removed for cleaning and repairs, if necessary. This study also describes a GCS retention appliance that fits into the attachments and fixes the appliance in a certain position, which precludes the use of clasps and may be adapted for practically all active or retentive orth odontic devices as it combines high retentive efficiency and fabrication simplicity.

To determine the dentofacial changes in children with skeletal Class III malocclusions treated with maxillary expansion, external maxillary protraction and intermaxillary traction.Fifteen Class III patients in either the deciduous or the mixed dentition (Mean age: 7.6 years; SD: 1.9 years) were used. The children were treated with a modified Haas expander, a modified lingual arch, intermaxillary elastics and facemask for nine months. Lateral cephalometric radiographs were taken at the beginning of treatment (T1) and at 3-month intervals (T2, T3, T4).Most significant sagittal skeletal modifications occurred in the first three months of treatment. During the first three months of treatment the upper and lower incisors tipped lingually and the face height increased. Towards the end of treatment the upper incisors proclined and the upper lip became more protrusive.The therapy corrected the horizontal skeletal and arch discrepancies and improved the positions of the lips.

Implants obtained popularity in Orthodontics by to make easy the maximum anchorage with the minimal patient׳s compliance. In this context, osseointegrated implants has been frequently used as auxiliaries of orthodontic treatments, substituting in some cases inter maxillaries elastics and extra oral appliances. These implants show as advantage a independence in opposite the patient׳s compliance, the anchorage possibility in periodontal loss cases, over there an esthetic improvement and the comfort propitiated, showing more expected results. This article approach the orthodontic treatment of a clinic case of Class II, division 1 malocclusion, non-extraction accomplished and with palatal implant to distalization of latter teeth.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T19:05:16Z No. of bitstreams: 1 S1415-54192006000500007.pdf: 438223 bytes, checksum: 0b526284077cdc8edee1843cfa48d2f9 (MD5) Made available in DSpace on 2013-08-22T19:05:16Z (GMT). No. of bitstreams: 1 S1415-54192006000500007.pdf: 438223 bytes, checksum: 0b526284077cdc8edee1843cfa48d2f9 (MD5) Previous issue date: 2006-10-01 Made available in DSpace on 2013-09-30T20:09:05Z (GMT). No. of bitstreams: 2 S1415-54192006000500007.pdf: 438223 bytes, checksum: 0b526284077cdc8edee1843cfa48d2f9 (MD5) S1415-54192006000500007.pdf.txt: 69562 bytes, checksum: c9458e369d412e1e7665b0cc95fe2625 (MD5) Previous issue date: 2006-10-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:17:35Z No. of bitstreams: 2 S1415-54192006000500007.pdf: 438223 bytes, checksum: 0b526284077cdc8edee1843cfa48d2f9 (MD5) S1415-54192006000500007.pdf.txt: 69562 bytes, checksum: c9458e369d412e1e7665b0cc95fe2625 (MD5) Made available in DSpace on 2014-05-20T15:17:35Z (GMT). No. of bitstreams: 2 S1415-54192006000500007.pdf: 438223 bytes, checksum: 0b526284077cdc8edee1843cfa48d2f9 (MD5) S1415-54192006000500007.pdf.txt: 69562 bytes, checksum: c9458e369d412e1e7665b0cc95fe2625 (MD5) Previous issue date: 2006-10-01 OBJETIVO: determinar as características mecânicas de molas T e T com helicóides, quando da incorporação de variações na liga metálica (aço inoxidável e beta-titânio), na intensidade de dobras de pré-ativação (0º e 40º/180º) e na secção transversal do fio utilizado para a construção destas molas (0,017 x 0,025 e 0,019 x 0,025). METODOLOGIA: foram submetidas ao ensaio mecânico 80 molas para fechamento de espaços, sendo estas centralizadas em um espaço de 21mm. As magnitudes de força horizontal, proporção momento/força e relação carga/deflexão produzidas pelos corpos de prova foram quantificadas utilizando-se um transdutor de momentos acoplado ao módulo indicador digital para extensiometria e adaptado a uma máquina universal de ensaios Instron. As molas foram submetidas a uma ativação total de 5mm, sendo registrados os valores a cada 1mm de ativação. No tratamento estatístico dos dados obtidos, foi realizada a análise de variância, sendo esta complementada pelo teste de comparações múltiplas de Tukey, considerando o nível de significância de 5%. RESULTADOS E CONCLUSÕES: os resultados demonstraram que, de maneira geral, as molas T com helicóides produziram menores magnitudes de força horizontal e relação carga/deflexão do que as molas T. Na presença de pré-ativação, as molas produziram altas proporções momento/força, enquanto, na ausência de dobras de pré-ativação, as mesmas geraram baixas proporções momento/força. Dentre todas as variáveis analisadas, aquela que apresentou uma maior influência na força horizontal e na relação carga/deflexão produzidas pelas molas foi a liga metálica. Já a proporção momento/força mostrou ser influenciada em maior grau pela pré-ativação das molas de fechamento. Resumo AIM: the present study determined the force systems produced by T-loop and T-loop with helices, with employment of different alloys (stainless steel and beta-titanium), different preactivation bends intensities (0º and 40º/180º) and different transverse sections (0.017 x 0.025 and 0.019 x 0.025). METHODS: 80 loops for space closure were submitted to mechanical testing, which were centralized in a space of 21mm. The magnitudes of horizontal force, moment/force ratio and load/deflection ratio were quantified using a moment transducer connected to a digital indicator for extensometry adapted to an Instron universal testing machine (model TTDML). The specimens were distended to a total activation of 5mm, being registered the values at every 1mm of activation. The data achieved were statistically analyzed by means of variance analysis and the Tukey test for multiple comparisons at a significance level of 5%. RESULTS and CONCLUSION: in general, the results indicated that the T-loops with helices produced lower magnitudes of horizontal force and load/deflection ratio than the T-loops. When inserted with the preactivation bends, the loops yielded high magnitudes of moment/force ratios, while when these preactivation bends were not presented, the moment/force ratios were low. The metallic alloy was the variable that presented the largest influence on the horizontal force and load/deflection ratio. The moment/force ratio was more intensely influenced by the incorporation of preactivation bends in the closure loops. Universidade Católica do Rio Grande do Sul UNISUL NOVAFAPI UFRJ ABO UNESP FO Universidade Tuiuti do Paraná ABO EAP UNESP FO

To determine the mechanical characteristics of beta-titanium T-loops with and without helices, with 0 and 180 degree gable bends and constructed from 0.017 inch x 0.025 inch and 0.019 inch x 0.025 inch wire.Forty beta-titanium T-loops were centrally positioned in a universal testing machine. The horizontal force and the moment/force ratios during activation were recorded at 1 mm intervals, up to a maximum of 7 mm. The data were analysed with analysis of variance complemented by the Tukey test for multiple comparisons.The results demonstrated that the transverse section of the wire had the greatest effect on the horizontal force produced by the loops. Significantly lower levels of horizontal force were obtained with loops made with the smaller 0.017 inch x 0.025 inch wire. Loops with gable bends yielded high moment/force ratios, whereas loops without gable bends had low moment/force ratios. In general, T-loops with helices yielded lower magnitudes of horizontal force and moment/force ratios than plain T-loops.The horizontal forces and moment/force ratios generated by plain T-loops with 180 degree gable bends yielded more adequate force systems. Incorporation of helices in the design of T-loops seems to be unnecessary.

O crescimento corporal de crianças e adolescentes e sua relação com a aceleração do crescimento do complexo craniofacial constituem assunto de enorme interesse para o ortodontista, uma vez que a instituição de uma terapia que vise controlar o desenvolvimento maxilo-mandibular é baseada no estudo da idade esquelética do paciente e sua conseqüente maturação somática. Este estudo objetivou assim avaliar a correlação existente entre o crescimento estatural e o crescimento mandibular em 30 indivíduos com Classe II esquelética, não tratados ortodonticamente, acompanhados longitudinalmente junto ao Burlington Growth Study - Canadá. As documentações seriadas foram obtidas aos 6, 9, 12, 14 e 16 anos de idade cronológica, constando de telerradiografias de perfil e fichas clínicas com dados cadastrais. Os resultados indicaram que o pico de crescimento estatural, bem como o maior incremento médio da maioria das medidas mandibulares avaliadas, ocorreu para o gênero feminino, no período entre 9 e 12 anos, e para o gênero masculino, entre 12 e 14 anos. Além disso, foi verificado que, dentre todas as medidas analisadas, a velocidade média de incremento no comprimento da mandíbula demonstrou a correlação mais consistente com a velocidade média de crescimento em altura destes indivíduos, principalmente para o gênero masculino durante seu pico de crescimento (r=0,758). The height growth of children and teenagers, as well as its relationship with the rate of craniofacial growth, are of large interest to the orthodontist, since the indication of a therapy to control jaw development is based on the study of the skeletal age of the patient and subsequent somatic maturation. Therefore, this study aimed at evaluating the correlation between height growth and mandibular growth of 30 subjects presenting with skeletal Class II, with no orthodontic treatment, which were longitudinally followed-up through the Burlington Growth Study of Canada. The serial records were obtained at 6, 9, 12, 14 and 16 years of chronological age and comprised lateral cephalograms, clinical records and personal information. The results indicated that the height growth spurt, as well as the largest mean increase in the mandibular measurements, occurred from 9 to 12 years of age for the females and from 12 to 14 years of age for the males. Moreover, it was also observed that, among all study measurements, the rate of increase of the mandibular length demonstrated the strongest correlation with the mean rate of height growth of these individuals, specially for the males during their growth spurt (r=0,758).

OBJECTIVE: To determine the mechanical characteristics of teardrop loop with and without helix fabricated using different metal alloy compositions (stainless steel and beta-titanium), submitted to different intensities of bends preactivation (0º and 40º), and with different cross-sectional dimension of the wire used to build these loops (0.017 x 0.025-in and 0.019 x 0.025-in). METHODS: Eighty loops used to close spaces were submitted to mechanical tests. The magnitudes of horizontal force, the moment/force ratio, and the load/deflection ratio produced by the specimens were quantified. Loops were submitted to a total activation of 5.0 mm and the values were registered for each 1.0 mm of activation. For statistic data analysis, a analysis of variance was performed and a Tukey's Multiple Comparison test was used as supplement, considering a 5% level of significance. RESULTS: In general, teardrop loops with helix produced lower magnitudes of horizontal force and load/deflection ratio, and higher moment/force ratio than teardrop loops without helix. Among all analyzed variables, metal alloy composition presented greater influence in the horizontal force and in the load/deflection ratio. The moment/force ratio showed to be more influenced by the preactivation of loops for space closure. OBJETIVO: determinar as características mecânicas de alças em gota e em gota com helicoide, quando da incorporação de variações na liga metálica (aço inoxidável e beta-titânio), na intensidade de dobras de pré-ativação (0º e 40º) e na secção transversal do fio utilizado para a construção dessas alças (0,017" x 0,025" e 0,019" x 0,025"). MÉTODOS: foram submetidas ao ensaio mecânico 80 alças para fechamento de espaços, sendo quantificadas as magnitudes de força horizontal, proporção momento/força e relação carga/deflexão produzidas pelos corpos de prova. As alças foram submetidas a uma ativação total de 5,0mm, sendo registrados os valores a cada 1,0mm de ativação. No tratamento estatístico dos dados obtidos, foi realizada a análise de variância, sendo essa complementada pelo teste de comparações múltiplas de Tukey, considerando o nível de significância de 5%. RESULTADOS: de maneira geral, as alças em gota com helicoide produziram menores magnitudes de força horizontal e relação carga/deflexão e maiores valores de proporção momento/força do que as alças em gota. Dentre todas as variáveis analisadas, aquela que apresentou uma maior influência na força horizontal e na relação carga/deflexão produzidas pelas alças foi a liga metálica. Já a proporção momento/força mostrou ser influenciada em maior grau pela pré-ativação das alças de fechamento de espaços.