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Introdução: Dos pacientes com diagnóstico de Infarto agudo do miocárdio com supradesnível de segmento ST (IAMCSST) submetidos à terapia de reperfusão coronária que apresentam Fluxo TIMI 3, cerca de 40% têm comprometimento do fluxo sanguíneo pela microcirculação coronária (MC), o que acarreta pior remodelamento do ventrículo esquerdo (RVE) com consequente aumento da mortalidade desta população, em relação àquela na qual o fluxo na MC se encontra normal. O clopidogrel é o único antiplaquetário que mostrou benefício na MC em pacientes com IAMCSST em relação ao placebo. No entanto, o ticagrelor mostrou-se superior ao clopidogrel no que diz respeito à eventos clínicos. O presente estudo tem como principal objetivo comparar o efeito do ticagrelor versus clopidogrel na MC em pacientes com IAMCSST. Métodos: O presente estudo incluiu de forma prospectiva 48 pacientes participantes do estudo TREAT, que comparou de forma aleatória ticagrelor e clopidogrel em pacientes com IAMCSST submetidos à fibrinólise. Estes pacientes foram transferidos para a Unidade Clínica de Coronariopatia Aguda do Instituto do Coração do HCFMUSP (InCor) o mais rapidamente possível após sua randomização pelo estudo TREAT. No InCor, foram submetidos a cinecoronariografia em 4 (±2) dias do início dos sintomas, sendo selecionados para o presente estudo aqueles que, ao final da cinecoronariografia, apresentavam obstrução residual na artéria culpada 46 AUC); no entanto, contrário às nossas expectativas, no grupo clopidogrel apenas 1 paciente (2,4%) apresentou hiper-reatividade plaquetária, muito aquém do observado em publicações prévias. Conclusão: No primeiro estudo que comparou o efeito do ticagrelor versus clopidogrel sobre a microcirculação coronária em pacientes com infarto agudo do miocárdio tratados com fibrinolítico, não foram observadas diferenças significativas nas respostas aos fármacos Background: Of the patients diagnosed with acute myocardial infarction with STsegment elevation (STEMI) undergoing coronary reperfusion therapy who have TIMI 3 flow, about 40% have impaired blood flow through the coronary microcirculation (CM), which leads to worse left ventrile remodeling with a consequent increase in mortality in this population. Clopidogrel is the only antiplatelet that has shown benefit in CM in patients with STEMI over placebo. However, ticagrelor was shown to be superior to clopidogrel with regard to clinical events. The present study has as main objective to compare the effect of ticagrelor versus clopidogrel on CM in patients with STEMI. Methods: The present study prospectively included 48 patients participating in the TREAT study, which randomly compared ticagrelor and clopidogrel in patients with STEMI undergoing fibrinolysis. These patients were transferred to the Coronary Critical Unit of the Heart Institute of HCFMUSP (InCor) as soon as possible after their randomization by the TREAT study. At InCor, cinecoronariography underwent 4 (± 2) days of symptom onset, and those who at the end of the cinecoronariography had residual obstruction in the culprit artery < 50% with TIMI 3 flow, were selected for the present study. whether or not they have undergone percutaneous coronary intervention (PCI). The evaluation of the microcirculation perfusion was performed using the Myocardial Perfusion Index Score (Global MPSI) obtained by Myocardial Contrast Echocardiography (ECM). Results: The result of the primary objective of the study, the CM evaluation obtained by the Global MPSI, demonstrated the absence of significant differences between the groups (1.412 in the ticagrelor group and 1.294 in the clopidogrel group (p = 0.417). The evaluation of myocardial perfusion only segments related to the culprit artery (Regional MPSI), also did not present significant differences between the groups, 1.726 vs 1.587, respectively, in the ticagrelor and clopidogrel groups (p = 0.243). As expected, the ticagrelor group did not present patients with platelet hyperreactivity ( > 46 AUC), however, contrary to our expectations, only 1 patient (2.4%) presented platelet hyperreactivity in the clopidogrel group, less than observed in previous publications. Conclusion: In the first study that comparing the effect of ticagrelor versus clopidogrel on coronary microcirculation in patients with acute myocardial infarction treated with fibrinolytic agents, no significant differences were observed between the two drugs

Recent reports have suggested that aspirin effect might be influenced by bodyweight, with decreased efficacy in heavier individuals. We investigated the influence of bodyweight on aspirin pharmacodynamics in two independent datasets of patients taking non-enteric coated aspirin 100 mg QD for coronary artery disease (CAD). In the first dataset, 368 patients had their platelet aggregation assessed using VerifyNow Aspirin and measured in Aspirin Reaction Units (ARU). In the second dataset, 70 patients had serum thromboxane B2 (TXB2) dosage assessed by an ELISA assay and measured in pg/mL. Platelet aggregation was independently associated with bodyweight, with 8.41 (95% CI 1.86–14.97; adjusted p-value = 0.012) increase in ARU for every 10 kg. Furthermore, the rate of non-response to aspirin (defined as ARU ≥ 550) was significantly associated with increased bodyweight (adjusted p-value = 0.007), with OR = 1.23 (95% CI 1.06–1.42) for every 10 kg. Similar results were found considering body mass index (in kg/m2), with 15.5 (95% CI 5.0 to 25.9; adjusted p-value = 0.004) increase in ARU for every 10 kg and non-response OR = 1.43 (95% CI 1.13 to 1.81, adjusted p-value = 0.003) for every 5 kg/m2. Moreover, serum TXB2 was higher in patients weighting more than 70 kg (222.6 ± 62.9 versus 194.9 ± 61.9 pg/mL; adjusted p-value = 0.018). In two different datasets of patients with CAD on non-enteric coated aspirin 100 mg QD, increased bodyweight was independently associated with impaired response to aspirin.

About 40% of patients (pts) with ST-segment elevation myocardial infarction successfully reperfused have some degree of microcirculation flow (MF) compromised; this leads to worse left ventricular remodeling and higher mortality. Clopidogrel is the only antiplatelet drug with proved benefit on MF.

Made available in DSpace on 2014-09-30T18:18:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-12-01Bitstream added on 2014-10-01T14:03:14Z : No. of bitstreams: 1 S2176-94512013000600016.pdf: 199455 bytes, checksum: a21c38edb47d3dade54c3cf18ac980fe (MD5) OBJETIVO: esse estudo avaliou o posicionamento anteroposterior dos primeiros molares superiores (1º MS) e inferiores, e o grau de rotação dos 1º MS, em indivíduos com má oclusão de Classe II, divisão 1. MÉTODOS: mensuraram-se, em aparelho de precisão Assimetria I, 60 pares de modelos, de 27 indivíduos do sexo feminino e 33 do masculino, entre 12 e 21 anos de idade, com má oclusão de Classe II, divisão 1. Utilizando a sutura palatina mediana como referência de eixo de simetria, os modelos foram posicionados no aparelho para mensuração da distância entre a crista marginal mesial do molar mais distal e a crista marginal mesial do molar do lado oposto, a fim de verificar o posicionamento sagital dos molares. Em relação à giroversão, mediu-se a distância entre pontos na crista marginal mesial. O teste qui-quadrado a 5% foi utilizado para verificar a variação de posicionamento dos molares, por arcos e por lado. O teste t de Student a 5% foi utilizado para comparar esses valores. RESULTADOS: houve maior número de molares inferiores mesializados e, comparando os lados, maior número de molares mesializados no lado direito em ambas as arcadas. As rotações médias dos molares foram de 0,76mm do lado direito e 0,93mm do esquerdo. CONCLUSÃO: não houve diferença estatisticamente significativa entre os valores médios das mesializações dos molares quanto a lado ou arco. Quando observada isoladamente, a rotação dos molares, quantificada em milímetros, representou uma situação de ¼ de Classe II. OBJECTIVE: This study assessed the anterior-posterior positioning of the upper and lower first molars, and the degree of rotation of the upper first molars in individuals with Class II, division 1, malocclusion. METHODS: Asymmetry I, an accurate device, was used to assess sixty sets of dental casts from 27 females and 33 males, aged between 12 and 21 years old, with bilateral Class II, division 1. The sagittal position of the molars was determined by positioning the casts onto the device, considering the midpalatal suture as a symmetry reference, and then measuring the distance between the mesial marginal ridge of the most distal molar and the mesial marginal ridge of its counterpart. With regard to the degree of rotation of the upper molar, the distance between landmarks on the mesial marginal ridge was measured. Chi-square test with a 5% significance level was used to verify the variation in molars position. Student's t test at 5% significance was used for statistical analysis. RESULTS: A great number of lower molars mesially positioned was registered, and the comparison between the right and left sides also demonstrated a higher number of mesially positioned molars on the right side of both arches. The average rotation of the molars was found to be 0.76 mm and 0.93 mm for the right and left sides, respectively. CONCLUSION: No statistically significant difference was detected between the mean values of molars mesialization regardless of the side and arch. Molars rotation, measured in millimeters, represented ¼ of Class II. UMESP APCD Specialization Course in Orthodontics UNESP USP FOB UNICAMP Federal University of Sergipe UNESP

INTRODUCTION: This study evaluated changes in the smile characteristics of patients with maxillary constriction submitted to rapid maxillary expansion (RME). METHODS: The sample consisted of 81 extraoral photographs of maximum smile of 27 patients with mean age of 10 years, before expansion and 3 and 6 months after fixation of the expanding screw. The photographs were analyzed on the software Cef X 2001, with achievement of the following measurements: Transverse smile area, buccal corridors, exposure of maxillary incisors, gingival exposure of maxillary incisors, smile height, upper and lower lip thickness, smile symmetry and smile arch. Statistical analysis was performed by analysis of variance (ANOVA), at a significance level of 5%. RESULTS: RME promoted statistically significant increase in the transverse smile dimension and exposure of maxillary central and lateral incisors; maintenance of right and left side smile symmetry and of the lack of parallelism between the curvature of the maxillary incisal edges and lower lip border. CONCLUSIONS: RME was beneficial for the smile esthetics with the increase of the transverse smile dimension and exposure of maxillary central and lateral incisors.INTRODUÇÃO: esse estudo avaliou as alterações das características do sorriso de pacientes com atresia maxilar submetidos à expansão rápida da maxila (ERM). MÉTODOS: a amostra consistiu de 81 fotografias extrabucais do sorriso máximo de 27 pacientes, com idade média de 10 anos, antes da expansão e aos três e seis meses após a fixação do parafuso expansor. As análises das fotografias foram realizadas por meio do programa Cef X 2001, e as seguintes medidas foram analisadas: dimensão transversal do sorriso, corredores bucais, quantidade de exposição dos incisivos superiores, exposição gengival dos incisivos superiores, altura do sorriso, espessuras dos lábios superior e inferior, simetria e arco do sorriso. As alterações no sorriso durante as diferentes fases foram avaliadas por meio da análise de variância (ANOVA), seguida pelo teste de comparações múltiplas de Bonferroni, com nível de significância de 5%. RESULTADOS: a ERM promoveu aumento estatisticamente significativo da dimensão transversal do sorriso e da quantidade de exposição dos incisivos centrais e laterais superiores; manutenção da simetria entre os lados direito e esquerdo e da falta de paralelismo entre a curvatura das bordas dos incisivos superiores e a do lábio inferior. CONCLUSÃO: a ERM beneficiou a estética do sorriso com o aumento da dimensão transversal do sorriso e da quantidade de exposição dos incisivos centrais e laterais superiores.

OBJECTIVE: To verify the presence and degree of asymmetry of dental arches in Brazilian individuals with natural normal occlusion and Class II, Divisions 1 and 2 malocclusions. METHODS: The study evaluated the symmetry of the maxillary and mandibular dental arches of 180 pairs of dental casts, divided into: Group I = 60 pairs of natural normal occlusion individuals; Group II = 60 pairs of Class II, Division 1 malocclusion individuals; and Group III = 60 pairs of Class II, Division 2 malocclusion individuals. A device was used to measure dental midline deviation and the canine tip in the dental arches (in degrees). It was also verified the distance of the upper canines from the palatal suture, intercanine distance, and anteroposterior upper and lower first molar position. RESULTS: Dental arches of individuals from all groups presented asymmetry, regardless of the presence of malocclusion. Group I showed a lower asymmetry degree in relation to Groups II and III. The asymmetry in Groups II and III was similar. CONCLUSION: The dental arches of individuals with natural normal occlusion and with Class II, Division 1 and Division 2 malocclusions showed asymmetry. The asymmetry degree was higher in the mandibular dental arches than in the maxillary dental arches in all 3 evaluated groups.

Introdução e objetivo: Procurou-se avaliar cefalometricamente o espaço disponível para erupção dos segundos e terceiros molares superiores permanentes na região da tuberosidade maxilar após a distalização dos primeiros molares superiores. Material e métodos: A amostra foi constituída de 38 telerradiografias em norma lateral direita, de 19 pacientes brasileiros, leucodermas e melanodermas, com idade média de 9 anos e 5 meses, obtidas no início e após a distalização dos primeiros molares superiores permanentes. O espaço avaliado compreendeu da extremidade da tuberosidade maxilar à face distal do primeiro molar superior permanente. Para a análise estatística foi utilizado o teste t de Student, e na correlação entre espaço e angulação, o coeficiente de correlação de Pearson. Resultados e conclusão: O espaço correspondente entre a distal dos primeiros molares superiores permanentes e a extremidade da tuberosidade maxilar, na fase inicial e após a movimentação distal, não foi suficiente para a erupção dos segundos e terceiros molares superiores permanentes. As coroas, da fase inicial até o fim da movimentação distal, posicionaram-se mais para distal. Quanto à correlação das angulações das coroas dos segundos e terceiros molares superiores permanentes e o espaço para erupção, verificou-se que quanto maior a angulação distal das coroas menor o espaço oferecido para a erupção.

This study evaluated the effect of low-level laser irradiation on the speed of orthodontic tooth movement of canines submitted to initial retraction.Twenty-six canines were retracted by using NiTi spring (force of 150 g/side). Thirteen of those were irradiated with diode laser (780 nm, 20 mW, 10 sec, 5 J/cm(2)) for 3 days, and the other 13 were not irradiated and thus were considered the control group. Patients were followed up for 4 months, and nine laser applications were performed (three each month). The movement of the canines was evaluated through 3D casts, and the statistical analysis was performed with ANOVA and Tukey tests (p 0.05). Periapical radiographs of the studied teeth were submitted to Levander, Malmgreen, and alveolar bone ridge analyses to evaluate tissue integrity and were compared with the Wilcoxon test (p 0.05).A statistically significant increase in the movement speed of irradiated canines was observed in comparison with nonirradiated canines in all evaluation periods. No statistically significant difference was observed in bone and root resorption of canines, whether irradiated or not.The diode laser used within the protocol guidelines increased the speed of tooth movement. This might reduce orthodontic treatment time.

Objective: To evaluate the job market for dental surgeons, within their different specialties, in the North region of Brazil, in addition to evaluating dental surgeon/inhabitant and specialist/inhabitant ratios. The study aims to better understand the trends in this profession, and also suggests fields of professional activity. Materials and Methods: Data was collected from the Brazilian National Council of Odontology and the Brazilian National Institute of Geography and Statistics. Results: Acre, Amazonas, Amapa and Para are the states within this region that have lower professional/inhabitant ratio levels than recommended by the World Health Organization (1:1,500), as opposed to the states of Roraima, Rondonia and Tocantins. This region concentrates 3.73% of all dental surgeons in Brazil. Conclusions: The job market for specialists in the North region in the fields of Bucomaxillofacial Prosthetics, Odontogeriatrics, Mouth Pathology, Dentistry for patients with special needs, Workplace Dentistry and Stomatology feature the best specialist/inhabitant ratio, while the fields of Orthodontics and Endodontics have higher specialist/inhabitant ratios.

Clinicians have worried about the effect the rapid maxillay expansion (RME) might have on the lower face height (LFH). This study cephalometrically evaluated the LFH after RME, using two kinds of palatal expanders (Haas–G1 and Hyrax–nG2). The sample contained 93 lateral cephalograms from 31 brasilian patients, 15 females and 16 males; with a mean age of 13.2 years, and a range of 9-16 years. The cephalograms were taken before disjunction (T1), immediately after disjunction (T2) and after leveling (T3). G1 and G2 experienced similar changes in N-Me. S-Go didn’t change, but both groups showed gradative increases of values in T2 and T3. G1 and G2 displayed increased anterior and posterior LFH (Me-PP and GO-PP) in T2 and T3. After using both types of palatal expanders showed statistically significant increases in anterior and posterior LFH.

A study comparing the number of occlusal contact points in maximum habitual intercuspation in a sample composed by 14 leucoderm patients, 9 female and 5 males, Angle Class II division 1 mallocclusion, treated using Edgewise technique, with extrations of the 4 first pre-molars. These points were registered in two times: T1 – at the end of superior retainer phase and T2 - after an average period of 5,2 years. The analysis verified the total points of contact of the upper and lower arches, separately. After the statistic analysis, it can be concluded that there were no significant differences between the average number of occlusal contacts in T1 and T2.

Objective The objective of this study was to evaluate, using computed tomography, correlations between Hyrax appliance opening and post-SARPE skeletal changes. Study design Fifteen patients underwent SARPE according to a specific protocol and were followed. Linear and angular measurements of the anterior, intermediate, and posterior portions of the maxilla were evaluated. The correlation between maxillary expansion and appliance opening was investigated. Results Significant overall expansion was observed. In the anterior and intermediate portions of the maxilla, the increase in maxillary width was greater than that observed in the posterior portion. The degree of appliance opening was significantly greater than that of the skeletal expansion. Also, no linear correlation between appliance opening and regional maxillary expansion was established. Conclusion The transverse expansion of the maxilla was less than uniform. The lack of linear correlation between appliance opening and skeletal expansion is attributable to multiple factors, including those related to the device, the surgical technique, and the craniofacial deformity itself.

The main objective of this study was to quantify the transverse maxillary dimensions using orthodontic cast models of individuals with natural normal occlusion. Sixty-eight pairs of orthodontic models were evaluated with the respective posteroanterior radiographies of white adults (38 women and 30 men; mean age, 17 years and 5 months). The models were placed in Class I molar occlusion, and on each pair, 4 points were marked on the alveolar buccal ridge (2 on the premolar region and 2 on the molar), determining the upper and lower transverse interpremolar and intermolar dimensions. The variables analyzed in the 3 measurements, obtained from the cephalometric radiographies and the cast models, showed no statistical differences. The upper intermolar distance was 57.20 +/- 2.60 mm; the lower intermolar, 55.16 +/- 2.40 mm; the upper interpremolar, 42.17 +/- 2.19 mm, and the lower interpremolar; 39.67 +/- 1.77 mm. On the posteroanterior cephalograms, the maxillary width was 65.97 +/- 3.42 mm and the mandibular width was 87.92 +/- 4.60 mm. There was intraresearcher and interresearcher correlation. There was no sexual dimorphism. The method proposed in this study can predict the transverse maxillary dimension, applying the formula ym = 8.62 + 0.88xm (ym = expected upper intermolar distance, xm = lower intermolar distance) for the molar region, and ypm = 4.87 + 0.94xpm (ypm = expected upper interpremolar distance, xpm = lower interpremolar distance) for the premolar region.

A quantidade ossea no tuber da maxila esta intimamente ligada com a erupcao dos terceiros molares superiores. O principal objetivo desta pesquisa e verificar o espaco disponivel no arco para a erupcao dos terceiros molares superiores. A amostra foi composta por 50 telerradiografias em norma lateral, com media de 15 anos de idade (variacao de12 a 18 anos). O metodo proposto avaliou a distância da face distal dos segundos molares superiores ate o fim da tuberosidade da maxila, que tambem coincide com o processo alveolar da maxila, assim sendo, teremos o espaco disponivel para a erupcao dos terceiros molares superiores. Pode-se observar que existe uma falta de espaco para a correta irrupcao dos terceiros molares superiores, uma vez que o espaco disponivel medio e de 6,18mm e o espaco requerido medio e de 9,42mm. A discrepância media para a amostra estudada, no momento da obtencao das telerradiografias em norma lateral foi negativa -3,24mm. A regiao do tuber e pobre em espaco para erupcao dos terceiros molares superiores.

OBJETIVO: esse trabalho teve como objetivo principal analisar a literatura relacionada a um relevante aspecto clínico, a configuração do arco dentário, salientando a importância da manutenção da forma original do arco dentário para se obter a estabilidade do tratamento ortodôntico, bem como avaliar os métodos utilizados para a determinação da forma do arco e os diagramas de forma propostos por diversos autores. RESULTADOS E CONCLUSÕES: constatou-se uma controvérsia quanto à indicação de uma forma ideal média e a seleção de uma forma individualizada a partir de diagramas que forneçam configurações variadas para o arco dentário. Entretanto, observou-se um progresso nas metodologias aplicadas nos recentes estudos, o que possivelmente fornecerá precisão nos próximos resultados.AIM: The main purposes of this study were to analyze the literature related to a relevant clinic aspect, the dental arch form, emphasizing the importance of maintaining the original form in order to obtain stability after the orthodontic treatment, as well as to evaluate the methods used for establishing the dental arch form and the arch form diagrams proposed by many authors. RESULTS AND CONCLUSIONS: It was verified that there is some controversy regarding the indication of an ideal average form and the selection of an individualized form from diagrams which provide varied formats for the dental arch. However, some progress was observed in the methodologies applied in recent studies, which will possibly provide more accuracy in arch form determination in the near future.

OBJETIVO: esse trabalho teve como objetivo principal analisar a literatura relacionada a um relevante aspecto clínico, a configuração do arco dentário, salientando a importância da manutenção da forma original do arco dentário para se obter a estabilidade do tratamento ortodôntico, bem como avaliar os métodos utilizados para a determinação da forma do arco e os diagramas de forma propostos por diversos autores. RESULTADOS E CONCLUSÕES: constatou-se uma controvérsia quanto à indicação de uma forma ideal média e a seleção de uma forma individualizada a partir de diagramas que forneçam configurações variadas para o arco dentário. Entretanto, observou-se um progresso nas metodologias aplicadas nos recentes estudos, o que possivelmente fornecerá precisão nos próximos resultados. AIM: The main purposes of this study were to analyze the literature related to a relevant clinic aspect, the dental arch form, emphasizing the importance of maintaining the original form in order to obtain stability after the orthodontic treatment, as well as to evaluate the methods used for establishing the dental arch form and the arch form diagrams proposed by many authors. RESULTS AND CONCLUSIONS: It was verified that there is some controversy regarding the indication of an ideal average form and the selection of an individualized form from diagrams which provide varied formats for the dental arch. However, some progress was observed in the methodologies applied in recent studies, which will possibly provide more accuracy in arch form determination in the near future.

O objetivo desta pesquisa foi comparar a adaptacao marginal entre restauracoes de cerâmica feldspatica (Noritake) e duas resinas compostas de laboratorio (Artglass e Targis). Analisou-se, atraves da microscopia optica, a magnitude da fenda marginal nas faces mesial, distal e lingual. Um pre-molar superior foi preparado para receber uma restauracao do tipo onlay MOD com cobertura da cuspide lingual. A partir deste elemento, foram confeccionadas 30 replicas em NiCr divididas em 3 grupos: l) Noritake; ll) Artglass; lll) Targis. As restauracoes foram posicionadas em suas respectivas replicas e observadas ao microscopio optico (40X), conectado a um microcomputador. As imagens foram capturadas atraves do software Microsoft VidCap 32 e as fendas medidas com auxilio de um cursor de distância (software Imagelab 2000). As medias (µm) obtidas foram: grupo l) mesial 64,50 ( + 38,26), lingual 47,50 ( + 35,69) e distal 53,00 ( + 29,36); grupo ll) mesial 56,00 ( + 25,03), lingual 35,50 ( + 25,65) e distal 56,00 ( + 19,55); grupo lll) mesial 69,50 ( + 9,56), lingual 53,00 ( + 20,44) e distal 55,50 ( + 29,29). A analise de variância de dois fatores (face e material) demonstrou que nao houve diferencas significantes entre os materiais estudados (5%). Entretanto, foram encontradas diferencas significantes entre as faces e foi, entao, aplicado o teste de Tukey (5%). As medias (µm) encontradas foram: mesial 63,33, distal 54,33 e lingual 45,33. Conclusoes: nao houve diferenca significante entre a adaptacao marginal dos materiais estudados (Noritake, Artglass e Targis). A face mesial apresentou maior fenda, quando comparada a lingual.

Surgically assisted rapid palatal expansion (SARPE) is the procedure of choice for treating transverse maxillary deficiency in adult patients. The use of computed tomography (CT) as a method of evaluating the efficiency of this procedure has not been yet reported. Consequently, few landmarks for use in evaluating maxillary expansion have been defined. The goals of the present study were to define parameters to assess skeletal changes after SARPE and to use CT to evaluate those parameters. From June of 2004 to May of 2005, 15 patients underwent SARPE (a modified Le Fort I maxillary osteotomy without pterygomaxillary separation, together with a sagittal palatal osteotomy) according to a defined protocol. To determine the pattern of transversal expansion, linear and angular measurements of the anterior, intermediate, and posterior portions of the maxilla were evaluated in axial and coronal views. The cross-sectional area of the maxilla was calculated to obtain general information about maxillary expansion. The reliability of the method was confirmed. Significant overall expansion was observed. However, different patterns of expansion were seen in the three regions analyzed. In the anterior and intermediate portions of the maxilla, the increase in maxillary width was greater than that observed in the posterior portion. The transverse expansion of the maxilla achieved through SARPE without pterygoid plate separation was less than uniform. The accurate evaluation of the postoperative changes was heavily dependent upon images acquired through CT.

Introduction: A recently published study raised doubts about the need for percutaneous treatment of nonculprit lesions in patients with acute coronary syndromes (ACS). Methods: Retrospective, unicentric, observational study. Objective: To analyze the long-term outcomes in patients undergoing treatment of the culprit artery, comparing those who remained with significant residual lesions in nonculprit arteries (group I) versus those without residual lesions in other coronary artery beds (group II). The study included 580 patients (284 in group I and 296 in group II) between May 2010 and May 2013. We obtained demographic and clinical data, as well as information regarding the coronary treatment administered to the patients. In the statistical analysis, the primary outcome included combined events (reinfarction/angina, death, heart failure, and need for reintervention). The comparison between groups was performed using the chi-square test and ANOVA. The long-term analysis was conducted with the Kaplan-Meier method, with a mean follow-up of 9.86 months. Results: The mean ages were 63 years in group I and 62 years in group II. On long-term follow-up, there was no significant difference in combined events in groups I and II (31.9% versus 35.6%, respectively, p = 0.76). Conclusion: The strategy of treating the culprit artery alone seems safe. In this study, no long-term differences in combined endpoints were observed between patients who remained with significant lesions compared with those without other obstructions. Resumo Fundamento: Um estudo publicado recentemente levantou dúvidas sobre a necessidade de abordagem percutânea de lesões não culpadas em pacientes com síndromes coronarianas agudas (SCA). Métodos: Estudo retrospectivo, unicêntrico e observacional. Objetivo: Comparar desfechos a longo prazo entre pacientes submetidos à abordagem da artéria culpada, comparando os que permaneceram com lesões residuais significativas em artérias não culpadas (grupo I) versus aqueles sem lesões residuais em outros leitos coronarianos (grupo II). Foram incluídos 580 pacientes (284 no grupo I e 296 no grupo II) entre maio de 2010 e maio de 2013. Foram obtidos dados demográficos e clínicos, além de informações sobre o tratamento coronariano administrado aos pacientes. Na análise estatística, o desfecho primário incluiu eventos combinados (reinfarto/angina, morte, insuficiência cardíaca e necessidade de reintervenção). A comparação entre grupos foi realizada através do teste do qui-quadrado e ANOVA. A análise a longo prazo foi realizada pelo método de Kaplan-Meier, com seguimento médio de 9,86 meses. Resultados: As médias das idades foram de 63 anos no grupo I e 62 anos no grupo II. O seguimento a longo prazo não mostrou diferença significativa em eventos combinados nos grupos I e II (31,9% versus 35,6%, respectivamente, p = 0,76). Conclusão: A estratégia de tratar somente a artéria considerada culpada parece segura. Neste estudo, não houve diferenças a longo prazo em desfechos combinados entre pacientes que permaneceram com lesões significativas comparativamente àqueles sem outras obstruções.

AIM: To verify the presence of Bolton anterior and total discrepancy in Brazilian individuals with natural normal occlusion and Angle's Class I and Class II, division 1 malocclusions. METHODS: The sample was divided in three groups (n=35 each): natural normal occlusion; Class I malocclusion; Class II, division 1 malocclusion. Of the 105 Caucasian Brazilian individuals, 24 were boys and 81 were girls aged from 13 to 17 years and 4 months. The mesiodistal width of the maxillary and mandibular teeth, from the left first molar to the right first molar, was measured on each pre-treatment dental plaster cast using a digital caliper accurate to 0.01 mm resolution. Values were tabulated and the Bolton ratio was applied. The Kolmogorov-Smirnov test was used to verify if data were normally distributed (p>0.2). For comparison between the values obtained and those from the Bolton standard, Student's t test was used and one-way ANOVA was used for comparisons among the 3 groups, with a significance level of 5% (p

Functional orthopedic appliances used for Class II malocclusion treatment, usually work by guiding jaws growth and modifying dental positions. Among these dentoalveolar effects, it is the lower incisors buccal tipping, that helps to improve the overjet, but may cause gingival recessions, especially when associated with other etiological factors. The objective of this study was to evaluate the clinical crown length of the lower anterior teeth in individuals with Angle's Class II malocclusion, after treatment with Fränkel-2 function regulator appliance (RF-2). Fifty Class II-malocclusion individuals were divided into 2 groups: G1 - 14 male, and 11 female, treated with the Fränkel-2 function regulator appliance for 18 months, with average pre-treatment age (T1) of 11 years (sd=7 months) and average post-treatment age (T2) of 12 years and 7 months (sd=7 months); and G2 - a control group with 25 individuals (12 male and 13 female) with average age at T1 of 10 years and 3 months (sd=11 months) and at T2 of 12 years and 1 month (sd=11 months), which was part of a normal occlusion sample. The 100 dental cast models were analyzed at T1 and T2, with a digital caliper, measuring the distance from the incisal edge to the most concave portion of the gingival margin of lower incisors and canines. Data were checked by a Student's t-test and a paired t-test. Considering T2, the group 1 presented a significant increase in the crown length of all lower anterior teeth. On the other hand, in the group 2, this was observed only for the teeth 33, 42 and 43, suggesting that patients treated with RF-2 had more gingival recession than the control group. Functional orthopedic appliances used for Class II malocclusion treatment, usually work by guiding jaws growth and modifying dental positions. Among these dentoalveolar effects, it is the lower incisors buccal tipping, that helps to improve the overjet, but may cause gingival recessions, especially when associated with other etiological factors. The objective of this study was to evaluate the clinical crown length of the lower anterior teeth in individuals with Angle's Class II malocclusion, after treatment with Fränkel-2 function regulator appliance (RF-2). Fifty Class II-malocclusion individuals were divided into 2 groups: G1 - 14 male, and 11 female, treated with the Fränkel-2 function regulator appliance for 18 months, with average pre-treatment age (T1) of 11 years (sd=7 months) and average post-treatment age (T2) of 12 years and 7 months (sd=7 months); and G2 - a control group with 25 individuals (12 male and 13 female) with average age at T1 of 10 years and 3 months (sd=11 months) and at T2 of 12 years and 1 month (sd=11 months), which was part of a normal occlusion sample. The 100 dental cast models were analyzed at T1 and T2, with a digital caliper, measuring the distance from the incisal edge to the most concave portion of the gingival margin of lower incisors and canines. Data were checked by a Student's t-test and a paired t-test. Considering T2, the group 1 presented a significant increase in the crown length of all lower anterior teeth. On the other hand, in the group 2, this was observed only for the teeth 33, 42 and 43, suggesting that patients treated with RF-2 had more gingival recession than the control group.

OBJETIVO: avaliar cefalometricamente os efeitos da expansão rápida da sutura palatina mediana sobre o posicionamento vertical e sagital da maxila, comparando os aparelhos de Haas e Hyrax. METODOLOGIA: a amostra consistiu de 93 telerradiografias obtidas de 31 pacientes jovens, brasileiros, de ambos os gêneros, na faixa etária inicial média de 13 anos e 2 meses. As radiografias foram tomadas ao início do tratamento (pré-disjunção), imediatamente após a disjunção (pós-disjunção) e ao final do nivelamento. RESULTADOS E CONCLUSÕES: constatou-se que os dois aparelhos disjuntores apresentaram resultados semelhantes, com a ocorrência de deslocamento da maxila em direção inferior, sem rotação, que se manteve ao final do nivelamento e ocorrência de um deslocamento anterior logo após a disjunção, que retornou aos valores pré-disjunção ao final do nivelamento. AIM: the purpose of this cephalometric study was to evaluate, by lateral cephalograms, the changes in maxilar positioning after rapid disjunction of the midpalatal suture, following the use of two types of maxillary disjunction appliances, checked in different phases, and the likely differences between the two appliances Haas and Hyrax. METHODS: the sample comprised of 93 lateral cephalograms, taken before treatment (pre-disjunction), immediately after disjunction and at the end of levelling, obtained from 31 brazilian youths with both genres and average age of 13 years and 2 months. RESULTS AND CONCLUSIONS: both types of appliances showed similar results, with anterior and lower displacement of maxila right after disjunction. Lower displacement was without rotation, and mainttened stable until the end of levelling. Anterior displacement, however, was not stable and cephalometric measurements like SNA and Nperp-A tended to returned to initial values at the end of levelling.

Purpose: The aim of this study was to test the null hypothesis that there is no change in the lower anterior teeth's crown size when measured just after the treatment with Frankel-2's orthopedic appliance and in a long-term posttreatment follow-up. Materials and Methods: The sample was composed of 34 plaster models belonging to 9 male and 8 female individuals, treated at the College of Health, Methodist University of Sao Paulo, Sao Bernardo do Campo, Sao Paulo, Brazil, with mean age of 12 years and 6 months (standard deviation [SD] =7 months) at T1 (end of the treatment with Frankel-2's function regulator), and 19 years and 8 months (SD = 7 months) at T2 (7.11 years after the end of the treatment). Results: The distance from the incisal edge to the most concave portion of the gingival margin of the lower incisors and canines was measured using a digital caliper. Data analysis was carried out by means of Student's t-test and paired-t test. Among the lower anterior teeth, the teeth 31, 33, 42 and 43 showed a statistically significant increase in their crown length, whereas the teeth 32 and 41 showed no changes. Conclusion: It can be concluded that there is a tendency to increase the clinical crown of lower anterior teeth throughout the years after the mandibular advancement treatment by using functional devices, rejecting the null hypotheisis.

Three-dimensional (3D) craniofacial images are commonly used in clinical studies in orthodontics to study developmental and morphologic relationships.We used 3D magnetic resonance imaging to study relationships among craniofacial components during the pubertal growth spurt and in response to Fränkel appliance therapy. The sample for this prospective study was 156 high-resolution magnetic resonance images with 1 mm isotropic voxel resolution of 78 subjects taken initially (T1) and 18 +/- 1 months (T2) after treatment or an observation period. The subjects were Brazilian children; 28 were treated and 25 were untreated for Class II malocclusion, and 25 were untreated with normal occlusions. A Procrustes geometric transformation of 3D skeletal landmarks was used to assess growth or treatment alterations from T1 to T2. The landmarks were located on the mandibular rami and the other craniofacial parts specifically related to the mandibular growth (the middle cranial fossae and the posterior part of the bilateral nasomaxilla). This allowed visualization of the entire volumetric dataset with an interactive 3D display.Statistically significant differences were found in the relative 3D skeletal growth directions from T1 to T2 for treated vs untreated Class II children (Bonferroni-adjusted P.001) and for treated Class II vs normal-occlusion subjects ( P.001). The major differences in the treated group were increased mandibular rami vertical dimensions and more forward rami relative to the posterior nasomaxilla and the middle cranial fossae. Principal component analysis made it possible to show individual variability and group differences in the principal dimensions of skeletal change.These methods are generalizable to other imaging techniques and 3D samples, and significantly enhance the potential of systematically controlled data collection and analysis of bony structures in 3 dimensions for quantitative assessment of patient parameters in craniofacial biology.

Introduction: The mandibular rami and their endochondrally growing condyles develop in many directions relative to the variable anatomic patterns of the nasomaxilla and middle cranial fossae during growth and response to orthopedic treatment. Methods: High-resolution magnetic resonance images were used to compare 3-dimensional (3D) growth vectors of skeletal displacement and bone remodeling in 25 untreated subjects with Class II malocclusions, 28 subjects with Class II malocclusions who were treated with Frankel appliance therapy, and 25 subjects with normal occlusions. Marked differences were noted over an 18-month observation period. The 3D coordinates of anatomic landmarks were registered by Procrustes fit to control for rotation, translation, and scale differences. Results: Compared with untreated Class II and normal-occlusion subjects, the treated group showed highly significant differences in the 3D displacement/remodeling vectors of gonion and pterygomaxillary fissure relative to condylion and middle cranial fossae bilateral skeletal landmarks, by using both permutation tests ( P P Conclusions: In a prospective and systematically controlled study, we quantitatively described significant 3D rami skeletal compensations in the structural assembly of facial morphogenesis at the beginning of the adolescent growth spurt using novel modeling techniques. These techniques have facilitated quantification of relative 3D growth vectors to illustrate skeletal changes with Frankel appliance therapy. Future studies are required to assess the long-term clinical significance of our findings.

The success or the failure of the orthodontic treatment accomplished in patients in the growth phase has been justified many times by the standard and the variability that this growth can present. Understanding these current changes of the growth and separating them from the changes imposed by the orthodontic treatment is the objective of this work. The superimposition cefalometric method developed by Ricketts will be used and applied to a patient with skeletal malocclusion Class II, first division, treated at the age of 9 years old and accompanied until the age of 18 years old. The mechanics used for the correction of the Class II was considered ideal since the obtained results were satisfactory, from the static point of view as well as the functional one. Besides, it was observed that a clockwise rotation of the jaw didn't take place in spite of the use of a Quad - helix, Elastic of Class II and Cervical headgear. Another important discovery was the great growth of the jaw that occurred between the beginning (T1) and the end of the treatment (T2) of 12mm or 3,5mm/year.

O sucesso ou o fracasso do tratamento ortodôntico realizado em pacientes na fase de crescimento têm sido muitas vezes justificado pelo padrão e pela variabilidade que este crescimento pode apresentar. Compreender estas mudanças de correntes do crescimento e separá-las das mudanças impostas pelo tratamento ortodôntico-ortopédico facial é o objetivo deste trabalho. Ilustramos o método de sobreposição cefalométrica desenvolvido por Ricketts, aplicado às características de uma paciente com má oclusão de Classe II, 1ª divisão esquelética, tratada aos 9 anos e acompanhada até os 18 anos. O uso das sobreposições permite entender os efeitos da mecânica utilizada para a correção da Classe II, bem como do crescimento ocorrido.The success or the failure of the orthodontic treatment accomplished in patients in the growth phase has been justified many times by the standard and the variability that this growth can present. Understanding these current changes of the growth and separating them from the changes imposed by the orthodontic treatment is the objective of this work. The superimposition cefalometric method developed by Ricketts will be used and applied to a patient with skeletal malocclusion Class II, first division, treated at the age of 9 years old and accompanied until the age of 18 years old. The mechanics used for the correction of the Class II was considered ideal since the obtained results were satisfactory, from the static point of view as well as the functional one. Besides, it was observed that a clockwise rotation of the jaw didn't take place in spite of the use of a Quad - helix, Elastic of Class II and Cervical headgear. Another important discovery was the great growth of the jaw that occurred between the beginning (T1) and the end of the treatment (T2) of 12mm or 3,5mm/year.

As características cefalométricas de uma amostra de 30 pacientes brasileiros, adultos, leucodermas, Padrão I, selecionados a partir da avaliação morfológica de fotografias do perfil, foram estudadas em telerradiografias laterais com o objetivo de definir um padrão de referência, considerando-se as médias e, principalmente, os desvios padrões para estudos comparativos com amostras portadoras de discrepâncias esqueléticas. Na avaliação do padrão de crescimento facial obteve-se 9,4°± 3,2° para o ângulo do plano palatino e 121,4°± 5,3° para o ângulo goníaco, ambos apresentando dimorfismo sexual. O ângulo do plano mandibular apresentou média de 29,2°± 4,2°, sem diferença entre os gêneros. Os valores obtidos para as alturas faciais total, inferior, média e posterior foram, respectivamente, 123,0mm± 8,3mm; 68,8mm± 6,6mm; 55,9mm± 3,5mm e 62,6mm± 4,7mm. Todas essas variáveis foram significativamente maiores no gênero masculino. Os valores das medidas que definiram a relação maxilo-mandibular corroboraram o equilíbrio esquelético da amostra, pois observou-se 82,2° ± 2,9° para o SNA; 79,8° ± 2,5° para o SNB e 2,4° ± 1,4° para o ANB, sem dimorfismo sexual. Os valores obtidos para os comprimentos efetivos da maxila e da mandíbula foram 95,2mm ± 5,7mm e 124,2mm ± 8,2mm, respectivamente, sendo as variáveis do gênero feminino significativamente menores que as do masculino. Os incisivos superiores e inferiores apresentaram-se mais inclinados que as médias da literatura, ou seja, 115,2° ± 5,5° para o 1.PP e 93,9° ± 5,7° para o IMPA.

To evaluate whether the Frankel Regulator-II (FR-II) induced mandibular growth rotations relative to the nasomaxilla and the middle cranial fossae, cephalometric changes in 28 treated Brazilian children were compared with changes in 28 untreated Class II children and in 28 children with normal occlusion. According to Enlow's counterpart analysis, the 3 groups were not significantly different initially in ramus alignment or relative ramus vertical dimension. These jaw relationships were maintained in both untreated groups. In the treated group, all children had overjet reduction, with correction of the dental arch relationship in 26 of the 28, and there was a significant trend toward a more forward ramus alignment ( P =.002) and increased ramus relative vertical dimension ( P =.0002). These treatment-induced changes showed a negative correlation with ramus alignment; ie, greater improvement was more likely in children who had backward ramus alignment before treatment and whose Class II malocclusion had not already been intrinsically compensated. Changes in the treated children were similar to but greater than those in the normal children, and different from those in the untreated Class II group. The data suggest that studies of skeletal variations with counterpart analysis can show ramus remodeling compensations from treatment that are missed with conventional cephalometrics. (Am J Orthod Dentofacial Orthop 2003;123:379-87)

Introdução: O objetivo deste trabalho é avaliar o mercado de trabalho do cirurgião-dentista, nas diferentes especialidades, na Região Nordeste do Brasil, além de avaliar a relação cirurgião-dentista/habitante e especialista/habitante, visando melhorar a compreensão dos rumos da profissão, direcionando a atuação profissional. Material e Métodos: Foram coletados dados do Conselho Federal de Odontologia e do Instituto Brasileiro de Geografia e Estatística. Resultados: Os Estados da Região Nordeste do Brasil apresentam índices maiores que o recomendado pela Organização Mundial de Saúde (1:1.500), com exceção da Paraíba e do Rio Grande do Norte que apresentam maior proporção entre habitantes por CD. A Região Nordeste concentra 13,59% do total de cirurgiões-dentistas de todo o Brasil. Conclusões: O mercado de trabalho para os especialistas da Região Nordeste nas áreas de Prótese Buco-Maxilo-Facial, Odontologia do Trabalho, Odontologia Legal, Patologia Bucal e Estomatologia apresenta-se com melhor proporção de especialista/ habitante, enquanto as áreas de Ortodontia, Endodontia e Prótese Dentária apresentam maior proporção de especialista/habitante.

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, Sao 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 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.

To evaluate the Bolton ratios in Brazilians with natural, normal occlusions.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.The anterior ratio amounted to 78.66% (SD ± 2.72) and the total ratio to 91.58% (SD ± 2.20).The anterior, but not the overall, ratio was significantly different from the ratio suggested by Bolton.

OBJETIVO: avaliar as alterações nos arcos dentários superiores no sentido transversal e a quantidade de inclinações nos dentes de apoio do aparelho de expansão tipo Hyrax em pacientes submetidos à expansão rápida da maxila assistida cirurgicamente (ERMAC) e a efetividade dessa técnica cirúrgica utilizada. A amostra foi composta por 34 pares de modelos de gesso de 17 pacientes, sendo 6 do gênero masculino e 11 do gênero feminino. MÉTODOS: as medidas foram realizadas em modelos de gesso por meio de medição das alterações nos planos vertical e transversal. O procedimento cirúrgico adotado foi uma osteotomia nas paredes laterais da maxila sem o envolvimento da lâmina pterigoide, osteotomia da espinha nasal à linha média dentária (incisivos centrais anteriores), separação da sutura palatina mediana por meio de cinzel e separação do septo nasal. O início das ativações ocorreu no terceiro dia pós-operatório, sendo uma pela manhã e uma à noite. RESULTADOS: houve expansão significativa estatisticamente na região dos caninos, primeiros e segundos pré-molares, primeiros e segundos molares, respectivamente de 6,03mm, 9,82mm, 8,66mm, 9,72mm e 5,67mm. Avaliando o comportamento dos dentes de apoio do disjuntor quanto às inclinações das coroas dentárias, notou-se que ocorreu uma vestibularização assimétrica, pois para os primeiros molares os valores encontrados foram 6,89º (direito) e 9,56º (esquerdo), e para os primeiros pré-molares os valores obtidos foram 4,74º (esquerdo) e 3,26º (direito), sendo esse considerado estatisticamente não-significativo. CONCLUSÕES: a técnica cirúrgica empregada para esta pesquisa mostrou ser eficiente para se obter alteração transversal maxilar, ocorrendo inclinação dentoalveolar dos dentes de apoio do disjuntor. AIM: To assess the changes to the superior dental arches, in the transversal direction, and the amount of inclinations in the support teeth of the Hyrax expansion appliance in patients who underwent surgically assisted rapid maxillary expansion (SARME), as well as the effectiveness of the surgical technique used. The sample was composed of 34 pairs of cast models, of 17 patients - 6 males and 11 females. METHODS: The measurements were performed on cast models, by measuring the changes on the vertical and transversal planes. The surgical procedure used was the lateral osteotomy on maxillary walls with no involvement of the pterygoid blade, osteotomy of nasal spine on dental midline (anterior central incisors), chisel separation of palatine suture, and separation of the nasal septum. The activation was initiated on the third postoperative day, consisting of two activations, one in the morning and another at night. RESULTS: There were statistically significant expansions in the regions of canines, first and second premolars, first molars, and second molars; respectively, 6.03 mm, 9.82 mm, 8.66 mm, 9.72 mm, and 5.67 mm. The evaluation of the behavior of the support teeth of the expansion appliance regarding the inclination of the dental crowns has shown that an asymmetric vestibularization had taken place, because the values found for the first molars were 6.89º (right) and 9.56º (left); the values for the first premolars were 4.74º (left) and 3.26º (right); this last value was not statistically significant. CONCLUSIONS: The surgical technique used in this research has been shown to be efficient to obtain maxillary transversal alterations, and there was dental-alveolar inclination of the support teeth of the expansion appliance.

INTRODUÇÃO: o posicionamento da maxila no esqueleto craniofacial tem sido motivo de investigação por diversos autores. Traduzindo suas idéias por meio de medidas lineares ou angulares, tais autores definiram o que consideraram como a posição "ideal", "normal" e, ainda, "aceitável" ou "inaceitável" da maxila, relacionando-a, na maioria das vezes, com a base do crânio. A partir da avaliação de indivíduos com oclusão considerada normal e com bom equilíbrio facial, eram calculados valores médios e desvios-padrão de determinadas medidas, os quais eram tomados como parâmetros para avaliações cefalométricas de pacientes distintos. OBJETIVOS: diante das divergências de opiniões encontradas na literatura, a proposta do presente estudo foi avaliar o posicionamento da maxila nos sentidos vertical e ântero-posterior, além da sua inclinação, numa amostra de 94 indivíduos com oclusão normal e equilíbrio facial. MÉTODOS: foram determinadas correlações entre medidas do próprio indivíduo: OPI-N com OPI-ENA e N-ENA com ENA-ENP. CONCLUSÕES: a partir dos fortes índices de correlação encontrados, concluiu-se que a medida OPI-N pode ser tomada como referência para determinação de OPI-ENA, da mesma forma que ENA-ENP pode ser considerada para determinação de N-ENA, definindo, respectivamente, a posição da maxila nos sentidos sagital e vertical. A inclinação da maxila, representada aqui pelo ângulo OPI.ENA.ENP, teve valor médio estatisticamente próximo a 0º (zero grau), indicando forte tendência do prolongamento posterior do plano palatino (ENA-ENP) tangenciar a base posterior do crânio (ponto OPI), o que se revela como uma importante característica de indivíduos com oclusão normal e equilíbrio facial. INTRODUCTION: The position of the maxilla in the skull is subject of investigation by many authors. Transmitting their ideas trough linear and angular measurements, they defined what is considered as "ideal", "normal" and "acceptable" or "unacceptable" position of the maxilla, relating it in most of the time with the cranial base. By the study of subjects with considered "normal" occlusion and good facial balance, it was calculated mean values and standard deviations of some measurements, which were considered as parameters to evaluate all kinds of malocclusions. AIM: Considering the divergences found in the literature, the aim of the present study was to evaluate the vertical and horizontal position of the maxilla and its inclination, in 94 subjects with normal occlusion and good facial balance. METHODS: Considering this, it was determined some correlations between measurements of the own subjects: OPI-N with OPI-ENA and N-ENA with ENA-ENP. CONCLUSIONS: By the strong index of correlation found between these measurements, it was concluded that OPI-N can be take as a reference to establishment of OPI-ENA. In addition, ENA-ENP can be considered a reference to the distance N-ENA, so it is possible to determine respectively the position of the maxilla on the horizontal and vertical planes. The inclination of the maxilla, defined by the angle OPI.ENA.ENP, showed a mean value statistically very close of 0º (zero), indicating a strong tendency of the posterior extension of the palatal plane (ENA-ENP) to touch the most posterior and inferior region of the occipital bone (OPI point). This was considered an important characteristic of subjects with normal occlusion and good facial balance.

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.Rapid maxillary expansion was performed with a Hyrax appliance, Petit orthopedic face mask, high-pull chin cap, and bioprogressive fixed mechanics.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.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.

OBJETIVO: estudar a relação entre o plano palatino e a região posterior da base do crânio, em indivíduos portadores de oclusão normal. METODOLOGIA: a amostra foi constituída por telerradiografias em norma lateral de 95 indivíduos portadores de oclusão normal natural. O plano palatino foi determinado pelos pontos Ena e Enp (Espinha Nasal Anterior e Posterior). Utilizou-se o ponto mais posterior e inferior do osso occipital (OPI), para definição da região póstero-inferior da base do crânio. Avaliou-se o comportamento do ângulo formado pelos planos OPI-Ena e Ena-Enp, denominado ângulo OPI.Ena.Enp, tendo como vértice o ponto Ena. Desta forma, valores angulares próximos a 0º indicaram tendência à coincidência entre os planos OPI-Ena e Ena-Enp, o que equivale a dizer que, nestes casos, a extensão do plano palatino tangencia a base posterior do crânio, representada pelo Ponto OPI. RESULTADOS: a média de valor encontrada em relação ao ângulo OPI.Ena.Enp na referida amostra foi de -0,13º, valor próximo a zero, indicando tendência à coincidência entre os planos OPI-Ena e Ena-Enp. CONCLUSÃO: os resultados indicam que em pacientes portadores de oclusão normal natural, o prolongamento do plano palatino tende a tangenciar a região posterior da base do crânio, o que se revela uma característica estrutural em crânios de indivíduos portadores de oclusão equilibrada. AIM: to study the inclination of the palatal plane in 95 subjects with clinically normal occlusion. METHODS: the study was made using lateral headfilms and the results showed that in normal occlusion the extension of the palatal plane (ANS-PNS) passes trough the most posterior and inferior region of the skull, defined as Point "OPI". RESULTS: OPI.Ena.Enp mean value was -0.13º, close to zero. CONCLUSION: the results indicated that in normal occlusion patients the palatal plane presents a tendency to be tangent with posterior cranial base.

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.

Made available in DSpace on 2018-11-26T17:44:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-10-01. Added 1 bitstream(s) on 2019-10-09T18:27:11Z : No. of bitstreams: 1 S0001-37652017000602875.pdf: 499322 bytes, checksum: 5149003cfd90fd51df7d5dc75fd1121b (MD5) The present study aimed to assess the perception and knowledge of Brazilian orthodontists on the ideal moment to treat Class II malocclusions. Questionnaires with open, semi-open and close questions were sent by e-mail to 1653 Brazilian orthodontists. These orthodontists were registered in the Brazilian Association of Orthodontics and Dentofacial Orthopedics (ABOR). One-hundred and three (9.86%) Orthodontists replied to the questionnaires. Most of them were males (60.5%) with specialization as the highest level of professional qualification (59.9%). Most of the orthodontists (51%) reported preference for treating Class II malocclusions in late mixed dentition, followed by the early mixed dentition (29%). The age range between 10 and 12 years old figured as the most prevalent in patients searching for treatment (42.7%). Most of the patients searching for treatment were females (69.7%). Preferences for functional orthopedic appliances were reported by 35% of the orthodontists. Brazilian orthodontists revealed a trend for treating patients with Class II malocclusions in the late mixed dentition. Female patients aged from 10 to 12 years old represented the majority of patients that search for orthodontic treatment. Functional orthopedic appliances were preferred by Brazilian orthodontists for treating Class II malocclusions. Univ Fed Campinas, Dept Odontol Social, Fac Odontol Piracicaba, UNICAMP, Ave Limeira 901, BR-13414018 Piracicaba, SP, Brazil Univ Fed Sergipe, Dept Odontol, Ave Governador Marcelo Deda Chagas 13, BR-49400000 Lagarto, SE, Brazil Univ Metodista Sao Paulo, Programa Posgrad Odontol, Rua Alfeu Tavares 149, BR-09641000 Sao Bernardo Do Campo, SP, Brazil Univ Estadual Sudoeste Bahia, Dept Saude, Ave Jose Moreira Sobrinho 638, BR-45205490 Jequie, BA, Brazil Univ Estadual Paulista, Inst Ciencia & Tecnol, Dept Mat Dent & Protese, Ave Engenheiro Francisco Jose Longo 777, BR-12201970 Sao Jose Dos Campos, SP, Brazil Univ Estadual Paulista, Inst Ciencia & Tecnol, Dept Mat Dent & Protese, Ave Engenheiro Francisco Jose Longo 777, BR-12201970 Sao Jose Dos Campos, SP, Brazil