Acácio Fuziy

Effect of soft laser in bone repair after expansion of the midpalatal suture in dogs

INTRODUCTION The purpose of this research was to study the influence of soft laser treatment on the process of bone repair after expansion of the midpalatal suture. METHODS The sample for this case-control experimental study was 11 dogs. They were randomly divided into 2 groups, both of which underwent rapid maxillary expansion with a hyrax appliance. The animals in group 1 were also treated with laser therapy. They were killed, and histologic specimens of the palatal suture were prepared. The Student t test was applied for independent data, and the Mann-Whitney test was used for nonparametric data. RESULTS A significant difference was observed in the quality of the palatal sutures between the animals in groups 1 and 2. The connective tissues of the sutures in the group 1 animals were similar to the original configurations, with more advanced osteogenesis and fibrogenesis, compared with those of group 2. CONCLUSIONS Soft laser appears to influence the behavior of the repair process, contributing to suture reorganization and palatal bone osteogenesis during and after expansion.

Cervical vertebrae maturation index estimates on cone beam CT: 3D reconstructions vs sagittal sections

OBJECTIVES The aim of this study was to evaluate the performance of CBCT three-dimensional (3D) reconstructions and sagittal sections for estimates of cervical vertebrae maturation index (CVMI). METHODS The sample consisted of 72 CBCT examinations from patients aged 8-16 years (45 females and 27 males) selected from the archives of two private clinics. Two calibrated observers (kappa scores: ≥0.901) interpreted the CBCT settings twice. Intra- and interobserver agreement for both imaging exhibition modes was analyzed by kappa statistics, which was also used to analyze the agreement between 3D reconstructions and sagittal sections. Correlations between cervical vertebrae maturation estimates and chronological age, as well as between the assessments by 3D reconstructions and sagittal sections, were analyzed using gamma Goodman-Kruskal coefficients (α = 0.05). RESULTS The kappa scores evidenced almost perfect agreement between the first and second assessments of the cervical vertebrae by 3D reconstructions (0.933-0.983) and sagittal sections (0.983-1.000). Similarly, the agreement between 3D reconstructions and sagittal sections was almost perfect (kappa index: 0.983). In most divergent cases, the difference between 3D reconstructions and sagittal sections was one stage of CVMI. Strongly positive correlations (>0.8, p < 0.001) were found not only between chronological age and CVMI but also between the estimates by 3D reconstructions and sagittal sections (p < 0.001). CONCLUSIONS Although CBCT imaging must not be used exclusively for this purpose, it may be suitable for skeletal maturity assessments.

Agenesis of all permanent maxillary incisors: a rare clinical case with an interdisciplinary solution

Background Clinical cases involving agenesis of all four maxillary incisors are rare, with no previous reports in the literature. Case report The present case report describes an orthodontic treatment combined with esthetic dentistry in a 10-year-old girl with agenesis of all four permanent maxillary incisors, anterior crossbite, permanence of deciduous maxillary canines and transmigration of permanent maxillary canines into the region of the maxillary central incisors. For this case, it was decided on space closure using a fixed orthodontic apparatus and reshaping of the first premolars transforming them into canines. Porcelain veneers were used on the permanent and deciduous canines, substituting the maxillary central and lateral incisors, respectively. Regarding outcome, there was an improvement in facial profile, correction of the anterior crossbite, satisfactory intercuspidation of the teeth and significant esthetic improvement in smile. Maintaining the patient´s natural dentition also kept the bone plate intact for future placement of implants to substitute maxillary deciduous canines at the appropriate age. Conclusions Interdisciplinary planning combining orthodontics and esthetic dentistry was key in resolving this case. Key words:Tooth agenesis, upper incisors, orthodontic treatment.

Investigation on the relationship of dimensions of the maxillary sinus drainage system with the presence of sinusopathies: a cone beam computed tomography study

OBJECTIVE This study sought to assess the relationship between the dimensions of the maxillary sinus drainage system with the content of sinuses. DESIGN Three-hundred cone beam computed tomography images were selected from a database (105 males and 195 females). The images were assessed by a single investigator, trained and calibrated, performing image analysis. The length of the infundibulum and the ostium height in both maxillary sinuses were measured. The data were analyzed using Minitab 16, using 5% as a critical p-value. RESULTS A significant gender difference was also found for presence in the normal content of sinus for females and presence of antral pseudocyst for males (p < 0.05). Subjects with normal content in the maxillary sinus present lower ostium height values. There were statistically significant with presence of and higher ostium height values and antral pseudocyst (p < 0.01). CONCLUSION The current study results demonstrated that some sinusopathies were significantly related to dimensions of maxillary sinus drainage.

Three-dimensional lateral pterygoid muscle volume: MRI analyses with insertion patterns correlation

We evaluated lateral pterygoid muscle volume in closed and open mouth positions in association with anterior disc displacement, effusion and abnormal articular disc shape from three-dimensional reformations of MRI. A total of 24 MRI of a sample (15 females, 9 males) aged 19-64 years (37.2 years±11.4) were assessed. Segmentation and volumetric assessment of the total, upper and lower heads of the lateral pterygoid muscle were performed using free software. The upper head of the lateral pterygoid muscle had a smaller volume than the lower head at both sides, in the closed- and open-mouth positions. In the open-mouth position, individuals with a subdivided upper head, where one component was inserted in the articular disc and another in the mandibular head, displayed a significantly larger volume of the upper head compared to individuals who had a single attachment to the articular disc (p=0.0130). The lateral pterygoid muscle has different volumes in the closed- and open-mouth positions. Gender affected muscle volume, specifically the upper head component. Insertion type in the upper head also seemed to affect muscle volume.

Evaluation of the Cervical Vertebrae Maturation Index in Lateral Cephalograms Taken in Different Head Positions

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