Alexandre Moro

Class II Correction with the Cantilever Bite Jumper

OBJECTIVE To identify the skeletal, dentoalveolar, and soft tissue changes that occur during Class II correction with the Cantilever Bite Jumper (CBJ). MATERIALS AND METHODS This prospective cephalometric study was conducted on 26 subjects with Class II division 1 malocclusion treated with the CBJ appliance. A comparison was made with 26 untreated subjects with Class II malocclusion. Lateral head films from before and after CBJ therapy were analyzed through conventional cephalometric and Johnston analyses. RESULTS Class II correction was accomplished by means of 2.9 mm apical base change, 1.5 mm distal movement of the maxillary molars, and 1.1 mm mesial movement of the mandibular molars. The CBJ exhibited good control of the vertical dimension. The main side effect of the CBJ is that the vertical force vectors of the telescope act as lever arms and can produce mesial tipping of the mandibular molars. CONCLUSIONS The Cantilever Bite Jumper corrects Class II malocclusions with similar percentages of skeletal and dentoalveolar effects.

Análise do perfil facial masculino adulto jovem, esteticamente agradável, em fotografias padronizadas: comparação da medição manual com a computadorizada

Aim: To analyze the young male adult facial profile using standardized photographs and compare manual measuring procedures to the measuring procedures with the software Cef X (CDT). METHODS: The sample consisted of 40 Brazilian Caucasian individuals, with an average age of 21.9 years, who possessed pleasant profiles, normal occlusion, and no history of previous orthodontic treatment. Colored photographs measuring 10cm x 15cm were taken in a standard way with the subject in natural head position. The photographs were measured manually, using dial caliper and a protractor, as well as using the Cef X (CDT) computer program. Thirty six facial variables were analyzed with linear, angular, and proportional measurements. RESULTS: Manual and computerized measurement scores presented different statistics to 24 variables. In the computerized method only one measurement showed significant difference between the first and the second measuring whereas in the manual method eight measurements presented differences. CONCLUSION: Considering that there were differences in manual and computerized measurements, one must use respective mean values for each type of measuring procedure. Both types of measurement are reliable although the computerized one is more accurate. Due to the convenience and swiftness of the computerized measuring, it is best recommended.

Effect of Different Surface Treatments for Ceramic Bracket Base on Bond Strength of Rebonded Brackets

The aim of this study was to evaluate the shear bond strength of rebonded ceramic brackets after subjecting the bracket base to different treatments. Seventy-five premolars were selected and randomly distributed into five groups (n=15), according to the type of the bracket surface treatment: I, no treatment, first bonding (control); II, sandblasting with aluminum oxide; III, sandblasting + silane; IV, silica coating + silane; and V, silicatization performed in a laboratory (Rocatec system). The brackets were fixed on an enamel surface with Transbond XT resin without acid etching. The brackets were then removed and their bases were subjected to different treatments. Thereafter, the brackets were fixed again to the enamel surface and the specimens were subjected to shear bond strength (SBS) test. The adhesive remnant index (ARI) was then evaluated for each specimen. Data were subjected to ANOVA and Tukeys tests (α=0.05). A statistically significant difference was observed only between Rocatec and the other groups; the Rocatec group showed the lowest SBS values. The highest SBS values were observed for group 1, without any significant difference from the values for groups II, III and IV. Most groups had a higher percentage of failures at the enamel-resin interface (score 1). It was concluded that the surface treatments of rebonded ceramic brackets were effective, with SBS values similar to that of the control group, except Rocatec group.

Immunoexpression of PPAR-? and Osteocalcin Proteins for Bone Repair of Critical-Size Defects Treated with Fragmented Autogenous Abdominal Adipose Tissue Graft

Immunoexpression of PPAR-γ and osteocalcin proteins was evaluated for bone repair of critical-size defects (CSDs), created in rat calvaria (n=42) and treated with fragmented abdominal autogenous adipose tissue graft. Three groups (n=14) were formed: C (control - blood clot), AB (autogenous bone) and AT (fragmented adipose tissue). The groups were divided into subgroups (n=7) for euthanasia at 30 and 90 days. Histological and immunohistochemical analyses were performed. Data were subjected to descriptive statistics (mode). A complete bone closure was observed in Group AB 90 days after surgery. In Group C, repair was achieved by the formation of collagen fiber bundles oriented parallel to the wound surface at both post-surgery periods. In Group AT the type of healing was characterized by dense connective tissue containing collagen fiber bundles arranged amidst the remaining adipose tissue, with rare heterotopic bone formation associated with fibrosis and different types of tissue necrosis. Immunostaining of PPAR-γ was not observed in any specimen from Groups C and AB. In Group AT, the immunostaining of PPAR-γ was more evident 30 days after surgery. Immunostaining of osteocalcin was present in all groups and at both postoperative periods. The fragmented autogenous abdominal adipose tissue graft did not favor the repair of critical-size bone defects created surgically in rat calvaria as evidenced by the positive immunostaining of PPAR-γ protein and the negative immunostaining of osteocalcin in the osteoblast-like cells and bone matrix.

Optimal management of orthodontic pain

Pain is an undesirable side effect of orthodontic tooth movement, which causes many patients to give up orthodontic treatment or avoid it altogether. The aim of this study was to investigate, through an analysis of the scientific literature, the best method for managing orthodontic pain. The methodological aspects involved careful definition of keywords and diligent search in databases of scientific articles published in the English language, without any restriction of publication date. We recovered 1281 articles. After the filtering and classification of these articles, 56 randomized clinical trials were selected. Of these, 19 evaluated the effects of different types of drugs for the control of orthodontic pain, 16 evaluated the effects of low-level laser therapy on orthodontic pain, and 21 evaluated other methods of pain control. Drugs reported as effective in orthodontic pain control included ibuprofen, paracetamol, naproxen sodium, aspirin, etoricoxib, meloxicam, piroxicam, and tenoxicam. Most studies report favorable outcomes in terms of alleviation of orthodontic pain with the use of low-level laser therapy. Nevertheless, we noticed that there is no consensus, both for the drug and for laser therapy, on the doses and clinical protocols most appropriate for orthodontic pain management. Alternative methods for orthodontic pain control can also broaden the clinician’s range of options in the search for better patient care.

Shear bond strength of nanofilled flowable resins used for indirect bracket bonding

Aim: To evaluate the bond strength of brackets fixed with different materials (two light-cured nanofilled resins - Transbond Supreme LV and Flow Tain LV, a light-cured resin - Transbond XT (control) and two chemically cured resins for indirect bonding - Sondhi Rapid- Set and Custom I.Q.) using the indirect bonding technique after 10 min and 24 h, and evaluate the type of failure. Methods: One hundred premolars were selected and randomly divided into groups (n=10) according to the material and fixation period. The brackets were bonded through the indirect technique following the manufacturer’s instructions and stored in deionized water at 37 o C for 10 min or 24 h. After, the specimens were submitted to a shear bond strength (SBS) test (Instron) at 0.5 mm/min and evaluated for adhesive remnant index (ARI). The data were submitted to ANOVA and Tukey’s test (p Sondhi Rapid-Set > Custom I.Q.). There was no significant difference in resistance values between 10 min and 24 h, regardless of the materials. Most groups showed adhesive remaining adhered to the enamel (scores 2 and 3) without statistically significant difference (p>0.05). Conclusions: It was concluded that the light-cured nanofilled materials used in indirect bonding showed greater resistance than the chemically cured materials. The period of fixation had no influence on the resistance for different materials.

Effects of active and passive lacebacks on antero-posterior position of maxillary first molars and central incisors

The purpose of this study was to compare the effects of active and passive lacebacks on antero-posterior position of maxillary first molars and central incisors during leveling phase. Twenty-three subjects with Class I and Class II malocclusion were treated with first premolars extraction using preadjusted appliances (MBT 0.022-inch brackets). The leveling phase was performed with stainless steel archwires only. The sample was divided into 2 groups: 14 subjects received active lacebacks (Group 1) and 9 subjects received passive lacebacks (Group 2). Lacebacks were made from 0.008-inch ligature wire. Lateral cephalometric radiographs were taken pre- and post-leveling phase. Students t-test was applied to determine the differences between pre- and post-leveling mean values and to determine the mean differences between groups. In Group I, the first molars showed a significant mesial movement, whereas no change was observed in Group 2. In both groups, maxillary central incisor crowns moved to lingual side. In conclusion, active laceback produced anchorage loss of maxillary first molars whereas passive laceback did not affect the position of these teeth. Active and passive lacebacks were effective in preventing central incisor proclination.

Análise facial frontal em repouso e durante o sorriso em fotografias padronizadas. Parte I - Avaliação em repouso*

Considering the importance of the frontal facial analysis in the diagnosis, the purpose of this research is to present a frontal facial analysis using standardized photographs, in rest position and during the smile, as an aid in the diagnosis and planning of the orthodontic and surgical treatment as well as in the evaluation of treatment results. The sample consisted of 40 white female subjects with a mean age of 22 years old, pleasant face, normal occlusion, and had not been previously submitted to orthodontic treatment nor plastic surgery. Colorful standardized 10x15 cm photographs were obtained with the patients in their natural head position. Two pictures were taken for each subject, one in maximum smile and another in rest position. Linear, angular and proportional measurements were used. Tests of normality, descriptive statistics, and error standard deviation were executed. The results showed that some of the measurements used in this study have values similar to that found in the literature and some are very different. All of the measurements were reliable after their repetition. And after this study, it is suggested a frontal facial analysis to be used regularly in the diagnosis and orthodontic treatment planning.

Twenty-year clinical experience with fixed functional appliances

ABSTRACT Introduction: Considering the large number of fixed functional appliances, choosing the best device for your patient is not an easy task. Objective: To describe the development of fixed functional appliances as well as our 20-year experience working with them. Methods: Fixed functional appliances are grouped into flexible, rigid and hybrid. They are different appliances, whose action is described here. Four clinical cases will be reported with a view to illustrating the different appliances. Conclusions: Rigid fixed functional appliances provide better skeletal results than flexible and hybrid ones. Flexible and hybrid appliances have similar effects to those produced by Class II elastics. They ultimately correct Class II with dentoalveolar changes. From a biomechanical standpoint, fixed functional appliances are more recommended to treat Class II in dolichofacial patients, in comparison to Class II elastics.

Experimental study of {sup 6}He+{sup 9}Be elastic scattering at low energies

This work has been partially supported by the Spanish Ministerio de Ciencia e Innovacion´ under Projects FPA2009-07653 and PCI2006-A7-0654 and by the Spanish Consolider-Ingenio 2010 Programme CPAN (CSD2007-00042).