Ana de Lourdes Sá de Lira

Surgical Prediction of Skeletal and Soft Tissue Changes in Class III Treatment

PURPOSE The purpose of this study was to study the treatment outcomes and accuracy of the digital prediction using Dolphin Imaging Software and the actual postoperative outcome in subjects presenting Class III malocclusions. MATERIALS AND METHODS Maxillary advancement surgery was performed in group 1, and maxillary advancement was combined with mandibular setback surgery in group 2. Predictive cephalometric tracings were made using Dolphin Imaging Software. RESULTS Before surgery, the maxillary deficiency was significantly greater in group 1 than in group 2, and the mandibular length was significantly greater in group 2. Surgical reductions in mandibular length and angle were significantly greater 12 months after surgery than indicated by the predictive cephalometric tracings. CONCLUSION In groups 1 and 2, maxillary advancement surgery was performed in accordance with the Dolphin Imaging Software. The mandibular setback surgery performed was beyond the established plan, but without clinical implications. Mandibular dentoskeletal measurements showed a greater correlation with the profile than the maxillary measurements.

Surgical prediction of skeletal and soft tissue changes in treatment of Class II

INTRODUCTION The purpose of this study was to study the treatment outcomes and the accuracy of digital prediction and the actual postoperative outcome with Dolphin program on subjects presenting Class II malocclusions. METHODS Forty patients underwent surgical mandibular advancement (Group 1) and 40 underwent combined surgery of mandibular advancement and maxillary impaction (Group 2). The available pre surgical (t₁) and a minimum of 12 months post surgical (t₂) cephalometric radiographs were digitized. Predictive cephalograms (t₃) for both groups were traced. RESULTS At all times evaluated, Group 1 displayed a shorter mandibular length and Group 2 had a longer lower face. In both groups the surgical interventions (t₂) were greater than initially predicted. There was no significant difference between groups with regards to overjet, overbite and soft tissue measurements. CONCLUSIONS In both groups surgeries were more extensive than planned. Facial convexity and the distance of the lips to cranial base presented similar values between t₂ (post surgical) and t₃ (predicted).

Anteroposterior dentoalveolar effects with cervical headgear and pendulum appliance: a systematic review

Aim: The aim of this systematic review was to compare the maxillary dental effects of cervical headgear and pendulum appliance during distalization of permanent maxillary first molars. Methods: A literature survey from databases covering the period from 1956 to August 2008 was carried out. Randomized controlled trials (RCT) and controlled clinical trials (CCT) were included. Two reviewers selected and extracted the data independently, and also assessed the quality of the retrieved studies. Results: The search strategy resulted in 48 articles, of which 3 met the inclusion criteria. Distal molar movement with headgear versus pendulum appliance was identified. In all studies selected, the methods used to detect and analyze the distal molar movement were valid and generally well know. All articles included an error analysis method and considered the risk for confounding factors, but only one study used blinding in measurements. Conclusions: The studies showed that both cervical headgear with patient compliance and a non-compliance pendulum appliance are very effective in distalizing maxillary molars. However, additional RCTs with larger samples of both molar distalizing appliances are needed to confirm this result and provide further reliable scientific evidence.

Dental caries in children on deciduous dentition: ART and socioeconomic aspect

Aim: Determine the prevalence and incidence of dental caries in children´s deciduous teeth, who were treated with ART technique. Methods: In T1, 62 children were examined for being between 3 and 6 years of age. A questionnaire was applied to the parents or guardians of the children involved in the research, to analyze their knowledge about eating habits and oral hygiene. An intra-oral examination of children from 3 to 6 years old was carried out and dental treatment was performed by the ART technique. Six months after,(T2), the clinical examination was redone to investigate the stability of restorations. Results: In T1, 94 caries cavities were found in 19 children and 86 were recommended for restoration with ART. In T2, 58 restorations were damaged or lost and 15 children had 20 new caries cavities. Conclusion: The prevalence of dental caries in the deciduous dentition was 38.8% and the incidence was 31.9%. In T2, the majority restorations class I and II were damaged or lost. ART technique is an option, despite the high failure in ART, especially for child population with deciduous teeth that has limited access to dental services. However, restorations should be supervised and healthy eating habits implemented.

Comparison of two types of biomecanics for deep overbite correction

Aim: To compare two types of treatment for Class II deep overbite malocclusion assessing maxillary and mandibular arches behavior in subjects submitted to full orthodontic treatment with standard edgewise appliance and those who used straight wire appliance. Methods: The sample consisted of 50 patients treated with full fixed appliances either with edgewise appliance (n=25, Group 1), or with straight wire appliance (n=25, Group 2). In both groups lateral cephalometric radiographs were compared with those done at the beginning of treatment and at its end, in order to quantify the cephalometric measures (8 linear and 6 angular) presenting the maxillary and mandibular arches behavior in the anteroposterior and vertical directions. All patients were treated without extraction or use of Class II intermaxillary elastics during the full orthodontic treatment. Results: In both groups the treatment of malocclusion contributed for mandibular forward displacement, reduction of deep overbite and overjet, reduction of mandibular plane with anti-clockwise rotation and labial projection of maxillary incisors. Conclusions: In both groups the sample showed favorable mandibular displacement, reduction of facial convexity, and profile improvement with anti-clockwise rotation. The correction of deep overbite was due to labial projection and intrusion of maxillary incisors.