Carla Enoki

Influência do padrão respiratório na morfologia craniofacial

OBJETIVO: este estudo teve como objetivo avaliar por meio de analise cefalometrica as diferencas nas proporcoes faciais de criancas respiradoras bucais e nasais. FORMA DE ESTUDO: coorte transversal. MATERIAL E METODO: Foram selecionadas 60 criancas entre 6 e 10 anos que, apos avaliacao otorrinolaringologica para o diagnostico do tipo de respiracao, foram divididas em dois grupos: grupo I, constituido de criancas respiradoras bucais, com elevado grau de obstrucao das vias aereas e grupo II, composto de criancas respiradoras nasais. Os pacientes foram submetidos a avaliacao ortodontica por meio de radiografias cefalometricas em norma lateral, a fim de avaliar as proporcoes faciais, atraves das seguintes medidas cefalometricas: SN.GoGn, ArGo.GoMe, N-Me, N-ENA, ENA-Me, S-Go, S-Ar, Ar-Go; e os seguintes indices: iAF=S-Go / N-Me, iAFA=ENA-Me / N-Me e iPFA=N-ENA / ENA-Me. RESULTADO: Foi constatada que a inclinacao do plano mandibular (SN.GoGn) nos pacientes respiradores bucais foi estatisticamente maior que nos respiradores nasais, enquanto que a proporcao da altura facial posterior e anterior (iAF), e da altura facial anterior superior e inferior (iPFA) foram estatisticamente menores nos pacientes bucais, indicando altura facial posterior menor que a anterior e altura facial anterior inferior aumentada nesses pacientes. CONCLUSAO: Pode-se concluir, entao, que os respiradores bucais tendem a apresentar maior inclinacao mandibular e padrao de crescimento vertical, evidenciando a influencia da funcao respiratoria no desenvolvimento craniofacial.

Breathing mode influence in craniofacial development

AIM The aim of this study was to evaluate the differences in facial proportions of nose and mouth breathing children using cephalometric analysis. STUDY DESIGN Transversal cohort. MATERIAL AND METHOD Sixty cephalometric radiographs from pediatric patients aged 6 to 10 years were used. After otorhinolaryngological evaluation, patients were divided into two groups: Group I, with mouth breathing children and group II, with nose breathers. Standard lateral cephalometric radiographs were obtained to evaluate facial proportions using the following measures: SN.GoGn, ArGo.GoMe, N-Me, N-ANS, ANS-Me and S-Go; and the following indexes: PFH-AFH ratio: S-Go/N-Me; LFH-AFH ratio: ANS-Me/N-Me and UFH-LFH ratio: N-ANS/ANS-Me. RESULTS It was observed that the measurements for the inclination of the mandibular plane (SN.GoGn) in mouth breathing children were statistically higher than those in nasal breathing children. The posterior facial height was statistically smaller than the anterior one in mouth breathing children (PFH-AFH ratio). Thus, the upper anterior facial height was statistically smaller than the lower facial height (UFH-LFH ratio). CONCLUSION We concluded that mouth breathing children tend to have higher mandibular inclination and more vertical growth. These findings support the influence of the breathing mode in craniofacial development.

In-vivo evaluation of the contamination of Super Slick elastomeric rings by Streptococcus mutans in orthodontic patients

INTRODUCTION We investigated in vivo the contamination by Streptococcus mutans of Super Slick elastomeric rings (TP Orthodontics, LaPorte, Ind), manufactured with Metafasix technology (TP Orthodontics), using microbial culture and scanning electron microscopy (SEM). METHODS Twenty patients undergoing fixed orthodontic appliance therapy were selected. Super Slick elastomeric rings (n = 160) were tied to brackets on the right maxillary premolars or molars and left mandibular premolars or molars. Conventional elastomeric rings (n = 160) were tied to brackets on the contralateral premolars or molars with the same split-mouth design. After a 15-day intraoral period, 75 elastomeric rings of each type were retrieved, submitted to microbiologic processing, and cultured in bacitracin sucrose broth-selective enrichment broth culture media. The number of S mutans colonies or biofilms on the surface of the electrometric rings was counted by using a stereomicroscope. Data were analyzed statistically with the Wilcoxon nonparametric test at the 5% significance level. Four representative rings of each type were chosen for SEM analysis. RESULTS Statistical analysis by the Wilcoxon nonparametric test showed that the Super Slick elastomeric rings had statistically significant greater S mutans contamination than the conventional elastomeric rings (P <.0001). No formation of S mutans colonies or biofilms was observed in the elastomeric rings removed directly from their original packages. SEM micrographs showed fissures on the surface of Super Slick elastomeric rings. No fissures were found on conventional elastomeric rings. When the microbiologic culture was positive, S mutans bacterial biofilm was observed on both types of ligatures. CONCLUSIONS There was no clinical evidence that Super Slick elastomeric rings are effective in reducing bacterial biofilm formation on their surfaces, and a recommendation for their use in orthodontic therapy for that purpose is not justifiable.

Anticariogenic effect of fluoride-releasing elastomers in orthodontic patients

This in vivo experimental study evaluated the efficacy of fluoride-releasing elastomers in the control of Streptococcus mutans levels in the oral cavity. Forty orthodontic patients were recruited and divided into two groups of 20. Fluoride-releasing elastomeric ligature ties (Fluor-I-Ties, Ortho Arch Co. Inc., USA) were used in the experimental group, and conventional elastomeric ligature ties (D. Morelli, Brazil), in the control group. Two initial samples of saliva were collected at a 14-day interval to determine the number of colony forming units (CFU) of Streptococcus mutans. Immediately after collecting the second sample, fluoride-releasing elastomeric ligature ties were placed in the patients of the experimental group, and conventional ligature ties, in the patients of the control group. Seven, 14 and 28 days after placement of the elastomeric ligature ties, saliva and plaque surrounding the orthodontic appliance were collected for microbiologic analysis. There were no significant differences in the number of Streptococcus mutans CFUs in saliva or plaque in the area surrounding the fluoride-releasing or conventional elastomeric ligature ties. Thus, fluoride-releasing elastomeric ligature ties should not be indicated to reduce the incidence of enamel decalcification in orthodontic patients. Since there was no significant reduction in S. mutans in saliva or plaque, other means of prevention against enamel decalcification should be indicated for these patients.

Streptococcus mutans counts in plaque adjacent to orthodontic brackets bonded with resin-modified glass ionomer cement or resin-based composite

This study investigated the number of Streptococcus mutans CFU (colony forming units) in the saliva and plaque adjacent to orthodontic brackets bonded with a glass ionomer cement--GIC (Fuji Ortho) or a resin-based composite--RC (Concise). Twenty male and female patients, aged 12 to 20 years, participated in the study. Saliva was collected before and after placement of appliances. Plaque was collected from areas adjacent to brackets and saliva was again collected on the 15th, 30th, and 45th day after placement. On the 30th day, 0.4% stannous fluoride gel was applied for 4 minutes. No significant modification in the number of Streptococcus mutans CFU in saliva was observed after placement of the fixed orthodontic appliances. On the 15th day, the percentage of Streptococcus mutans CFU in plaque was statistically lower in sites adjacent to GIC-bonded brackets (mean = 0.365) than in those adjacent to RC-bonded brackets (mean = 0.935). No evidence was found of a contribution of GIC to the reduction of CFU in plaque after the 15th day. Topical application of stannous fluoride gel on the 30th day reduced the number of CFU in saliva, but not in plaque. This study suggests that the antimicrobial activity of GIC occurs only in the initial phase and is not responsible for a long-term anticariogenic property.

Dimensões do palato e características oclusais de crianças respiradoras nasais e bucais

Objective: To investigate differences between nose and mouthbreathing children with respect to the occlusal characteristics and palatal dimensions. Method: F...

Normal torque of the buccal surface of mandibular teeth and its relationship with bracket positioning: a study in normal occlusion

This study evaluated the degree of buccolingual inclination of mandibular tooth crowns relative to torque. For such purpose, mandibular and maxillary stone casts from 31 Caucasian Brazilian adults with normal occlusion, pleasant facial aspect and no history of previous orthodontic treatment were examined. A custom device was developed for measuring the degree of inclination (torque) of bracket slots of orthodontic appliances relative to the occlusion plane, at three bonding height: standard (center of clinical crown), occlusal (0.5 mm occlusally from standard) and cervical (0.5 mm cervically from standard). Except for the mandibular incisors, which presented a small difference in torque from one another (lingual root torque for central incisors and buccal root torque for lateral incisors), the remaining average values are close to those found in the literature. Due to the convexity of the buccal surface, the 1-mm vertical shift of the brackets from occlusal to cervical affected the values corresponding to the normal torque, in approximately 2 degrees in central and lateral incisors, 3 degrees in canines and 8 degrees in premolars and molars.

Orthopedic cervical headgear in Class II treatment: case report

Early treatment for Class II malocclusion was undertaken with the objective of correcting skeletal disproportion by altering the growth pattern. A case of Class II, Division 1 malocclusion in the mixed dentition was corrected to Class I molar relationship using orthopedic cervical headgear, with nonextraction edgewise therapy. Cephalometric analysis indicated a reduction in the maxillomandibular discrepancy (ANB) correcting the Class II malocclusion to Class I malocclusion. The treatment showed that this was achieved by downward displacement and inhibition of the forward growth of the maxilla and growth of the mandible. There was no downward rotation of the mandible nor maxillary first molar extrusion. There was improvement in the jaw relationship.

The impact of Metzembaum septoplasty on nasal and facial growth in children

UNLABELLED Several studies have investigated the effects of septoplasty on facial growth in children, with conflicting results. However, just handful of those employed objective measures or evaluated patients after facial growth completion. OBJECTIVE This study assesses the effects of the Metzenbaum septoplasty, which preserves the perichondrium and growth-related areas on nasal and facial growth in children. METHOD We included those children submitted to surgery before the age of 14 and who had 16 years or years of follow up. Sixteen patients were selected. We evaluated the following parameters: clinical satisfaction (nasal patency and aesthetics), anthropometric measurements and cephalometry. Scientific design: cross-sectional historical cohort. RESULTS The mean age at surgery was 13 years, children were assessed on average 4.3 years after surgery. Only one patient had anthropometric and cephalometric values below normal, but no aesthetics or patency complaints. Four other patients complained about their nasal aesthetics and three had patency complaints. CONCLUSION The Metzenbaum septoplasty appears to be a safe technique to correct caudal septum deviations. This technique had no significant impact on facial growth of the patients assessed.