Cristiane Aparecida de Assis Claro

Análise Facial Subjetiva

INTRODUCTION: facial analysis has been an important diagnostic method since the beginning of Orthodontics. Many authors have tried to define references of beauty to be reached with orthodontic treatment. This preoccupation is in accordance with patient expectation with orthodontic treatment. The main motivation for them is esthetic improvement. To solve it successfully orthodontists must know witch parameters the population use for esthetic evaluation. With suggest, through this paper, the Subjective Facial Analysis, esthetic and morphologic. AIM: to evaluate the application of the analysis proposed. METHODS: it was asked a heterogeneous group (14 orthodontists, 12 laymen, 7 artists) to classify 100 photographs of facial profile as esthetically pleasant (grades 7, 8 or 9), acceptable (grades 4, 5 or 6) or unpleasant (grades 1, 2 or 3). Eigthy nine percent of the sample was esthetically acceptable, 8% esthetically unpleasant and 3% esthetically pleasant. The nose and the chin were the structures of the facial profile more frequently related by appraisers (38.35% and 18.9% respectively) as responsible for the unpleasant esthetic appearance. CONCLUSION: subjective Facial Analysis is a diagnostic tool, important because is the parameter used by patients and relatives to evaluate the results of orthodontic treatment.

Análise facial numérica do perfil de brasileiros Padrão I

AIM: the aim of this study was to determine measurements of the facial profile in balanced faces of Pattern I Brazilian patients. METHODS: the sample was comprised by 50 Brazilian adults (32 women and 18 men) selected by morphologic facial analysis in frontal and lateral views. Standardized lateral facial photographs were taken. They were measured for two different researches to obtain the following: 1) nasolabial angle; 2) angle of mentolabial fold; 3) interlabial angle; 4) angle of facial convexity; 5) angle of total facial convexity; 6) angle of the lower third of the face; 7) proportion between medium facial height and lower facial height; 8) proportion of the lower third of the face. RESULTS AND CONCLUSIONS: there was no statistical difference between the two measurements. The averages, standard deviation, minimal and maximal values obtained were: 1) nasolabial angle: 108.13° ± 9.75° (81° to 127°); 2) angle of mentolabial fold: 132.37° ± 9.82° (110.5° to 152°); 3) interlabial angle: 135.35° ± 11.14° (116.5° to 159.5°); 4) angle of facial convexity: 12.32°± 3.93° (4° to 19.5°); 5) angle of total facial convexity: 137.85° ± 4.08° (129.5° to 147.5°); 6) angle of lower third of the face: 103.41° ± 8.12° (88° to 124°); 7) proportion between medium facial height and lower facial height: 0.93 ± 0.10 (0.80 to 1.21); 8) proportion of lower third of the face: 0.45 ± 0.06 (0.30 to 0.66). With those results, we intend to determine values of reference for the measurements of facial profile, establishing averages and standard deviation to be used comparatively in the study and treatment of compromised faces of white Brazilians adults.

Estudo comparativo do perfil facial de indivíduos Padrões I, II e III portadores de selamento labial passivo

Objetivo: avaliar as caracteristicas numericas do perfil facial. Metodologia: avaliou-se uma amostra de 50 individuos, brasileiros, adultos, leucodermas, portadores de selamento labial passivo, classificados pela avaliacao morfologica do perfil em 41% Padrao II e 9% Padrao III. A analise facial numerica do perfil foi realizada em fotografias padronizadas. As medidas obtidas para as variaveis estudadas nos dois padroes foram comparadas entre si e com as do Padrao I por meio da Analise de variância (ANOVA) complementada pelo Teste de Tukey. Resultados e Conclusoes: nao foram observadas diferencas estatisticas entre os Grupos Padrao I, II e III nas medidas obtidas para os ângulos nasolabial e do sulco mentolabial e a proporcao entre as alturas faciais media e inferior. O ângulo interlabial foi mais obtuso no Padrao III. Esse Padrao tambem apresentou menor convexidade facial e menor proporcao do terco inferior da face. O ângulo do terco inferior da face, que avalia a protrusao mandibular, foi mais obtuso no Padrao II.

Avaliação dos fatores determinantes da estética do perfil facial

OBJECTIVE: To evaluate the influence of age, gender, sagittal occlusal relationship, facial pattern and 8 facial profile measures on profile aesthetics. METHODS: Contingency tables, chi-square test and Cramers coefficient were used to evaluate the possible association between the scores assigned by 32 examiners (14 orthodontists, 12 laypeople and 6 artists) to the aesthetics of the profile of 100 Brazilian Caucasian adults, all patients with lip seal competence, and age, gender, sagittal occlusal relationship, facial pattern and the variables of the numerical analysis of the facial profile. RESULTS: No association was found between age, gender and sagittal occlusal relationship and the aesthetics of facial profile. An association was observed between profile scores and facial pattern, facial convexity angle and lower face angle. CONCLUSIONS: Among the factors evaluated in this study, facial profile convexity and anterior chin projection were the key determinants of facial profile aesthetics.

Concordância dos ortodontistas no diagnóstico do padrão facial

OBJECTIVE To assess agreement among orthodontists trained in facial pattern diagnosis through the morphological evaluation of the face. METHODS: Facial photographs were taken in front and side view, as well as photos of the smiles of 105 individuals randomly selected among patients seeking orthodontic treatment. The photos were sent to orthodontists trained in facial pattern classification. Intra-rater agreement, agreement between raters and the Gold Standard, as well as inter-rater agreement were assessed using the Kappa index. RESULTS: Intra-rater agreement was almost perfect, with Kappa index reaching 0.85. Agreement between raters and the Gold Standard was moderate (Kappa = 0.48), higher for Pattern I (Kappa = 0.62) and lower for the short face pattern (Kappa = 0.33). Agreement between raters was significant (Kappa = 0.61) and even higher than agreement with the Gold Standard for all patterns. CONCLUSIONS: The criteria used by raters to determine the facial pattern were the same in the first and second evaluation. Agreement between raters and the Gold Standard was moderate, with raters exhibiting greater agreement between them than with the Gold Standard.

Correlation between transverse expansion and increase in the upper arch perimeter after rapid maxillary expansion

The purpose of the present study was to assess the correlation between transverse expansion and the increase in upper arch perimeter, after maxillary expansion. Dental casts of eighteen patients were obtained before treatment and again five months after maxillary expansion. Measurements of intermolar width, intercanine width, arch length and arch perimeter were made with a digital caliper on photocopies taken from the dental casts. After assessment of the method error, a multiple regression model was developed following the identification of the best subset of variables. The resulting equation led to the conclusion that the increase in arch perimeter is approximately given by the addition of 0.54 times the intercanine expansion, and 0.87 times the arch length alteration.

Association between overbite and craniofacial growth pattern

The purpose of the present study was to assess the association between overbite and craniofacial growth pattern. The sample comprised eighty-six cephalograms obtained during the orthodontic pretreatment phase and analyzed using the Radiocef program to identify the craniofacial landmarks and perform orthodontic measurements. The variables utilized were overbite, the Jarabak percentage and the Vert index, as well as classifications resulting from the interpretation of these measurements. In all the statistical tests, a significance level of 5% was considered. Measurement reliability was checked by calculating method error. Weighted Kappa analysis showed that agreement between the facial types defined by the Vert index and the direction of growth trend established by the Jarabak percentage was not satisfactory. Owing to this lack of equivalency, a potential association between overbite and craniofacial growth pattern was evaluated using the chi-square test, considering the two methods separately. No relationship of dependence between overbite and craniofacial growth pattern was revealed by the results obtained. Therefore, it can be concluded that the classification of facial growth pattern will not be the same when considering the Jarabak and the Ricketts anayses, and that increased overbite cannot be associated with a braquifacial growth pattern, nor can openbite be associated with a dolichofacial growth pattern.

Three-dimensional finite element analysis of occlusal splint and implant connection on stress distribution in implant–supported fixed dental prosthesis and peri-implantal bone

The aim of this study was to investigate the influence of occlusal splint therapy on the stress distribution of implant-supported fixed dental prosthesis (FDP) and peri-implantal bone structures using three-dimensional (3D) finite element analysis (FEA). The system consisted of two implants (positioned on region of second premolar and second molar) as retainers of fixed porcelain-fused-to-metal 3-unit FDP (first molar as pontic element). Two implant connections systems (external and internal hexagon) were tested. Static axial loads simulating functional (100N) and overloaded (300N) chewing were applied on the occlusal surface of the FDP covered or not with the occlusal splint. Maximum von Mises stress and bioperformance were accessed for the implants and bone tissues (cortical and cancellous) models. Analytic results indicated that independently of the load condition, implant region, and connection type, the presence of the occlusal splint decreased the stress developed in the implants. Both bone tissues showed increased levels of von Mises stress, and the bioperformance index was far from their maximum yield strength. The internal hexagon implants presented lower stress on premolar and molar regions than external hexagon implants under functional load and overload. The presence of the occlusal splint device over implant-supported FDP may be clinically useful for forwarding stresses towards the bone structure to maintain implants for long term.

Comparative photoelastic study of dental and skeletal anchorages in the canine retraction

Objective To compare dental and skeletal anchorages in mandibular canine retraction by means of a stress distribution analysis. Methods A photoelastic model was produced from second molar to canine, without the first premolar, and mandibular canine retraction was simulated by a rubber band tied to two types of anchorage: dental anchorage, in the first molar attached to adjacent teeth, and skeletal anchorage with a hook simulating the mini-implant. The forces were applied 10 times and observed in a circular polariscope. The stresses located in the mandibular canine were recorded in 7 regions. The Mann-Whitney test was employed to compare the stress in each region and between both anchorage systems. The stresses in the mandibular canine periradicular regions were compared by the Kruskal-Wallis test. Results Stresses were similar in the cervical region and the middle third. In the apical third, the stresses associated with skeletal anchorage were higher than the stresses associated with dental anchorage. The results of the Kruskal-Wallis test showed that the highest stresses were identified in the cervical-distal, apical-distal, and apex regions with the use of dental anchorage, and in the apical-distal, apical-mesial, cervical-distal, and apex regions with the use of skeletal anchorage. Conclusions The use of skeletal anchorage in canine retraction caused greater stress in the apical third than the use of dental anchorage, which indicates an intrusive component resulting from the direction of the force due to the position of the mini-implant and the bracket hook of the canine.

Influência de diferentes aplicações de cargas e interposição de aparelho oclusal plano em implantes dentais: análise fotoelástica

0 0 1 292 1668 Universidade de Taubate 13 3 1957 14.0 Normal 0 false false false PT-BR JA X-NONE 0 0 1 247 1412 Universidade de Taubate 11 3 1656 14.0 Normal 0 false false false PT-BR JA X-NONE Introducao: Se forcas oclusais excederem a capacidade de absorcao do sistema implante/osso, o implante tende a fracassar. O objetivo deste estudo foi avaliar a tensao peri-implantar com e sem utilizacao de placa oclusal plana sob carregamentos diferentes. Materiais e Metodos: Foram confeccionados cinco modelos fotoelasticos, com um implante em cada. Sobre estes implantes foram instaladas coroas unitarias e construida uma placa oclusal plana. Foram aplicadas cargas axiais de 100N, 200N e 300N, com e sem a presenca da placa oclusal plana, por meio da maquina universal de ensaio conjugada ao polariscopio. O teste de Mann-Whitney foi utilizado para comparar os grupos com e sem placa, em todas as condicoes de carregamento. O teste de Kruskal-Wallis foi utilizado para comparar as tensoes decorrentes das cargas de 100, 200 e 300N e tambem para comparar as tensoes nas seis areas periimplantares analisadas. Resultados: Os resultados dos testes de Mann-Whitney nao identificaram diferencas estatisticas (p>0,05) ao comparar as ordens de franjas com e sem a utilizacao de aparelho oclusal plano, em todas as areas periimplantares analisadas, sob cargas verticais de 100, 200 e 300N. Os resultados dos testes de Kruskal-Wallis indicaram tensoes significativamente maiores nas regioes apicais (pConclusoes: A utilizacao da placa oclusal plana sobre a protese unitaria nao reduziu significativamente as tensoes nas regioes periimplantares; as tensoes tendem a se concentrarem na regiao periapical e nestas areas a maior magnitude de forca implicou em maior tensao.