Danilo Furquim Siqueira

Effect of a low-level laser on bone regeneration after rapid maxillary expansion

INTRODUCTION In this study, we evaluated the effects of a low-level laser on bone regeneration in rapid maxillary expansion procedures. METHODS Twenty-seven children, aged 8 to 12 years, took part in the experiment, with a mean age of 10.2 years, divided into 2 groups: the laser group (n = 14), in which rapid maxillary expansion was performed in conjunction with laser use, and the no-laser group (n = 13), with rapid maxillary expansion only. The activation protocol of the expansion screw was 1 full turn on the first day and a half turn daily until achieving overcorrection. The laser type used was a laser diode (TWIN Laser; MMOptics, São Carlos, Brazil), according to the following protocol: 780 nm wavelength, 40 mW power, and 10 J/cm(2) density at 10 points located around the midpalatal suture. The application stages were 1 (days 1-5 of activation), 2 (at screw locking, on 3 consecutive days), 3, 4, and 5 (7, 14, and 21 days after stage 2). Occlusal radiographs of the maxilla were taken with the aid of an aluminum scale ruler as a densitometry reference at different times: T1 (initial), T2 (day of locking), T3 (3-5 days after T2), T4 (30 days after T3), and T5 (60 days after T4). The radiographs were digitized and submitted to imaging software (Image Tool; UTHSCSA, San Antonio, Tex) to measure the optic density of the previously selected areas. To perform the statistical test, analysis of covariance was used, with the time for the evaluated stage as the covariable. In all tests, a significance level of 5% (P <0.05) was adopted. RESULTS From the evaluation of bone density, the results showed that the laser improved the opening of the midpalatal suture and accelerated the bone regeneration process. CONCLUSIONS The low-level laser, associated with rapid maxillary expansion, provided efficient opening of the midpalatal suture and influenced the bone regeneration process of the suture, accelerating healing.

Six-year follow-up of maxillary anterior rehabilitation with forced orthodontic extrusion: Achieving esthetic excellence with a multidisciplinary approach

Orthodontic extrusion with multidisciplinary treatment can provide predictable outcomes in selected situations, reducing the costs and the adaptation times of gingival tissues after implant integration. Forced orthodontic extrusion is strongly related to interactions of teeth with their supportive periodontal tissues. This article reports a case of orthodontic extrusion of the maxillary incisors for later implant rehabilitation in a patient with periodontal disease. Slow forces were applied for 14 months. After this time, the teeth were extracted, and the implants were placed on the same day. Also in the same session, the provisional crown was fabricated for restoration of the anterior maxillary interdental papillae loss and for gingival contouring. Clinical and radiographic examinations at the 6-year follow-up showed successful tooth replacement and an improved esthetic appearance achieved by this multidisciplinary treatment. The decision to perform orthodontic extrusion for implant placement in adult patients should be multidisciplinary.

Efeitos do laser de baixa intensidade na sensibilidade dolorosa durante a movimentação ortodôntica

AbstractObjective: To evaluate the efficiency of infrared diode laser on pain reduction during canine initial retraction. Meth-ods: Twelve patients in need of canine retraction were selected. The canines were retracted with closed NiTi coil springs activated to 150g per side. One canine of each patient was randomly selected for laser irradiation immedi-ately after activation and after 3 and 7 days. The contralateral canines were taken as control group and were submitted only to simulation of laser application. Diode laser (ArGaAl) was employed at wavelength of 780nm, power of 20mW and energy density in the target tissue of 5J/cm 2 , for 10 seconds per point, delivering an energy of 0.2J per point and total energy (TE) of 2J. The analgesic effect was evaluated with aid of a visual analogue scale (VAS), on which the patients indicated 0 to 10 according to the pain experienced at 12, 24, 48 and 72 hours after coil spring activation and laser application. The procedure was repeated after one month, upon reactivation of canine retraction.

Effects of mandibular protraction appliance associated to fixed appliance in adults

OBJECTIVE This retrospective study aimed to conduct a cephalometric evaluation of the skeletal, dental and soft tissue effects resulting from treatment of adult patients presenting Class II malocclusion, performed with a Mandibular Protraction Appliance (MPA) combined with a fixed orthodontic appliance. METHODS The sample consisted of teleradiographs obtained before and after treatment of 9 adult patients (initial mean age of 22.48 years) with bilateral Class II, division 1, malocclusion. Paired t test (p < 0.05) was applied to compare initial and final values. RESULTS t test revealed an increase in anteroinferior facial height and posterior facial height. The dental changes include: extrusion of upper incisors, buccal inclination, protrusion of lower incisors, mesialization and extrusion of mandibular molars. Regarding the soft tissue component, there was an increase in nasolabial angle in addition to upper lip retrusion. CONCLUSIONS The effects of treating Class II malocclusion adult patients, by means of using Mandibular Protraction Appliance (MPA) combined with a fixed appliance were mostly observed in the mandibular arch, and consisted of buccal inclination, protrusion and intrusion of incisors, and mesialization and extrusion of the molars.

Comparative in vitro study of the shear bond strength of brackets bonded with restorative and orthodontic resins

The aim of this study was to evaluate the shear bond strength of brackets bonded with different restorative systems and compare it with that afforded by an established orthodontic bonding system. Seventy human bicuspids were used, divided into five different groups with 14 teeth each. Whereas a specific orthodontic bonding resin (Transbond™ XT) was used in the control group, the restorative systems Charisma, Tetric Ceram, TPH Spectrum and Z100 were used in the other four groups. Seven days after bonding the brackets to the samples, shear forces were applied under pressure in a universal testing machine. The data collected was evaluated using the ANOVA test and, when a difference was identified, the Tukey test was applied. A 5% level of significance was adopted. The mean results of the shear bond strength tests were as follows: Group 1 (Charisma), 14.98 MPa; Group 2 (Tetric Ceram), 15.16 MPa; Group 3 (TPH), 17.70 MPa; Group 4 (Z100), 13.91 MPa; and Group 5 or control group (Transbond™ XT), 17.15 MPa. No statistically significant difference was found among the groups. It was concluded that all tested resins have sufficient bond strength to be recommended for bonding orthodontic brackets.

Periodontal and dental effects of surgically assisted rapid maxillary expansion, assessed by using digital study models

OBJECTIVE: The present study assessed the maxillary dental arch changes produced by surgically assisted rapid maxillary expansion (SARME). METHODS: Dental casts from 18 patients (mean age of 23.3 years) were obtained at treatment onset (T1), three months after SARME (T2) and 6 months after expansion (T3). The casts were scanned in a 3D scanner (D-250, 3Shape, Copenhagen, Denmark). Maxillary dental arch width, dental crown tipping and height were measured and assessed by ANOVA and Tukeys test. RESULTS: Increased transversal widths from T1 and T2 and the maintenance of these values from T2 and T3 were observed. Buccal teeth tipping also showed statistically significant differences, with an increase in all teeth from T1 to T2 and a decrease from T2 to T3. No statistically significant difference was found for dental crown height, except for left first and second molars, although clinically irrelevant. CONCLUSION: SARME proved to be an effective and stable procedure, with minimum periodontal hazards.

Perfuração do esmalte para o tracionamento de caninos: vantagens, desvantagens, descrição da técnica cirúrgica e biomecânica

INTRODUCAO: a tracao de dentes nao irrompidos sempre foi considerada um procedimento de risco na pratica ortodontica. Com essa perspectiva, e indispensavel a busca por eficiencia nos procedimentos adotados para esse mister, o que justifica a proposta do presente artigo. Ao perfurar, vazamos uma estrutura natural, cuja restauracao com material artificial e uma acao que esta no escopo da area de maior evolucao da Odontologia, nao havendo justificativa para se evocar procedimentos de maior risco, como a colagem ou lacada com fios. OBJETIVO: este artigo objetiva apresentar protocolos para a Perfuracao do Esmalte para o Tracionamento de Caninos (PETC), especificamente os caninos superiores, mais acometidos pelas anomalias de posicionamento, tambem denominadas disgenesias. Serao abordadas as vantagens e desvantagens da PETC em relacao a Colagem de Acessorio para o Tracionamento de Caninos (CATC), apresentando-se casos clinicos de diferentes niveis de complexidade, tendo como ponto de partida a literatura e a experiencia clinica de 30 anos com elevado indice de sucesso.

Análise do mercado de trabalho odontológico na região nordeste do Brasil

Introducao: O objetivo deste trabalho e avaliar o mercado de trabalho do cirurgiao-dentista, nas diferentesespecialidades, na Regiao Nordeste do Brasil, alem de avaliar a relacao cirurgiao-dentista/habitante eespecialista/habitante, visando melhorar a compreensao dos rumos da profissao, direcionando a atuacao profissional. Material e Metodos: Foram coletados dados do Conselho Federal de Odontologia e do InstitutoBrasileiro de Geografia e Estatistica. Resultados: Os Estados da Regiao Nordeste do Brasil apresentam indices maiores que o recomendado pela Organizacao Mundial de Saude (1:1.500), com excecao da Paraibae do Rio Grande do Norte que apresentam maior proporcao entre habitantes por CD. A Regiao Nordeste concentra 13,59% do total de cirurgioes-dentistas de todo o Brasil. Conclusoes: O mercado de trabalho para os especialistas da Regiao Nordeste nas areas de Protese Buco-Maxilo-Facial, Odontologia do Trabalho, Odontologia Legal, Patologia Bucal e Estomatologia apresenta-se com melhor proporcao de especialista/habitante, enquanto as areas de Ortodontia, Endodontia e Protese Dentaria apresentam maior proporcao de especialista/habitante Introduction: This work aims to evaluate the job market for dental surgeons, within their different specialties,in the Northeast region of Brazil, in addition to evaluating dental surgeon/inhabitant and specialist/inhabitant ratios. This study aims to better understand the trends in this profession, and also suggests sof professional activity. Materials and Methods: Data was collected from the Brazilian National Councilof Odontology and the Brazilian National Institute of Geography and Statistics. Results: The states withinthe Northeast region of Brazil have higher professional/inhabitant ratio levels than recommended by theWorld Health Organization (1:1,500), with the exceptions of the states of Paraiba and Rio Grande do Norte,which feature higher inhabitant/surgeon ratios. This region concentrates 13.59% of all dental surgeonsin Brazil. Conclusions: The job market for specialists in the Northeast region in the s of BucomaxillofacialProsthetics, Workplace Dentistry, Forensic Dentistry, Mouth Pathology and Stomatology featuresthe best specialist/inhabitant ratio, while the s of Orthodontics, Endodontics and Dental Prostheticshave higher specialist/inhabitant ratios

Efeitos do aparelho de protrusão mandibular FLF na face: análise pelo método de Farkas modificado

Objetivo: este estudo teve como objetivo determinar os efeitos do aparelho de protrusao mandibular FLF associado ao aparelho ortodontico fixo sobre a face, por meio do metodo de Farkas modificado. Metodo: a amostra constou de 60 fotografias em norma lateral (30 fotografias iniciais e 30 fotografias finais) de 30 jovens brasileiros (17 do sexo masculino e 13 feminino), com media de idade inicial de 12 anos e 7 meses. Participaram desta amostra pacientes leucodermas, com ma oclusao de Classe II, 1a divisao (minimo de ½ classe II), deficiencia mandibular e perfil convexo, dentadura permanente completa e padrao de crescimento equilibrado. O tempo medio de uso do FLF foi de 8 meses e o tempo medio total de tratamento com aparelho fixo e APM FLF foi de 2 anos e 1 mes. Para comparacao entre a amostra FLF e o padrao de Farkas, assim como a comparacao entre as fases Pre e Pos foi utilizado o teste “t” pareado e adotado nivel de significância de 5% (p<0,05). Resultados: Houve diferenca estatisticamente significante entre os valores da amostra estudada (APM FLF) e a amostra de Farkas no T1 analisado isoladamente, em T2 tambem analisado isoladamente, mas ao se verificar a diferenca de T2 - T1, ou seja, o que realmente aconteceu com a proporcao da face nao houve diferenca estatisticamente significante. Conclusao: baseado nisto, pode-se afirmar que o APM FLF nao demonstrou impacto na face apesar de ser um metodo efetivo na correcao da ma oclusao de Classe II

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.