Eloisa Marcantonio Boeck

Jarabak 's cephalometric analysis of Brazilian black patients

The treatment of skeletal disharmonies presents better results when performed during the growth period. The physical changes that occur in every individual express growth, which is ruled by genetic, general and environmental factors. In order to identify such disharmonies and hence concentrate the clinical actions during treatment and influence facial growth, cephalometrics appears as a useful a diagnostic tool for identifying facial growth patterns or growth direction. Jarabaks cephalometric analysis is used to assess facial growth pattern of subjects with normal occlusion or malocclusions. The purpose of this study was to obtain mean values for cephalometric measurements from Jarabaks cephalometric analyses of black Brazilian subjects resident in the city of Piracicaba, São Paulo state, Brazil and vicinities, who presented Class I molar relationship with normal overjet and overbite, mild or no tooth crowding or spacing, and no history of orthodontic treatment. A sample of 37 stone plaster casts and 37 lateral teleradiographs from both male and female individuals aged 10 to 14 years was evaluated. Data were analyzed statistically by Students t-test at 5% significance level. There was no significant differences between genders. The cephalometric measurements obtained in this study were similar to the Jarabaks standards, except for S-N mean value in females (66.50 mm +/- 3.16), which was significantly lower than the standard.

Prevalência dos hábitos de sucção não nutritiva e sua relação com a idade, gênero e tipo de aleitamento em pré-escolares da cidade de Araraquara

PURPOSE: to evaluate the prevalence of nonnutritive sucking habits in preschool children from Araraquara-SP, seeking to better understand their characteristics, distribution and relation to breastfeeding. METHOD: application of a questionnaire sent to parents or guardians. The sample comprised 1371 children aged between 6 months and 5-year old, where 702 children (51.2%) had deleterious habits, from a total of 812 reported habits. RESULTS: the habits were more prevalent in women (55%) and aged between 6 months and 2 years. The most commonly found practice was sucking a pacifier (30%), followed by suction bottle (18.4%) and sucking (7.6%), there was no association between the type of habit and socioeconomic status. From the participating children, 1,239 (90.4%) were breastfed, and the length of breastfeeding was most prevalent between 6 months and 12 months (43%), not necessarily exclusive but for a period not less than the recommended by WHO. CONCLUSION: there was an association between duration of breastfeeding in the presence and type of habit, since children who received breastfeeding for a period exceeding 12 months tended not to develop harmful habits. The results show that the greater the duration of breastfeeding is, the lower becomes the prevalence of habits.

Prevalência de má oclusão em crianças de 3 a 6 anos portadoras de hábito de sucção de dedo e/ou chupeta

INTRODUCAO: A ma oclusao, pela sua elevada prevalencia na populacao, e considerada atualmente um problema de saude publica. Considerando-se a associacao entre habitos bucais deleterios e mas oclusoes, o conhecimento da epidemiologia das alteracoes oclusais em criancas portadoras de succao nao nutritiva pode contribuir com a instituicao de politicas publicas. OBJETIVO: Avaliar a prevalencia de ma oclusao em criancas na fase de dentadura decidua portadoras de habitos deleterios de succao, quer sejam de dedo e/ou chupeta. MATERIAL E METODO: O estudo envolveu 135 criancas de ambos os generos, na faixa etaria de 3 a 6 anos, portadoras de habitos de succao nao nutritiva. O historico de succao de dedo e/ou chupeta foi levantado por questionario direcionado aos pais e responsaveis. A avaliacao clinica das mas oclusoes foi realizada por um unico examinador, previamente calibrado, visando minimizar eventuais erros do metodo. RESULTADO: A ma oclusao foi encontrada em 87,4% das criancas. Verificou-se uma prevalencia de 72% de mordida aberta anterior, seguida de atresia maxilar com 62,2%, mordida cruzada posterior com 26,3%, mordida cruzada anterior com 3,4% e apinhamento e topo a topo correspondendo a 5,1% da amostra. O habito deleterio mais frequente foi o de succao de chupeta, presente em 76,3% da amostra, sendo que o mesmo estava distribuido da seguinte maneira: 20% na forma isolada, 25,9% associado a outros habitos deleterios, 3% associado a dedo, 26,7% associado a mamadeira e 0,8% associado a dedo e mamadeira. Ja a succao digital foi encontrada em 25,9% da amostra, sendo 14,1% na forma isolada. CONCLUSAO: Criancas portadoras de succao nao nutritiva durante a fase de dentadura decidua apresentam elevada prevalencia de ma oclusao. Nao se encontraram diferencas estatisticamente significantes entre os generos e as faixas etarias no que se refere a ma oclusao e ao tipo de habito.

Prevalência de maloclusão em escolares de 5 a 12 anos de rede municipal de ensino de Araraquara

OBJETIVO: avaliar a prevalencia de maloclusoes em escolares na faixa etaria de cinco a 12 anos, matriculadas em escolas municipais de Araraquara. METODO: com base no numero total de criancas (7235) realizou-se o calculo da amostragem, envolvendo sete escolas, num total de 3380 criancas. Um estudo piloto e a calibracao dos examinadores precederam o inicio da pesquisa. Foram excluidas 1934 criancas da amostra por nao atenderem aos criterios de inclusao. Na avaliacao clinica, foram analisados, as relacoes inter-arcos nos sentidos transversal, vertical e sagital, a relacao intra-arcos, o perfil e padrao de crescimento, a presenca de assimetria, alem de habitos deleterios. RESULTADOS: da amostragem total (1446), 80,29% apresentou maloclusao, sendo mais prevalente no genero feminino (81,34%) e na faixa etaria de nove a 12 anos (82,52%). A relacao dentaria mais prevalente foi a de Classe I (63,27%), o padrao facial mais encontrado foi o Padrao I (92,87%). As alteracoes oclusais inter-arcos mais encontradas foram a mordida profunda e a mordida aberta, as alteracoes intra-arcos predominantes foram os diastemas e as giroversoes. De acordo com o Teste Qui-quadrado nao houve significância entre maloclusao e as variaveis: presenca de habito, assimetria, diastemas e padrao facial. Houve diferenca estatisticamente significante na prevalencia das variaveis: mordida aberta, mordida profunda, diastemas e dos habitos de succao (dedo, chupeta, mamadeira) e onicofagia quando comparada as duas faixas etarias estudadas. CONCLUSAO: as maloclusoes acometem a maior parte das criancas nessa faixa etaria, tendo origem predominantemente dentaria e com pouco ou nenhum comprometimento facial, evidenciando a necessidade da intervencao precoce.

Cephalometric evaluation of surgical mandibular advancement

The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6 degrees. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23 degrees (from 8.1 degrees to 4.9 degrees). Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm), and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm). It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM) or indirectly to it (ANB, AOBO and OJ).

Insertion angle of orthodontic mini-implants and their biomechanical performance: finite element analysis

ObjectiveThe aim of this study was to assess the stresses and strains generated after the application of two types of forces (traction of 200 gf and torsion of 20 N.cm) in two types of orthodontic mini-implants inserted at different (45° and 90° to the cortical bone) angles.Material and methodthree-dimensional models of two brands of mini-implant (SIN – Sao Paulo, Brazil, and RMO – South Korea) were exported and analyzed by finite element analysis (FEA). Analyses were performed on simulations of cortical bone, cancellous bone and the screw.ResultFEA analysis showed that RMO mini-implants had greater elastic deformation when subjected to tensile and torsional forces when compared with SIN mini-implants. For both trademarks and insertion angles tested, there was greater cortical bone deformation, but with the greatest strain located on the mini-implant. Tension on the mini-implant was located in its transmucosal profile region.ConclusionWhen comparing the two brands of mini-implants by FEA, it is fair to conclude that that the larger number of threads and their greater angle of inclination resulted in less resistance to deformation and induced a higher level of tension in the mini-implant and cortical bone when subjected to forces, especially when inserted at an angle of 45o to the cortical bone.

Avaliação da percepção pessoal em relação à condição de halitose e confirmação clínica

IntroductionHalitosis is a condition characterized by unpleasant breath,affecting thousands of people and causing a negative impact on them.ObjectiveThe aim of this study was to evaluate self-perception of halitosis condition by applying a specific questionnaire and having clinical evaluation.Material and methodThe sample was composed by 59 randomly selected voluntaries between the ages of 20 and 60 years old who were users of Basic Health Units of Araraquara. The methodologies applied were: 1. Signature of informed consent; 2. Application of standardized questionnaire specially designed for this research; 3. Clinical confirmation through halimeter (Tanita Breath Alert CHC-212S). After the experimental phase, all the volunteers received a document with general information about halitosis (causes and treatment). The results were grouped in Microsoft Excel tables and analyzed by Chi-square test.Result and conclusionAfter the analyses, it was concluded that people had lost the ability to perceive their own breath when they had halitosis and they are unable to evaluate themselves effectively; the risky factors that influenced the halitosis were: people over the age of 40, the use some types of drugs, some diseases, frequency of visit to the dentist and poor oral hygiene including bad-technique procedures such as teeth brushing, flossing, tongue cleaning and dentures cleaning. Other factors studied were not statistically sufficient to influence halitosis.

Perimolysis: case report

Perimolysis is a form of dental erosion, characterized by dental tissue demineralization without bacterial involvement. It can be of intrinsic or extrinsic origin. Extrinsic origin is considered when it is caused by excessive consumption of acid drinks and foods such as soft drinks, alcoholic beverages, acid fruit and prescription drugs for daily use. When caused by gastrointestinal disorders, such as those resulting from bulimia, anorexia nervosa and gastroesophageal reflux, it is considered of intrinsic origin. The acid action can cause erosion on palatal/lingual incisor surfaces, and occlusal and palatal/lingual posterior tooth surfaces causing pain (dental hyperesthesia). Treatment is often multidisciplinary, and the causes should be identified, eliminated or controlled. In dentistry, the approach must include preventive measures to reduce future risks, and restorative intervention using materials such as glass ionomer cement, resin composite, or endodontic and prosthetic rehabilitation in more complex cases. The aim of this study was to describe the restorative treatment in the case of a patient with this condition.

Jaw dimensions and inter arches relation in mouth brearhing children

AIM: This research evaluates the dimension characteristics of jaw and the inter arches relation in children with reduction of nasopharynx space by hypertrophy of the pharyngeal tonsils in the mixed dentition stage. MATERIAL AND METHODS: the sample was composed by initial orthodontic documents of 25 patients of both genders, from 6 to 10 years old, diagnosed with nasopharynx obstruction by two specialists (one orthodontist and one otorhinolaryngologist) based on anamnesis, medical history, clinical tests, face photos and evaluation of the respiratory airways through lateral telereadiography. In this early moment, occlusal characteristics were not considered during the diagnosis. The sample was composed by only the cases in which both professionals considered presenting significant obstruction of airways (isthmus ≤ 4mm), able to provide changes on growth and occlusion and that presented the inclusion criteria. The cases selected had their initial plaster models evaluated by means of a digital caliper (brand Vonder) previously calibrated. The intra arches and inter arches included in this study were: intercanine and intermolar distance; anterior and total length of dental arch, depth of the dental arch overjet, overbite and terminal plan/molar and canine relation. RESULTS: It was not found correlation among the isthmus values and variable analyzed. Intra arches measurements presented similar behavior among them, showing their severity. CONCLUSION: Intra arches and inter arches analyzed showed values similar to them reported in the literature, evidencing the influence of nasopharynx space reduction on the morphology of arcade and on occlusion.

Evaluation of Torsional Strength, Design, and Stress Distribution of Different Brands of Orthodontic Mini-Implants.

To the Editor: Treatment options in orthodontics have been expanded by skeletal anchorage through mini-implants over the last years. The stability of the orthodontic mini-implant is influenced by bone quality, especially by the amount of cortical bone in which it is inserted. Scientific evidence shows that stability is also affected by the design of mini-implants; large-size mini-implants require deeper drilling which, consequently, results in greater damage to the bone microstructure, affecting the stability of these anchoring devices. Fracture and early loss of mini-implants during orthodontic treatment are still major concerns in using this type of anchorage system. The design of an orthodontic mini-implant is complex because of the need for reduced diameter to facilitate insertion between roots of adjacent teeth and in different bone regions with different bone qualities. To be effective, a mini-implant must have a reduced diameter associated with a resilient alloy to allow its insertion into bones of different qualities without fracturing the bone. Its design must allow proper bone resorption without causing injuries that could result in necrosis and subsequent screw loss. Given the great diversity of shapes and dimensions of orthodontic mini-implants, knowledge on the biomechanical performance of these anchorage devices can result in less failure and improved guidelines for clinical use. Therefore, this study aimed to evaluate the resistance to torsion, design, and stress distribution of mini-implants of 5 different manufactured brands.