Fabiane Azeredo

Characteristics and distribution of dental anomalies in a Brazilian cleft population

OBJETIVOS: Determinar a prevalencia de anomalias dentarias em 200 pacientes com fissura sob tratamento ortodontico no Centro de Reabilitacao Labio-Palatal (CERLAP) da Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS). METODOLOGIA: Os dados referentes a idade, raca, genero, tipo de fissura (pre, trans ou pos-forame incisivo), lado afetado (uni ou bilateral), agenesias e supranumerarios em ambas arcadas foram avaliados a partir da documentacao ortodontica constituida por radiografias panorâmicas, cefalometricas, oclusais e periapicais, modelos de estudo e fotografias intra e extrabucais obtidas no inicio do tratamento, fornecendo informacoes necessarias para diagnostico de anomalias dentarias. Os dados coletados foram registrados em planilhas. RESULTADOS: A media de idade dos pacientes foi de 13.5 anos; 86% eram brancos; e 57% eram meninos. Fissuras transforame incisivo demonstraram-se mais frequentes (83%); o lado esquerdo foi mais afetado (48.5%). Agenesias foram encontradas em 66.5% dos pacientes. Incisivos laterais superiores foram os dentes mais ausentes (78.5%). Supranumerarios foram encontrados em 35.5 % dos pacientes. CONCLUSAO: Meninos demonstraram maior tendencia a apresentar fissuras e a manifestar agenesias dentarias e supranumerarios. As fissuras completas de labio e palato prevaleceram e os incisivos laterais superiores foram os dentes mais ausentes. Os supranumerarios localizaram-se distalmente a fissura na maioria dos casos.

Análises microbiológicas de alicates ortodônticos

AbstractObjective: To evaluate bacterial contamination in the active tip of orthodontic pliers used in an academic setting. Methods: Thirty-four pliers were selected: 17 debonding pliers and 17 model 139 pliers. The control group was composed of 3 previously autoclaved pliers of each model. After use, the pliers in the experimental group were immersed in 10 ml of brain-heart infusion (BHI) culture medium for 2 minutes, incubated at 37o C for 24 to 48 h and seeded in duplicates in different agar-based solid culture media to detect and identify microbial agents. Results: Microbiological analyses revealed that there was contamination in both types of orthodontic pliers. Several bacteria were detected, predominantly staphylococcus and isolated Gram-positive (G+) cocci. The debonding pliers had a greater contamination rate and mean values of 2.83 x 10 9 and 6.25 x 10 CFU/ml, with variations according to the type of culture medium. The 139 pliers also had all types of bacteria from the oral microbiota at values that ranged from 1.33 x 10

Volumetric assessment of alveolar clefts: a literature review

OBJECTIVE To conduct a review of the literature on methods for volumetric assessment of alveolar clefts and ascertain which methods are most precise to guide future research. METHODS The PubMed and MEDLINE databases were searched for English-language reports of clinical and in vitro studies with detailed descriptions of imaging modality, sample characteristics, and method for measurement of alveolar cleft volume. RESULTS The search strategy yielded 34 articles, of which 14 were selected for in-depth analysis. According to the findings of computed tomography (CT)-based studies, the CT modalities and software employed for assessment were deemed reliable and satisfactory. CONCLUSIONS Measurement of alveolar cleft volume by the proposed methods and using the equipment and software employed in the analyzed studies has high efficacy and efficiency and can be safely used for cleft lip and palate treatment planning.

Cone-Beam computed tomography evaluation of maxillary expansion in twins with cleft lip and palate

OBJECTIVE: The establishment of normal occlusal relationships in patients with cleft lip and palate using rapid maxillary expansion may promote good conditions for future rehabilitation. OBJECTIVE: This study describes the clinical case of monozygotic twins with unilateral cleft lip and palate at the age of mixed dentition, who were treated using the same rapid maxillary expansion protocol, but with two different screws (conventional and fan-type expansion screw). Results were evaluated using plaster models, intraoral and extraoral photographs, and Cone-Beam computed tomography (CBCT) scans obtained before the beginning of the treatment, (T1). METHODS: The patients were followed up for 6 months after maxillary expansion, when the same tests requested at T1 were obtained again for review (T2). T1 and T2 results were compared using lateral cephalometric tracings and measurements of the intercanine and intermolar distances in the plaster models using a digital caliper. RESULTS: The two types of expansion screws corrected the transverse discrepancy in patients with cleft lip and palate. The shape of the upper arches improved at 10 days after activation. CONCLUSION: CBCT scans provide detailed information about craniofacial, maxillary and mandibular changes resulting from rapid maxillary expansion. The most adequate screw for each type of malocclusion should be chosen after detailed examination of the dental arches.

Cone-beam computed tomography evaluation of bone plate and root length after maxillary expansion using tooth-borne and tooth-tissue-borne banded expanders

Introduction The objective of this research was to evaluate the buccal bone plate and root length of maxillary permanent first molars using cone‐beam computed tomography after maxillary expansion with different activation protocols. Methods Cone‐beam computed tomography images of growing patients were obtained from the orthodontic department of Pontifical Catholic University of Rio Grande do Sul in Brazil. The groups were Haas‐type 2/4 turns, Haas‐type 4/4 turns, hyrax‐type 2/4 turns, and hyrax‐type with alternate rapid maxillary expansions and constrictions (alt‐RAMEC) 4/4 turns a day. Tooth length, periodontal insertion, alveolar bone thickness, and intermolar distances were evaluated. The data at the start of treatment and 6 months later were compared using generalized linear models. The intergroup differences were determined by univariate analysis of variance with the Bonferroni adjustment. Results Tooth length was significantly shortened after expansion in all groups (−0.28 to −0.51 mm), except for the alt‐RAMEC group. Bone level variables (bone level and bone level at the tooth tip) changed statistically in all groups, except for the Haas 4/4 turns group. There was significant periodontal attachment loss after rapid maxillary expansion with the hyrax/alt‐RAMEC (5.09 mm). The hyrax/alt‐RAMEC and hyrax groups had more dehiscences, fenestrations, and exposures of the root. Conclusions The consequence of rapid maxillary expansion using the hyrax was alveolar bone resorption, especially in the hyrax/alt‐RAMEC group, whereas the Haas expander caused mild root resorption. HighlightsWe evaluated buccal bone plate and maxillary first molar root length after RME.The hyrax groups showed more alveolar bone resorption.The hyrax/alt‐RAMEC group also showed more attachment loss.The hyrax groups had more dehiscences, fenestrations, and root exposure.The Haas group had more root resorption.

Immediate effects of rapid maxillary expansion on the nasal cavity using Haas-type and Hyrax-type expanders in CBCT

Purpose: To evaluate and compare the immediate effects of rapid maxillary expansion (RME) on the nasal cavity dimensions in subjects treated with Haas-type and Hyrax-type expanders using cone-beam computed tomography (CBCT). Methods: Thirty-one growing patients (mean age=10.8 years old) with transverse maxillary deficiency were randomly divided into two groups: Haas group (n=16) and Hyrax group (n=15). All patients had RME with initial screw activation of 4 quarter turns followed by activations of 1⁄2 turns per day (0.4mm) until the expansion reached 8mm opening at the screw. CBCT scans were taken before RME (T1) and at the end of the active phase of expansion (T2). Vertical and transverse measurements were performed at different regions of nasal cavity for comparison between groups and treatment times. Intraclass correlation coefficient (ICC), paired Student’s t-test and repeated measures ANOVA (α-level p<0.05) were calculated. Results: RME procedure increased every vertical and lateral nasal cavity dimensions (p<0.001). The most significant gains were observed in the lower portions of the nasal cavity located at the anterior and medial regions. Conclusions: Both appliances were able to create significant changes in the dimensions of the nasal cavity immediately after RME. However, the Hyrax-type expander presented greater transverse effects on the airway. Correspondence to: Luciane Macedo de Menezes, Professor, Department of Orthodontics, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil, Tel: 55-51 3320.3562; E-mail: luciane. menezes @pucrs.br