Luciane Quadrado Closs

Dentofacial deformities are associated with lower degrees of self-esteem and higher impact on oral health-related quality of life: results from an observational study involving adults.

PURPOSE Patients with dentofacial deformities tend to show poorer oral health-related quality of life, but few studies thus far have focused on this topic. Therefore, the objectives of this study were to evaluate oral health-related quality of life, self-esteem, and depression in patients with Class II and Class III dentofacial deformities before orthodontic treatment and to compare these patients with controls with harmonic faces. MATERIALS AND METHODS This observational, cross-sectional study compared 2 groups (experimental vs control) of patients recruited at an outpatient orthodontic clinic. Oral health-related quality of life was assessed using a short form of the Oral Health Impact Profile, self-esteem was evaluated with the Rosenberg Self-Esteem Scale, and depression symptoms were assessed using the General Hospital Depression Scale (outcome variables). The presence of dentofacial deformities (ie, group allocation) was the primary predictor variable. The χ(2) test and Spearman correlation coefficient were used to analyze data. RESULTS The total sample was composed of 68 individuals (34 in each group). In the experimental group, 55.9% of patients were women, and 88.2% presented a Class III occlusal relation. The mean age in the experimental group was 27.56 years. Significant differences were observed between the 2 groups in oral health-related quality of life (P < .001) and self-esteem (P < .019), but no differences were found for depression (P = .161). CONCLUSIONS Patients with dentofacial deformities had a more negative oral health-related quality of life and a lower self-esteem compared with controls. No association was observed between dentofacial deformities and depression.

Evaluation of the use of low-level laser therapy in pain control in orthodontic patients: A randomized split-mouth clinical trial

OBJECTIVE To evaluate the effect of using low-level laser therapy (LLLT) to control pain and discomfort during orthodontic treatment. MATERIALS AND METHODS A randomized, split-mouth clinical trial was conducted with 30 volunteers in need of orthodontic treatment, of both genders, aged between 18 and 40 years, who were randomly divided into two groups. One hemiarch was considered the exposed group (EG) and the other, the placebo group (PG). Both groups had elastic separators placed mesially and distally to the first molars of the two hemiarches at different times. The EG received an AIGaAs diode LLLT (810 nm, 100 mW, 2J/cm(2)) application for 15 seconds per point (interdental papilla at the mesial, distal, and near the root apex) immediately after separator placement on the maxillary right side. The PG also had elastics placed around the maxillary right molars, but received only simulated LLLT application. The elastics were left in place for 5 days, and after a waiting period of 1 week, they were inserted on the left side in both groups; however, the order of laser application was changed. While the separator remained in place, the patient marked his degree of perceived discomfort on a Visual Analog Scale (VAS) at 5 minutes (T0), 24 hours (T1), and 120 hours (T2), after LLLT application. RESULTS A statistically significant difference was observed (P < .005) in reducing discomfort in the exposed group compared with the placebo group. This reduction of discomfort in the EG was observed at all time intervals. CONCLUSIONS A sincle AIGaAs diode LLLT application may be indicated for the control or reduction of pain in the early stages of orthodontic treatment.

Vertical alveolar growth in subjects with infraoccluded mandibular deciduous molars

INTRODUCTION Our objective was to compare vertical alveolar growth in areas adjacent to infraoccluded deciduous molars with growth in areas of deciduous molars and normal occlusion for a period of at least 1 year by using digital subtraction radiography. METHODS This case-control study included 40 pairs of panoramic radiographs of growing patients with infraoccluded deciduous molars and 40 pairs of radiographs of patients without infraoccluded deciduous molars. One radiograph at baseline was obtained at diagnosis, and the other at least 1 year later. The subjects and the controls were matched according to chronologic age and time interval between the 2 radiographs. The 2 groups were compared with regard to vertical alveolar growth and vertical tooth movement. Measurements were assessed by using nonparametric tests (Mann-Whitney and Friedman) and a multiple comparison test. Significance was set at 5%. RESULTS A statistically significant difference was observed between the groups with regard to vertical alveolar growth measured on the bone crest between the first permanent molars and second premolars. CONCLUSIONS Vertical alveolar growth between the first permanent molar and the second premolar adjacent to the infraoccluded teeth was smaller than in areas adjacent to teeth with normal occlusion.

Combination of Bionator and high-pull headgear therapy in a skeletal open bite case

Abstract This case was presented at the Student Case Display, ABO in 1995 San Francisco, Calif., in partial fulfillment of the requirements for the certification process conducted by the Board. (A M J O RTHOD D ENTOFAC O RTHOP 1996;109:341-7.)

Predictors of Success in the Treatment of Obstructive Sleep Apnea Syndrome with Mandibular Repositioning Appliance: A Systematic Review

Introduction Obstructive sleep apnea syndrome affects up to 4% of middle-aged men and 2% of adult women. It is associated with obesity. Objective The objective of this article is to review the literature to determine which factors best correlate with treatment success in patients with obstructive sleep apnea syndrome treated with a mandibular repositioning appliance. Data Synthesis A search was performed of the PubMed, Cochrane, Lilacs, Scielo, and Web of Science databases of articles published from January 1988 to January 2012. Two review authors independently collected data and assessed trial quality. Sixty-nine articles were selected from PubMed and 1 from Cochrane library. Of these, 42 were excluded based on the title and abstract, and 27 were retrieved for complete reading. A total of 13 articles and 1 systematic review were considered eligible for further review and inclusion in this study: 6 studies evaluated anthropomorphic and physiologic factors, 3 articles addressed cephalometric and anatomic factors, and 4 studies evaluated variables related to mandibular repositioning appliance design and activation. All the studies evaluated had low to moderate methodologic quality and were not able to support evidence on prediction of treatment success. Conclusion Based on this systematic review on obstructive sleep apnea syndrome treatment, it remains unclear which predictive factors can be used with confidence to select patients suitable for treatment with a mandibular repositioning appliance.

Aarskog-scott syndrome: a review and case report.

Abstract This paper reports the treatment and 12-year follow-up of a patient 7 years old who had been diagnosed with Aarskog-Scott syndrome. The patient had a history of premature multiple tooth loss, vertical dimension loss and severe dentoalveolar discrepancy. Orthopedic and orthodontic rehabilitation treatments were performed to improve the patient’s esthetic, functional and psychological condition. How to cite this article: Closs LQ, Tovo M, Dias C, Corradi DP, Vargas IA. Aarskog-Scott Syndrome: A Review and Case Report. Int J Clin Pediatr Dent 2012;5(3):209-212.

Orthodontic-restorative treatment as an option for biologic replacement of a maxillary central incisor: 5-year follow-up

The maxillary central incisor is the tooth most often affected by trauma, especially in the age range of 7 to 10 years, when high-impact sports are prevalent. The options for conservative treatment should be prioritized in these patients, aiming to achieve a biologic response that might provide continuity of growth of the alveolus, to provide functional and esthetic development of the affected region. This case report describes a patient with a history of trauma during the deciduous dentition with consequent intrusion, root dilaceration, and retention of the maxillary left central incisor. The treatment involved extraction of the traumatized tooth and mesial movement of the lateral incisor and posterior segments.

Alteração da inclinação dos incisivos inferiores e ocorrência de recessão gengival

OBJETIVOS: o objetivo deste estudo foi investigar se alteracoes na posicao vestibulolingual dos incisivos inferiores em adolescentes podem predispor ao desenvolvimento de recessoes gengivais. METODOS: documentacoes de 189 adolescentes leucodermas (107 meninos e 81 meninas) pre e pos-tratamento ortodontico foram selecionadas. Os pacientes apresentavam uma idade media de 11,2 ± 1,9 anos nos exames iniciais e 14,7 ± 1,8 anos nos exames finais. A presenca de recessao gengival foi avaliada em modelos de estudo e em fotografias. A inclinacao dos incisivos inferiores, em relacao ao plano mandibular (IMPA) foi medida nos cefalogramas laterais pre e pos-tratamento e os casos foram divididos em proclinados, retroinclinados e inalterados. RESULTADOS: nao foi observada associacao significativa entre a alteracao da inclinacao dentaria e a presenca de recessoes gengivais, utilizando o teste do qui-quadrado (p = 0,277). Foi observado que 107 pacientes (56,6%) apresentaram os incisivos proclinados; 64 pacientes (33,9%) com incisivos retroinclinados; e 18 pacientes (9,5%) nao apresentaram alteracao na inclinacao. Nos casos em que novas recessoes gengivais ocorreram, 64,9% foram vestibularizados, 26,3% foram lingualizados e 8,8% nao apresentaram alteracao na inclinacao. No grupo de pacientes que apresentou migracao coronal da margem gengival, 60% foram movimentados para lingual, 30% foram vestibularizados e 10% nao alteraram de posicao. CONCLUSOES: apesar de a porcentagem de casos que foram vestibularizados apresentar um maior numero de novas recessoes, esse nao foi estatisticamente significativo.

ASSOCIATION BETWEEN POST-ORTHODONTIC TREATMENT GINGIVAL MARGIN ALTERATIONS AND SYMPHYSIS DIMENSIONS

Orthodontic therapy is known to be associated with the development of gingival recession. Several factors may be involved in the causal chain of this outcome, including anatomical and behavioral aspects. Among the anatomical aspects, the dimensions of the mandibular symphysis could play a predisposing role. This study evaluated the relationship between the mandibular symphysis dimensions prior to orthodontic therapy and the development of gingival recessions on the lower incisors and cuspids. Records from 189 orthodontically treated adolescents were evaluated, including radiographs, casts and intra-oral photographs. Symphysis dimensions were assessed by cephalograms. Gingival margin alterations were determined in photographs and cast models. Association between gingival margin alterations and symphysis dimensions was tested by chi-square (α=0.05). Occurrence of gingival recession increased after orthodontic therapy. No association was observed on average of symphysis dimensions and the occurrence of gingival recessions. It may be concluded that pretreatment symphysis dimensions may not be used as predictors of gingival recession after orthodontic therapy.

Orthodontic space closure of lost traumatized anterior teeth – case report

This case report refers to an 11-year-old boy with avulsion of the upper left central and lateral incisors. The teeth were replanted after 4 h, splinted with a semi-rigid splint for 12 days, and then endodontically treated. Severe progressive root resorption was seen after 2 years and the teeth were extracted. The boy had a normal occlusion with spacing in both jaws and slight protrusion of the anterior teeth. The treatment objectives were to close some of the spaces by mesial movement of the buccal segments in the upper jaw to minimize bone loss for a future single osseointegrated implant. Fixed appliance in combination with a removable plate was used for the mesial movements, levelling, and alignment of the upper jaw. Fixed appliance in the lower jaw and Class II traction were used for the final adjustment of the occlusion. A good occlusion with coincident upper and lower midlines and up-righted anterior teeth were achieved. A Maryland bridge was performed as a temporary solution for a future osseointegrated implant.