Márcio Costa Sobral

Ancoragem esquelética em Ortodontia com miniimplantes

Temporary anchorage devices, such as mini-implants, have been widely used over the last few years. These devices are very important where anchorage is a major factor for the successful outcome of orthodontic treatment. The authors will comment on the broader aspects of orthodontic treatment with application of mini-implants, choice of implant sites, discussing their indications, surgical procedures, post-surgical oral hygiene care and the most frequent complications.

Estudo comparativo entre traçados cefalométricos manual e digital, através do programa Dolphin Imaging em telerradiografias laterais

OBJECTIVE: The purpose of this study was to compare angular and linear cephalometric measurements obtained through manual and digital cephalometric tracings using Dolphin Imaging® 11.0 software with lateral cephalometric radiographs. METHODS: The sample consisted of 50 lateral cephalometric radiographs. One properly calibrated examiner performed 50 manual and 50 digital cephalometric tracings using eight angular measurements (FMA, IMPA, SNA, SNB, ANB, 1.NA, 1.NB, Y-Axis) and six linear measurements (1-NA, 1-NB, Co-Gn, Co-A, E Line-Lower lip and LAFH). Results were assessed using Students t-test. RESULTS: The results showed no statistically significant differences in any of the assessed measurements (p> 0.05). CONCLUSIONS: Conventional and computerized methods showed consistency in all angular and linear measurements. The computer program Dolphin Imaging® 11.0 can be used reliably as an aid in diagnosing, planning, monitoring and evaluating orthodontic treatment both in clinical and research settings

Estudo comparativo de seis tipos de braquetes ortodônticos quanto à força de adesão

INTRODUCTION: An accurate diagnosis as well as the correct selection of materials, brackets in particular, are important pre-requisites for success in orthodontic therapy. AIM: The aim of this study was to examine the influence of various brackets-base designs on bond strength. METHODS: Six models were evaluated by a test of sheer bond strength: Discovery (Dentaurum) - metallic with laser grooves and 13.12mm2 of base area; Monobloc (Morelli) - metallic one-piece with raised bumps and 10.22mm2 of area; Edgewise Standard (Ortho Organizers) - metallic with MIM (Metal Injection Molding) and 12.02mm2 of area; Illusion Plus (Ortho Organizers) - ceramic with retention ridges and 13.49mm2 of area; Composite (Morelli) - polycarbonate with raised bumps for mechanical retention with 14.68mm2 of area; and Edgewise Standard (Morelli) - metallic with single mesh and 14.31mm2 of area. The brackets were bonded on bovine teeth with Fill Magic Ortodontico (Vigodent) bond agent, for testing. The study was conduced in a universal test machine (EMIC), and the bond strength was recorded at the moment of split by TESC software, 3.01 version; it was calculated in newtons (N) and megapascal (Mpa). RESULTS AND CONCLUSIONS: No statistical difference among tested brackets was found, and the group with the greatest average bond strength was Discovery with 10,12Mpa.

Evaluation of the susceptibility to pigmentation of orthodontic esthetic elastomeric ligatures

OBJECTIVE The purpose of this laboratory study was to evaluate changes in the pigmentation of esthetic elastomeric ligatures after immersion in a staining solution. METHODS Sixty ligatures were selected and divided into 12 groups according to their brand and also considering their condition, i.e., unstretched or stretched. The groups were divided into: Morelli (clear), TP Orthodontics (clear), American Orthodontics (clear), 3M/Unitek (clear), American Orthodontics (pearl color) and 3M/Unitek (pearl color), separated in groups of 5 unstretched and 5 stretched ligatures. Assessment of their color changes was performed by means of digital photograph and computer analysis using Adobe Photoshop. Standardized digital photographs were taken at T₀ (before the staining process, with unstretched ligatures) and at T₁ (following the 5-days staining process). The staining solution was composed of artificial saliva and foods with staining potential. At T₁ the ligatures were either stretched or unstretched. RESULTS The results of this study showed that esthetic elastomeric ligatures are prone to staining. Among the evaluated brands, TP Orthodontics and American Orthodontics clear ligatures were the most stable. Moreover, 3M/Unitek pearl ligatures demonstrated statistically significant changes in all variables. CONCLUSIONS Esthetic elastomeric ligatures are susceptible to staining and no statistically significant difference was found between unstretched or stretched ligatures, with the sole exception of the TP Orthodontics brand. The 3M/Uniteks pearl color ligatures displayed the greatest staining potential.

Vertical control in the Class III compensatory treatment

INTRODUCTION Compensatory orthodontic treatment, or simply orthodontic camouflage, consists in an important alternative to orthognathic surgery in the resolution of skeletal discrepancies in adult patients. It is important to point that, to be successfully performed, diagnosis must be detailed, to evaluate, specifically, dental and facial features, as well as the limitations imposed by the magnitude of the discrepancy. The main complaint, patients treatment expectation, periodontal limits, facial pattern and vertical control are some of the items to be explored in the determination of the viability of a compensatory treatment. Hyperdivergent patients who present with a Class III skeletal discrepancy, associated with a vertical facial pattern, with the presence or tendency to anterior open bite, deserve special attention. In these cases, an efficient strategy of vertical control must be planned and executed. OBJECTIVE The present article aims at illustrating the evolution of efficient alternatives of vertical control in hiperdivergent patients, from the use, in the recent past, of extraoral appliances on the lower dental arch (J-hook), until nowadays, with the advent of skeletal anchorage. But for patients with a more balanced facial pattern, the conventional mechanics with Class III intermaxillary elastics, associated to an accentuated curve of Spee in the upper arch and a reverse curve of Spee in the lower arch, and vertical elastics in the anterior region, continues to be an excellent alternative, if there is extreme collaboration in using the elastics.

Compensatory treatment of Angle Class III malocclusion with anterior open bite and mandibular asymmetry

1Class III malocclusion is characterized by anterior posterior dental disharmony, either with or without skeletal discrepancies. Facial esthetics may be compromised to a greater or lesser degree, depending on the magnitude of the discrepancy, and is one of the main factors motivating individuals to seek orthodontic treatment. In adult patients, therapy may be performed by means of dental compensation, in simpler cases, or in more severe situations, by means of association between Orthodontics and Orthognathic Surgery. The present article is a clinical case report of a patient with a vertical facial pattern, Angle Class III malocclusion, with open bite and important facial asymmetry. The patient was treated in a compensatory manner with extractions, using extra-oral appliances on the mandibular arch with high pull, applying the principles of the Tweed-Merrifield technique. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as part of the requisites for becoming a BBO Diplomate.

Assessing bone thickness in the infrazygomatic crest area aiming the orthodontic miniplates positioning: a tomographic study

ABSTRACT Introduction: Due to the increasing use of miniplates for anchorage purposes in orthodontics, it is very important to know more about infrazigomatic crest anatomy (thickness), in adult patients. Objectives: Evaluate the infrazygomatic crest region thickness, in adult (male and female) patients. Methods: Cone-beam computerized tomography (CBCT) images from 40 patients were used to assess cross-sectional measurements of the infrazygomatic crest region. Measurement 1 considered thickness 2 mm above the distobuccal root of the permanent maxillary first molar, while measurement 2 was taken 2 mm above the first measurement. Results: The mean thickness of the infrazygomatic crest in males was 3.55 mm for measurement 1 and 2.84 mm for measurement 2, while in females these were 2.37 mm and 2.24 mm, respectively. Conclusion: The authors concluded that the overall mean thickness of the infrazygomatic crest was 2.49 mm with respect to measurement 1, and 2.29 mm for measurement 2, with no statistically significant differences between gender.

Influence of in vitro pigmenting of esthetic orthodontic ligatures on smile attractiveness

OBJECTIVE: To evaluate the perception of dental students and orthodontists on the degree of influence that pigmented esthetic elastic ligatures have on smile attractiveness, by judging clinical photographs. METHODS: Sixteen clinical facial photographs of the smile and 16 close up images of the smile of a single patient wearing monocrystalline porcelain orthodontic brackets, Teflon coated NiTi wire brackets and esthetic elastic ligatures of five different commercial brands were distributed into eight groups, G1 to G8 (Morelli®, Ortho Tecnology™, TP Orthodontics™, Unitek/3M™clear, Unitek/3M™ obscure, American Orthodontics™ clear, American Orthodontics™ pearl and American Orthodontics™ metallic pearl). Twenty ligatures were used in each group, totaling 160 ligatures. Half of them were used in their natural state, and the other half after in vitro pigmentation. All the photographs were judged by 40 evaluators, 20 orthodontists and 20 dental students. RESULTS: For orthodontists, American™ pearl (G7) ligatures were those that least influenced the degree of attractiveness of the smile in the two types of photographs used. For the dental students, in the facial photographs of the smile, ligatures with the best performance were Morelli® (G1), American™ clear (G6) and American™ pearl (G7) and in the close up photographs of the smile, American™ pearl, metallic pearl and clear (G7, G8 and G6). CONCLUSIONS: For both orthodontists and dental students, pigmentation of the elastic ligatures had a negative influence on the degree of attractiveness of smiles in the two types of clinical photographs evaluated.

Conservative compensatory Angle Class III malocclusion treatment

INTRODUCTION: Angles Class III malocclusion is a dental discrepancy in a sagittal view that may appear or not with an important skeletal discrepancy. Facial esthetics may be affected by this skeletal discrepancy and it is one of the most common complaints of patients who seek orthodontic treatment. Class III treatment, in adults, may be done by compensatory tooth movement, in simple cases, or through an association between orthodontics and orthognathic surgery, in more severe cases. OBJECTIVE: This article describes a non-extraction compensatory Class III treatment case, applying the Tweed-Merrifield mechanical principles with headgear (J-Hook) in the mandibular arch. This case was presented at the V Brazilian Association of Orthodontics and Dentofacial Orthopedics (ABOR) Meeting, it was evaluated by members of Brazilian Board of Orthodontics and obtained third place in the general classification.