Renata Castro

Prospective study of dentoskeletal changes in Class II division malocclusion treatment with twin force bite corrector

OBJECTIVE To evaluate the dentoskeletal changes of Class II malocclusion treatment with the Twin Force Bite Corrector (TFBC). MATERIALS AND METHODS The sample comprised 86 lateral cephalograms obtained from 43 subjects with Class II division 1 malocclusion; the subjects were divided into two groups. The experimental group comprised 23 patients with a mean initial age of 12.11 years who were treated with the TFBC for a mean period of 2.19 years. The control group included 40 lateral cephalograms from 20 Class II nontreated patients, with an initial mean age of 12.55 years and a mean observation period of 2.19 years. The lateral cephalograms were evaluated before and after orthodontic treatment in group 1 and in the beginning and end of the observation period in group 2. t-Tests were used to compare the initial and final cephalometric characteristics of the groups as well as the amount of change. RESULTS The experimental group presented greater maxillary growth restriction and mandibular retrusion than the control group, as well as greater maxillomandibular relationship improvement and greater labial tipping of the mandibular incisors. The results also showed a greater decrease in overbite and overjet in the experimental group, and there were no statistically significant differences in the craniofacial growth pattern between groups. CONCLUSIONS The TFBC promotes restriction of anterior maxillary displacement without significant changes in mandibular length and position and improvement of maxillomandibular relationship without changes in facial growth and significant buccal tipping of mandibular incisors. Class II correction with the TFBC occurred primarily as a result of dentoalveolar changes.

A multidisciplinary treatment of congenitally missing maxillary lateral incisors: a 14-year follow-up case report

Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and the teeth, including the presentation of malocclusion and the effect on the occlusion must be considered. The objective of this study was to describe the etiology, prevalence and alternative treatment modalities for dental agenesis and to present a clinical case of agenesis of the maxillary lateral incisors treated by the closure of excessive spaces and canine re-anatomization. A clinical case is presented to illustrate the interdisciplinary approach between orthodontics and restorative dentistry for improved esthetic results. In this report, the treatment of a girl with a Class II malocclusion of molars and canines with missing maxillary lateral incisors and convex facial profile is shown. Treatment was successfully achieved and included the space closure of the areas corresponding to the missing upper lateral incisors, through movement of the canines and the posterior teeth to mesial by fixed appliances as well as the canines transformation in the maxillary lateral incisors. This is a 14-year follow-up case report involving orthodontics and restorative dentistry in which pretreatment, post-treatment, and long-term follow-up records for the patient are presented.

Orthodontic-surgical treatment of Class III malocclusion with extraction of an impacted canine and multi-segmented maxillary surgery

Establishment of a treatment plan is based on efficacy and easy application by the clinician, and acceptance by the patient. Treatment of adult patients with Class III malocclusion might require orthognathic surgery, especially when the deformity is severe, with a significant impact on facial esthetics. Impacted teeth can remarkably influence treatment planning, which should be precise and concise to allow a reasonably short treatment time with low biologic cost. We report here the case of a 20-year-old man who had a skeletal Class III malocclusion and impaction of the maxillary right canine, leading to remarkable deviation of the maxillary midline; this was his chief complaint. Because of the severely deviated position of the impacted canine, treatment included extraction of the maxillary right canine and left first premolar for midline correction followed by leveling, alignment, correction of compensatory tooth positioning, and orthognathic surgery to correct the skeletal Class III malocclusion because of the severe maxillary deficiency. This treatment approach allowed correction of the maxillary dental midline discrepancy to the midsagittal plane and establishment of good occlusion and optimal esthetics.

Braquetes autoligados: eficiência x evidências científicas

Os braquetes autoligados tem sido apresentados como um diferencial para o ortodontista clinico que procura se desdobrar na tentativa de oferecer um tratamento de excelencia no menor tempo pos-sivel e com numero minimo de consultas. No en-tanto, a quantidade de informacoes propiciadas por verdades estabelecidas e nao comprovadas a longo prazo cresce a uma velocidade vertiginosa. Contrariamente ao que muitos pensam, os bra-quetes autoligados nao representam um desenvol-vimento recente e revolucionario, pois, desde 1935, Russel

Correlação entre o índice morfológico das coroas dos incisivos inferiores e a estabilidade da correção do apinhamento ântero-inferior

OBJETIVO: investigar ate que ponto as dimensoes mesiodistais e vestibulolinguais das coroas dos incisivos inferiores contribuem para a estabilidade da correcao do apinhamento ântero-inferior. METODOLOGIA: foram avaliados 56 pacientes leucodermas, de ambos os generos (27 feminino e 29 masculino), que inicialmente apresentavam ma oclusao de Classe I ou de Classe II, divisao 1 (28 cada), tratados com extracoes dos quatro primeiros pre-molares e com mecânica Edgewise. Nenhum caso foi submetido a desgastes interproximais durante ou apos o tratamento. As medidas foram realizadas nos modelos de estudo obtidos de cada caso nas fases pre, pos-tratamento e pos-contencao, totalizando na avaliacao de 168 modelos inferiores. A idade media pre-tratamento foi de 13,23 anos, o tempo de tratamento de 2,11 anos e pos-tratamento foi de 5,12 anos. O indice de irregularidade de Little foi utilizado para quantificar o apinhamento ântero-inferior e o indice de Peck e Peck para mensuracao das dimensoes mesiodistais e vestibulolinguais dos mesmos. O teste de correlacao de Pearson foi utilizado para determinar a significância de correlacao entre a morfologia das coroas dos incisivos inferiores e a estabilidade. Secundariamente, investigou-se a presenca de dimorfismo entre os generos e a existencia de diferenca entre os dois tipos de ma oclusao inicial, em relacao a estabilidade da correcao do apinhamento ântero-inferior, utilizando o teste t independente. RESULTADOS E CONCLUSOES: concluiu-se que a morfologia da coroa dos incisivos inferiores apresentou uma fraca correlacao com a estabilidade pos-contencao. Nem o genero dos pacientes, nem o tipo de ma oclusao inicial influenciaram na estabilidade da correcao do apinhamento ântero-inferior, cinco anos pos-tratamento.