Ricardo Moresca

Estudo comparativo de complicações durante o uso do aparelho de Herbst com cantiléver e com splint inferior de acrílico removível

OBJECTIVE: To assess and compare the type of complications during Herbst treatment with Cantilever Bite Jumper (CBJ) and removable mandibular splint. METHODS: Twenty one consecutive Herbst patients treated with the CBJ were compared with twenty one patients consecutively treated with Herbst with stainless steel crowns on the maxillary first molars and a removable mandibular acrylic splint. The initial mean age for the CBJ group was 12 years and 3 months and for the Splint group was 11 years and 3 months. Both groups used the Herbst appliance for 12 months. Based on the patients clinical records an occurrence survey of complications during Herbst treatment was performed. RESULTS: There were 24 complications for the CBJ and 53 for the Splint group, which were statistically different (Mann-Whitney test, p<0.05). The prevalence of patients exhibiting complications during treatment was 66.67% in the CBJ and 85.71% in the Splint group. The frequencies of complications were also statistically different between the groups. CONCLUSIONS: The CBJ exhibited a significantly smaller number of complications during Herbst appliance treatment than the removable mandibular splint. Herbst appliance with first molar crowns and a cantilever on the mandibular molars is preferable to the removable mandibular acrylic splint because of savings in clinical and laboratory time.

Effect of Different Surface Treatments for Ceramic Bracket Base on Bond Strength of Rebonded Brackets

The aim of this study was to evaluate the shear bond strength of rebonded ceramic brackets after subjecting the bracket base to different treatments. Seventy-five premolars were selected and randomly distributed into five groups (n=15), according to the type of the bracket surface treatment: I, no treatment, first bonding (control); II, sandblasting with aluminum oxide; III, sandblasting + silane; IV, silica coating + silane; and V, silicatization performed in a laboratory (Rocatec system). The brackets were fixed on an enamel surface with Transbond XT resin without acid etching. The brackets were then removed and their bases were subjected to different treatments. Thereafter, the brackets were fixed again to the enamel surface and the specimens were subjected to shear bond strength (SBS) test. The adhesive remnant index (ARI) was then evaluated for each specimen. Data were subjected to ANOVA and Tukeys tests (α=0.05). A statistically significant difference was observed only between Rocatec and the other groups; the Rocatec group showed the lowest SBS values. The highest SBS values were observed for group 1, without any significant difference from the values for groups II, III and IV. Most groups had a higher percentage of failures at the enamel-resin interface (score 1). It was concluded that the surface treatments of rebonded ceramic brackets were effective, with SBS values similar to that of the control group, except Rocatec group.

Effects of active and passive lacebacks on antero-posterior position of maxillary first molars and central incisors

The purpose of this study was to compare the effects of active and passive lacebacks on antero-posterior position of maxillary first molars and central incisors during leveling phase. Twenty-three subjects with Class I and Class II malocclusion were treated with first premolars extraction using preadjusted appliances (MBT 0.022-inch brackets). The leveling phase was performed with stainless steel archwires only. The sample was divided into 2 groups: 14 subjects received active lacebacks (Group 1) and 9 subjects received passive lacebacks (Group 2). Lacebacks were made from 0.008-inch ligature wire. Lateral cephalometric radiographs were taken pre- and post-leveling phase. Students t-test was applied to determine the differences between pre- and post-leveling mean values and to determine the mean differences between groups. In Group I, the first molars showed a significant mesial movement, whereas no change was observed in Group 2. In both groups, maxillary central incisor crowns moved to lingual side. In conclusion, active laceback produced anchorage loss of maxillary first molars whereas passive laceback did not affect the position of these teeth. Active and passive lacebacks were effective in preventing central incisor proclination.

Avaliação do nível de satisfação de pacientes em tratamento ortodôntico em relação à atuação do ortodontista

OBJECTIVE: Considering the increasing professional preoccupation in accounting new patients and establish a close rapport with satisfied patients, this study aimed to evaluate the patient satisfaction level in orthodontic treatment in relation to orthodontic actuation. METHODS: Sixty questionnaires filled out by patients in orthodontic treatment with specialists in Orthodontics, from the Curitiba city. The patients were divided into two groups. The first had 30 patients which considered unsatisfied with the orthodontists conduct or treatment and transferred of orthodontist in the last 12 months. The second group had 30 patients which considered satisfied, and were in treatment with the same professional during, at least, 12 months. RESULTS AND DISCUSSION: After the statistical analysis (chi-square test), it was concluded that patients satisfaction with orthodontist actuation is strongly related to the doctor-patient personal relationship and interaction, motivation, technical degree, doctors indication and titles. The factors that predicted satisfaction of the patient with the orthodontic treatment were the number of patients attended simultaneously and the integration of the patients during the proceeding

Efeitos dos fios de nivelamento de níquel-titânio e de aço inoxidável na posição dos incisivos inferiores

OBJETIVO: estudar os efeitos do nivelamento realizado com fios de NiTi termoativado e de aco inoxidavel, avaliando-se as possiveis alteracoes na posicao dos incisivos inferiores, em casos com extracoes, correlacionando com o tempo de tratamento. METODOS: a amostra foi composta de 36 individuos, de ambos os sexos, leucodermas brasileiros, com idade media inicial de 15 anos e 5 meses, portadores de mas oclusoes de Classes I e II, distribuidos em dois grupos. No Grupo 1 (n=17), o nivelamento foi realizado com a sequencia 1, utilizando-se tres fios - 0,016 e 0,019x0,025 de NiTi termoativado, e 0,019x0,025 de aco inoxidavel. No Grupo 2 (n=19), foi testada a sequencia 2, na qual foram utilizados apenas fios de aco inoxidavel (0,014; 0,016; 0,018; 0,020 e 0,019x0,025 com torque passivo nos incisivos inferiores). Os dados foram coletados utilizando-se o metodo cefalometrico computadorizado e comparados pelo teste t de Student com o nivel de significância de 5%. RESULTADOS: no Grupo 1, os incisivos inferiores inclinaram-se para lingual, com movimento significativo apenas da coroa (1,6mm). No Grupo 2, os incisivos inferiores permaneceram estaveis. Nao houve alteracao vertical em nenhum dos grupos. CONCLUSOES: a sequencia 2 proporcionou um melhor controle dos incisivos inferiores, nao alterando suas posicoes iniciais, enquanto a sequencia 1 permitiu a expressao do torque da prescricao utilizada, levando a uma inclinacao lingual desses dentes. O tempo de tratamento foi menor utilizando-se a sequencia 1. As variacoes biomecânicas estudadas apresentaram vantagens e desvantagens que devem ser conhecidas e ponderadas pelo ortodontista no planejamento do caso.