Pistas Indiretas Planas - opção terapêutica para mordidas cruzadas funcionais / Planas Indirect Tracks - option therapy for funcional crossbite

A mordida cruzada funcional, caracterizada pelo desvio funcional durante o fechamento mandibular, acomete, em sua maioria, crianças em idade precoce. Uma das terapias preconizadas para a remoção de interferências oclusais e correção de mordida cruzada nas fases de dentadura decídua e mista é a terapia de Planas, baseada nos conceitos de reabilitação neuro-oclusal. As pistas Planas, quando comparadas com os aparelhos ortopédicos e/ou ortodônticos convencionais, apresentam baixo custo, além de muitas outras vantagens, como não depender da colaboração do paciente, ser simples, eficaz e estável ao longo do tempo. A técnica consiste, basicamente, de ajuste oclusal, seja por remoção (desgastes seletivos) ou por acréscimos de resina composta. O artigo tem como objetivo descrever o caso clínico de um paciente portador de mordida cruzada posterior funcional, na fase da dentadura mista, tratada de forma interceptiva com Pistas Indiretas Planas. Também há a descrição do método de confecção, vantagens e indicações da técnica (AU)

The functional crossbite, characterized by functional deviation during jaw closing, affects mostly children at an early age. One of the recommended therapies for removal of occlusal interferences and correction of crossbite during the deciduous and mixed dentition is Planas therapy, based on the concepts of neuro-occlusal rehabilitation. The Planas Tracks, when compared to conventional orthopedic and/or orthodontics appliances, are low cost, besides many other advantages, as to be independent on patient cooperation, to be simple, eficiente, and stable over time. The technique consists, basically, of occlusal adjustment, by removal or addition of composite resin. The article aims to describe the case of a patient with posterior crossbite, at the stage of mixed dentition treated on an interceptive way with Planas Indirect Tracks. It is also described the preparation method, advantages, and technical instructions.(AU)

In vitro evaluation of the antimicrobial activity of Basil ( Ocimum baslicum L. ) and Coriander ( Coriandrum satirum L. ) oil extracts on Streptococus mutans

Plant extracts and essential oils show efficiency on growth control in a wide variation of microorganisms, including filamentous fungi, yeasts and bacteria. To evaluate antimicrobial activity of plant extracts, determine the lower quantity of substance to inhibit the microorganism test growth is necessary. This value is known as Minimum Inhibitory Concentration (MIC). This study had as aim to verify the antimicrobial action and the Minimum Inhibitory Concentration (MIC) of basil (Ocimum basilicum L.) and coriander (Coriandrum sativum L.) oil extract before S. mutans (ATCC 25175) strains. Antimicrobial activity determination was carried out by microdilution method and performed according to recommendations of CLSI (previously known as NCCLS), standard M7-A6 (NCCLS, 2003) for bacteria, and standard M27-A2 (NCCLS, 2002). All the experiments were carried out in triplicate. Results showed the Minimum Inhibitory Concentration (MIC) determination by microdilution method in broth showed Ocimum basilicum L. and Coriandrum sativum L. extract oils presented inhibitory activity before S. mutans strain. Basil in 1:4 concentration is bacteriostatic and in 1:3 concentration is bactericide. Coriander in 1:2 concentration is bacteriostatic and in 1:1 concentration is bactericide. We concluded that basil presented higher inhibitory activity regarding to the coriander. We also observed as bigger the extract dilution, lower their effectivity.o assess the attitude and practice of dental professionals towards using of advance Radiographic technique.

In situ evaluation of basil oil essential oil cytotoxicity ( Ocimum basilicum L. )

Essential oils derived from plants used as condiments represent a large group of natural antimicrobials. Extracts and essential oils from plants have been shown to be efficient in controlling the growth of a wide variety of microorganisms, including filamentous fungi, yeasts and bacteria. Practical uses of these activities are suggested in humans and animals, as well as in the food industry. This study aimed to evaluate the basal basil essential oil (Ocimum basilicum L.) cytotoxicity in NCTC Clone 929 cell line, mouse connective tissue cells (CCIAL 020), which were seeded in Petri dishes and incubated for 48 hours To to form the cell monolayer. For the this test accomplishment of this test, we counted with the collaboration of the Nucleus of Cell Cultures - NCC of the Adolfo Lutz Institute, of the city of São Paulo-SP. The culture medium used is the solid coating medium, and fragments of the samples fragments are were placed on this coating medium and the plates were again incubated for 24 hours. The Biological Reactivity Degree (GR) index, which is the area not stained by the vital dye, is were observed macro and microscopically. Samples were tested in quadruplicates on separate plates. ThusThereunto, the test result showed that the essential oil was cytotoxic in the cell line studied, and that the future work in pharmacology and toxicology needs to be performed to better standardize the therapeutic dose, which is not cytotoxic as the pure oil behaved.o assess the attitude and practice of dental professionals towards using of advance Radiographic technique.

The use of botulinum toxin as a way of treatment for gingival smile: case report

Gingival smile is defined as excessive gum exposition. Its etiology may be related to several factors, among them a maxillary vertical excess, superior dentoalveolar protrusion, changed passive extrusion and or eruption of anterior-superior teeth and hyperactivity of superior lip lift muscle. In cases in which the etiological factor is from muscle, the use of Botulinum toxin typo A (BTX-A) should be indicated. To highlight the benefits obtained with therapeutic use of this substance, the authors describe a clinical case of a female young patient, in which the Botox® was applied to correct gingival smile as a way to complement the orthodontic treatment. The applications were performed in two lateral points on the nose wing in a single session. The result was very satisfactory and there was no need additional dose. The authors concluded that BTX-A is a safe option and minimum invasive for treatment of gingival smile when provoked by muscle hypercontraction. Its side effects are rare with discrete discomfort during the application.

Insertion angle of orthodontic mini-implants and their biomechanical performance: finite element analysis / Ângulo de inserção de mini-implantes ortodônticos e seu desempenho biomecânico: análise de elementos finitos

Objective: The aim of this study was to assess the stresses and strains generated after the application of two types of forces (traction of 200 gf and torsion of 20 N.cm) in two types of orthodontic mini-implants inserted at different (45° and 90° to the cortical bone) angles. Material and method: three-dimensional models of two brands of mini-implant (SIN - Sao Paulo, Brazil, and RMO - South Korea) were exported and analyzed by finite element analysis (FEA). Analyses were performed on simulations of cortical bone, cancellous bone and the screw. Result: FEA analysis showed that RMO mini-implants had greater elastic deformation when subjected to tensile and torsional forces when compared with SIN mini-implants. For both trademarks and insertion angles tested, there was greater cortical bone deformation, but with the greatest strain located on the mini-implant. Tension on the mini-implant was located in its transmucosal profile region. Conclusion: When comparing the two brands of mini-implants by FEA, it is fair to conclude that that the larger number of threads and their greater angle of inclination resulted in less resistance to deformation and induced a higher level of tension in the mini-implant and cortical bone when subjected to forces, especially when inserted at an angle of 45º to the cortical bone.

Objetivo: O objetivo deste estudo foi avaliar as tensões e deformações de duas marcas comerciais de mini-implantes ortodônticos geradas após a aplicação de dois tipos de forças (de tração de 200 gf e torção de 20 N.cm) inseridos em duas angulações (45° e 90° em relação ao osso cortical). Material e método: Modelos tridimensionais das duas marcas de mini-implantes (SIN - Sao Paulo, Brasil, e RMO - Coréia do Sul) foram construídos e analisados por análise de elementos finitos (FEA). As análises foram realizadas em simulações no osso cortical, osso esponjoso e no parafuso. Resultado: A análise FEA mostrou que os mini-implantes da marca RMO apresentaram maior deformação elástica quando submetidos à tração e as forças de torção quando comparado aos mini-implantes da marca SIN. Em ambas as marcas testadas, e para os diferentes ângulos de inserção, houve uma maior deformação do osso cortical, com maior tensão localizado no mini-implante. A tensão no mini-implante foi localizado na região do perfil transmucoso. Conclusão: Ao comparar as análises de elementos finitos das duas marcas comerciais de mini-implantes, concluiu-se que um maior número de roscas e maior inclinação resultam em menor resistência à deformação e induzem uma maior tensão no osso cortical quando submetidos à forças de torção e tração, especialmente quando inserido em um ângulo de 45º com o osso cortical.

In vitro evaluation of anti-adherence activity of the Ocimum basilicum l. ( basil) extract and of the Coriandrum sativum l. ( coriander) in acrylic surface of removable orthodontic appliances

AIM: The aim of this study is evaluate the antimicrobial activity of the Ocimum basilicum L. (basil) extract and of the Coriandrum sativum L. (coriander) extract in biofilm of Streptococcus mutans colonized in specimens confectioned in acrylic used to confection removable orthodontic appliances. MATERIAL AND METHODS: To perform this work, specimens were confectioned (spherical discs in sterile acrylic) which were immersed in extracts pure and in series dilutions (1:2 a 1:128) by 24, 48 and 72 hours. For each time of exposition, the disintegration of bacterial films was performed by sonication in saline solution. RESULTS: The results obtained were satisfactory for the extracts studied on the inhibition of biofilm formation. CONCLUSION: We conclude that polyphenols present in the extracts interfered on the glucan synthesis engine, possibly inhibiting the enzymes (glucosyl- and fructosyl transferase) which synthesize the extracellular polymers, also acting as antioxidant, and therewith they presented antimicrobial activity.

Chemical analysis and Vickers hardness of orthodontic mini-implants

Orthodontic mini-implants are used in clinical practice to provide efficient and aesthetically-pleasing anchorage. AIM: To evaluate the hardness Vickers hardness and chemical composition of mini-implant titanium alloys from five commercial brands. METHODS: Thirty self-drilling mini-implants, six each from the following commercial brands, were used: Neodent NEO, Morelli MOR, Sin SIN, Conexão CON, and Rocky Mountain RMO. The hardness and chemical composition of the titanium alloys were performed by the Vickers hardness test and energy dispersive X-ray spectroscopy, respectively. RESULTS: Vickers hardness was significantly higher in SIN implants than in NEO, MOR, and CON implants. Similarly, VH was significantly higher in RMO implants than in MOR and NEO ones. In addition, VH was higher in CON implants than in NEO ones. There were no significant differences in the proportions of titanium and aluminum in the mini-implant alloy of the five commercial brands. Conversely, the proportion of vanadium differed significantly between CON and MOR/NEO implants. CONCLUSIONS: Mini-implants of different brands presented distinct properties of hardness and composition of the alloy...

Jaw dimensions and inter arches relation in mouth brearhing children

AIM: This research evaluates the dimension characteristics of jaw and the inter arches relation in children with reduction of nasopharynx space by hypertrophy of the pharyngeal tonsils in the mixed dentition stage. MATERIAL AND METHODS: the sample was composed by initial orthodontic documents of 25 patients of both genders, from 6 to 10 years old, diagnosed with nasopharynx obstruction by two specialists (one orthodontist and one otorhinolaryngologist) based on anamnesis, medical history, clinical tests, face photos and evaluation of the respiratory airways through lateral telereadiography. In this early moment, occlusal characteristics were not considered during the diagnosis. The sample was composed by only the cases in which both professionals considered presenting significant obstruction of airways (isthmus ≤ 4mm), able to provide changes on growth and occlusion and that presented the inclusion criteria. The cases selected had their initial plaster models evaluated by means of a digital caliper (brand Vonder) previously calibrated. The intra arches and inter arches included in this study were: intercanine and intermolar distance; anterior and total length of dental arch, depth of the dental arch overjet, overbite and terminal plan/molar and canine relation. RESULTS: It was not found correlation among the isthmus values and variable analyzed. Intra arches measurements presented similar behavior among them, showing their severity. CONCLUSION: Intra arches and inter arches analyzed showed values similar to them reported in the literature, evidencing the influence of nasopharynx space reduction on the morphology of arcade and on occlusion.

Evaluation of minimum inhibitory concentration and antimicrobial activity of basil extract ( Ocimum basilicum L. ) incorporated to the mouthwash

AIM: This study has as aim to evaluate the minimum inhibitory concentration and the antimicrobial activity of basil extract incorporated to the mouthwash against the bacteria S.mutans. MATERIAL AND METHODS: For the study, the hydro alcoholic basil extract (Ocimum basilicum L.) incorporated to the mouthwash was used in order to evaluate the effect of this formulation on bacteria and its Minimum Inhibitory Concentration (MIC). As positive control, TBS + S. mutans was used; as negative control, only the TBS; the fluid hydro alcoholic basil extract 20% and the concentrated basil extract 12%, both incorporated to the mouthwash, were also evaluated. As MIC verification method and antimicrobial activity, the micro dilution was used in the concentrations: pure, 1/2, 1/4, 1/8, 1/16, 1/32, 1/64, 1/128; and carried out in triplicate. The microtiter plates were incubated and evaluated after 24 and 72hs. RESULTS: The results showed there was no antimicrobial activity of mouthwash associated to the fluid and concentrated basil extract. However, the mouthwash insulated showed antimicrobial activity only as pure; other dilutions did not presented the same result. CONCLUSION: Before the findings in this study, it is possible conclude that hydro alcoholic basil extract incorporated to the mouthwash did not present antimicrobial activity against the bacteria S. mutans.

Removal program of nonnutritive sucking habits based on simple actions and parents and children motivation

AIM: This research aims to present a program that uses simple measures and practices for the child becomes motivated to remove the habit. MATERIAL AND METHODS: The sample consisted of children aged 3-6 years, of both genders, with habit of finger or pacifier sucking enrolled in preschools in the municipal education of Araraquara, S.P (Brazil). The methodology can be divided into three parts: 1. Parents orientation about the need and importance of immediate abandonment of the habit; 2. Problem presentation for the child; 3. Development of playful activities. It was considered as a parameter for successful cases when the habit was removed within 8 weeks from the beginning of the work. RESULTS: As a result, it was observed that when the children were motivated, most of them removed the habit, reducing the chances of future malocclusions. CONCLUSION: It is considered that the presented method is an alternative to be used by professionals such as dentists, psychologists, pediatricians and speech therapists in helping to care for children with non-nutritive sucking habit.

Evaluation of knowledge on oral health, malocclusions and non- nutritive habits of daycare educators

AIM: The purpose of this study was to evaluate daycare educators' knowledge on oral health, malocclusions and non-nutritive habits and how to address these issues. Educators were also investigated on whether or not they had received previous instructions on oral health and the quality of such information. MATERIAL AND METHODS: A survey was conducted using a questionnaire, given to daycare educators of Araraquara (SP, Brazil). The structured questionnaire had close-ended questions, and was divided into three sections according to subject matter. RESULTS: Based on the analyzed questionnaires (n=143), most educators showed reasonable knowledge on oral health (72%) and non-nutritive habits (52.4%), although 89.5% of them had received previous instructions on the subject. Chi-square test showed no association between the level of knowledge among educators and the variables: age, type of school and self assessment of knowledge. CONCLUSIONS: These professionals need additional information about oral health in order to address these topics through educational practices, since educators are the best suited professionals to teach and motivate children.

Tratamento multidisciplinar: relato de casos clínicos / Multidisciplinary treatment: clinical cases report

Opaciente adulto apresenta maior predisposição para doença periodontal, decorrente, principalmente, do mal controle de placa. Nesses pacientes, a movimentação ortodôntica não é contraindicada, porém, é necessária uma avaliação da condição periodontal para que se possa estabelecer o plano de tratamento apropriado. / Objetivo / Descrever e discutir casos clínicos de indivíduos com necessidade de reabilitação bucal e com periodonto severamente comprometido. / Métodos / Os métodos consistiram no tratamento ortodôntico de dois casos com comprometimento periodontal. Após exames clínicos e radiográficos, os casos foram analisados de forma multidisciplinar, envolvendo as especialidades de Ortodontia, Periodontia e Prótese, com objetivo de proporcionar ao paciente os melhores resultados estético, funcional e estabilidade. O tratamento periodontal consistiu de raspagem supra- e subgengival, previamente ao tratamento ortodôntico, e programa de manutenção periódica trimestral durante toda movimentação ortodôntica. As ativações foram realizadas em intervalos de 45 a 50 dias, com a utilização de forças leves, sendo utilizadas contenções em ambas as arcadas, mesmo após a finalização da reabilitação. / Conclusão / O tratamento reabilitador bucal, quando feito de forma multidisciplinar, traz resultados bastante satisfatórios. A interação da Ortodontia e da Periodontia comprovou que pacientes com periodonto reduzido, porém saudável, podem receber tratamento ortodôntico, desde que as forças não excedam o limite biológico desse.

Evaluation in vitro of antimicrobial activity of basil extract (Ocimum basilicum L. ) on an acrylic surface of removable orthodontic appliances

AIM: The aim of this study was to evaluate in vitro the antimicrobial activity of Ocimum basilicum L. (basil) extract in S. Muttans biofilm colonized in specimens confectioned in the same acrylic used for removable orthodontics appliances. MATERIAL AND METHODS: To perform this work, 42 specimens were confectioned (sterile spherical acrylic disks) and immersed in pure extract and in serial dilution of extract (1:2 until 1:10) during 24, 48 and 72 hours. For each time of exposition, a disintegration of bacterial film by sonication in saline and posterior seed in agar, for colony count, were carried out. ATCC strains of S. muttans were selected, and 2% chlorhexidine solution was used as inhibition control. RESULTS: The results showed, by quantitative analysis, that basil extract has antibacterial activity in S. muttans biofilm, when used in pure state or in dilution until 1:4. CONCLUSION: Besides, it was possible observe the more increase the incubation time, independent the dilution, the higher degradation of extract.

Effect of angled installation of orthodontic mini-implants on primary stability

AIM: The aim of this work was evaluate the insertion and removal torque for orthodontic mini-implants inserted in different inclination. Materials and methods: Ten self[drilling mini-implants from the brand SIN (Sistema de Implantes Nacional, São Paulo/SP, Brazil), and the surgical kit for their insertion were used. Two plaques of synthetic bone of 120mm x 170mm x 41,5mm were used (Sawbones, Pacific Research Laboratories Inc, Vashon, Wash), with 1,5mm height, simulating the cortical bone (density 40 pcf) and 40 mm simulating the medullary bone (density 15 pcf). In each block, five areas were demarcated for each mark, totalizing ten areas. The ten mini-implants were inserted by the same operator, previously calibrated; five of them at 900 and five at 600, using the manual key kit. After the insertion of all the mini-implants, the final threading and the reading of insertion torque value were carried out with a manual torque wrench digital Lutron TQ[8800 (Lutron Electronic Enterprise Co., Ltd, Taipei, Taiwan) until the trans-mucosal profile achieve the cortical bone. The maximum insertion torque value was registered in N/cm. After all the implants inserted, the measurement of removal torque was started, performed in the same way of insertion, but in the opposite anticlockwise. The results were submitted to the T test (parametric) and to a Mann-Whitney test (non-parametric). Results: The results demonstrated that the insertion torque was lower than the removal one in both insertion degrees, with statistically significance. Despite insertion torque at 90 degrees had been lightly higher than that inserted at 60 degrees, they were not statistically significant. Conclusion: In view of the results, it was possible conclude that insertion at 60º angulation does not offer advantages to the primary stability for orthodontic mini-implants.

Prevalência de má oclusão em crianças de 3 a 6 anos portadoras de hábito de sucção de dedo e/ou chupeta / Prevalence of malocclusion in 3 to 6 year-old sucking habit children

Introdução: A má oclusão, pela sua elevada prevalência na população, é considerada atualmente um problema de saúde pública. Considerando-se a associação entre hábitos bucais deletérios e más oclusões, o conhecimento da epidemiologia das alterações oclusais em crianças portadoras de sucção não nutritiva pode contribuir com a instituição de políticas públicas. Objetivo: Avaliar a prevalência de má oclusão em crianças na fase de dentadura decídua portadoras de hábitos deletérios de sucção, quer sejam de dedo e/ou chupeta. Material e Método: O estudo envolveu 135 crianças de ambos os gêneros, na faixa etária de 3 a 6 anos, portadoras de hábitos de sucção não nutritiva. O histórico de sucção de dedo e/ou chupeta foi levantado por questionário direcionado aos pais e responsáveis. A avaliação clínica das más oclusões foi realizada por um único examinador, previamente calibrado, visando minimizar eventuais erros do método. Resultado: A má oclusão foi encontrada em 87,4% das crianças. Verificou-se uma prevalência de 72% de mordida aberta anterior, seguida de atresia maxilar com 62,2%, mordida cruzada posterior com 26,3%, mordida cruzada anterior com 3,4% e apinhamento e topo a topo correspondendo a 5,1% da amostra. O hábito deletério mais frequente foi o de sucção de chupeta, presente em 76,3% da amostra, sendo que o mesmo estava distribuído da seguinte maneira: 20% na forma isolada, 25,9% associado a outros hábitos deletérios, 3% associado a dedo, 26,7% associado à mamadeira e 0,8% associado a dedo e mamadeira. Já a sucção digital foi encontrada em 25,9% da amostra, sendo 14,1% na forma isolada. Conclusão: Crianças portadoras de sucção não nutritiva durante a fase de dentadura decídua apresentam elevada prevalência de má oclusão. Não se encontraram diferenças estatisticamente significantes entre os gêneros e as faixas etárias no que se refere à má oclusão e ao tipo de hábito.

Introduction: The malocclusion, due to its high prevalence in the population is currently considered a public health problem. Considering the association between oral habits and malocclusion, knowledge of the epidemiology of occlusal alterations in children with non-nutritive sucking can contribute to the establishment of public policies. Objective: To assess the prevalence of malocclusion in children in primary dentition phase with deleterious habits of finger sucking and/or pacifier. Material and Method: The study involved 135 children of both genders, aged 3-6 years, with non-nutritive sucking habits. The history of finger sucking and/or pacifier was raised by a questionnaire given to parents and guardians. Clinical assessment of malocclusion was performed by a single examiner previously calibrated in order to minimize possible errors of the method. Result: Malocclusion was found in 87.4% of children. There was a 72% prevalence of anterior open bite, followed by maxillary atresia with 62.2%, posterior cross bite with 26.3%, anterior cross bite with 3.4%, crowding and top-to-end corresponding to 5.1% of the sample. The most common harmful habit was the pacifier-sucking, present in 76.3% of the sample, while the same was distributed as follows: 20% in the isolated, 25.9% associated with other deleterious habits, 3% associated the finger, 26.7% associated with bottle and 0.8% associated with finger and bottle. Already finger sucking was found in 25.9% of the sample, 14.1% in isolation. Conclusion: Children with nonnutritive sucking during the deciduous dentition show a high prevalence of malocclusion. No statistically differences were found between genders and age groups in relation to malocclusion type and habit.

Protocolo alternativo para o tratamento da síndrome da apneia obstrutiva do sono com aparelho intrabucal / Alternative protocol for treatment of Obstructive Sleep Apnea with intraoral appliance

Introdução: a síndrome da apneia obstrutiva do sono (SAOS) tornou-se um problema de saúde pública, sendo mais prevalente na população mundial do que outras doenças crônicas. A Ortodontia tem um papel importante em seu tratamento com a utilização dos aparelhos intrabucais (AIB) dinâmicos de avanço mandibular, principalmente em casos de SAOS de intensidade leve a moderada. Existem na literatura protocolos de tratamento, no quais a cooperação do paciente para realizar a ativação do AIB é fundamental para o sucesso e evolução do caso. Métodos: foi usado um protocolo de atendimento alternativo para um paciente adulto, do sexo feminino, com índice de apneia/hipopneia (IAH) de 12 episódios por hora, associado a ronco intenso, índice de massa corporal de 27,4 kg/m2 e quadro de hipertensão arterial. Foi realizada uma abordagem terapêutica integrada envolvendo a Otorrinolaringologia, a Ortodontia e a Fonoaudiologia, de forma que a ativação do avanço mandibular do AIB foi controlada mensalmente pelo ortodontista. Resultados: redução significativa do ronco, diminuição da frequência cardíaca (sono REM 61 para 47,3 e NREM 51 para 42,7), atenuando o AIH para 2 episódios por hora em um período de 6 meses. Conclusão: o protocolo proposto nesse artigo mostrou-se eficaz ao tratar um paciente com SAOS de intensidade leve, com o mínimo de avanço mandibular em um curto período de tempo, apresentando estabilidade oclusal, clinicamente observada após um ano de acompanhamento.

Influência do ambiente familiar e da condição socioeconômica na introdução e na manutenção de hábito de sucção não nutritiva / Influence of family environment and socioeconomic status in the introduction and maintenance of non-nutritive oral habits

Os hábitos bucais não nutritivos, como sucção de chupeta e de dedo, estão presentes na maioria das crianças nas fases das dentaduras decídua e início da mista. Assim, o objetivo da pesquisa foi avaliar a influência do ambiente familiar e da condição socioeconômica na presença de hábitos de sucção de dedo e/ou chupeta, em crianças entre 6 meses e 5 anos, matriculadas em pré-escolas de Araraquara-SP. Foram enviados 514 questionários aos pais das crianças que compunham a amostra, contendo perguntas relativas aos seguintes aspectos: idade, ocupação e carga horária de trabalho, número de filhos, condição socioeconômica, duração e frequência de hábitos, tempo de amamentação, relacionamento familiar, entre outras informações. Dos 219 questionários que retornaram, evidenciou-se que o hábito mais frequentemente encontrado foi o de sucção de chupeta, normalmente introduzida antes do primeiro mês de vida (66,4%), por influência dos pais, e apresentando um declínio com o aumento da idade. Já a sucção digital tendeu a aumentar com o acréscimo da idade, tendo como período de maior prevalência a hora do sono. A condição socioeconômica, a idade materna e o nível de escolaridade dos pais influenciaram diretamente no índice de aleitamento natural e na prevalência dos hábitos. As mães com maior escolaridade e renda tenderam a amamentar seus filhos de forma natural e a evitar a presença de hábitos deletérios. Com base nos resultados, nota-se a necessidade de acesso dos pais e das crianças a um programa preventivo educacional, visando à importância da remoção dos hábitos em idade precoce.

Non-nutritive oral habits, such as pacifier and finger-sucking, are present in most children in the phases of the primary and the early mixed dentitions. The objective of this research was to evaluate the influence of family environment and socioeconomic conditions on pacifier and/or finger-sucking habits, in children between 6 months and 5 years old, enrolled in pre-schools in Araraquara, S.P. (Brazil). 514 parents received surveys containing questions regarding age; occupation and working hours;, number of children; socioeconomic status; duration and frequency of habits; feeding time; and family dynamics. Feedback from 219 surveys showed that pacifier-sucking was the most frequent habit, which was introduced before the first month of life (66.4%), usually under the influence of parents, and decreased with the increase of age. Whereas the finger-sucking habit tended to increase with the increase of age, and showed higher prevalence during the hours of sleep. The rate of breastfeeding and the prevalence of habits were directly influenced by factors such as socioeconomic condition, maternal age and educational level of parents. Mothers with higher income and education level, tended to breastfeed their children in a natural way, which seemed to avoid the presence of harmful habits. Based on the results, there seems to be a great need to provide parents and children with access to a prevention program, which would aim at the importance of the removal of habits at early ages.

Occurrence of skeletal malocclusions in Brazilian patients with dentofacial deformities

In this study, a survey was conducted on the occurrence of skeletal malocclusions presented by patients of the Center for Research and Treatment of Buccofacial Deformities (CEDEFACE) in the city of Araraquara, SP, Brazil. The clinical charts of 381 patients with dentoskeletal deformities, who underwent combined orthodontic-surgical treatment in the period between 2000 and 2006, were reviewed. After sample selection (convenience method), based on the data of the pre- and post-surgical documentation, the number of patients was reduced to 171. For classification of the survey, the anteroposterior discrepancy (Class I, II and III), race, age, gender, absence or presence of asymmetry, vertical maxillary excess and maxillary biprotrusion were considered, in addition to determining in which bony base the surgical procedure was performed. Patients' documentations were analyzed by one examiner previously calibrated by repetition of the process until the method was considered adequate (intraclass correlation coefficient > 0.94). Patients' mean age was 23.59 (SD 6.93) years, the majority (102 patients) were women, and Caucasians (160 patients). Class III malocclusion was the most prevalent (81 patients). Asymmetry, vertical maxillary excess and biprotrusion were present in 54, 33, and 7 patients, respectively. The majority of surgeries for correction of dentoskeletal deformities were combined, involving the maxilla and mandible. In conclusion, Class III was the most prevalent skeletal deformity and Class I was the least prevalent; in general, the prevalence of skeletal deformities was higher in women; in the majority of patients with skeletal malocclusions there was a combination of maxillary and mandibular problems, which interferes directly in the decision regarding the most adequate treatment plan, and a higher incidence of asymmetry was observed in skeletal Class III; vertical excess occurred in a similar manner in Class II and III and there was a low incidence of biprotrusion among the malocclusions evaluated.

Este estudo avaliou a ocorrência de más oclusões esqueléticas apresentadas pelos pacientes do Centro de Pesquisa e Tratamento das Deformidades Bucofaciais (CEDEFACE), na cidade de Araraquara, SP, Brasil. Foram avaliados prontuários de 381 pacientes com deformidades dentoesqueléticas, que fizeram tratamento combinado ortodôntico-cirúrgico no período entre 2000 e 2006. Após a seleção da amostra (método de conveniência), baseado nos dados da documentação pré e pós-cirúrgica, o número de pacientes foi reduzido para 171. Para classificação do levantamento, considerou-se a discrepância ântero-posterior (Classe I, II e III), raça, idade, gênero, ausência ou presença de assimetria, excesso vertical maxilar e biprotrusão maxilar, além de determinar em qual base óssea o procedimento cirúrgico foi realizado. As documentações dos pacientes foram analisadas por um examinador previamente calibrado pelo processo de repetição até que o método fosse considerado adequado (correlação intraclasse >0,94). A idade média dos pacientes foi de 23,59 anos (DP 6,93), a maioria do gênero feminino (102 pacientes) e leucoderma (160 pacientes). A má oclusão mais prevalente foi a Classe III (81 pacientes). A assimetria, o excesso maxilar vertical e biprotrusão maxilar estavam presentes em 54, 33, e 7 pacientes, respectivamente. Na maioria dos casos, as cirurgias para correção de deformidades dentoesqueléticas foram combinadas, envolvendo os dois maxilares. Com base nos resultados, conclui-se que a Classe III foi a deformidade esquelética mais prevalente e a Classe I a menos prevalente. Em geral, a prevalência de deformidades esqueléticas foi maior entre as mulheres e a maioria dos pacientes apresentou uma combinação de problemas maxilares e mandibulares, o que interfere diretamente na decisão sobre o plano de tratamento mais adequado. Houve uma maior incidência de assimetria na Classe III esquelética; o excesso vertical ocorreu de forma semelhante na Classe II e III e a biprotrusão teve baixa incidência entre as más oclusões avaliadas.

Cephalometric evaluation of surgical mandibular advancement

The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6°. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23° (from 8.1° to 4.9°). Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm), and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm). It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM) or indirectly to it (ANB, AOBO and OJ).

Extração de pré-molares em pacientes adultos: relato de caso clínico / Premolars extraction in adult patients: case report

A obtenção de uma estética facial agradável é um dos objetivos do tratamento ortodôntico. A exodontia de pré-molares é indicada para a correção do apinhamento, redução da protrusão dentária e correção da relação sagital entre os arcos dentários, além de poder causar redução cefalométrica na dimensão vertical da face, uma vez que a mesialização dos dentes posteriores resulta em giro anti-horário mandibular, contribuindo na melhora do perfil. O objetivo desse trabalho foi relatar um caso clínico de uma paciente adulta tratada com exodontia de quatro pré-molares, onde se obteve um resultado satisfatório, com redução da biprotrusão dentária e melhora na estética facial, devido também à rotação mandibular anti-horária.