Posición del incisivo inferior en pacientes de clase esqueletal I y II según su biotipo facial en una muestra de una clínica privada, Cali 2014 - 2020

Introducción: la sínfisis mentoniana es la articulación cartilaginosa medial de los huesos mandibulares, su posición se relaciona con los diferentes biotipos y puede influir en la posición del incisivo inferior. Objetivo: determinar si existen variaciones en la posición del incisivo inferior, en pacientes clase II con diferentes biotipos. Materiales y métodos: se evaluaron la totalidad de tomografías de pacientes clase I y II esquelética que asistieron entre 2014 y 2020 a una clínica privada, teniendo una muestra total de 74 pacientes, caracterizándolos por sexo y edad. Se determinó biotipo facial, Incisor Mandibular Plane Angle, distancias a la sínfisis como el ACV-ACL y altura desde el ápice. Para el análisis se utilizó I-CAT Visión Q, para las medidas de las tomografías digitales y para el análisis estadístico Stata 17. Resultados: se en- contró un Incisor Mandibular Plane Angle mayor en pacientes clase II en los tres biotipos; los dolicofaciales clase II mostraron menor valor en corticales ACV-ACL, los pacientes mostraron mayor proinclinación en la clase II. La posición del incisivo en pacientes clase II presenta una proinclinación significativa en braquifaciales (p = 0.04). Conclusión: se encontraron variaciones entre los tres biotipos faciales en las diversas mediciones en pacientes clase I y II, el sexo femenino evidenció diferencias significativas en las clases en las medidas del Incisor Mandibular Plane Angle y la altura de la sínfisis a nivel del ápice; estos hallazgos son relevantes en el momento de realizar un tratamiento ortodóntico ya que puede limitar el movimiento de los incisivos inferiores.

Introduction: the mental symphysis is the medial cartilaginous joint of the mandibular bones, its position is related with the different biotypes and can influence the position of the lower incisor. Objective: to determine if there are variations in the position of the lower incisor, in class II patients with different biotypes. Materials and methods: all the tomography of skeletal class I and II patients who attended a private clinic between 2014 and 2020 were evaluated, having a total sample of 74 participants, characterizing the patients by sex and age. Facial biotype, Incisor Mandibular Plane Angle, distances to the symphysis such as the ACV-ACL and height from the apex were determined. For the analysis, I-CAT Vision Q was used for the measurements of the digital tomography and for the statistical analysis Stata 17. Results: a greater Incisor Mandibular Plane Angle in class II patients in the three biotypes was evident; class II dolichofacials showed a lower value in both cortical ACV-ACL, with the narrowest and longest measurement of the symphysis, the patients showed proclination in class II for both sexes, being higher for the male. The position of the incisor within the symphysis in class II patients presents a significant proclination in brachyfacial patients (p=0.04), despite presenting greater proclination, it maintains its apices centered within the symphysis. Conclusion: variations were found between the three facial biotypes in class I and II patients, it is relevant when performing orthodontic treatment since it can limit the movement of the lower incisors.

Estética y patrones craneofaciales en la Ortodoncia / Aesthetics and craniofacial patterns in Orthodontics

RESUMEN La belleza se puede definir como una combinación de cualidades que dan placer a los sentidos o a la mente. En Ortodoncia, la mayoría de los pacientes acuden a consulta para mejorar su estética. Las características faciales y esqueléticas determinan el desarrollo del patrón facial, este puede ser descrito y cuantificado y es resultado del crecimiento. Dicho aspecto, ofrece, además, las bases para el diagnóstico correcto de la anomalía dentomaxilofacial y es un requisito para lograr una estética y una función adecuadas. Se realizó un estudio de los diferentes conceptos de estética y los análisis craneofaciales tomados en cuenta a lo largo de la historia de la Ortodoncia para definir tratamientos y diagnósticos en los pacientes. Si bien existen numerosos estudios que avalan la importancia de estos datos para llegar a la armonía facial, es evidente la ausencia de un acercamiento a la realidad cubana y su diversidad de razas.

ABSTRACT Beauty can be defined as a combination of qualities that give pleasure to the senses or to the mind. In Orthodontics, most patients come for consultation to improve their aesthetics. Facial and skeletal characteristics determine facial pattern development, which can be described and quantified and is the result of growth. It also provides the basis for the correct diagnosis of dentomaxillofacial anomalies and is a prerequisite for adequate function and aesthetics. A study of the different aesthetics concepts and the craniofacial analysis, throughout the history of Orthodontics, was made to define treatments and diagnoses in patients. Although there are numerous studies that endorse the importance of these data to achieve facial harmony, it is evident that there is no an approach to the Cuban reality and its racial diversity.

Study on the transverse relationship of the mandible between different skeletal vertical patterns in patients with skeletal ClassⅠ malocclusion / 口腔疾病防治

Objective@#To analyze the correlation between skeletal vertical patterns and mandibular dental arch width, basal arch width and the dental buccolingual inclination of patients with skeletal ClassⅠ@*Methods@#The CBCT data of 62 skeletal ClassⅠ malocclusion patients were collected and divided into a high-angle group with 19 cases, a mean-angle group with 22 cases, and a low-angle group with 21 cases according to the GoGn-SN angle. Mandible 3D reconstruction of the three groups was performed using Dolphin software, and dental arch widths, basal arch widths and buccolingual inclination of canines, first premolars and first molars, were measured and statistically analyzed respectively. @*Redults@#Mandibular dental arch width showed no significant difference among the three groups (P>0.05). The basal arch widths of mandibular canines and first premolars in low-angle group were larger than those in the other groups (P<0.05). The buccolingual inclinations of mandibular canines and first premolars in high-angle group were larger than those in the other groups (P<0.05). The buccolingual inclination and basal arch width of the first molars among the three groups showed no significant differences (P>0.05). Pearson correlation tests showed that the basal arch widths of mandibular canines and first premolars were negatively correlated with GoGn-SN angle. Excluding the influence of dental arch width and basal arch width, there was still a significant positive correlation between the buccolingual inclination of mandibular canines and first premolars and the GoGn-SN angle (P<0.05).@*Conclusion@#The width of the basal bone arch between different skeletal vertical patterns mainly differs in the canine segment and the premolar segment, and the difference in the buccolingual inclination of the teeth is mainly to compensate for the difference in the GoGn-SN angle. In clinical practice, individualized therapy should be adopted according to the differences to achieve the long-term efficacy of correction.

Comparison of airway dimensions in skeletal Class I malocclusion subjects with different vertical facial patterns

ABSTRACT Objective: The aim of this study was to compare upper airway widths among skeletal Class I malocclusion subjects with different vertical facial patterns. Methods: The sample included a total of 99 lateral cephalograms of post pubertal individuals (18.19 ± 1.76 years old). The vertical facial pattern was determined by the Vert index. The McNamara method was used to quantify upper airway widths. ANOVA test and Student's t test for independent groups were used, when normal distribution was not supported Kruskal-Wallis test and U-Mann-Whitney test were used. A multiple linear regression analysis was also performed. Results: Statistically significant differences in several nasopharyngeal widths were found among the distinct vertical facial patterns. Subjects with brachyfacial pattern presented larger nasopharyngeal widths than subjects with mesofacial (p= 0.030) or dolichofacial (p= 0.034) patterns. The larger the Vert value, the larger the nasopharyngeal widths (R2= 26.2%, p< 0.001). At the level of oropharynx no statistically significant differences were found. Conclusion: It was concluded that nasopharyngeal linear anteroposterior widths in Class I malocclusion brachyfacial are larger than in mesofacial and dolichofacial individuals. The Vert index only explained 25% of the total variability. No correlation was found for the oropharyngeal widths.

RESUMO Objetivo: o objetivo desse estudo foi comparar as dimensões das vias aéreas superiores em indivíduos portadores de má oclusão de Classe I esquelética com diferentes padrões faciais verticais. Métodos: a amostra consistiu de 99 cefalogramas laterais de indivíduos na pós-puberdade (18,19 ± 1,76 anos). O padrão facial vertical foi determinado por meio do índice VERT. O método de McNamara foi utilizado para quantificar as dimensões das vias aéreas superiores. O teste ANOVA e o teste t de Student para grupos independentes foram utilizados e, quando a distribuição normal não era possível, o teste de Kruskal-Wallis e o teste U de Mann-Whitney foram aplicados. Foi também realizada uma análise de regressão linear múltipla. Resultados: diferenças estatisticamente significativas nas dimensões da nasofaringe foram encontradas entre os diferentes padrões faciais verticais. Os indivíduos com padrão braquifacial apresentaram dimensões nasofaríngeas maiores do que os indivíduos com padrão mesofacial (p= 0,030) ou dolicofacial (p= 0,034). Quanto maior o valor do VERT, maior a dimensão nasofaríngea (R2 = 26,2%, p< 0,001). Não foram encontradas, entretanto, diferenças estatisticamente significativas ao nível da orofaringe. Conclusão: pode-se concluir que as dimensões anteroposteriores lineares da nasofaringe nos indivíduos braquifaciais com má oclusão de Classe I são maiores do que nos indivíduos mesofaciais e dolicofaciais. O índice VERT foi capaz de explicar apenas 25% da variabilidade total. Não foi encontrada correlação para as dimensões da orofaringe.

Facial pattern analysis: critic review and collection of facial proportions in a brazilian sample using cone-beam computed tomography / Análise de tipos faciais: revisão crítica e coleta de proporções faciais em amostra de brasileiros utilizando tomografia computadorizada de feixe cônico

The classification of facial vertical patterns is a common practice among dentists of different specialties. It influences treatment planning and expected outcomes, but is usually carried out qualitatively. The aim of this study is to better understand vertical facial proportions, combining a critic review of the literature with the collection of data from 100 Brazilian adult sample in search of 3D quantitative parameters with the use of Cone-Beam Computed Tomography (CBCT) measurements. In Pubmed database, the following quoted phrases were used: "Facial pattern" AND "Facial Index" AND "Facial height Index" AND "Facial height" AND "Dolichofacial" AND "Brachyfacial" AND "Longface syndrome" AND "Short-face syndrome" in a 25 years interval (1990-2015). Study selection was performed searching for crucial facial features, commonly used to determine the facial pattern of a patient. In CBCT exams, 100 patients had facial features measured and classified by the three most reliable methods. The literature on the field can be very confusing, as the methods, landmarks and averages differed considerably. Most of the facial features researched had different values when the literature was analyzed and compared to our data. This indicates that ethnic, age and gender variations play an important whole in facial pattern diagnostic and should be taken in account when using general cephalometric approaches on diagnosis. With a group sorting method, combining the ratios between the anterior Facial height and the width, the anterior vertical proportion and the gonial angle divergence, and with anatomical landmarks we successfully correlated the sample to the qualitative description, as shorter faced patients to larger bi-zygomatic distances and less divergent gonial angles and longer faced patients with narrower and more divergent faces.

A classificação de padrões faciais verticais é prática comum entre Cirurgiões Dentistas de diferentes especialidades. Esta influencia o planejamento de tratamento e resultados esperados, no entanto, essa tarefa é frequentemente realizada de forma qualitativa. O objetivo deste trabalho foi compreender melhor as proporções verticais da face, combinando uma análise crítica da literatura com a coleta de dados de 100 adultos brasileiros na procura por parâmetros quantitativos em 3D, usando tomografias computadorizada de feixe cônico (TCFC). Na base de dado pubmed, a seguinte frase foi utilizada: "Facial pattern" AND "Facial Index" AND "Facial height Index" AND "Facial height" AND "Dolichofacial" AND "Brachyfacial" AND "Long-face syndrome" AND "Short-face syndrome" em um intervalo de 25 anos (1990-2015). A seleção dos estudos foi realizada procurando características faciais cruciais e métodos comuns para a determinação do padrão facial do paciente. Em exames de TCFC de 100 pacientes adultos, foram medidas as dimensões faciais foram registradas e os três métodos mais confiáveis e encontrados na literatura foram testados. A literatura sobre o assunto pode ser muito confusa, ao ponto de que os métodos, pontos de referência e médias variaram consideravelmente. Muitas das características pesquisadas tinham valores diferentes quando analisada a literatura em comparação com os dados dessa pesquisa. Isso indica que variações de etnia, idade e gênero tem papel importante no diagnóstico do padrão facial e deve ser levada em consideração quando utilizados padrões cefalométricos para diagnóstico. Com a metodologia de agrupamento, utilizando o índice entre a altura facial anterior e a largura, a proporção anterior da face e a divergência do ângulo goníaco, assim como os pontos cefalométricos selecionados, nós correlacionamos com sucesso a amostra com as descrições qualitativas como: os pacientes de face curta e as distâncias bi-zigomáticas e ângulos faciais menos divergentes, assim como os pacientes de face longa com faces mais estreitas e menos divergentes.

Correlação da curva de spee com overbite, overjet e padrão facial / Spee curve correlation with overbite, overjet and facial pattern

Objetivou-se com o presente estudo verificar a relação entre a profundidade da curva de Spee superior e inferior com o overjet, overbite e o padrão facial. Quarenta e três modelos e radiografias cefalométricas laterais iniciais foram selecionados de pacientes do arquivo do Curso de Especialização de Ortodontia da Faculdade de Odontologia da UERJ, pós-surto de crescimento, com dentição permanente completa e apresentando overjet de 1 a 3 mm. Os modelos foram digitalizados e a profundidade máxima da curva de Spee superior e inferior, o overjet e o overbite foram calculados, utilizando-se o programa 3Shape Ortho Analyser. O padrão facial foi determinado a partir do ângulo SN.GoGn. As associações da curva de Spee superior e inferior com overbite, overjet e padrão facial foram avaliadas através do teste de correlação de Pearson. Encontrou-se associação da profundidade da curva de Spee inferior com o overjet e com a curva de Spee superior. Não houve significância estatística na correlação da curva de Spee inferior com o overbite e padrão facial, nem da curva de Spee superior com o overbite, com o overjet ou com o ângulo do plano mandibular, sugerindo que a curva de Spee inferior acentuada está mais frequentemente associada ao overjet aumentado.(AU)

The aim of this study was to verify the relationship between the depth of the lower and upper curves of Spee with overjet, overbite and facial pattern. Forty-three initial casts and lateral cephalometric radiographs were selected from the archives of the Graduate Program in Orthodontics of Rio de Janeiro State University. All patients were postpubertal, with permanent dentition and presenting an overjet varying from 1 to 3 mm. The cast models were scanned and the maximum depth of the upper and lower curve of Spee, the overjet and the overbite were calculated using the 3Shape Ortho Analyzer software. The facial pattern was determined from the SN.GoGn angle. The associations of the upper and lower curve of Spee with overbite, overjet and facial pattern were assessed using the Pearson correlation test. An association was found between the depth of the lower curve of Spee with the overjet and with the upper curve of Spee. There was no correlation of the lower curve of Spee with the overbite and facial pattern, neither between the upper curve of Spee with the overbite, overjet or the mandibular plane angle, suggesting that a marked lower curve of Spee is more frequently associated with increased overjet. (AU)

From conventional to self-ligating bracket systems: Is it possible to aggregate the experience with the former to the use of the latter?

INTRODUCTION: Orthodontics, just as any other science, has undergone advances in technology that aim at improving treatment efficacy with a view to reducing treatment time, providing patients with comfort, and achieving the expected, yet hardly attained long-term stability. The current advances in orthodontic technology seem to represent a period of transition between conventional brackets (with elastic ligatures) and self-ligating brackets systems. Scientific evidence does not always confirm the clear clinical advantages of the self-ligating system, particularly with regard to reduced time required for alignment and leveling (a relatively simple protocol), greater comfort for patients, and higher chances of performing treatment without extractions - even though the number of extractions is more closely related to patient's facial morphological pattern, regardless of the technique of choice. Orthodontics has recently and brilliantly used bracket individualization in compensatory treatment with a view to improving treatment efficacy with lower biological costs and reduced treatment time. OBJECTIVE: This paper aims at presenting a well-defined protocol employed to produce a better treatment performance during this period of technological transition. It explores the advantages of each system, particularly with regards to reduced treatment time and increased compensatory tooth movement in adult patients. It particularly addresses compensable Class III malocclusions, comparing the system of self-ligating brackets, with which greater expansive and protrusive tooth movement (maxillary arch) is expected, with conventional brackets Capelozza Prescription III, with which maintaining the original form of the arch (mandibular arch) with as little changes as possible is key to yield the desired results. .

INTRODUÇÃO: a Ortodontia passa, como toda ciência, por constantes evoluções tecnológicas que buscam aumentar a efetividade da abordagem terapêutica, visando a diminuição do tempo de tratamento, o aumento do conforto para os pacientes, bem como a obtenção da tão almejada, e pouco alcançada, estabilidade em longo prazo. O estágio atual de desenvolvimento tecnológico da Ortodontia representa, ao que tudo indica, uma fase de transição entre os sistemas convencionais de ligação (com módulos elásticos) e os chamados autoligáveis. As evidências científicas nem sempre consubstanciam a clara percepção clínica das vantagens desse sistema, no que diz respeito a um menor tempo de alinhamento e nivelamento, uma relativa simplificação técnica, maior conforto para os pacientes, além do aumento da capacidade de tratamento sem extrações - embora essa indicação esteja mais ligada à avaliação do padrão morfológico facial, e menos a qualquer escolha técnica. Desde um passado recente e não menos brilhante, a Ortodontia vem utilizando a individualização de braquetes para tratamentos compensatórios, buscando aumentar a efetividade da abordagem terapêutica, com menores custos biológicos e menor tempo de tratamento. OBJETIVO: o presente artigo tem como objetivo apresentar um protocolo bem definido de melhor aproveitamento dessa fase de transição tecnológica, buscando explorar o que cada sistema tem de melhor, principalmente sob a óptica da redução do tempo de tratamento e aumento da capacidade de movimentação dentária compensatória em pacientes adultos. Especificamente, serão abordadas as más oclusões de Classe III compensáveis, usando o sistema de braquetes ...

Descripción cefalométrica del patrón facial en mordida abierta esqueletal / Cephalometric description of facial patterns in skeletal open bite

Distintos indicadores de mordida abierta han sido descritos, sin embargo, para lograr un tratamiento adecuado y estable, es importante identificar la etiología de dicha maloclusión. El patrón facial, que está directamente relacionado con la dirección de crecimiento, y por lo tanto con el comportamiento vertical de las bases óseas representa un factor crucial para la expresión de la mordida abierta. La descripción del patrón facial a través de medidas cefalométricas brinda información acerca de la estructura ósea afectada facilitando así el tratamiento. El objetivo de este estudio es identificar la(s) estructura(s) involucrada(s) en la aparición de la mordida abierta a través del patrón facial mediante la fórmula facial de Bimler. Se determinó el patrón facial mediante el ángulo basal superior, ángulo basal inferior e índice facial suborbital en 40 radiografías laterales de cráneo de pacientes que acudieron a la clínica de Ortodoncia de la DEPeI de la FO UNAM de 2004-2006 diagnosticados con mordida abierta esqueletal mediante indicadores cefalométricos para mordida abierta. El patrón facial dominante en mordida abierta esqueletal corresponde al leptoprosopo. Se encontraron seis diferentes relaciones entre los ángulos basales superior e inferior. La relación de máxima expresión de mordida abierta corresponde al 27.5% (D/L) con ambos maxilares involucrados, seguido en menor severidad por el 40% (M/L), 20% (M/M), 5% (L/L) reflejando la mayor compensación, 5% (D/M) y MM/L con 2.5%.

Different open bite indicators have been described in scientific literature. However, to attain proper and stable treatment it is important to be able to identify the etiology of the malocclusion. Facial patterns are directly related to growth direction, and therefore to the vertical behavior of bone bases. They embody a crucial factor for open bite expression. Description of facial pattern through cephalometric measurements supplies information of affected bone structures, providing thus an easier treatment. The aim of the present study was, using Bimler facial formula, to identify bone structures involved in open bite cases. Facial pattern was determined through upper basal angle, lower basal angle and suborbital facial index. The study encompassed 40 lateral skull x-rays taken from patients attending the Orthodontics clinic at the Graduate School, National School of Dentistry, National University of Mexico, within the 2004-2006 period. Patients had received diagnosis of skeletal open bite. This diagnosis was emitted with the help of open bite cephalometric indicators. Dominant facial pattern in skeletal open bite was leptoprosopic. Six different relationships were found among upper and lower basal angles. Maximum open bite relation was 27.5% with both jaws involved, followed by 40% (M/L) with less severity, 5% (L/L) with greater compensation, 5% (D/M) and m/ML with 2.5%.

Evaluation of transverse changes in the dental arches according to growth pattern: a longitudinal study

OBJECTIVE: To evaluate changes in intercanine (LICW and UICW) and intermolar (LIMW and UIMW) widths on the dental arches of subjects with normal occlusion and Angle Class I malocclusion during the transition to permanent dentition, and evaluate whether or not facial pattern influences on the normal development of the dentition and occlusion. METHODS: Nineteen Caucasian Brazilian children were selected, with ages ranging from 6 to 8.6 years at T1 and from 10.10 to 14.2 years at T2. Their second records consisted of study dental casts and a lateral cephalometric radiograph. To obtain intermolar and intercanine widths a three-dimensional scanner unit (digitizer MicroScribe 3DX) was used connected to a microcomputer. To analyze changes at T1 and T2 Student's paired t-test was applied, whereas Spearman's correlation analysis was used to assess the relationship between measurements obtained at T1 and T2 and the facial pattern, both at 95% level of confidence. RESULTS: The mean values found on each assessment time (T1 and T2) were statistically different (p=0.000 for LICW, p=0.001 for UICW, p=0.000 for UIMW, and p=0.046 for LIMW), regardless of the facial pattern. The anterior dimensions, UICW and LICW, increased by 3.21 mm and 1.52 mm, respectively. And the posterior dimensions, UIMW and LIMW, increased by 2.16 mm and 0.50 mm, respectively. Only UIMW showed a significant correlation with the facial pattern (p<0.01). CONCLUSION: There was an increase in dental arch width during the transition period from primary or mixed dentition to permanent dentition irrespective of facial pattern. Only the changes observed in the maxillary intermolar width were associated with the facial pattern.

Concordância dos ortodontistas no diagnóstico do padrão facial / Agreement among orthodontists regarding facial pattern diagnosis

OBJETIVO: avaliar a concordância de ortodontistas treinados no diagnóstico do Padrão Facial, por meio da avaliação morfológica da face. MÉTODOS: foram utilizadas fotografias faciais de frente, perfil e sorriso de 105 indivíduos selecionados aleatoriamente entre pacientes que procuraram tratamento ortodôntico, as quais foram enviadas a ortodontistas treinados na classificação do Padrão Facial. A concordância intraexaminador, dos examinadores com o Padrão-Ouro e interexaminadores foi avaliada por meio do Índice Kappa. RESULTADOS: a concordância na avaliação intraexaminador foi quase perfeita, com Índice Kappa 0,85. A concordância entre os examinadores e o Padrão-Ouro foi moderada (Kappa 0,48), sendo mais alta no Padrão I (Kappa 0,62) e mais baixa no Padrão Face Curta (Kappa 0,33). A concordância entre os examinadores foi substancial (Kappa 0,61), mais alta que a concordância com o Padrão-Ouro em todos os Padrões. CONCLUSÃO: os critérios utilizados pelos examinadores para determinação do Padrão Facial foram os mesmos na primeira e na segunda avaliação. A concordância entre os examinadores e o Padrão-Ouro é moderada, e eles apresentam maior concordância entre si que com o Padrão-Ouro.

OBJECTIVE To assess agreement among orthodontists trained in facial pattern diagnosis through the morphological evaluation of the face. METHODS: Facial photographs were taken in front and side view, as well as photos of the smiles of 105 individuals randomly selected among patients seeking orthodontic treatment. The photos were sent to orthodontists trained in facial pattern classification. Intra-rater agreement, agreement between raters and the Gold Standard, as well as inter-rater agreement were assessed using the Kappa index. RESULTS: Intra-rater agreement was almost perfect, with Kappa index reaching 0.85. Agreement between raters and the Gold Standard was moderate (Kappa = 0.48), higher for Pattern I (Kappa = 0.62) and lower for the short face pattern (Kappa = 0.33). Agreement between raters was significant (Kappa = 0.61) and even higher than agreement with the Gold Standard for all patterns. CONCLUSIONS: The criteria used by raters to determine the facial pattern were the same in the first and second evaluation. Agreement between raters and the Gold Standard was moderate, with raters exhibiting greater agreement between them than with the Gold Standard.

Tratamento ortopédico com aparelho de Herbst: ocorrem mudanças verticais no padrão de crescimento facial / Orthopedic treatment with the Herbst appliance: do vertical changes occur in the facial growth pattern

OBJETIVO: o objetivo deste estudo prospectivo de 32 adolescentes com má oclusão de Classe II, divisão 1, associada a retrognatismo mandibular, tratados com aparelho de Herbst, construído sobre bandas e coroas metálicas, foi avaliar cefalometricamente as possíveis mudanças no padrão de crescimento facial. METODOLOGIA: as telerradiografias laterais foram obtidas ao início do tratamento (T1) e imediatamente após 12 meses de tratamento com o referido aparelho ortopédico (T2). Foram utilizados o quociente de Jarabak e o VERT de Ricketts (modificado) para determinação do padrão facial em T1 e T2. RESULTADOS: utilizando o quociente de Jarabak, os resultados evidenciaram que 27 casos (84,4 por cento) apresentaram padrões hipodivergentes em T1 e permaneceram da mesma forma em T2. Cinco casos (15,6 por cento) apresentaram padrão neutro em T1 e não exibiram mudanças em T2. Quando avaliado o VERT de Ricketts (modificado), não ocorreram mudanças no padrão facial em 31 pacientes. Em apenas um caso ocorreu mudança do tipo facial. CONCLUSÃO: baseado nos resultados obtidos, pode-se concluir que, após 12 meses de tratamento com aparelho de Herbst, não ocorreram mudanças verticais no padrão de crescimento facial dos pacientes estudados.

OBJECTIVE: The aim of this prospective study was to evaluate through the exam of cephalograms the occurrence of changes in facial growth pattern. The sample was composed by 32 adolescent with Angle Class II, division 1 malocclusion and mandibular retrognathism. All patients were treated with the Herbst appliance built over bands and metal crowns. METHODOLOGY: Lateral cephalograms were taken at the beginning of treatment (T1) and immediately after 12 months of treatment with Herbst appliance (T2). Jarabak's coefficient and Ricketts' VERT (modified) were used to establish the facial pattern in T1 and T2. RESULTS: According to Jarabak's coefficient, in T1, 84.4 percent (27 cases) presented hypodiverging pattern and 15.6 percent (5 cases) presented neutral pattern. The facial growth pattern was maintained in all patients from T1 to T2. When the (modified) Ricketts' VERT was used, 31 patients showed the same growth pattern from T1 to T2. Only one patient exhibited a different pattern. CONCLUSION: Based on the results it can be concluded that, after 12 months of treatment with the Herbst appliance, there were no vertical changes in the facial growth pattern of the studied subjects.

Estudo cefalométrico da correlação da anatomia da base craniana com o padrão facial e as bases apicais / Cephalometric study of the cranial base anatomy correlation with the facial pattern and apical bases

OBJETIVOS: este estudo transversal foi realizado com o objetivo de avaliar cefalometricamente a correlação da anatomia da base craniana com o padrão facial e as bases apicais. METODOLOGIA: foram utilizadas 88 telerradiografias de norma lateral de jovens leucodermas brasileiros com média de idade de 10,3 anos. Utilizou-se o índice VERT de Ricketts para a determinação do padrão facial, distribuindo a amostra em: 37 para o grupo M (mesofaciais), 34 para o grupo D (dolicofaciais) e 17 para o grupo B (braquifaciais). Realizaram-se, manualmente: o desenho anatômico, a demarcação de pontos, o traçado de linhas e planos e a aferição de medidas lineares e angulares. As medidas da base do crânio utilizadas foram S-N, N.S.Ba e S-N.Po-Or, e as medidas das bases apicais foram S.N.A, S.N.B e A.N.B. RESULTADOS E CONCLUSÕES: concluiu-se que, na correlação entre a base craniana e o padrão facial, houve significância entre a variável N.S.Ba e o índice VERT. Na correlação entre a base craniana e as bases apicais, houve significância entre N.S.Ba e as variáveis S.N.A e S.N.B, e entre S-N.Po-Or e as variáveis S.N.A e S.N.B.

AIM: This cross-sectional study was conducted with the object of making a cephalometric evaluation of the cranial base anatomy correlation with the facial pattern and apical bases. METHODS: 88 lateral teleradiographies of young white Brazilian with mean age of 10.3 years were used. The Ricketts VERT index was used to determine the facial pattern, and the sample was distributed as follows: 37 in group M (mesofacial), 34 in group D (dolicofacial) and 17 in group B (brachyfacial). The anatomic drawing, demarcation of points, line and plane tracings, and linear and angular measurement gauging were done manually. The cranial base measurements used were S-N, N.S.Ba and S-N.Po-Or and the apical base measurements were S.N.A, S.N.B and A.N.B. RESULTS AND CONCLUSION: It was concluded that, in the correlation between the cranial base and the facial pattern, there was significance between the variable N.S.Ba and the VERT Index. In the correlation between the cranial base and the apical bases, there was significance between N.S.Ba and the variables S.N.A and S.N.B, and between S-N.Po-Or and the variables S.N.A and S.N.B.

Post-treatment stability of the occlusal plane according to different vertical facial patterns / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to find changes in the occlusal plane related to different vertical facial patterns and suggest treatment goals and conduct possible treatment mechanisms. METHODS: 60 adult patients (28 males, 32 females) who had been diagnosed as Class I skeletal malocclusion and treated without extraction were selected. Patients were divided into three groups; short face type (group 1), average face type (group 2) and long face type (group 3), using the data on normal occlusion of Korean adults. RESULTS: The results were achieved by analyzing cephalometric tracings of each group at pre-treatment, end-treatment and post-treatment (about 1 year recall check). The inclination of the occlusion plane tends to gradually increase as the face becomes longer. In group 1, COP-X, FOP-X, L6/L1, MP-L6 were significantly decreased, and L1-FOP was significantly increased during the retention period (T3-T2). Group 2 showed no significant change. In group 3, FOP-X was significantly increased during the retention period (T3-T2). During the retention period, FOP-X showed significant change among each group, especially between group 1 and group 3. CONCLUSION: These results suggest that changes of occlusal plane inclination according to facial vertical pattern need to be considered during the retention period for intrusion, extrusion, and incisor overbite.

A study on the position of tongue and hyoid bone in relation to vertical facial patterns in skeletal Class III malocclusion / 대한치과교정학회지

The purpose of this study was to evaluate the position of tongue and hyoid bone in relation to vertical facial patterns in the adult and child. Lateral cephalograms taken in adults(63 cases, 11.7 years in average age) and children(69 cases, 22.6 years in average age) were traced and measured about position and posture of tongue and hyoid bone using the horizontal and vertical reference lines. The angle of mandibular plane to SN plane was employed to classify the samples into groups of hypodivergent and hyperdivergent. The comparison of the tongue/hyoid bone measurements between hypodivergent group and hyperdivergent group in the adult and child were statistically executed with Student's t-test. The results were as follows; 1. The tongue height was lower in the hyperdivergent group than in hypodivergent group, and higher in children than in adults. 2. The vertical height of hyoid bone was higher in hypodivergent group than in hyperdivergent group and also higher in children than in adults. 3. The anteroposterior position was of no significant difference in relation to age or vertical facial pattern. 4. The inclination of hyoid bone in relation to cranial base was steeper in children than in adults.

A study on relationship between TMD and skeletodental form in long face patterns / 대한치과교정학회지

Forty-four females with normal temporomandibular joint were compared with fifty-one females with abnormal temporomandibular joint, An orthodontic study model and lateral cephalometric radiographic were used to investigate the relationship between TMD group and non-TMD group in long face patterns. The result were followed that : 1. There were no significant in oberbite and overjet amount. 2. A mandibular 1`st molar inclination and height to the mandibular plane were more mesial inclined in TMD group. 3. The functional factors, which were craniocervical posture, tongue posture and hyoid bone position, were no significant.