Tempo de tratamento ortodôntico com aparelhos autoligados: revisão de literatura

Introdução: Atualmente, braquetes autoligados têm sido sugeridos para reduzir o tempo de tratamento na Ortodontia. Objetivo: Dessa maneira, o presente estudo objetivou revisar a literatura acerca do tempo de tratamento com esses braquetes, em comparação com outros braquetes e tratamentos sugeridos. Revisão de literatura: Foi realizada pesquisa bibliográfica de caráter descritivo, que compreendeu o levantamento de referencial teórico na base de dados eletrônica Medline ­ PubMed. A seleção de artigos foi feita a partir dos títulos e resumos e a revisão compreendeu 4 artigos publicados na língua inglesa no período de 2019 a 2023. Conclusão: Há uma escassez de estudos clínicos envolvendo essa temática e o tratamento ortodôntico com aparelhos autoligados parece apresentar menor tempo de tratamento em comparação com aparelhos fixos tradicionais. No entanto, os estudos não mostraram diferenças estatisticamente significativas na redução desse tempo. Pode-se sugerir que mais estudos clínicos sejam conduzidos no intuito de elucidar essa questão.

Introduction: Currently, self-ligating brackets have been suggested to reduce treatment time in Orthodontics. Objective: Therefore, the present study aimed to review the literature about the treatment time with these brackets, in comparison with other brackets and suggested treatments. Literature review: Descriptive bibliographical research was carried out, which included the survey of theoretical references in the electronic database Medline ­ PubMed. The selection of articles was made based on titles and abstracts and the review comprised 4 articles published in the English language from 2019 to 2023. Conclusion: there is a shortage of clinical studies involving this topic and orthodontic treatment with self-ligating appliances seems to present shorter treatment time compared to traditional fixed appliances. However, the studies did not show statistically significant differences in reducing this time. It can be suggested that more clinical studies be conducted to elucidate this issue.

Correção da má oclusão de classe II com propulsor mandibular: revisão de literatura / Correction of class II malocclusion with mandibular trusters: literature review

Introdução: a má oclusão de classe II consiste no desequilíbrio da relação entre as arcadas, podendo ser causada por deficiência mandibular, protrusão maxilar, ou ambas, sendo caracterizada pelo molar inferior distalmente posicionado em relação ao molar superior. Objetivo: este estudo tem o objetivo de apresentar uma revisão de literatura sobre a eficiência dos propulsores mandibulares fixos disponíveis no mercado odontológico no tratamento da má oclusão de classe II. Métodos: a pesquisa foi realizada nas bases de dados Google Acadêmico, SciELO e PubMed, para filtragem dos artigos selecionados. Para revisão de literatura, foram utilizados 17 artigos. Entre os protocolos de tratamento de classe II, esses aparelhos se destacam por serem fixos, por esse motivo, não dependem da colaboração direta do paciente. Com o passar dos anos, os propulsores mandibulares fixos foram cada vez mais aprimorados, oferecendo mais simplicidade na sua instalação e maior conforto ao paciente. Considerações finais: concluiu-se que os aparelhos funcionais propulsores mandibulares fixos são uma ótima escolha para o tratamento compensatório na má oclusão de classe II, sendo eficazes na correção da relação dentária e dependendo de menor cooperação do paciente.(AU)

Introduction: class II malocclusion consists of an imbalance in the relationship between the arches, which can be caused by mandibular deficiency, maxillary protrusion, or both, and is characterized by the mandibular molar distally positioned in relation to the maxillary molar. Objective: this study aims to present a literature review on the efficiency of fixed mandibular thrusters available in the dental market in the treatment of Class II malocclusion. Methods: the research was carried out in the Google Scholar, SciELO and PubMed databases to filter the selected articles. For literature review, 17 articles were used. Among Class II treatment protocols, these devices stand out for being fixed, for this reason, they do not depend on the direct collaboration of the patient. Over the years, fixed mandibular thrusters have been increasingly improved, offering more simplicity in their installation and greater comfort to the patient. Final considerations: it was concluded that the fixed mandibular thrusters functional devices are a great choice for compensatory treatment in Class II malocclusion, being effective in correcting the dental relationship and depending on less patient cooperation.(AU)

Analysis of adverse events with use of orthodontic sequential aligners as reported in the manufacturer and user facility device experience database.

Background: Sequential aligners (SAs) introduced about a decade ago, changed the practice of orthodontics as we knew it but the adverse events and reactions (AER) associated with SA is not known. The Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) database is a reliable database that has AERs reported. The manuscript attempts to review the AER associated with SA using the MAUDE database. Materials and Methods: The authors downloaded and reviewed the SA‑related AER from MAUDE for a period of 5 years. In‑depth analysis of the site and nature of intraoral and extraoral AERs were performed. We attempted to calculate the probability of pathologies being directly related to SA use, using Bayes’ theorem. Results: In the study period of 5 years, 175 cases of AER registered with MAUDE database owing to use of SA. Of the 175 cases, 129 (73.71%) instances were mandatory reports filed by the manufacturer. Of all AERs, 32 (18.29%) cases had been diagnosed/suspected to have an allergic reaction, 20 (11.43%) of them with anaphylactic reaction and 4 (2.29%) of them with angioedema. Lesions involving tongue, throat, and lip such as soreness, inflammation, and hives were more commonly reported. In addition, 12 cases (6.86%) reported of nausea, 11 (6.29%) of gastrointestinal issues (stomach upset, diarrhea, and vomiting), 13 (7.43%) of neuromuscular issues (muscle cramps, spasm, and pain), 13 (7.43%) of cough, 10 (5.71%) of persistent headache, 3 (1.71%) of fever, and 12 (6.86%) of cardiac‑related issues were identified. Conclusions: The AERs associated with SA has been described. Though the MAUDE database is not an exact, wholesome and reliable source to identify the potential AER, currently, it is the only available source of AERs associated with SA use. The nature of AERs with the use of SA and its potential pathogenesis and implications has been discussed.

Randomized controlled clinical trial of oral health-related quality of life in patients wearing conventional and self-ligating brackets / 대한치과교정학회지

OBJECTIVE: The aim of this randomized controlled clinical trial was to compare oral health-related quality of life (OHRQoL) of patients treated with conventional, active self-ligating (ASL), and passive self-ligating (PSL) brackets in different therapeutic phases. METHODS: Sixty patients (mean age 18.3 years; 29 males and 31 females) requiring orthodontic treatment were randomly and equally assigned to receive conventional (Victory Series), ASL (In-Ovation R), or PSL (Damon 3MX) brackets. OHRQoL was measured with a self-administered modified 16-item Malaysian version of the Oral Health Impact Profile for immediate (soon after the visit) and late (just before the subsequent visit) assessments of the bonding and activation phases. Data were analyzed with the Kruskal-Wallis and chi-square tests. RESULTS: The PSL and ASL groups showed more immediate and late impacts in the bonding phase, respectively; the conventional group was affected in both the assessments. The first activation phase had similar impacts in the groups. After the second activation, the conventional group showed more immediate impacts, whereas the PSL and ASL groups had more late impacts. The commonly affected domains were "physical disability," "functional limitation," "physical pain," and "psychological discomfort." No significant differences in the prevalence and severity of immediate and late impacts on OHRQoL of the patients were noted in any therapeutic phase. CONCLUSIONS: No bracket system seems to ensure superior OHRQoL. This information could be useful for explaining the therapeutic phases, especially the initial one, and selecting the optimal bracket system based on the patient's preference.

Soportes de autoligado en ortodoncia / Orthodontic brackets

Fundamento: el sistema de ligado del arco al soporte debe ser seguro, fuerte, rápido, confortable para el paciente, fácil de usar y producir poca fricción. Objetivo: argumentar el manejo de las técnicas fijas con el uso de los soportes de autoligado. Conclusiones: los soportes de autoligado constituyen una opción novedosa en ortodoncia, pero en Cuba se han utilizado poco. Se clasifican en pasivos y activos. El sistema Damon, Vision LP y Time son los más utilizados entre los pasivos y el Speed e In Ovation entre los activos. Se describen cuatro fases de tratamiento para usar la técnica con este tipo de soportes y a pesar de su alto costo, es más ventajosa que las técnicas precedentes.

Background: the system bound to the orthodontic bracket arch must be safe, strong, rapid and comfortable for the patient, easy to use and must provoke little friction. Objective: to argue about the management of fixed techniques with the use of brackets. Conclusions: brackets constitute a newfangled option in orthodontics, but in Cuba it has been rarely used. They are classified into passive and active. Damon system, Vision LP and Time are the mostly used among the passive ones and the Speed and In Ovation among the active ones. Four phases of treatment are described to use the technique of these orthodontic brackets and in spite of its high cost; it is more advantageous than the previous techniques.

Fluoride penetration from three orthodontic adhesives: an experimental study / 대한치과교정학회지

OBJECTIVE: To examine the prophylactic potential of 3 orthodontic bonding adhesives: Fuji Ortho SC, Illuminate, and Resilience. METHODS: Thirty-six Wistar Wag rats were randomly divided into 4 groups consisting of 9 rats each. One of the groups received no treatment and was used as a control. In the other groups, individual bands coated with one of the 3 adhesives were cemented to the lower incisors. Enamel samples were obtained after 6 and 12 weeks and analyzed using scanning electron microscopy in combination with energy dispersive spectrometry. RESULTS: Six weeks after band cementation, no fluoride was found in the enamel of the lower incisors. After 12 weeks, there was no fluoride in the enamel of teeth coated with the Resilience composite. However, in the case of the Illuminate composite and the resin-modified glass ionomer Fuji Ortho SC cement, the depth of fluoride penetration reached 2 microm and 4.8 - 5.7 microm, respectively. CONCLUSIONS: Fluoride ions from orthodontic adhesives can be incorporated into the surface layer of the enamel. Orthodontists may apply orthodontic adhesives, such as the Fuji Ortho SC, to reduce the occurrence of caries during orthodontic treatment with fixed appliances.

The anterior dental cross-bite: the paradigm of interception in orthodontics / A mordida cruzada anterior: o paradigma da interceptação em ortodontia

OBJECTIVES: To present specific clinical interception procedures instituted to reduce malocclusionseverity on developmental stage. Anterior tooth cross-bite, involving one or two permanent teeth, is acommon form of malocclusion diagnosed in children about 6 years of age. RESULTS ANDDISCUSSION: Various devices can be suggested for single tooth cases, like removable cantilevereddouble-helix apparatus with digital springs, which is one of the most efficient to intercept malocclusion.In the other hand, fixed appliance does not depend on patient’s cooperation and have greater actionpower and liberates more continuous forces. CONCLUSION: Dental anterior cross-bite, involvingone tooth, can be corrected by means of the multi-loop arch wire with a double-helix, even in caseswhere adequate space for alignment is lacking.

OBJETIVOS: Apresentar procedimento de interceptação clínica específica para reduzir aseveridade da má oclusão no estágio de desenvolvimento. O cruzamento anterior, comprometendoum ou dois dentes permanentes, é forma comum de má-oclusão, diagnosticada em crianças emtorno de seis anos de idade. RESULTADOS E DISCUSSÃO: Vários dispositivos podem ser utilizados para casos de cruzamento de um dente apenas, como os aparelhos de duplo hélice emextremo livre, com molas digitais, um dos mais eficientes para interceptar más-oclusões. Poroutro lado, os aparelhos fixos não dependem da colaboração do paciente, tendo maior poder deação e de liberação de forças contínuas. CONCLUSÃO: Os cruzamentos anteriorescomprometendo um dente podem ser corrigidos por meio de arco com dobras múltiplas, comhélice dupla, mesmo em casos onde há deficiência de espaço para o alinhamento.

Effect of dental water jet on oral hygiene maintenance in orthodontic patients with fixed appliances / 中国实用护理杂志

Objective To evaluate the effect of dental water jet on oral hygiene maintenance in orthodontic patients with fixed appliances. Methods One hundred and twenty orthodontic patients with fixed appliances were randomly assigned into the manual toothbrush group and the dental water jet group. Dental plaque was evaluated and compared before the bonding of orthodontic appliances, three months and six months after the treatment. Results There was no significant difference between two groups before treatment. But the dental water jet group was superior than the manual toothbrush group in dental plaque index 3 and 6 months after treatment. Conclusions Dental water jet can reduce dental plaque and im -prove the oral hygiene of patients with fixed appliances.

Importancia del control de placa bacteriana en el tratamiento ortodóncico / Plaque control importance in orthodontic treatment

El creciente éxito y promoción de los tratamientos de ortodoncia en personas de todas las edades, ha hecho necesario reconsiderar las acciones de salud oral y prevención en pacientes que utilizan esta aparatología. La evidencia clínica relaciona el uso de los aparatos ortodoncicos con una clara elevación en la acumulación y retención de placa bacteriana, lo cual desencadena una cascada de respuestas inflamatorias e inmunológicas que involucra todos los tejidos periodontales. El conocimiento de todos estos factores, la implementación de nuevas tecnologías en aparatología de ortodoncia y un adecuado enfoque de salud oral se constituyen en un elemento indispensable para el abordaje actual de este tipo de tratamientos bajo un enfoque multidisciplinario.

The growing success of orthodontic treatments in people of all ages have had a necessary reconsideration in oral health actions and preventive education in patients who are using these appliances. Clinical evidences relate the use of fixed orthodontics with a clearly elevation in dental plaque amounts, following with a cascade of inflammatory and immunological responses involving all periodontal tissues. Implementation of new technologies in orthodontic appliances and oral health is an important topic that must be included in the multidisciplinary approach of actual treatments.