Change in crown inclination accompanying initial tooth alignment with round archwires

ABSTRACT Objective: To evaluate, in-vitro, the change in crown inclination that occurs during orthodontic leveling and alignment using different archwire-bracket-ligation combinations. Materials and Methods: Four archwire types were tested: (1) 0.012-in stainless steel and (2) 0.0155-in stainless steel multi-stranded, (3) 0.012-in nitinol Orthonol® and (4) 0.012-in nitinol Thermalloy®. Combinations with five types of 0.022-in slot orthodontic brackets were tested: SmartClipTM and Time3® self-ligating brackets, Mini-Taurus® and Victory SeriesTM conventional brackets, and Synergy® conventional-low friction bracket. Conventional brackets were ligated with both stainless steel and elastomeric ligatures. The simulated malocclusion comprised 2.0mm gingival and 2.0mm labial displacements of a maxillary right central incisor. Rotation around the Y-axis (representing labio-palatal inclination) was measured for the different archwire-bracket-ligation combinations. Results: The largest rotation was measured whith Orthonol® and Thermalloy® wires when combined with SmartClipTM brackets (8.07±0.24º and 8.06±0.26º, respectively) and with Synergy® brackets ligated with stainless steel ligatures (8.03±0.49º and 8.0±0.37º, respectively). The lower rotation was recorded when Thermalloy®, multi-stranded, and Orthonol® wires were ligated with elastomeric rings to Mini-Taurus® brackets (1.53±0.18º, 1.65± 0.23º and 1.70±0.28º, respectively) and to Victory SeriesTM brackets (1.68± 0.78º, 2.92± 1.40º and 1.74±0.46º, respectively). Conclusions: All archwire-bracket-ligation combinations produced lingual crown inclination; however, lower changes were observed when the conventional brackets were ligated with elastomeric rings. The multi-stranded archwire produced less rotation with nearly every bracket-ligation combination, compared to the other archwires. The effect of the archwire-bracket-ligation combination on tooth inclination during leveling and alignment should be considered during planning treatment mechanics.

RESUMO Objetivo: Avaliar, in vitro, as mudanças na inclinação das coroas dentárias que acontecem durante o alinhamento e nivelamento usando diferentes combinações de arcos/braquetes/ligaduras. Material e Métodos: Foram usados quatro tipos de arcos ortodônticos: (1) 0,012" de aço inoxidável, (2) 0,0155" de aço multifilamentado, (3) Orthonol® 0,012" de nitinol e (4) Thermalloy® 0,012" de nitinol. Esses arcos foram combinados com cinco tipos de braquetes ortodônticos com slot 0,022": braquetes autoligáveis SmartClipTM e Time3®, braquetes convencionais Mini-Taurus® e Victory SeriesTM, e braquetes convencionais de baixo atrito Synergy®. Os braquetes convencionais receberam ligaduras de aço ou elastoméricas. A má oclusão simulada foi composta por um deslocamento do incisivo central superior direito em 2 mm para a cervical e 2 mm para a vestibular. A rotação ao redor do eixo Y (representando a inclinação vestibulolingual) foi medida para as diferentes combinações de arco/braquete/ligadura. Resultados: A maior rotação foi medida quando os arcos Orthonol® e Thermalloy® foram usados com os braquetes SmartClipTM (8,07±0,24º e 8,06±0,26º, respectivamente) e com os braquetes Synergy® com ligaduras metálicas (8,03±0,49º e 8,0±0,37º, respectivamente). A menor rotação foi vista quando os arcos Thermalloy®, multifilamentado e Orthonol® foram presos por ligaduras elastoméricas aos braquetes Mini-Taurus® (1,53±0,18º, 1,65±0,23º e 1,70±0,28º, respectivamente) e aos braquetes Victory SeriesTM (1,68±0,78º, 2,92±1,40º e 1,74±0,46º, respectivamente). Conclusões: todas as combinações arco-braquete-ligadura produziram inclinação palatina da coroa. Entretanto, as menores mudanças foram observadas quando os braquetes convencionais receberam ligaduras elastoméricas. O arco multifilamentado produziu menor rotação com quase todas as combinações braquete-ligadura, em comparação aos outros arcos. O efeito da combinação arco-braquete-ligadura na inclinação dentária durante o alinhamento e nivelamento deve ser considerado durante o planejamento da mecânica dos tratamentos.

Anatomical variations and congenital anomalies of the ribs revisited by multidetector computed tomography / Variantes anatômicas e anomalias congênitas dos arcos costais revisitadas por meio da tomografia computadorizada de multidetectores

Abstract As they are asymptomatic or have a nonspecific, anatomical variations of the ribs are usually detected as incidental findings on imaging studies. They may be isolated changes or can be related to anomalies or clinical syndromes. Such variations are easily overlooked on conventional radiography and computed tomography if they are not actively investigated, mainly because most indications for a chest X-ray studies aim to evaluate the lung parenchyma and mediastinal structures. The objective of this pictorial essay was to use multislice computed tomography images to illustrate the imaging aspects of the main anatomical variations and congenital anomalies of the ribs.

Resumo As variantes anatômicas dos arcos costais são, geralmente, achados incidentais nos exames de imagem, em razão do seu comportamento assintomático ou quadro inespecífico, podendo constituir alterações isoladas ou relacionadas a anomalias e síndromes clínicas. Essas alterações são facilmente negligenciadas na radiografia convencional e na tomografia computadorizada se não forem investigadas ativamente, principalmente quando a maioria das indicações do estudo radiológico do tórax tem como objetivo a avaliação do parênquima pulmonar e das estruturas mediastinais. O objetivo deste artigo é demonstrar, por meio da tomografia computadorizada multidetectores, os aspectos de imagem das principais variantes anatômicas e anomalias congênitas dos arcos costais.

Influence of the palatine tonsil grade on the morphology of the maxillary and mandibular dental arches / Influencia del grado de las tonsilas palatinas en la morfología de los arcos dentales maxilar y mandibular

SUMMARY: Enlarged palatine tonsils and adenoids are thought to cause obstruction of the upper airway, triggering changes in breathing patterns, which in turn lead to dentofacial alterations, including malocclusions. The object of the present study was to correlate the size (grade) of the palatine tonsil with measurements of the maxillary and mandibular dental arches in children. This was an observational cross-sectional study carried out in 35 children aged between 6 and 11 years. The inter- and intra-arch parameters were measured (horizontal, vertical and sagittal analyses) by making plastercasts and then taking measurements with callipers. The tonsil size was classified in 5 grades from 0-4, using the Brodsky tonsil grading scale. The researcher was calibrated prior to carrying out the measurements. Pearson's chi-squared test was used and Pearson's correlation coefficient was calculated. The SPSS v.22.0 software was used, with a significance threshold of 5 %. Six patients were classified as grade 1, sixteen grade 2, eleven grade 3, two grade 4 and none of the patients presented grade 0.A low positive association was found between tonsil grade and the total length of the mandibular arch, a very low positive association between tonsil grade and maxillary inter-first premolar distance, total length of the maxillary arch and depth of the palatine recess.A very low negative association was found for tonsil grade and overjet, overbite, mandibular inter-permanent first molar distance, mandibular inter-first premolar distance, and mandibular and maxillary intercanine widths. No statistically significant correlation was observed for any of the measurements. No association was found between the tonsil grade and Angle's Classification, canine relationship, overjet and overbite. According to the results of this study there is no significant correlation between the dental arches and the tonsil grade.

RESUMEN: Se ha considerado que el grado del tamaño de las tonsilas palatinas y los adenoides pueden ser factores que generan obstrucción de la vía aérea superior, desencadenando cambios en el patrón de respiración, lo que provoca alteraciones dentofaciales, entre ellas, maloclusiones. El objetivo del presente estudio fue correlacionar el grado tonsilar palatino con medidas de los arcos dentales maxilar y mandibular en niños. Se realizó un estudio observacional de corte transversal. Fueron incluidos 35 niños entre 6 y 11 años de edad. Fueron medidos parámetros interarco e intra-arco (análisis transversal, vertical, sagital). Para eso fueron tomados modelos de yeso y luego las medidas fueron realizadas con un caliper. El grado tonsilar fue clasificado en 5 grados (0-5), de acuerdo a la escala de graduación de Brodsky. Para la realización de las mediciones el evaluador fue previamente calibrado. Se realizó la prueba Chi-cuadrado de Pearson, y coefi- ciente de correlación de Pearson. Se utilizó el software SPSS 22.0, considerándose umbral de significación de 5 %. Seis pacientes fueron clasificados en grado 1, dieciséis grado 2, once grado 3, dos grado 4 y ningún paciente presentó grado 0. Se encontró una asociación positiva baja entre grado tonsilar y la longitud total del arco mandibular, positiva muy baja entre grado tonsilar y distancia inter-primer premolar maxilar, longitud total del arco maxilar y profundidad de la bóveda palatina. Una asociación negativa muy baja fue encontrada para el grado tonsilar y overjet, overbite, distancia inter-primer molar permanente mandibular, distancia inter- primer premolar mandibular, ancho intercanino mandibular y maxilar. Se observó ausencia de correlación estadísticamente significativa para todas las medidas. No se encontró asociación entre el grado tonsilar y clase molar de Angle, relación canina, overjet y overbite. Según los resultados de este estudio no se aprecia una correlación significativa entre los arcos dentales y el grado tonsilar.

Von Mises stresses on Mushroom-loop archwires for incisor retraction: a numerical study

ABSTRACT Objective: To perform a numerical simulation using FEM to study the von Mises stresses on Mushroom archwires. Methods: Mushroom archwires made of titanium-molybdenum alloy with 0.017 x 0.025-in cross-section were used in this study. A YS of 1240 MPa and a Young's modulus of 69 GPa were adopted. The archwire was modeled in Autodesk Inventor software and its behavior was simulated using the finite element code Ansys Workbench (Swanson Analysis Systems, Houston, Pennsylvania, USA). A large displacement simulation was used for non-linear analysis. The archwires were deformed in their extremities with 0° and 45°, and activated by their vertical extremities separated at 4.0 or 5.0 mm. Results: Tensions revealed a maximum of 1158 MPa at the whole part of the loop at 5.0mm of activation, except in a very small area situated at the top of the loop, in which a maximum of 1324 Mpa was found. Conclusions: Mushroom loops are capable to produce tension levels in an elastic range and could be safely activated up to 5.0mm.

RESUMO Objetivo: Realizar uma simulação numérica, por meio do Método dos Elementos Finitos (MEF), para obter as tensões de von Mises em arcos Mushroom. Métodos: Foram usados arcos com geometria Mushroom de titânio-molibdênio, com secção transversal 0,017" x 0,025". Adotou-se valores de tensão de escoamento (σesc) de 1.240 MPa e módulo de elasticidade (E) de 69 GPa. O arco foi modelado por meio do software Autodesk Inventor, e seu desempenho foi simulado utilizando-se o software de elementos finitos Ansys Workbench (Swanson Analysis System, Houston, Pennsylvania, EUA). Para a simulação, foi considerada a análise para grandes deslocamentos. O arco foi conformado em suas extremidades considerando-se planos de 0° e 45°, pré-ativado em 2,5mm e ativado por meio de suas extremidades verticais, separadas 4,0 mm ou 5,0 mm. Resultados: As tensões revelaram um valor máximo de 1.158 MPa na maior parte da alça, aos 5,0 mm de ativação, com exceção de uma área muito pequena, com valor de 1.324 MPa, situada no topo da alça. Conclusões: Os arcos Mushroom são capazes de produzir níveis de tensão situados dentro da região elástica e poderiam ser ativados com segurança até os 5,0 mm de ativação.

Comparación del tamaño transversal de los arcos 0. 012, 0. 014 y 0. 016 de NiTi de tres marcas / Comparação do tamanho transversal dos arcos 0. 012, 0. 014 e 0.016 de NiTi de três marcas / Comparison of the cross-sectional size of the 0. 012, 0. 014 and 0. 016 NiTi archs of three brands

Objetivo: Determinar si existen diferencias en el tamaño de los arcos de NiTi en los calibres 0.012, 0.014 y 0.016 de tres marcas comerciales. Material y métodos: Se utilizaron 180 arcos de NiTi de las marcas American Orthodontics, TD Orthodontics y OrthoPremium. La estadística descriptiva, la ANOVA y el Post Hoc se realizaron en el programa SPSS 18. Resultados: los arcos de American Orthodontics presentaron diferencias estadísticas significativas en la parte anterior y posterior. En los arcos superiores de TD Orthodontics se encontró contracción en el calibre 0.016. En los arcos superiores OrthoPremium presento una contracción en la parte anterior y en el arco inferior de los 10 a los 40mm. Al comparar las tres marcas se encontraron diferencias estadísticas significativas (p<0.05) entre ellas con las pruebas de ANOVA. Conclusiones: existen diferencias en los tamaños de los arcos superiores e inferiores de cada marca y entre ellas.

Objective: To determine if there are differences between the 0.012, 0.014 and 0.016 NiTi archwires of three brands. Material and methods: 180 NiTi archwires of the following brands were used: American Orthodontics, TD Orthodontics and OrthoPremium. Descriptive statistics, ANOVA and Post Hoc were performed in the SPSS 18 program. Results: The American Orthodontics archwires presented significant statistical differences in the anterior and posterior parts. In the TD Orthodontics upper archwires, contraction was found in the 0.016 caliber. In the upper archwires, OrthoPremium presented a contraction in the anterior part and in the lower archwire of 10 to 40mm. When comparing the three brands, significant statistical differences (p <0.05) were found between them with the ANOVA tests. Conclusions: there are differences in the sizes of the upper and lower archwires of each brand and between them.

Objetivo: determinar se existem diferenças no tamanho dos arcos de NiTi em calibres 0, 12, 0, 14 e 0, 16 de três marcas comerciais. Material e métodos: foram utilizados 180 arcos NiTi das marcas American Orthodontics, TD Orthodontics e OrthoPremium. Estatística descritiva, ANOVA e Post Hoc foram realizadas no programa SPSS 18. Resultados: os arcos da American Orthodontics apresentaram diferenças estatísticas significativas na parte anterior e posterior. Nos arcos superiores da TD Ortodontia foi encontrada contração no calibre 0, 16. Nos arcos superiores, o OrthoPremium apresentou contração na parte anterior e no arco inferior de 10 a 40mm. Ao comparar as três marcas, foram encontradas diferenças estatísticas significativas (p <0,05) entre elas com os testes ANOVA. Conclusões: existem diferenças nos tamanhos dos arcos superior e inferior de cada marca e entre eles.

Impact of the First Archwires Placement on the Everyday Activities of Orthodontics Patients / Impacto de la Instalación de los Primeros Arcos en las Actividades de Vida Diaria en Pacientes de Ortodoncia

ABSTRACT: Orthodontic treatment (OT) is essential for the aesthetic and functional rehabilitation of the chewing apparatus, however it may lead to certain complications which can have a negative impact on patients' everyday lives. The study included patients of the Dental Teaching Clinic of Universidad de La Frontera who were undergoing OT for the first time, with the placement of their first orthodontic arch. To analyse the impact of the placement of the first arches on everyday activities (EDA), patients completed a questionnaire with questions relating to their oral condition, including: functional limitation, physical impairment, psychological malaise, physical pain and oral hygiene. The impact on EDAs was classified as high, moderate or low. The chisquared test, Student's t-test and Spearman's coefficient were applied, using a significance threshold of 5 %. Statistical analysis used the SPSS software, v. 22.0. The variables were analysed by sex and age-band. Difficulty in brushing their teeth, eating and speaking were the limitations on EDAs most frequently reported by the patients. Females presented higher scores than males (p=0.003), showing that they suffer a greater negative impact on EDAs than do males. The majority of the patients presented a low impact on EDAs after the placement of their first orthodontic arches. Physical pain after installation, and difficulty in adapting to the orthodontic apparatus were factors determining a negative impact on EDAs, affecting sleep, speech, eating and oral hygiene of patients after starting OT.

RESUMEN: El tratamiento ortodóntico (TO) es esencial para la rehabilitación estética y funcional del aparato masticatorio, sin embargo puede determinar algunas complicaciones que pueden impactar negativamente en la vida diaria de los pacientes. Fueron incluidos pacientes de la Clínica Odontológica Docente Asistencial de la Universidad de La Frontera que realizaban tratamiento ortodóntico por primera vez, con instalación del primer arco ortodóntico. Para análisis del impacto de la instalación de los primeros arcos en las actividades de vida diaria (AVD), los pacientes llenaron un cuestionario con preguntas relacionadas a su condición oral, incluyendo: limitación funcional, incapacidad física, incapacidad psicológica, dolor físico e higiene oral. El impacto en las AVDs fueclasificado como alto, moderado y bajo. Para análisis estadístico se utilizó el software SPSS v. 22.0. Fueron aplicadas las pruebas de chi-cuadrado, t-student y Spearman's coefficient, considerándose umbral de significación de 5 %. Para análisis estadístico se utilizó el software SPSS v. 22.0. Las variables fueron analizadas según sexos y rangos etarios. Dificultad para cepillar los dientes, para comer y hablar fueron las limitaciones en las AVDs más frecuentemente reportadas por los pacientes. Las mujeres presentaron mayores puntajes en relación a los hombres (p=0,003), lo que demostró que presentan mayor impacto negativo en las AVDs en relación a los hombres. La mayoría de los pacientes presentaron bajo impacto en las AVDs tras la instalación de los primeros arcos de ortodoncia. El dolor físico tras instalación y la dificultad en la adaptación con el aparato ortodóntico fueron factores que determinaron impacto negativo en las AVDs, afectando el sueño, el habla, la alimentación y la higiene oral de los pacientes que iniciaron el TO.

Biomechanical analysis of micro-implants lingual straight wire appliance during retracting maxillary anterior teeth / Análisis biomecánico de microimplantes con dispositivo de alambre recto lingual durante la retracción de dientes maxilares anteriores

This study aimed to establish three-dimensional finite element models of micro-implants-lingual straight wire appliance and to investigate the effects of different wire patterns on the initial displacement of the maxillary anterior teeth and the stress of the periodontal ligament and tooth root during retracting maxillary anterior teeth in lingual orthodontics. A three-dimensional geometric models of maxilla with maxillary dentition was established using Cone-beam CT scan .Three types of maxilla models including microimplants and Duet-Slot Lingual Bracket appliance with three different arch wires ( model A: 0.016 inch × 0.022 inch stainless steel square wire; modelB: 0.016 inch stainless steel round wire; model C: double wire of 0.016 inch × 0.022 inch stainless steel square wire + anterior teeth 0.016 inch stainless steel round wire) were assembled by Unigraphics NX 8.5 software. The labial intrusion force and lingual retraction force were simulatively loaded to obtain initial displacement of the anterior teeth and the stresses of each tooth root and periodontal ligament, using three-dimensional finite element calculation software Ansys Workbench 15. The initial displacement of the lateral incisors was close to the bodily movement; and central incisors and lateral incisors slightly extruded. Compared with group A and group C, canine teeth appeared obviously horizontal "arched effect" by crown labial tipping in group B. The stress distribution of the tooth root and periodontal ligament was minimal and uniform in the group C. The 0.016 × 0.022- in stainless steel rectangular wire combined with 0.016- in stainless steel round wire used in the anterior teeth can better control the torque of the maxillary anterior teeth for space close in lingual orthodontics. Moreover, the stress distribution of tooth root and periodontal ligament is even, which is difficult to damage the periodontal ligament or result in external resorption of tooth root.

Este estudio tuvo como objetivo establecer modelos tridimensionales de elementos finitos de microimplantes linguales de alambre recto e investigar los efectos de diferentes patrones de alambre en el desplazamiento inicial de los dientes maxilares anteriores y el estrés del ligamento periodontal y la raíz del diente durante la retracción lingual sobre los dientes anteriores del hueso maxilar en ortodoncia. Se establecieron modelos geométricos tridimensionales del hueso maxilar con dentición utilizando una exploración por tomografía computarizada de haz cónico. Tres tipos de modelos maxilares, incluidos los microimplantes y el dispositivo Duet-Slot Lingual Bracket con tres arcos diferentes (modelo A: 0.016 pulgada × 0.022 pulgada alambre cuadrado de acero inoxidable; modelo B: alambre redondo de acero inoxidable de 0.016 pulgadas; alambre cuadrado de acero inoxidable de 0.016 pulgada × 0.022 pulgada y alambre redondo de acero inoxidable de 0.016 pulgada) ensamblados por el software Unigraphics NX 8.5. La fuerza de intrusión labial y la fuerza de retracción lingual se cargó simultáneamente, para obtener el desplazamiento inicial de los dientes anteriores y las tensiones de cada raíz dental y ligamento periodontal, usando el software tridimensional de cálculo de elementos finitos Ansys Workbench 15. El desplazamiento inicial de los incisivos laterales se relacionaba al movimiento corporal; mientra que los incisivos centrales e incisivos laterales se mostraron ligeramente extruidos. Comparado con el grupo A y el grupo C, los dientes caninos presentaron un "efecto arqueado" horizontal por la inclinación labial de la corona en el grupo B. La distribución del estrés de la raíz del diente y el ligamento periodontal fue mínima y uniforme en el grupo C. El alambre rectangular de acero inoxidable combinado con el alambre redondo de acero inoxidable de 0.016 usado en los dientes anteriores puede controlar mejor el torque de los dientes maxilares anteriores para cerrar el espacio en ortodoncia lingual. Además, la distribución del estrés de la raíz del diente y del ligamento periodontal es pareja, lo que dificulta dañar el ligamento periodontal o provocar una resorción externa de la raíz del diente.

Increased interpremolar development with self-ligating orthodontics: a prospective randomized clinical trial

In compressed dental arches with mild to moderate crowding, space can be gained during the alignment phase to help improve tooth location. The aim of this study was to compare transverse measurements before and after the alignment stage in two groups: Group A treated with passive selfligating brackets, (Damon System) and Group B with conventional brackets (Roth philosophy). The change in transverse diameter between teeth was measured on dental casts taken before and after orthodontic alignment. Twenty four patients of both sexes aged 13 to 36 years, with moderate tooth crowding (4 to 6 mm), were treated. They all received treatment at the Department of Orthodontics, School of Dentistry, University of Buenos Aires. Patients were distributed randomly into two groups of 12. No extraction was performed until the end of the alignment. Dental casts were measured before and after alignment. The distance between upper first premolars increased more in Group B (p = 0.008), and the distance between canines was higher in Group B, with statistically significant difference (p < 0.01). Both systems enable tooth alignment by increasing transverse diameter of the arches in patients with mild to moderate crowding. The greatest transversal development occurs in the interpremolar area in both techniques and is significantly higher with selfligating orthodontics. Intercanine distance increases significantly with conventional orthodontics compared to selfligating orthodontics (AU)

En las arcadas dentarias comprimidas, con apiñamiento dentario de leve a moderado, es posible obtener ganancia de espacio que favorezca la ubicación de las piezas en la fase de alineación por remodelación alvéolodentaria de las arcadas. El objetivo de este trabajo fue comparar las diferencias pre y post tratamiento en la etapa de alineación de los grupos A: brackets autoligables pasivos, (Sistema Damon) y grupo B: brackets convencionales (Filosofía de Roth). Se evaluaron las variaciones en el diámetro transversal, antes y después de alinear ortodón cicamente los dientes, utilizando modelos de estudio. Participaron 24 pacientes de ambos sexos, entre 13 y 36 años con apiñamiento dentario moderado (entre 4 y 6 mm) tratados en la Cátedra de Ortodoncia de la Facultad de Odontología, Universidad de Buenos Aires. Los pacientes fueron distribuidos al azar en dos grupos de 12 pacientes cada uno. No se realizaron exodoncias hasta finalizar la alineación. Se midieron los modelos pre y post alineación. La distancia entre primeros premolares superiores aumentó en el grupo A más que en el B (p=0.008) y entre caninos fue mayor en el grupo B, con diferencia estadísticamente significativa (p< 0,01). En pacientes con apiñamiento leve a moderado, la expansión con ambos sistemas permite la alineación dentaria por aumento del diámetro transversal de las arcadas fundamentalmente en el área premolar. El mayor desarrollo transversal se produce en el área premolar para ambas técnicas y es significativamente mayor con ortodoncia autoligable. En ortodoncia convencional, aumenta significativamente la distancia intercanina en comparación con la autoligable (AU)

Fístulas del seno piriforme congénitas: reporte de 4 casos y revisión de la literatura / Congenital pyriform sinus fistula: report of 4 cases and review of the literature

Resumen Introducción: Las fístulas del seno piriforme, originadas desde el tercer o cuarto arco branquial, son entidades poco frecuentes. Se pueden presentar como aumento de volumen cervical, fístula cervical, absceso cervical, tiroiditis abscedada y/o disfonía. Objetivo: Reportar 4 casos tratados en nuestro hospital y revisión de la literatura. Discusión: Frente a un cuadro clínico compatible, se debe realizar estudio endos- cópico y de imágenes. El manejo quirúrgico sigue siendo el de mejores resultados, pero se han desarrollado terapias endoscópicas y combinaciones de estas con buenos resultados. Conclusión: El diagnóstico requiere un alto índice de sospecha clínica. La cirugía abierta se mantiene como el gold standard, sin embargo, en población pediátrica estaría indicada la resolución endoscópica debido a la alta morbilidad de la cirugía tradicional.

Introduction: Pyriform sinus fistula is a rare cervical branchial anomaly derived from the third and fourth branchial arch. Pyriform sinus fistula should be considered in children presenting enlarged neck mass, fistula, abscess, thyroid infection and/or dysphonia. Objective: We here report 4 cases treated in Hospital Clínico Universidad de Chile and review of the current literature on pyriform sinus fistula. Discussion: When clinical presentation is compatible with pyriform sinus fistula, endoscopic and imaging techniques are required. Surgical outcomes are better, although endoscopic therapies and combination of both surgery and endoscopy have also reported good outcomes. Conclusion: Diagnosis is made based on signs and symptoms and a high index of clinical suspicion. Open surgery is gold standard, however in pediatric population endoscopic resolution should be considered to reduce the high morbidity of traditional surgery.

Arco palmar: correlato anátomo-quirúrgico en trauma / Palmar arch: anatomical and surgical correlation in trauma

La irrigación de la palma de la mano es proporcionada por arcos arteriales (superficial y profundo) que están conformados más frecuentemente por las arterias ulnar y radial estableciendo un patrón descrita como clásico. Se describen variaciones anatómicas en la conformación de ambos arcos, más frecuentemente en el arco palmar superficial; pudiendo ser los mismos completos o incompletos. Es objetivode este trabajo, la descripción anatómica de los arcos palmares, de sus diferentes patrones y variaciones de conformación, y sus implicancias clínico-quirúrgicas. Se llevó a cabo un estudio descriptivo, observacional y morfométrico de las arterias que participan en la formación de los arcos palmares; se utilizaron 100 preparaciones cadavéricas fijadas en solución de formol, de la Tercera Cátedra de Anatomía - Facultad de Medicina- Universidad de Buenos Aires. Se realizó además un análisis retrospectivo de casos con lesiones de la/sarteria/s principal/es que conforman los arcos palmares, en el Servicio de Emergencias del Hospital de Morón, entre 2015-2016. La arteria radial conforma el arco arterial profundo con la arteria cubito palmar más frecuentemente en el 100 % de los casos. El arco arterial superficial es el más variable. Fue completo en el 56 % y la presentación más frecuente (83 %) es aquella que se conforma por la anastomosis de la arteria ulnar y la arteria radiopalmar. El resto de las anastomosis son: entre arteria ulnar y arteria mediana (9 %),entre rama profunda de arteria radial y arteria ulnar (5 %); triple anastomosis entre arteria ulnar, arteria mediana y arteria radiopalmar (2 %), y anastomosis entre la arteria mediana y la arteria radiopalmar, sinparticipación de la arteria ulnar (1 %). El resto de la muestra (44 %) se lo puede denominar como incompleto. Los subtipos B1a y B1b fueron los más encontrados. Se describen dos casos clínicos, uno con sección completa de la arteria radial a nivel de la muñeca y el otro con sección completa de arteria ulnar con compromiso del nervio ulnar. Resulta esencial un correcto conocimiento de los arcos palmares para un adecuado abordaje quirúrgico de la mano. La importancia de la presencia o ausencia, así como de las distintas variaciones de los arcos arteriales palmares radica en su aplicación clínica quirúrgica como punto departida en el tratamiento del trauma como de otras patologías en las que existe compromiso de estos vasos.

The irrigation of the palm is provided by arterial arches (shallow and deep) that are made more frequently by the ulnar or radial arteries described as setting a classic pattern. Anatomical variations are described in shaping both arches, most often in the superficial palmar arch; may be the same complete or incomplete. The objective of this work is the anatomical description of the palmar arches, their different patterns and variations in conformation, and their clinical and surgical implications. A descriptive, observational and morphometric study of the arteries involved in the formation of the palmar arches was done in the Faculty of Medicine, University of Buenos Aires. One hundred 1(00) cadaveric preparations fixed in formalin solution, of the Third Chair of Anatomy were used. A retrospective analysis of cases with lesions / s artery /main / s that make the palmar arches in the Emergency Hospital of Moron, between 2015-2016 s was alsocarried out. Most frequently the radial artery forms the deep palmar arch with the deep palmar branch ofthe ulnar artery. Superficial palmar arch is the most variable. It was complete in 56 % and the most common presentation (83 %) is one that is formed by the anastomosis of the ulnar artery and the superficial palmar branch of the radial artery. The rest of the anastomosis are between ulnar artery and median artery(9%), between deep branch of radial artery and ulnar artery (5 %); triple anastomosis between ulnar artery,median artery and superficial palmar branch of the radial artery (2 %), and anastomosis between the median artery and superficial palmar branch of the radial artery without participation of the ulnar artery (1%). The rest of the sample (44 %) can be termed as incomplete. The B1a and B1b subtypes were the mostfound. Two cases, one entire section of the radial artery at the wrist and the other with complete section ofulnar artery with involvement of the ulnar nerve are described. It is essential to a proper understanding ofthe palmar arches for a suitable surgical approach to hand. The importance of the presence or absence, aswell as different variations of palmar arterial arch lies in its clinical application as surgical starting point in the treatment of trauma and other diseases in which there is engagement of arteries.

Cambios de los arcos dentales deciduos clase I con apiñamiento, utilizando pistas planas directas. Medellín 2012-2013 / Dimensional changes of the deciduos dental arch class I with crowding, using direct planas tracks. Medellin 2012-2013

Resumen Introducción y objetivo: El apiñamiento se ha convertido en una de las primeras causas de morbilidad y de consulta en la odontología pediátrica, por esto el tratamiento temprano ha sido propuesto como una alternativa para interceptarlo, y así evitar que empeoren o se extiendan a la dentición permanente. Las Pistas Planas Directas (PPD) son aparatos de acción bimaxilar que están encaminadas a la rehabilitación neurooclusal en edades tempranas, con la finalidad de rehabilitar el movimiento lateral de la mandíbula y magnificar la alternancia en la función masticatoria. El objetivo de esta investigación fue evaluar los cambios dentoalveolares que ocurren en el plano transversal con el uso de PPD en pacientes clase I con apiñamiento anterior, entre los 4-5 años de edad con dentición decidua. Materiales y métodos: La muestra constó de 6 sujetos a los cuales se les realizaron modelos iníciales, montaje en gnatostato, elaboración y cementación de PPD y modelos 6 y 12 meses después, para observar diferencias. Resultados: Se encontraron diferencias estadísticamente significativas en la distancia intercanina maxilar, en la distancia intermolar maxilar y en el espacio requerido maxilar derecho, entre el modelo inicial, los 6 y 12 meses de instalada la terapéutica. Conclusión: Pacientes tratados tempranamente con PPD presentan mayor desarrollo transversal y disminución en el apiñamiento, cuando son comparados con estudios longitudinales en pacientes sin tratamiento.

Abstract Introduction and objective: Crowding has become one of the leading causes of morbidity and consultation in pediatric dentistry, early treatment has been proposed as the best alternative to intercept malocclusions, preventing these from getting worse or perpetuate to the permanent dentition. Planas Direct Tracks (PPD) are devices with bimaxillary action aimed at neurooclusal rehabilitation at an early age, in order to rehabilitate the laterals movements of the jaw and enhace the masticatory function alternation. The objective of this study is to evaluate the dentoalveolar changes occurring in the transverse plane using PPD in patients Class I with anterior crowding between 4-5 years old. Materials and methods: The sample consisted of 6 subjects were models were performed before mounting them in the gnatostato, preparation and cementation of PPD and models six and twelve months later, to observe differences. Results: Statistically significant differences were found in the maxillary intercanine width, in maxillary intermolar distance and right space required maxillary, between the initial model and after 6 and 12 months of installed the therapy. Conclusion: Patients treated early with PPD have higher transverse development and decreased crowding, when compared with longitudinal studies in untreated patients.

A importância dos arcos dentários na identificação humana / The importance of the dental arches in human identification

O trabalho objetiva analisar e discutir a importância da Odontologia na identificação humana através dos arcos dentários. Além do aspecto preventivo e o curativo, o aspecto legal procura normatizar o próprio exercício da profissão nos seus vários ângulos, no diagnóstico de danos com vistas ao seu ressarcimento ou, mais especificamente, a própria identificação de indivíduos. O aspecto pericial se desdobra em diversas espécies de exames possíveis tendo como base a cavidade oral, desde o exame direto de um arco dentário até a pesquisa de DNA das amostras colhidas nessa cavidade natural, mesmo as marcas de mordida, ocorridas em áreas da superfície corpórea, trazem detalhes dos arcos que a provocaram, contribuindo no processo de identificação.

The work aims to analyze and discuss the importance of the dentistry in human identification through dental arches. In addition to the preventive aspect and the bandage, the legal aspect seeks to standardize the practice of the profession in their various angles, the diagnosis of damage to your compensation or, more specifically, the identification of individuals. The forensic aspect unfolds in several species of possible examinations based on the oral cavity, since the direct examination of a dental arch to the DNA of the samples taken in this natural cavity, even the bite marks, occurred in areas of the body surface, bring details of the bows that provoked, contributing in the identification process.

Gill rakers in six teleost species: influence of feeding habit and body size / Rastros branquiais em seis espécies de teleósteos: influência do hábito alimentar e tamanho corporal

This study analyzed the structure of the gill rakers of Parapimelodus valenciennis and Parapimelodus nigribarbis (planktivorous), Serrasalmus maculatus and Hoplias malabaricus (piscivorous), Iheringichthys labrosus (benthophagous) and Hypostomus commersonii (detritivorous) and related it with the body size and feeding habits of these species. The species of Parapimelodus and H. commersonii showed long, filiform and closely spaced gill rakers, similar to those of species that use the gill rakers as a filter to assist in the retention of small particles. The widely spaced gill rakers of I. labrosus probably allow the retention of insect larvae, but not particles of inorganic matter. In H. malabaricus and S. maculatus the gill rakers are most likely related to prey capture and swallowing, as observed in other piscivorous species. In general, gill raker length and the distance between gill rakers have a positive relationship with fish length. The gill rakers show adaptations related to the diet of the fish, but morphological variation may occur even between species whose feeding habits are the same.

Este estudo analisou a estrutura dos rastros branquiais de Parapimelodus valenciennis e Parapimelodus nigribarbis (planctívoro), Serrasalmus maculatus e Hoplias malabaricus (piscívoros), Iheringichthys labrosus (bentófago) e Hypostomus commersonii (detritívoro) e a relacionou com o tamanho corporal e hábito alimentar dessas espécies. As espécies de Parapimelodus e H. commersonii apresentaram rastros branquiais longos, filiformes e próximos entre si, similar àquelas que usam os rastros branquiais como um filtro para ajudar na retenção de partículas pequenas. Os rastros branquiais espaçados de I. labrosus provavelmente permitem a retenção de larvas de insetos, mas não de partículas de matéria inorgânica. Em H. malabaricus e S. maculatus, os rastros branquiais são mais relacionados à captura da presa e deglutição, como observado em outras espécies piscívoras. Em geral, o comprimento do rastro branquial e a distância entre os rastros branquiais tem uma relação positiva com o comprimento do peixe. Os rastros branquiais apresentam adaptações relacionadas com a dieta do peixe, mas variações morfológicas podem ocorrer mesmo entre espécies cujos hábitos alimentares são os mesmos.

Determinación del biotipo facial basado en características fenotípicas a través del modelo de ecuaciones estructurales: estuDio sobre tres etnias / Determining facial biotype based upon phenotypic features through structural equation modeling: a study of three ethnic groups

Introducción: el conjunto de características fenotípicas se pueden agrupar y además determinar el peso individual y colectivo que tienen a la hora de definir un biotipo. El modelo de ecuaciones estructurales (MES) se basa en relaciones causales en las que el cambio de una variable se supone que produce un cambio en otras variables. Con este modelo se validaron las relaciones causales a partir de diferentes tipos de variables mediadoras: fuerza de mordida, medidas transversales, arcos dentales, anchura bicigomática y altura morfológica de la cara. Métodos: el estudio incluyó 197 preadolescentes entre 12 y 14 años en condiciones de neutroclusion dental. El 33% mestizos, 35% afrodescendiente y 32% indígenas. El modelo hipotético fue puesto a prueba estadísticamente a través del modelo de ecuaciones estructurales. Resultados: existe un buen ajuste del modelo a los datos puesto que los indicadores de bondad de ajuste como el RMSEA = 0,078, la magnitud del índice RMR = 0,061 y el CIF = 0,988 estuvieron en el umbral esperado. Los parámetros fueron significativos, al nivel del 5%, a excepción del índice facial con la fuerza de mordida. Las cargas factoriales oscilan entre 0,55 y 0,92 y una carga factorial negativa entre el índice facial y las medidas transversales del arco dental (-0,60). Conclusión: el modelo evidencia que la variable latente que más se correlaciona con el biotipo facial es la fuerza de mordida (0,82), seguida de la relación con los arcos dentales (0,73), siendo esta una correlación moderada.

Introduction: the various phenotypic characteristics may be grouped; also, their individual and collective influence may be determined when defining a biotype. Structural equation modeling (SEM) is based on causal relations so that the change in a variable is supposed to produce a change in another variable. This model was used to validate causal relations using different types of mediating variables: masticatory force, transverse measures, dental arches, bizygomatic width, and morphological face height. Methods: this study included 197 preteens between 12 and 14 years of age with dental neutroclusion, distributed like this: 33% mestizos, 35% of African descent, and 32% indigenous. The hypothetical model was statistically tested through structural equation modeling. Results: the model is well fitted to the data since goodness of fit indicators such as RMSEA = 0.078, RMR index magnitude = 0.061, and CIF = 0.988 were within the expected limits. The parameters were significant to a 5%, except for facial index with masticatory force. Factor loads ranged from 0.55 to 0.92 and negative factor loads between the facial index and dental arch transverse measures (–0.60). Conclusion: this model shows that the variable that best correlates with facial biotype is masticatory force (0.82), followed by dental arches relation (0.73), this being a moderate correlation.

Utility of dermatoglyphics as a non-invasive diagnostic tool inrecurrent aphthous stomatitis / Utilidade da dermatoglifia como ferramenta diagnóstica não invasivapara estomatite aftosa recorrente

Introduction: Dermatoglyphics is an advancing branch of medical science in which the dermal ridge patterns are studied and used in prediction of genetic disorders. Objective: To assess the usefulness of dermatoglyphics, as a non-invasive early predicator in RAS, since genetics plays a role in both. Materials and methods: This case control study comprised of 40 patients with recurrent aphthous stomatitis compared to 30 control subjects of similar age and sex. All subjects were investigated for their dermatoglyphic patterns of both hands, which were obtained by smearing the ink uniformly over the palm and fingers and pressing the hands firmly against the good quality paper. Qualitative analysis of prints was done for arches, loops and whorls and quantitative analysis included Total Finger Ridge Count (TFRC) and atd angle. Fisher’s Exact Tests were used to evaluate the significance between recurrent aphthous stomatitis and the dermatoglyphic features. Results: Among various dermatoglyphic parameters analyzed, recurrent aphthous stomatitis patients showed 9% arches, 62% loops and 29% whorls as the finger ridge configuration. In comparing the results between the two groups, the frequency of arches was observed more in study group while composite whorl and the nar pattern were more frequent in control group, the results were statistically significant (p < 0.05). In addition to this, study group patients demonstrated higher frequency of total finger ridge count, and control group showed higher frequency for atd angle on both hands, statistically significant difference is observed (p < 0.05). Conclusion: The study found significant correlation between palmar dermatoglyphics and recurrent aphthous stomatitis, suggesting that genetics is one of the host risk factor associated with the latter, and could aid in early detection of the disease.

Introdução: Dermatoglifia é um avançado ramo da ciência médica em que os padrões de cristas dérmicas são estudados e utilizados para predizer distúrbios genéticos. Objetivo: Avaliar a utilidade da dermatoglifia, como método de diagnóstico não invasivo para a estomatite aftosa recorrente, uma vez que a genética desempenha um papel em ambos. Materiais e métodos: Estudo caso-controle composto por 40 pacientes com estomatite aftosa recorrente comparados a 30 controles de mesma idade e sexo. Todos os sujeitos foram avaliados quanto a seus padrões dermatóglifos de ambas as mãos. Os padrões dermatóglifos foram obtidos espalhando uniformemente uma tinta sobre a palma da mão e os dedos e pressionada firmemente contra um papel de boa qualidade. A análise qualitativa das impressões foi feita por arcos, laços e espirais e a análise quantitativa pela contagem total da polpa do dedo (TFRC) e ângulo atd. Teste de Fischer foi utilizado para avaliar a significância entre estomatites recorrentes e características dermatoglíficas. Resultados: Entre os vários parâmetros dermatoglíficos analisados, os pacientes com estomatite aftosa recorrente mostraram 9% de arcos, 62% de laços e 29% de espirais na configuração da polpa digital. Ao comparar os resultados entre os dois grupos, a frequência de arcos foi mais observada no grupo de estudo, enquanto verticilos e padrão tênar foram mais frequentes no grupo controle, com resultados estatisticamente significativos (p < 0,05). Além disso, os pacientes do grupo de estudo demonstraram maior frequência de contagem total da polpa digital e o grupo controle apresentou maior frequência para o ângulo atd em ambas as mãos, com diferenças estatisticamente significativas (p < 0,05). Conclusão: O estudo encontrou correlação significativa entre a dermatoglifia palmar e estomatites recorrentes, sugerindo que a genética é um dos fatores de risco de hospedeiro associado com estomatite aftosa recorrente, e poderia ajudar na detecção precoce da doença.

Desarrollo de Cara y Cuello en Vertebrados / Face and Neck Development in Vertebrates

El desarrollo embrionario de las regiones facial, del cuello, cavidades nasales y oral en conjunto con las glándulas asociadas, involucra el crecimiento y fusión tridimensional de múltiples procesos. Existe participación de elementos derivados de las 3 capas embrionarias locales y adicionalmente de células derivas de la cresta neural, procedentes de los rombómeros vecinos. Estas últimas se ven involucradas en la formación del esqueleto local, entre otras estructuras. El estudio evolutivo desde los vertebrados sin mandíbula nos enseña como se expresan los genes Hox en las diferentes especies, y como esto determina la formación de diferentes estructuras. En la siguiente revisión contemplamos algunos aspectos morfológicos, moleculares y evolutivos básicos del desarrollo facial y cervical, con énfasis en mamíferos con un epílogo referente a las malformaciones de la región en humanos.

The embryonic development of the facial area, neck, nasal, oral and pharyngeal cavities with glands, involves growth and fusion of multi-dimensional processes. There is involvement of elements from the embryo-derived local 3 layers cells further neural crest derived cells from the neighbors rhombomeres. The neural crest cells are involved in the formation of local skeleton, among other structures. The study of evolution from jawless vertebrates shows us how Hox genes are expressed in different species, and how this determines the formation of different structures. The following review contemplate some morphological, molecular and evolutionary basis of facial and neck development, with emphasis on mammals with an epilogue concerning to the face and neck malformations in humans.

Ortodontia lingual com sistema 2D / 2D Lingual Orthodontics

A Ortodontia lingual é uma alternativa no tratamento de pacientes adultos que desejam aparelhos ortodônticos totalmente invisíveis. A técnica lingual 2D emprega conhecimentos e procedimentos clínicos exclusivamente com os braquetes linguais 2D e permite que se obtenha uma oclusão bastante funcional e estética, mesmo em casos de má-oclusão severa, pois utiliza os princípios de biomecânica lingual. Esta é uma técnica simplificada que possibilita a colagem direta dos braquetes, sem a necessidade de se fazer o set up convencional.

2D Lingual Orthodontics is the array of knowledge and clinical procedures adopted and finalized exclusively for the use and application of 2D Lingual braquetes. It represents a valuable alternative to treat adult patients, who demand a completely invisible orthodontic appliance. The ease of direct application of 2D lingual braquetes makes it possible to achieve a good functional and esthetic occlusion also in the presence of severe malocclusions, adopting the biomechanical options offered by lingual appliances, in addition to the improved esthetics during the active phase of treatment.

Biodesintegración de aparatología ortodóntica metálica / Biodisintegration of metal orthodontic appliances

El objetivo de esta revisión de la literatura es describir los procesos de alteración de la aparatología de uso en ortodoncia a partir de su interacción con el medio bucal. En este aspecto se describe el medio bucal desde el punto de vista químico-biológico y a partir de allí los mecanismos de corrosión y sus posibles efectos sobre los arcos y brackets. Este último aspecto es analizado desde su composición y configuración. Se realizan consideraciones también desde el punto de vista de los materiales sin uso y reciclados.

Forma y tamaño de los arcos dentales en una población escolar de indígenas amazónicos / Form and size of the dental arches in a school population of Amazonian’s aborigines

Objetivo: El propósito del presente estudio es determinar la forma de los arcos dentales, describir las diferencias en las dimensiones transversales y en profundidad de los arcos durante la dentición mixta, con el fin de conocer su incidencia en la disposición de la armonía oclusal en una población de escolares indígenas de Leticia, Amazonas, Colombia. Materiales y métodos: Se realizó un estudio descriptivo transversal donde se incluyeron 64 escolares, 32 niños y 32 niñas distribuidos en dos grupos: con dentición mixta temprana, 31 escolares y el grupo de dentición mixta tardía con 33 estudiantes entre 6 y 12 años. Las variables estudiadas fueron las medidas de los modelos de estudio. Resultados: El arco superior tuvo forma ovalada en 86% de la población y en 14% la forma fue cuadrada; para el arco inferior las formas fueron 75% ovaladas y 25% cuadradas. Casi todas las medidas transversales presentaron diferencias en ambos grupos, la distancia intercanina inferior se mantuvo constante. Las medidas en profundidad, anchura y longitud evidencianarmonía en el desarrollo de los arcos en los niños amazónicos. Discusión: En este grupo étnico predominó el arco de forma ovalada, seguida de la forma cuadrada. Se encontraron diferencias para todas las medidas en profundidad del arco, principalmente en el sector anterior que sería el más susceptiblea cambios por factores ambientales durante el período de la dentición mixta de transición. Conclusiones: La armonía oclusal de la población estudiada es el resultado de una forma de arco y cambios transversales y en profundidad fisiológicamente normales.

Objective: The purpose of this study was to determine dental archs’ shape, and to describe differences in transversal dimensions and archs’ depths in mixed dentition, in order to know occlusal harmony arrangement in a native student population from Leticia, Amazonas, Colombia. Methods and Materials: A cross-sectional study with 64 students (32 boys and 32 girls) distributed in two groups: 31 students with early mixed dentitions and 33 students with belated mixed dentitions between 6 and 12 years old was carriedout. Studied variables were measured from plaster cast study models. Results: Oval upper arch was found in 86% of students while 14% had squared upper arch. Proportions for lower arch shapewere 75% oval and 25% squared, respectively. Most of the transversal dimensions had differences in both groups. Inferior intercanine distances were constant. Depth, width and length measurements are evidence of harmonic dental arch developmentfor Amazonian children Discussion: This ethnic group had higher oval arch shape prevalence, followed by squared arch shape There were differences for all arch depth measurements, mainly in anterior sector due to the susceptibility to environmental factors in mixeddentition period. Conclusions: Occlusal harmony in this population is a result of arch shape, as well as transversal and depth changes physiologically normal.

Alterações dimensionais transversas do arco dentário com fissura labiopalatina, no estágio de dentadura decídua / Transversal dimensional changes of cleft lip and/or palate arch, in the primary dentition

OBJETIVO: avaliar as alterações dimensionais do arco dentário maxilar de crianças portadoras de fissuras labiopalatinas, na fase de dentadura decídua completa, através de um estudo comparativo. METODOLOGIA: foram estudadas as distâncias entre caninos e entre molares em 64 crianças fissuradas, formando o grupo de estudo, e 20 crianças sem deformidades, formando o grupo controle, na faixa etária entre 3 e 6 anos. O grupo de estudo incluiu 23 crianças com fissura transforame incisivo unilateral completa, 14 com fissura transforame incisivo bilateral completa, 15 com fissura pré-forame incisivo e 12 com fissura pós-forame incisivo. Após a obtenção de modelos em gesso, foram demarcados os pontos necessários para que as mensurações pudessem ser realizadas. As medidas foram executadas duas vezes pelo mesmo examinador em oportunidades diferentes, utilizando um paquímetro digital (Mitutoyo), sendo registrada a média aritmética. Os resultados obtidos foram submetidos à análise estatística (Teste F Anova no procedimento Tukey-Kramer). CONCLUSÕES: as fissuras transforame incisivo, unilaterais ou bilaterais, por romperem totalmente a maxila, foram as que apresentaram alterações da distância entre caninos, comprometendo significantemente sua dimensão transversal anterior, na fase de dentadura decídua.

OBJECTIVE: To evaluate changes in maxillary transversal arch dimension in children with cleft lip and palate, during the complete deciduous dentition period, by a comparative study. METHOD: This study examined the intercanine and intermolar widths in 64 children with cleft lip and palate, as a study group, and 20 children presenting no deformities as a control group. Children were from 3 to 6 years old. The study group comprised 23 children with unilateral cleft lip and palate (UCLP), 14 with bilateral cleft lip and palate, 15 with cleft lip (CL) and 12 with cleft palate (CP). Dental casts were obtained from both groups and the main points were marked for measurement. Using a digital caliper (Mitutoyo) the same examiner measured each cast twice at different moments and recorded the arithmetic mean. The results were subjected to statistical analysis (Anova F test within Tukey-Kramer procedure). CONCLUSIONS: The UCLP and BCLP presented intercanine width changed, affecting significantly the anterior maxillary transversal dimension during the deciduous dentition period, because they broke the whole maxillary structure.