Violet LED-Based Tooth Whitening and Resin Composite Restorations to Reestablish Smile Aesthetics Case Report

ABSTRACT: This clinical case described the aesthetic treatment of a patient complaining about the aspect of their upper teeth. After anamnesis and clinical examination, the association of tooth whitening photoactivated by violet LED and resin composite restorations was indicated. Prior to restorative treatment, three bleaching sessions were performed with low concentration hydrogen peroxide (6 %; Nano white flex) for 30 minutes. During this period, violet LED irradiation was intercalating performed every 1 minute, totalizing 15 minutes. Ten days after the final bleaching session, old restorations in the upper lateral incisors were removed for better color selection of resin composites. Then, all upper anterior teeth were directly restored with nanofilled resin composite (Filtek Z350XT), reestablishing anatomy, form, and function. At the end of the treatment, the association of techniques proved to be cost-effective, restoring the esthetics satisfactorily and promoting the patient's well-being by a minimally invasive approach.

RESUMEN: En este reporte de caso se describió el tratamiento para una paciente que se quejaba del aspecto de sus dientes superiores. Tras anamnesis y exploración clínica, se indicó la asociación de blanqueamiento dental fotoactivado por LED violeta y restauraciones de resina compuesta. Antes del tratamiento restaurador, se realizaron tres sesiones de blanqueamiento con peróxido de hidrógeno de baja concentración (6 %; Nano white flex) durante 30 minutos. Durante este período, la irradiación con LED violeta se intercalaba cada 1 minuto, totalizando 15 minutos. Diez días después de la última sesión de blanqueamiento, se retiraron las restauraciones antiguas de los incisivos laterales superiores para una mejor selección del color de la resina compuesta. Luego, todos los dientes anteriores superiores fueron restaurados de manera directa con resina de nanorrelleno (Filtek Z350XT), restableciendo la anatomía, forma y función. Al final del tratamiento, la asociación de las técnicas resultó beneficioso, restaurando la estética de forma satisfactoria y promoviendo el bienestar de la paciente mediante un abordaje mínimamente invasivo.

The influence of elastomeric ligatures pigmentation on smile aesthetics during orthodontic treatment

ABSTRACT Aim: To assess the influence of elastomeric ligatures, subjected to a previous in vitro pigmentation process using different substances, on smile aesthetics during orthodontic treatment, from the perception of students and professionals. Methods: Eight elastomeric ligatures of five commercial brands (3M/Unitek, American Orthodontics, Morelli, Ortho Technology, and Orthometric) (n=8) were immersed in coffee, Coca-Cola, and red wine for one minute per day, for 28 days; and another group of ligatures was immersed in artificial saliva. All samples were photographed and subsequently analyzed using the Adobe Photoshop software, by the RGB method. Afterwards, the pigmented ligatures were inserted in a patient wearing orthodontic brackets, and zoomed photographs of the smile were taken and presented to 40 evaluators, who filled in a satisfaction scale sheet to express their opinion on the smile aesthetics of each photograph. The color data were subjected to analysis of variance (ANOVA) and Tukey tests. Results: The substance with the highest pigmentation potential was coffee (p< 0.05) followed by red wine (p< 0.05). Comparison among the brands used in this study showed that American Orthodontics and Orthometric had the lowest degree of pigmentation when immersed in coffee and red wine (p< 0.05), respectively. However, the brand that showed the highest level of satisfaction among the evaluators was Ortho Technology. Conclusions: The presence of pigmented elastomeric ligatures affected smile aesthetics, when compared with the control group.

RESUMO Objetivo: Avaliar a influência das ligaduras elásticas submetidas a um processo prévio de pigmentação in vitro, com diferentes substâncias, na estética do sorriso durante o tratamento ortodôntico, segundo a percepção de alunos e profissionais. Métodos: Oito ligaduras elásticas de cinco marcas comerciais (3M Unitek, American Orthodontics, Morelli, Ortho Technology e Orthometric) (n = 8) foram imersas em café, Coca-Cola e vinho tinto por um minuto por dia, por 28 dias, e outro grupo de ligaduras foi imerso em saliva artificial. Todas as amostras foram fotografadas e posteriormente analisadas no software Adobe Photoshop, pelo método RGB. Em seguida, as ligaduras pigmentadas foram inseridas em um paciente com braquetes ortodônticos, e fotografias ampliadas do sorriso foram tiradas e apresentadas a 40 avaliadores, que preencheram uma escala de satisfação para representar sua opinião sobre a estética do sorriso de cada fotografia. Os dados de cor foram submetidos à análise de variância (ANOVA) e testes de Tukey. Resultados: A substância com maior potencial de pigmentação foi o café (p< 0,05), seguido do vinho tinto (p< 0,05). A comparação entre as marcas utilizadas nesse estudo mostrou que a American Orthodontics e a Orthometric apresentaram o menor grau de pigmentação quando imersas em café e vinho tinto (p< 0,05), respectivamente. Porém, a marca que apresentou maior nível de satisfação entre os avaliadores foi a Ortho Technology. Conclusões: A presença de ligaduras elásticas pigmentadas afetou a estética do sorriso, quando comparada à do grupo controle.

Rehabilitación estética asistida por diseño digital de sonrisa en asimetrías dentofaciales: Reporte de caso / Aesthetic rehabilitation assisted by digital smile design for dentofacial asymmetries: Case report

RESUMEN: Tradicionalmente se ha propuesto una coincidencia entre la línea media facial y dentaria como requisito para transmitir una impresión de simetría, balance y armonía estética. Sin embargo, esta situación puede ser compleja de lograr en rostros asimétricos, impulsando el desarrollo de nuevos protocolos de análisis dentofacial para obtener resultados armónicos y conservadores integrando las estructuras anatómicas que se desvíen de las normas establecidas. Caso: El objetivo de este reporte de caso es presentar una rehabilitación estética integral en base a prótesis fija unitaria libre de metal, asistida por diseño digital de sonrisa, en un paciente con asimetría facial utilizando el concepto de flujo facial (FF) como protocolo de análisis estético dentofacial. Conclusiones: El concepto de FF establece parámetros estéticos dentro de rangos de armonía, permitiendo planificar rehabilitaciones más conservadoras. Sin embargo, faltan estudios para determinar el impacto de este análisis.

ABSTRACT: The traditional aesthetic parameters demand a coincidence between the facial and dental midlines that transmits an impression of symmetry, balance and harmony. However, the complexity of achieving this standard in faces with large asymmetries, has driven to the development of new dentofacial analysis protocols such as the concept of facial flow (FF), in order to obtain harmonic and conservative results integrating the structures that deviate from the norm. Case: The aim of this case report is to present an integral aesthetic rehabilitation based on metal-free fixed prostheses assisted by digital smile design in a patient with facial asymmetry using the concept of FF. Conclusions: The use of dentofacial aesthetic analysis protocols such as FF aids in the development of harmonic and less invasive dental treatments. However, due to the recent appearance of the FF concept, further studies are needed to reveal the implications of this analysis.

Relationship of Oral Aesthetic Assessment according to Self Perception with Oral Malocclusion Condition of High School Students in Sidrap District, South Sulawesi Indonesia / Relação da avaliação estética de acordo com a autopercepção da condição de má oclusão oral de estudantes do ensino médio no distrito de Sidrap, Sulawesi do Sul na Indonésia

Self-perception of dental aesthetics needs to be considered in planning orthodontic treatment because it is known that everyone has a self-perception of different oral esthetic conditions. Objective: To assess the state of malocclusion based on self-perception of dental aesthetics using the Oral Aesthetic Subjective Impact Score (OASIS); to determine the relationship of self-perceptions of oral aesthetics and the state of malocclusion from the results of clinical examinations using the Dental Aesthetic Index (DAI). Material and Methods: Research subjects were middle school students aged between 14-18 years as many as 187 students. For oral aesthetic assessment using the OASIS index questionnaire, and to evaluate the aesthetic and anatomical components of the malocclusion clinic using the Dental Aesthetic Index (DAI). Results: The prevalence of malocclusion according to Dental Aesthetic Index (DAI) showed that mild / normal malocclusion (59.9%), moderate malocclusion (33.4%), severe malocclusion (5.7%), and very severe malocclusion (1%). The prevalence of self-perception of oral aesthetics was 54.6% judging good. The results of the analysis with logistic regression tests showed that there was a significant (p (p<0.001) relationship between self-perception of oral aesthetics using the OASIS index and malocclusion status using the DAI index. Conclusion: Based on the results of this study, there was a significant relationship (p <0.01) between oral aesthetic self perception and malocclusion status of high school students. (AU)

A autopercepção da estética dentária precisa ser considerada no planejamento do tratamento ortodôntico, porque é sabido que existem diferenças nesta autopercepção de condições estéticas orais entre os indivíduos. Objetivo: Avaliar o estado de má oclusão com base na autopercepção da estética dentária utilizando o Oral Aesthetic Subjective Impact Score (OASIS); determinar a relação entre a autopercepção da estética bucal e o estado de má oclusão a partir dos resultados de exames clínicos utilizando o Índice de Dental Aesthetic Index (DAI). Material e Métodos: Os sujeitos da pesquisa foram estudantes do ensino médio, com idades entre 14 e 18 anos, num total de 187 alunos. Para avaliação da estética bucal, foi utilizado o questionário do índice OASIS, e para avaliar os componentes estéticos e anatômicos da clínica de más oclusões, o Índice de DAI. Resultados: A prevalência de má oclusão segundo o DAI, mostrou resultados de percepção de: oclusão leve / normal (59,9%), oclusão moderada (33,4%), oclusão grave (5,7%) e oclusão muito grave (1%). A prevalência de autopercepção da estética oral foi de 54,6%, considerando-se boa. Os resultados da análise com testes de regressão logística mostraram que houve uma relação significativa (p <0,01) entre a autopercepção da estética oral e o estado de má oclusão de estudantes do ensino médio. (AU)

Restorations with Bulk Fill restorative system: case report / Restaurações com sistema restaurador Bulk Fill: relato de caso

ABSTRACT Bulk Fill Composite resins are restorative materials that present low tension and polymerization shrinkage, allowing them to be inserted in a single increment of up to 4 mm of thickness, in a restorative cavity. This paper aims to report a clinical case of restorations done on posterior teeth with Bulk Fill restorative system, using selective acid-etching with self-etch adhesive system. Patient, male, 24 years old, presented a carious lesion on the occlusal surface of dental element 37 and an occlusal unsatisfactory amalgam restoration, on element 36. A restorative treatment with Universal Bond 3M / ESPE and bulk fill composite resin (3M / ESPE) was done. According to the case described, it was possible to observe that the materials and techniques used restored the form and function of the teeth involved, preserving pulp vitality with a satisfactory aesthetic result. The bulk fill resins employed offer practicality and decrease clinical time, with satisfactory clinical applicability in the aesthetic and functional rehabilitation of posterior teeth.

RESUMO Resinas compostas do tipo Bulk fill constituem um material restaurador que apresenta baixas tensão e contração de polimerização, podendo ser inserido em incremento único, de até 4mm de espessura, numa cavidade. Este trabalho objetiva relatar um caso clínico de restaurações em dentes posteriores com o sistema restaurador Bulk fill, empregando o condicionamento ácido seletivo com sistema adesivo autocondicionante de emprego universal. Paciente, sexo masculino, 24 anos, apresentava lesão de cárie na face oclusal do elemento dentário 37 e restauração oclusal de amálgama insatisfatória, no elemento 36. Sendo proposto e realizado tratamento restaurador com Single Bond Universal 3M/ESPE e resina composta bulk fill (3M/ESPE). De acordo com o caso descrito, foi possível observar que os materiais e técnica empregados restituíram forma e função dos dentes envolvidos, preservando a vitalidade pulpar com estética considerada satisfatória. As resinas bulk fill empregadas oferecem praticidade e diminuição do tempo clínico, tendo aplicabilidade clínica satisfatória na reabilitação estética e funcional de dentes posteriores.

Need for orthodontic treatment in a sample of Ecuadorian adolescents from Cojitambo, 2017

Aim: To determine the need for orthodontic treatment in Ecuadorian adolescents aged 13 to 18 years in Cojitambo, 2017. Materials and methods: A cross-sectional and descriptive study was made including 140 adolescents aged 13 to 18 years, 50% males. For determining the prevalence of malocclusion, a visual clinical examination was performed to obtain the data required using the Dental Aesthetic Index (DAI). Results: 37.14% of the adolescents presented a minor malocclusion (without the need for treatment), 20% a definitivemalocclusion (need for elective treatment), 30% a severe malocclusion (highly desirable treatment) and 12.86% a very severe malocclusion (mandatory treatment). No statistically significant differences were found by sex (p =0.53) or by age (p =0.05). Conclusion: There is a higher prevalence of adolescents who had a normal occlusion without the need of orthodontic treatment and the ones with the lowest prevalence were adolescents with very severe malocclusion that needed compulsory treatment, without differences by sex or age

Understanding the interaction of resin composite with light for predictable aesthetic results in anterior teeth: A case report / Compreensão da interação das resinas compostas com a luz para resultados estéticos previsíveis em dentes anteriores: Relato de caso

This case report illustrates a conservative technique for reintervention on anterior composite restorations in a young patient with composite veneers. The treatment incorporated the use of photos and digital planning to establish a harmonious smile design. In order to conserve the dental tissues, existing resin composites restorations in maxillary anterior teeth were carefully removed to minimize enamel reduction, followed by a study of color and shade of teeth considering factors such as hue, chroma, luminosity, opacity, translucency and light effects. Eight direct veneers were built up with resin composite taking the optical properties of the material into account and their influence on the thickness of the layers that create specific light effects when superimposed on each other. To obtain excellent results with a predictable working protocol, nanohybrid composite systems facilitate good aesthetics, avoiding more invasive treatment in an economic manner.(AU)

O presente relato de caso ilustra uma técnica conservadora para a re-intervenção em restaurações diretas de resina composta em pacientes jovens. O tratamento consistiu em fotos e planejamento digital para obtenção de um desenho digital do sorriso individual e harmonioso. De acordo com os princípios de máxima conservação da estrutura dentária, as restaurações existentes nos dentes superiores anteriores foram criteriosamente removidas para minimizar a redução do esmalte, seguido do estudo de cor e sombra dos dentes considerando fatores como matiz, croma, valor, opacidade, translucidez e efeitos de luz. Oito facetas diretas foram realizadas em resina composta considerando as propriedades ópticas do material e a influência destas na espessura das camadas de resina para criar efeitos de luz singulares quando sobrepostas. Para a execução de uma odontologia estética e consciente, em associação a um protocolo de trabalho previsível, os sistemas de resinas compostas nanohibridas possibilitam resultados estéticos satisfatórios, evitando tratamentos mais invasivos de maneira economicamente viável.(AU)

Concerns about dental aesthetics are associated with oral health related quality of life in Southern Brazilian adults / Preocupações sobre a estética dentária com qualidade de vida relacionada à saúde bucal em adultos no sul do Brasil

Abstract It aims to evaluate the association between dental appearance and Oral Health Related Quality of Life. Fifteen primary care services with dental services were selected in Porto Alegre, Brazil. Individuals were interviewed from a random sampling of households in the catchment area of the health centres. The outcome was having an OHIP14 score > 0 (any impact). The main exposures included self-reported tooth colour and position, perception of oral health and concern with dental aesthetics. Data were analysed with stepwise logistic regression. Of 1943 individuals contacted, 433 used public dental services in the last year. Seventy-three percent had some impact on quality of life, 35.2% and 47.5% reported stained and crowded teeth, respectively. Also, 22.2% had already tried bleaching their teeth. Individuals concerned with colour were 2.56 times (95% CI: 1.34-4.89) more likely to report any impact after adjusting for number of teeth, smoking and education. Concerns about tooth position, reporting stained or crowded teeth, age, sex and income were not significant (p > 0.30). There is a direct and independent association between concerns with tooth colour and quality of life. The effect of tooth colour on quality of life may be mediated by individuals' perceptions of aesthetics.

Resumo O objetivo do presente estudo foi avaliar a associação entre a aparência dos dentes com a qualidade de vida relacionada à saúde bucal. Quinze centros de atenção primária com serviços odontológicos foram selecionados em Porto Alegre, Brasil. Os indivíduos foram entrevistados a partir de uma amostragem aleatória de domicílios. O desfecho avaliado foi ter um escore de OHIP14 > 0. As exposições foram: cor e posição autorreferida dos dentes, percepção da saúde bucal e preocupação com a estética dental. Os dados foram analisados com regressão logística. De 1.943 indivíduos contatados, 433 utilizaram os serviços públicos odontológicos, dos quais 73% tinham algum impacto na qualidade de vida; 35,2% dentes manchados e 47,5% dentes apinhados. Além disso, 22,2% já haviam tentado clarear os dentes. Indivíduos preocupados com a cor tinham 2,56 vezes (IC 95%: 1.34-4.89) mais chances de relatar qualquer impacto após o ajuste para número de dentes, tabagismo e educação. Preocupações com a posição dos dentes, relato de dentes manchados ou apinhados, idade, sexo e renda não foram significativas (p > 0,30). Houve uma associação direta e independente entre as preocupações com a cor do dente e qualidade de vida. O efeito da cor do dente pode ser mediado pela percepção da estética.

Prevalencia de Anomalías Dentomaxilares y Necesidad de Tratamiento en Adolescentes / Prevalence of Dentomaxillary Anomalies and Treatment Needs in Adolescents

RESUMEN: Las anomalías dentomaxilares (ADM) constituyen un problema de salud pública en Chile, lo que genera la necesidad de un diagnóstico sistemático y la asignación de prioridades de tratamiento. Las ADM que afectan la estética pueden constituir una barrera para la inserción social de los adolescentes. El Dental Aesthetic Index (IED), es un instrumento que permite jerarquizar la necesidad de tratamiento de las ADM. El propósito de esta investigación fue caracterizar las ADM, necesidad de tratamiento a través de IED y auto-percepción estética en escolares de 12 a 15 años. Estudio de Prevalencia en adolescentes de 12 a 15 años, de la ciudad de Viña del Mar. El criterio de exclusión fue tratamiento ortodóncico previo. Se seleccionaron 204 sujetos mediante asignación uniforme con un nivel de confianza de 95 %. Variables recogidas: Edad, tipo de establecimiento educacional, sexo, percepción estética y IED por componentes. La prevalencia según IED fue de 63 % [56 % - 70 %]. La necesidad de tratamiento fue 44,2 % electivo, 31,01 % altamente deseable y 24,81 % obligatorio y prioritario. El IED Comunitario dio 29.5. Se encontró una relación significativa entre IED y percepción estética con un p-valor: 0,006 (Rho: 0,343). La prevalencia de anomalías dentomaxilares medido a través del indicador IED alcanza el 63 % y el IED comunitario de 29,54 % afirmando que el grupo "requiere tratamiento electivo por ADM definida"; en los establecimientos particulares está subestimado pues algunos casos ya han sido tratados con anterioridad a esta investigación.

ABSTRACT: Dentomaxillary anomalies are a public health problem in Chile, resulting in the need for screening and prioritization of treatment. Dentomaxillary anomalies affecting the aesthetics can be a barrier to social integration of adolescents. The Dental Aesthetic Index (DAI) is an instrument to prioritize the need for treatment of malocclusions. The purpose of this research was to characterize the malocclusions, orthodontic treatment needs and esthetic self-perception in schoolchildren from 12 to 15 years through DAI. Prevalence Study in 12 to 15 year-old adolescents from Viña del Mar. The exclusion criteria was previous orthodontic treatment. The sample was 204 subjects selected by uniform allocation with a confidence level of 95 %. Variables included age, type of educational establishment, sex, aesthetic perception and DAI by component. Prevalence of dentomaxillary anomalies by DAI was 63 % [56 % - 70 %], Treatment needs were 44.2 % treatment elective, 31.01 % highly desirable and 24.81 % mandatory. The Community's DAI was 29.5. The relationship between DAI and aesthetic perception was significant (p-value: 0.006; Rho: 0.343). The prevalence of dento-maxillary anomalies measured by DAI reaches 63 % and the communal DAI was 29.54 stating that the group "requires elective treatment for definite malocclusion"; in private schools, it is underestimated because some cases had already been treated prior to this investigation.

Cirurgia mucogengival em Implantodontia / Mucogingival surgery in implant therapy

O objetivo deste trabalho foi discutir algumas técnicas de cirurgia mucogengival usadas em Implantodontia, suas indicações e o melhor momento para serem empregadas. Foram identificados quatro momentos de importância clínica na manipulação dos tecidos mucosos e suas principais técnicas cirúrgicas correspondentes: 1) antes da instalação do implante: enxerto gengival livre, e enxerto de tecido conjuntivo (para minimizar as complicações nas cirurgias de primeiro e segundo estágios); 2) durante a instalação do implante: selamento do alvéolo modificado, enxerto pediculado de tecido conjuntivo (para fechar o alvéolo), reposicionamento coronal (que pode diminuir a profundidade do vestíbulo), o reposicionamento lateral do retalho (podendo causar recessão no sítio doador), retalho palatino de espessura dividida (que evita as desvantagens das outras técnicas), e o enxerto de tecido conjuntivo subepitelial (para aumentar e manter a espessura da mucosa vestibular favorecendo a estética); 3) durante a conexão do pilar protético: retalho palatino ou incisão circular, incisão em H (que são conservadoras), retalho reposicionado apicalmente (que aumenta a gengiva queratinizada vestibular), enxerto da tuberosidade, retalho em rolo (que mantem a cor a textura, mas possui sitio doador limitado); e 4) após a conexão do pilar protético: enxertos onlay/inlay, enxerto conjuntivo envelopado, e as técnicas de recontorno gengival. Embora o cirurgião possa valer-se das técnicas de cirurgia mucogengival a qualquer tempo, uma abordagem criteriosa antes da instalação do implante ou mesmo durante sua instalação pode eliminar a necessidade de procedimentos cirúrgicos adicionais, reduzindo o custo e tempo de tratamento.

The aim of this study was to discuss some mucogingival surgery techniques for implant dentistry, their indications, and best moments for application. Four stages of clinical importance regarding mucosal tissue management were identified with their main corresponding surgical techniques: 1) before implant placement: free gingival graft and the connective tissue graft (to minimize complications in the first and second surgical stages); 2) during implant placement: modified socket seal, the pedicle connective tissue graft (to close the alveolus), coronal flap positioning (which can reduce the vestibular depth), the lateral flap positioning (which may cause recession in donor site), split-thickness palatal flap (which avoids the disadvantages of other techniques), and the subepithelial connective tissue graft (to augment and maintain the thickness of the buccal mucosa favoring aesthetics); 3) during abutment connection: palatal flap or circular incision, H-type incision (which is more conservative), the apically positioned flap (which increases the keratinized buccal gingiva), the tuberosity graft, the palatal roll flap (which keeps color and texture, but has limited donor site availability); and 4) after abutment connection: inlay/onlay grafts, the envelop connective tissue graft, and techniques for gingival recontouring. Although the surgeon can use all those mucogingival surgical techniques at any time, a careful approach before implant placement or even during its installation can eliminate the need for additional surgical procedures, reducing treatment time and costs.

Evaluation of relationship between orthodontic treatment need according Dental Aesthetic Index (DAI) and student’s perception in 11-14 year old students in the city of Shiraz in 2012.

Background: Although the demand for orthodontic treatment is affected by understanding the needs for treatment and costs, patients’ concerns do not always match with expert’s assessments. To gain a clearer understanding of children’s orthodontic needs, treatment recommendations and how an abnormality can affect a child’s quality of life is critical. Information on the relationship between assessment of need for treatment and an individual’s perception of need for orthodontic treatment is of great interest for orthodontic service providers. The present study aimed to assess the relationship between need for orthodontic treatment according to Dental Aesthetic Index (DAI) and individuals’ perception of need for treatment in 11-14 year old students. Methods: In this study, 240 primary and middle school students from the four educational districts of Shiraz were selected through multi-stage random sampling and completed the study questionnaire. Then dental examination was done by the dentist according to DAI index to determine the student’s need for orthodontic treatment. Results: According to the results, 73.8% of the students had DAI score of13-25 (little or no need for treatment), 15.2% had DAI score of 25-30 (specific malocclusion with elective need for treatment), 4.4% had DAI score of 30-35 (severe malocclusion with extreme need for treatment), and 6.7% had DAI score exceeding 35 indicating their serious need for orthodontic treatment. The total mean score of DAI was 23.57. Conclusion: The results revealed a significant relationship between the students’ perception of need for treatment and professional assessment of need for orthodontic treatment based on DAI index (P = 0.002).

Amelogênese Imperfeita: Relato de umaReabilitação Estética Conservadora / Amelogenesis Imperfecta: Report of A Conservative Aesthetic Rehabilitation

O objetivo desse artigo foi relatar um caso clínicode reabilitação estética em um paciente com amelogêneseimperfeita, por meio da técnica de microabrasão do esmalteassociada à resina composta. Relato do caso: Paciente de18 anos de idade, gênero feminino, apresentou-se à Clínicade Odontologia da Universidade Federal Paraíba a procurade tratamento estético para os elementos ântero-superiores.Após anamnese e exame clínico detalhados, foi diagnosticadaa amelogênese imperfeita. O tratamento de microabrasão doesmalte em associação ao preenchimento com resinacomposta das áreas com perda de substância foi proposto.As manchas foram minimizadas empregando-se a técnicade microabrasão do esmalte com a mistura do ácido fosfóricoa 37% e pedra-pomes e, em seguida, aplicou-se flúor tópico.Para a obtenção de um melhor resultado estético, incrementosde resina composta foram inseridos nas áreas de depressãodo esmalte. Foi realizado condicionamento ácido fosfórico37% por 30 segundos, lavagem por 15 segundos, secagemcom papel absorvente, aplicação do adesivo convencionalde 2 passos, fotoativação por 20 segundos e aplicaçãoincremental da resina composta nanoparticulada para esmaltena cor EA3. Conclusão: Pôde-se concluir que a técnica demicroabrasão do esmalte foi capaz de minimizar as manchasdo esmalte, mostrando sua eficácia e, associada à resinacomposta, restabeleceu-se a estética dos elementosdentários envolvidos...

The aim of this study was to report a case of anaesthetic rehabilitation in a patient with amelogenesisimperfecta, who was treated with the use of the enamelmicroabrasion technique associated with composite resin.Case Report: An 18-year-old female patient was admitted tothe Dental Clinic of the Federal University of Paraíba in needof aesthetic treatment in her maxillary anterior teeth. Afteranamnesis and detailed clinical examination, the patient wasdiagnosed with amelogenesis imperfecta. The enamelmicroabrasion technique in association with composite resinwas proposed to restore the dental areas showing loss ofsubstance. The stains were minimized by the enamelmicroabrasion technique using a mixture of 37% phosphoricacid and pumice stone, followed by fluoride topical application.In order to achieve a better aesthetic result, increments ofcomposite resin were used in the areas that showed enamelslope. The enamel was etched with 37% phosphoric acid for30 seconds, rinsed for 15 seconds, and dried with tissuepaper. Then conventional adhesive was applied and lightcuredfor 20 seconds, followed by incremental application ofcomposite resin (nanofilled composite resin, EA3).Conclusion: Enamel microabrasion was an effectivetechnique to minimize stains. When associated with the useof composite resin, aesthetic recovery of the affected teethwas observed...

Necesidad de tratamiento ortodóntico en estudiantes de 10 a 12 años. Matanzas / Necessity of the orthodontic treatment in students aged 10 to 12 years. Matanzas

La detección de las maloclusiones dentarias en edades tempranas evitaría su agravamiento y las consecuencias funcionales, psicosociales y económicas, así como su repercusión en la calidad de vida de muchos individuos. El propósito de este trabajo fue determinar determinar las necesidades de tratamiento ortodóntico y su correspondiente nivel de atención. El universo estuvo comprendido por 4896 niños de los cuales fue seleccionada una muestra integrada por 537 estudiantes (49.2% femenino y 50.8% masculino), mediante muestreo aleatorio simple; constituida por 537 estudiantes de 10, 11 y 12 años pertenecientes al área de Milanés, municipio Matanzas. Se aplicó el índice de estética dental Índice de Estética Dental de necesidad de tratamiento ortodóntico, añadiendo el criterio del profesional. El 36.3% de la muestra presentó maloclusión leve u oclusión normal, 24% maloclusión definida, 16.2% maloclusión severa y 23.5% maloclusión muy severa. El criterio del profesional determinó que el 27.7% de los necesitados de tratamiento pueden ser atendidos por el Estomatólogo General Integral para la realización de medidas preventivas e interceptivas que eviten el agravamiento de las maloclusiones y el 59.5% podría ser atendido por especialistas de ortodoncia. La mayoría de los sujetos estudiados fueron identificados con necesidad de tratamiento definida, muy severa y severa y necesitaban tratamiento en el nivel secundario de atención.

The detection of dental malocclusions in early ages would avoid their worsening and functional, psycho-social and functional consequences, and also their repercussions on the life quality of many individuals. The purpose of this work was determining the necessities of orthodontic treatment its correspondent care level. The universe was formed by 4 896 children and the sample was integrated by 537 students (49,2 % female and 50.8 % male) selected through a simple random sampling among students aged 10, 11 and 12 years old belonging to the health care area Milanes, municipality of Matanzas. We applied the Dental Aesthetic Index of orthodontic treatment necessity, adding the criteria of the professional. 36.3 % of the sample showed a mild malocclusion or normal malocclusion, 24 % showed a definite malocclusion, 16.2 % severe malocclusion and 23.5 % a very severe malocclusion. The professional criteria determined that 27.7 % of the patients who need the treatment may be attended by the General Integral Stomatologist to carry out preventive and interceptive measures to avoid the worsening of the malocclusions and 59.5 % could be attended by specialists in orthodontics. Most of the studied subjects were identified with defined treatment necessity, very severe and severe, and they need treatment in the health care secondary level.

Malocclusion status among 15 years old adolescents in relation to fluoride concentration and area of residence.

Objectives: To compare the overall dental aesthetic index scores between rural and urban areas, males and females, and to correlate dental aesthetic index score with fluoride concentration in drinking water. Settings and Design: The study was cross sectional and conducted among 15 year old adolescents in the rural and urban areas of Nalgonda district, Andhra Pradesh, India (an endemic fluoride belt). Materials and Methods: Six out of 59 mandals in Nalgonda district were first selected by simple random sampling technique. Then 24 secondary schools were selected from these six selected mandals. All eligible grade X children from these sixteen rural and eight urban schools, having different fluoride concentrations in drinking water, selected by simple random sampling, were considered for the study. Dentofacial anomalies with criteria of dental aesthetic index were used for assessing malocclusion. The information on the dietary habits, orthodontic treatment history, parafunctional habits, continuous residence etc., was collected using a pre-designed questionnaire. The examination was carried out by three trained and calibrated dentists. The Dental Aesthetic Index (DAI) scores, in areas with below optimal, optimal and above optimal fluoride concentrations, between urban and rural areas were compared and analyzed using SPSS windows version 16. Results: The mean DAI scores, for the rural and urban population were 21.37 ± 5.845 (mean ± SD) and 22.26 ± 6.115, for males and females, it was 20.86 ± 5.100 and 22.70 ± 6.713 respectively. The mean DAI scores in areas with below optimal, optimal and above optimal fluoride concentration were 23.42 ± 7.205 (mean ± SD), 20.85 ± 4.658 and 19.93 ± 4.312 respectively. Conclusion: The prevalence and severity of malocclusion was more in urban than rural areas, more among females than males, and it decreased with increasing concentration of fluoride in drinking water.

Dental aesthetics and self-esteem in adolescents / Estética dental y autoestima en adolescentes

Objective: The aim of this study was to investigate the relationship between dental aesthetics and self-esteem in adolescents. Methods: The sample was 387 randomly selected high school adolescents between 13 and 16 years of age. A clinical examination to evaluate dental aesthetics was conducted using the Dental Aesthetic Index (DAI). Self-esteem was assessed with the Rosenberg's Self-esteem Scale. The statistical analysis included a descriptive analysis and means comparison, which was made through t-Student and ANOVA tests. DAI was correlated to Rosenberg's Self-esteem Scale with Spearman's rank correlation coefficient. The data collected was analyzed by using the SPSS program version 17. Results: The mean DAI score was 34.2 (SD=14.2) and self-esteem was 22.6 (SD=4.6). The low socioeconomic status (SES) group had the highest levels of DAI and the lowest levels of self-esteem. A weak, but statistically significant, negative correlation was found between DAI scores and Rosenberg's self-esteem scale (r=-0.1, p<0.05). According to age, in adolescents aged sixteen there was a slight correlation with both variables (p>0.05). Regarding gender, in female individuals a negative weak correlation (r=-0.14, p<0.05) was observed. No statistically significant difference was shown among SES groups. Nevertheless, there was a positive slight correlation in the middle SES group (p>0.05). Conclusions: The outcomes generated by this investigation can improve our understanding of how the correlation between dental aesthetics and self-esteem may fluctuate because of the SES variability.

Objetivo: Investigar la relación entre estética dental y autoestima en adolescentes. Métodos: La muestra de 387 adolescentes entre 13 y 16 años seleccionados aleatoriamente de los colegios de educación secundaria. Se realizó un examen clínico para evaluar la estética dental a través del Dental Aesthetic Index (DAI). La autoestima se valoró usando la Rosenberg's Self-esteem Scale. El análisis estadístico incluyó medidas descriptivas y una comparación de medias realizadas a través de las pruebas t-Student y ANOVA. El DAI se correlacionó con la Rosenberg Self-esteem Scale por medio del coeficiente de correlación de Spearman. Los datos recolectados se analizaron en el programa SPSS versión 17. Resultados: La media de DAI fue 34.2 (DE=14.2) y de autoestima de 22.6 (DE=4.6). El grupo de estrato socio-económico (SES) bajo tuvo los niveles más altos de DAI y los más bajos de autoestima. Una pequeña pero significativa correlación negativa se encontró entre los niveles del DAI y la Rosenberg's Self-esteem Scale (r=-0.1; p<0.05). De acuerdo con la edad, los adolescentes de 16 años tuvieron una leve correlación en las dos variables (p>0.05). En relación con género, en mujeres se encontró una pequeña correlación negativa (r=-0.14; p<0.05). Ninguna correlación estadísticamente significativa se observó entre los grupos según estrato socioeconómico. Sin embargo, existió una leve correlación positiva en estrato socio-económico medio (p>0.05). Conclusiones: Los resultados obtenidos por esta investigación pueden mejorar el entendimiento de cómo la correlación de estética dental y autoestima podría fluctuar debido a la variabilidad del SES.

Necesidad de tratamiento ortodóncico en escolares. Aplicación del índice DAI / Orthodontic treatment's necessity in students. Application of the Dental Aesthetic Index (DAI)

Las maloclusiones dentarias son alteraciones o desórdenes oclusales sujetos a importantes condicionantes estéticos, étnicos y culturales, lo cual dificulta su definición y clasificación. Un diagnóstico temprano y un tratamiento exitoso de las maloclusiones pueden tener beneficios a corto plazo. En esta investigación se examinaron todos los escolares de 8 y 9 años de edad matriculados en las escuelas primarias del área de salud Milanés, de los cuales 232 pertenecieron al grupo de 8 años para un 51,6 por ciento, y 218 de 9 años, que representaron un 48,4 por ciento. Con el propósito de determinar la necesidad de tratamiento de ortodoncia, fue realizado un estudio descriptivo y transversal, en el que se aplicó el índice de estética dental de necesidad de tratamiento ortodóntico, determinándose que el 32,9 por ciento presentó maloclusión leve u oclusión normal, 24,4 por ciento maloclusión definida, 16,0 por ciento maloclusión severa y 26,7 por ciento maloclusión muy severa. Se determinó que existe una alta prevalencia de necesidad de tratamiento en las edades estudiadas.

The dental malocclusions are occlusal alterations or disorders that are subject of important aesthetic, ethnic and cultural conditionings, making it difficult its definition and classification. An early diagnosis and a successful treatment of the malocclusions may have benefits in a short term. This research was made in a sample of 450 students aged 8 and 9 years, 232 in the 8-years-old group, for the 51,6 percent, and 218 in the 9-years-old group, representing the 48,4 percent. With the purpose of determining the orthodontic treatment necessity, we carried out a cross-sectional, descriptive study, applying the dental esthetic index of the orthodontic treatment necessity, and determining that 32,9 percent of the students had a slight malocclusion or normal occlusion, 24, 4 percent a defined malocclusion, 16,0 percent a serious malocclusion and 26,7 percent a very serious malocclusion. We determined the high prevalence of treatment necessity in the studied ages.

Prevalence of malocclusion and orthodontic treatment needs among 16 and 17 year-old school-going children in Shimla city, Himachal Pradesh.

Background: Many studies have been conducted in India to know the prevalence of malocclusion and the orthodontic treatment needs using dental aesthetic index (DAI), but no study so far has been conducted in Shimla city, Himachal Pradesh. Objective: To know the prevalence of malocclusion and orthodontic treatment needs among 16- and 17 year-old school-going children in Shimla city, Himachal Pradesh. Materials and Methods: The study was carried out on 622 (365 boys and 257 girls) school children, aged 16 and 17 years, from February 2009 to May 2009. Type III examination was conducted and the assessment of malocclusion was done according to the DAI. Results: 20.28% of the male and 24.52% of the female students in the sample were affected with malocclusion. The mean DAI scores of the male and female children were 22.26 and 21.79, respectively. Distribution of the four DAI grades was as follows: DAI-I (no abnormality or minor malocclusion) 79.58%, DAI-II (definite malocclusion) 16.39%, DAI-III (severe malocclusion) 3.69%, DAI-IV (very severe/handicapping malocclusion) 0.34%. Conclusion: The present study shows that 20.42% of the children examined had malocclusion which required treatment.

Associação entre presença de oclusopatias e insatisfação com a aparência dos dentes e gengivas: estudo com adolescentes brasileiros / Association between malocclusion and dissatisfaction with dental and gingival appearance: study with brazilian adolescents

Apesar da alta prevalência de oclusopatias em adolescentes ser mundialmente relatada, poucos estudos investigaram a associação entre oclusopatias definidas por critérios clínicos e a auto-avaliação da aparência dentária e das gengivas em adolescentes. O objetivo deste estudo foi investigar a associação entre oclusopatias e auto-avaliação da aparência dentária e gengival em adolescentes brasileiros. Foram utilizados os dados de um estudo transversal realizado com adolescentes de 15 a 19 anos de idade (n = 16.126) de 250 cidades localizadas nas cinco macrorregiões do Brasil. O desfecho foi a insatisfação com a aparência dentária e gengival, sendo a principal variável exploratória as oclusopatias, medidas através do Índice de Estética Dental - DAI. As demais variáveis exploratórias, potenciais fatores de confusão e mediação, foram renda familiar per capita, atraso escolar, condição de estudo, sexo, idade, cor da pele, agravos bucais (cárie não tratada, perda dentária devido à cárie, cálculo, fluorose e dor nos dentes e gengivas) e a utilização dos serviços odontológicos. Realizaram-se análises de regressão de Poisson simples e multiva-riável. A prevalência de insatisfação com a aparência dos dentes e gengivas foi de 11,4 por cento (IC 95 por cento: 10,4-12,5). Todos os graus de oclusopatias foram associados à insatisfação com a aparência dos dentes e gengivas. A análise multivariável ajustada mostrou que a auto-avaliação negativa da aparência em adolescentes com oclusopatias graves ou muito graves foi 40 por cento e 80 por cento maior quando comparados àqueles com oclusão normal, respectivamente. Os resultados contribuem para a inclusão do critério de auto-avaliação da aparência dental durante as decisões de tratamento ortodôntico, principalmente no âmbito do Sistema Único de Saúde.

In spite of the high prevalence of malocclusion in adolescents reported worldwide, there are few studies that have investigated the association between normative malocclusion and self-rated dental and gingival appearance among adolescents. The aim of this study was to identify the association between normative malocclusion and dissatisfaction with dental and gingival appearance among Brazilian adolescents. A cross-sectional study was carried out with adolescents aged 15 to 19 years (n= 16,126) living in 250 towns of all five Brazilian regions. Dissatisfaction with dental and gingival appearance was the outcome. The main explanatory variable was malocclusion assessed by using the Dental Aesthetic Index - DAI. The other explanatory variables included were per capita family income, schooling delay, study conditions, sex, age, skin color, dental outcomes (untreated dental caries, missing teeth due dental caries, dental calculus, fluorosis, and dental pain) and use of dental services. Simple and multivariable Poisson regression analyses were performed. Dissatisfaction with dental appearance reached 11.4 percent (95 percentCI: 10.4-12.5) of the entire sample. All levels of malocclusion were associated with dissatisfaction with dental appearance. Adjusted multivariable analysis showed that dissatisfaction with dental appearance among individuals affected by severe or very severe malocclusion was respectively 40 percent and 80 percent higher than among those with normal occlusion. Malocclusion was associated with dissatisfaction with dental and gingival appearance. The results contribute to include self-rated dental appearance criteria in orthodontic treatment decision, mainly within the National Health System - SUS.

Prevalência de oclusopatias e comparação entre a Classificação de Angle e o Índice de Estética Dentária em escolares do interior do estado de São Paulo - Brasil / Malocclusion prevalence and comparison between the Angle classification and the Dental Aesthetic Index in scholars in the interior of São Paulo state - Brazil

INTRODUÇÃO: as oclusopatias estão entre os principais problemas de saúde bucal em todo o mundo, juntamente com a cárie dentária e a doença periodontal, e vários índices têm sido utilizados para registrá-las. OBJETIVOS: verificar a prevalência de oclusopatias utilizando a Classificação de Angle e o Índice de Estética Dentária (DAI), sua severidade e a necessidade de tratamento ortodôntico registradas pelo DAI, e comparar os resultados de ambos os índices, visando correlacionar o padrão dos dados coletados e a viabilidade de utilizá-los de forma conjunta. MÉTODOS: a amostra consistiu de 734 escolares com idade de 12 anos, de ambos os sexos, da rede pública do município de Lins/SP. Foram realizados exames nos pátios das escolas com utilização de sondas IPC a olho nu. RESULTADOS: pela Classificação de Angle, encontrou-se 33,24 por cento das crianças com oclusão normal e 66,76 por cento com má oclusão. Pelo DAI, observou-se que 65,26 por cento das crianças apresentavam-se sem anormalidades ou com más oclusões leves. A má oclusão definida esteve presente em 12,81 por cento, a má oclusão severa foi observada em 10,90 por cento e a muito severa ou incapacitante em 11,03 por cento. A maioria das crianças (70,57 por cento) apresentou relação molar normal, e o overjet maxilar anterior foi a alteração mais frequentemente observada. No cruzamento dos índices houve semelhanças e divergências. CONCLUSÃO: o DAI não foi sensível a alguns problemas de oclusão detectados pela Classificação de Angle, e a recíproca foi verdadeira, demonstrando que ambos os índices possuem pontos distintos na detecção das oclusopatias, podendo ser utilizados de forma reciprocamente complementar.

INTRODUCTION: The malocclusions are among the main buccal health problems all over the world, together with dental cavity and periodontal disease. Several indexes are being used for malocclusion registration. The present study verified the prevalence of this condition, using the Angle classification and the Dental Aesthetic Index (DAI), the severity and the necessity of orthodontic treatment registered with the DAI and the results of both indexes were compared, seeking to correlate collected data pattern and the viability of using them together. METHODS: The sample consisted of 734 schoolchildren with 12 years of age, both male and female from the public municipal schools in Lins-SP, Brazil. The exams were performed at the school's playgrounds with the use of IPC probes with a naked eye. RESULTS: For the Angle classification, it was found that 33.24 percent of the children presented normal occlusion and 66.76 percent presented malocclusions. It was observed, with the DAI, that 65.26 percent of the children had no abnormalities or had slight malocclusions. The defined malocclusion was present in 12.81 percent, severe malocclusion was observed in 10.90 percent and very severe or disabling malocclusion in 11.03 percent. Most of the children (70.57 percent) presented normal molar relationship and the anterior maxillary overjet was the most frequently observed alteration. When the indexes were compared there were similarities and divergences. CONCLUSION: DAI was not sensitive for some occlusion problems detected by the Angle classification, and vice-versa, demonstrating that both indexes have different points in malocclusions detection, so they could be used mutually in a complementary way.

Maloclusiones y su impacto psicosocial en estudiantes de un liceo intercultural / Malocclusions and its psychosocial impact in intercultural highschool students

Las maloclusiones están consideradas como la tercera patología oral de mayor prevalencia e impacto en el mundo, a pesar de esto son pocos los estudios en Chile que abordan el tema y consideran sus consecuencias en la calidad de vida o su relación con grupos poblacionales específicos. El objetivo de este estudio es determinar la prevalencia y su impacto psicosocial en jóvenes que estudian en un liceo con población indígena. Se realizó un estudio descriptivo de corte transversal, en 129 alumnos, 73,6 por ciento pehuenche, del Liceo de Ralco; se utilizó el Índice Estético Dental para cuantificar la magnitud de las maloclusiones y un Cuestionario de Autoimagen para evaluar el aspecto psicosocial. Los resultados muestran una prevalencia del 67,4 por ciento y un 21,7 por ciento para el nivel discapacitante de maloclusiones, siendo significativamente mayor en población pehuenche y rural, valores por sobre el de estadísticas nacionales e internacionales. A más de la mitad de los jóvenes las maloclusiones le ocasionan problemas para relacionarse con sus pares. Todo lo anterior hace necesario implementar estrategias preventivas y curativas que den solución a este problema.

Malocclusions are regarded as the third oral disease with most prevalence and impact in the world, despite this there are few studies in Chile that address the issue and consider their impact on the quality of life and relationship to specific population groups. The aim of this study is to determine the prevalence and psychosocial impact on young people studying in a high school with indigenous people. We performed a descriptive cross-sectional study in 129 students, 73.6 percent pehuenche, of Ralco High-school; Dental Aesthetic Index was used to quantify the malocclusion magnitude and a Selfimage Questionnaire for assessing psychosocial aspect. The results show a prevalence of 67.4 percent and 21.7 percent for disabling malocclusions level, was significantly higher in pehuenche and rural population, this values are over national and international statistics. More than half of youngs have troubles to relating with their peers to cause of malocclusion. This requires the implementation of preventive and curative strategies providing a solution to this problem.