Tratamiento ortodóncicoquirúrgico de canino inferior derechotransmigrado / Orthodontic-surgical approach in the treatment of a transmigrated lower right canine

RESUMEN Introducción: Si un canino impactado cruza la línea media desde su posición normal al lado contrario, se denomina transmigración. Esta presenta bajos rangos de prevalencia por lo que se le considera una condición rara. El tratamiento ortodóncico quirúrgico es una de sus opciones terapéuticas. Objetivo: Describir los resultados del tratamientoortodóncico quirúrgico en un pacientecon canino inferior derecho transmigrado. Caso clínico: Paciente masculino de 11 años de edad con antecedentes de salud que acudió a consulta de Estomatología General Integral por tener los dientes botados y por la falta de uno que mudó y el sucesor aún no ha brotado. El caso se refiere al servicio de Ortodoncia. Al examen bucal destacó la ausencia clínica del 43, sin espacio necesario para su ubicación en la arcada. El paciente clasificó como síndrome de clase II división 1 de Moyers. Se indicó estudio radiográfico y se confirmó el diagnóstico de canino incluido, transmigrado y mesioangular en región mentoniana. Se decidió realizar tratamiento ortodóncico quirúrgico para colocar el canino en su posición. Conclusiones: El tratamiento ortodóncico quirúrgico devolvió al paciente la función y la estética, mediante la correcta ubicación del canino en la arcada. Este puede ser considerado como una alternativa terapéutica en el caso de canino mandibular transmigrado que presenta patrón tipo 1.

ABSTRACT Introduction: If an impacted canine tooth crosses the midline towards the opposite side, it is considered as dental transmigration. It is a rare condition with low ranges of prevalence. The surgical-orthodontic treatment is one of the therapeutic options. Objective: To describe the orthodontic-surgical treatment results, in a patient, with transmigrated lower right canine. Case report: An 11-year-old male patient attended the general practitioner for dental evaluation, his chief complaint was the absence of one deciduous tooth and the permanent still un-erupted and the tipping of the upper incisors. During the orthodontic examination was noted insufficient space to tooth 43 in the arch. The patient was diagnosed with Moyers' class II malocclusion division 1 syndrome. The radiographic examination confirmed the diagnosis of impacted and transmigrated lower right canine, mesioangular position across the midline within the chin area. Orthodontic-surgical treatment was carried out to bring the canine tooth to its functional position. Conclusions: Orthodontic-surgical treatment restored the function and aesthetics to the patient, through the right positioning of the canine in the arch. It could be considered as a therapeutic alternative in the case of transmigrated mandibular canine with type 1 pattern.

Bio-Exercise (BioEx) - A biocreative orofacial myofunctional therapy: preliminary cephalometric study and clinical application

ABSTRACT Objective: To introduce newly structured and developed orofacial myofunctional therapy (OFMFT) protocols named Bio-Exercise (BioEx), and evaluate the treatment effect of this method, using lateral cephalometric analysis on malocclusion with low tongue posture in young patients. Methods: A retrospective preliminary study was performed using orthodontic records from 28 patients (mean age of 8.41±1.45-year-old, 13 males, 15 females) treated with BioEx therapy using tongue elevators for 18.14±9.04 months (range: 6 to 37 months). Pretreatment (T0) and post-BioEx therapy (T1) lateral cephalograms were subsequently analyzed for tongue posture changes by linear, anteroposterior and vertical measurements. The data were analyzed by paired t-test, considering a 5% significance level. Results: The tongue length (TGL) and tongue height (TGH) increased statistically significant between T0 and T1. The decrease of the dorsum of the tongue perpendicular to the palatal plane (Td-PP value) was statistically significant. The increase of the tip of the tongue perpendicular to the pterygomaxillary vertical line (TT-PMV) was not statistically significant. Conclusions: These preliminary cephalometric results indicate that BioEx can be an effective OFMFT modality in increasing the tonicity of the tongue muscles to establish more normalized tongue position at rest.

RESUMO Objetivo: Introduzir protocolos de terapia miofuncional orofacial (TMO) recém-estruturados e desenvolvidos, denominados Bio-Exercise (BioEx), e avaliar o efeito do tratamento com esse método, usando análise cefalométrica em radiografias laterais de jovens com má oclusão e postura baixa da língua. Métodos: Foi realizado um estudo preliminar retrospectivo com registros ortodônticos de 28 pacientes (idade média de 8,41±1,45 anos, 13 homens, 15 mulheres) tratados com terapia BioEx usando elevadores de língua por 18,14±9,04 meses (intervalo: 6 a 37 meses). As radiografias cefalométricas laterais pré-tratamento (T0) e pós-tratamento com BioEx (T1) foram analisadas quanto às alterações na postura da língua, por meio de medidas lineares, anteroposteriores e verticais. Os dados foram analisados pelo teste t pareado, considerando-se um nível de significância de 5%. Resultados: O comprimento da língua (CL) e a altura da língua (AL) aumentaram entre T0 e T1, com significância estatística. A diminuição do dorso da língua perpendicular ao plano palatino (valor Td-PP) foi estatisticamente significativa. O aumento da ponta da língua perpendicular à linha vertical pterigomaxilar (PL-PMV) não foi estatisticamente significativo. Conclusões: Esses resultados cefalométricos preliminares indicam que o BioEx pode ser uma modalidade de TMO eficaz no aumento da tonicidade dos músculos da língua, para estabelecer uma postura de língua adequada em repouso.

Is there a better interceptive treatment for unerupted palatally displaced canines? A network meta-analysis

Abstract This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12-9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31-10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09-1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11-1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00-1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC.

Assessment of the need for orthodontic treatment in a peruvian sample using the dental aesthetic index / Necesidad de tratamiento ortodóntico en una muestra peruana mediante el índice estético dental

Introduction: The Dental Aesthetic Index (DAI) is considered an essential tool in the association of the aesthetic and clinical elements of occlusion. It plays a key role in the timely and essential orthodontic treatment. Objective: to determine the orthodontic treatment required in students of a Peruvian public institution using the DAI. Material and Methods: A descriptive, observational, cross-sectional study was carried out during the months of June to July 2016 in a Peruvian educational institution. The sample consisted of 120 students. The use of the DAI allowed to assess the orthodontic treatment required, through the 10 occlusal conditions and regression indicators that constitute a linear formula, with the following components: no treatment required, elective treatment, desirable treatment, and priority treatment, according to the severity of the malocclusion as normal, defined, severe, and very severe, respectively. Results: 53.3% (64) of the students required priority orthodontic treatment due to presenting DAI=43.03. Between the ages of 12-14 years, 56.7% (34), 8.3% (5), and 28.3% (17) required priority, desirable, and elective orthodontic treatment, respectively. The need for priority orthodontic treatment was more prevalent in females accounting for 57.6% (38). 95% (57) of the students from rural areas required orthodontic treatment. Conclusion: The need for orthodontic treatment in a Peruvian sample using the Dental Aesthetic Index was priority orthodontic treatment, mostly in females with ages ranging between 12-14 years.

Introducción: El Índice Estético Dental (DAI) es considerada una herramienta indispensable en la aso-ciación de los elementos estéticos y clínicos de la oclusión, influyendo directamente en el tratamiento de ortodoncia oportuno y requerido. Objetivo: determinar el tratamiento de ortodoncia requerido en estudiantes de una institución pública peruana haciendo uso del DAI. Material y Métodos: Estudio de diseño descriptivo, observacional, con corte transversal, ejecutado durante los meses junio a julio de 2016, en una institución educativa peruana. La muestra fueron 120 estudiantes. La observación mediante el uso del instrumento DAI permitió valorar el tratamiento de ortodoncia requerido, mediante las 10 condiciones oclusales e indicadores de regresión que constituyen una fórmula lineal, con categorías de: No requiere tratamiento, tratamiento electivo, trata-miento deseable, tratamiento prioritario, de acuerdo a la severidad de la maloclusión presente como oclusión normal, definida, severa y muy severa, respectivamente. Resultados: Estudio de diseño descriptivo, observacional, con corte transversal, ejecutado durante los meses junio a julio de 2016, en una institución educativa peruana. La muestra fueron 120 estudiantes. La observación mediante el uso del instrumento DAI permitió valorar el tratamiento de ortodoncia requerido, mediante las 10 condiciones oclusales e indicadores de regresión que constituyen una fórmula lineal, con categorías de: No requiere tratamiento, tratamiento electivo, tratamiento deseable, tratamiento prioritario, de acuerdo a la severidad de la maloclusión presente como oclusión normal, definida, severa y muy severa, respectivamente. Conclusion: La necesidad de tratamiento ortodóntico en una muestra peruana mediante el Índice Estético Dental fue tratamiento de ortodoncia prioritario, predominando el género femenino entre los 12 -14 años.

Modified Arnold expander: an alternative for mandibular arch expansion

ABSTRACT Introduction: Due to the anatomical constraints of the mandible, mandibular dental arch usually serves as a guideline to determine the required changes in the maxillary transverse dimension. The Schwarz appliance and the Lip Bumper are the traditional orthodontic appliances for mandibular arch expansion in patients with borderline amounts of crowding, and/or transverse discrepancy. However, they often require patient cooperation, which may be a concern for orthodontists in daily practice. Objectives: This article illustrates a simple fixed orthodontic device as an alternative to achieve mandibular arch expansion in patients with moderate tooth-size/arch-length discrepancy. The four reported cases refer to 8 to 10-year-old patients in the mixed dentition, with an Angle Class I or Class II malocclusion, transverse deficiency in both arches, moderate crowding and/or posterior crossbite, combined with compromised smile aesthetics. The patients were treated with rapid maxillary expansion (RME) using Hass expander appliance and the modified Arnold expander (MAE). Conclusion: This low-cost compliance-free orthodontic appliance provided dentoalveolar decompensation by means of uprighting the posterior teeth, with minimal or no adjustments during treatment. The final results were achieved in only three to four months, and fulfilled all treatment objectives, such as an increase in the arch perimeter and width, and a better teeth alignment.

RESUMO Introdução: Devido aos limites anatômicos da mandíbula, a arcada dentária inferior geralmente serve como guia para determinar as alterações necessárias na dimensão transversal da maxila. O aparelho de Schwarz e o Lip Bumper são os aparelhos usados tradicionalmente para expansão da arcada inferior em pacientes com quantidades limítrofes de apinhamento e/ou discrepância transversal. No entanto, eles requerem a cooperação do paciente, o que pode ser uma preocupação para os ortodontistas na prática diária. Objetivos: O presente artigo ilustra uma alternativa diferente de aparelho fixo para se obter a expansão da arcada inferior em pacientes com discrepância moderada de tamanho dentário e/ou comprimento da arcada. Os quatro casos relatados referem-se a pacientes com 8 a 10 anos de idade, na dentição mista, com má oclusão de Classe I ou II de Angle, deficiência transversal em ambas as arcadas, apinhamento moderado e/ou mordida cruzada posterior, apresentando comprometimento da estética do sorriso. Os pacientes foram tratados com expansão rápida da maxila (ERM), usando aparelho expansor de Hass, e expansor Arnold modificado (EAM). Conclusão: O EAM, que é um aparelho de baixo custo e não depende da colaboração do paciente, promoveu uma descompensação dentoalveolar por meio da verticalização dos dentes posteriores, necessitando de mínimo ou nenhum ajuste durante o tratamento. Os resultados pretendidos foram alcançados em três a quatro meses e cumpriram todos os objetivos do tratamento, como aumento do perímetro e largura da arcada, assim como o melhor alinhamento dos dentes.

Clinical complications during early treatment of anterior open bite

Abstract The object of this study was to compare the clinical complications of 4 different appliances used in the early treatment of anterior open bite (AOB), and to test the null hypothesis that there is no difference in the number of complications among the appliances. Records from 99 Class I malocclusion patients with AOB treated using bonded spurs, BS, n = 25; chin cup, CC, n = 25; fixed palatal crib, FPC, n = 25; and removable palatal crib, RPC, n = 24) were examined. The total number and frequency of clinical complications that occurred over 12 months were described and compared by using chi-square and Kruskal-Wallis tests (Dunn's post-test) (α = 5%, CI = 95%). The incidence of clinical complications was 66.7%, comprising: breakage, bond failure, maladjustment, allergy, soft-tissue lesion, loss of removable appliance and abandonment. Eighteen patients gave up treatment; this occurred more frequently in the groups with removable appliances. Regarding the total number of complications per patient, Group BS exhibited a significantly higher number than the other groups (p < 0.0001). A low frequency of complications (1 to 3) was found in the groups, except for Group BS, in which 8% of the patients presented moderate frequency (4 to 6). In terms of appliance types (fixed or removable), there was no difference in the incidence of complications (p > 0.094). The null hypothesis was rejected, since the BS group exhibited the highest total number and frequency of complications. There was no difference between fixed and removable appliances in terms of incidence of clinical complications, although more patients using removable appliances abandoned their treatment.

Indication of clear aligners in the early treatment of anterior crossbite: a case series

ABSTRACT Introduction: Anterior crossbite (AC) is defined as a reverse sagittal relationship between maxillary and mandibular incisors. According to an evidence-based orthodontic triage, the treatment need of AC is indicated if any occlusal interference is forcing the mandible towards a Class III growth pattern. Removable and fixed appliances have been suggested to correct AC. Objective: The present report aims at presenting the benefits of an alternative therapy for the early treatment of anterior crossbite using clear aligners. Methods: Two cases of anterior crossbite corrected using clear aligners in 8-years-old children are presented. Results: In both cases, AC was successfully corrected within 5 months. At the end of the treatment, overjet and overbite were corrected. No major discomfort or speech impairment was noticed by the parents. Conclusions: Due to the perceived shortcomings of alternative approaches, the use of clear aligners for correcting AC in mixed dentition should be considered as a comfortable and well tolerated appliance for young patients.

RESUMO Introdução: A mordida cruzada anterior (MCA) é definida como uma relação sagital reversa entre os incisivos superiores e inferiores. De acordo com a evidência científica, o tratamento da MCA é indicado em casos em que a interferência oclusal favorece o crescimento mandibular em direção a um padrão de Classe III. A literatura descreve diversos aparelhos removíveis e fixos para a correção dessa má oclusão. Objetivo: A presente série de casos tem como objetivo apresentar os benefícios de uma terapia alternativa para o tratamento precoce da MCA por meio do uso de alinhadores transparentes. Métodos: Apresentação de dois casos de MCA tratados com alinhadores transparentes em crianças de 8 anos de idade. Resultados: Em ambos os casos, a MCA foi corrigida com sucesso em um período de 5 meses. Ao fim do tratamento, obteve-se sobressaliência e sobremordida ideais. Segundo o relato dos pais, nenhum grande desconforto ou comprometimento na fala foi observado. Conclusões: Tendo em vista os problemas associados a algumas abordagens alternativas, o uso de alinhadores transparentes para correção da MCA durante a dentição mista pode ser considerado confortável e bem tolerado por pacientes jovens.

Patterns of Maxillary Canine Impaction in Iraqi Population

Abstract Objective: To investigate the prevalence of maxillary canine impaction and whether the impacted canine cases have had a potentially good or poor prognosis if interceptive treatment was practiced at earlier ages. Material and Methods: 1755 panoramic radiographs of patients, aged 13 to 60 years, attending the University of Babylon, College of Dentistry for the period from November 2016 to July 2018 were collected and assessed for the presence of impacted maxillary canines. Subsequently, four suggested prognostic factors for each impacted canine were analyzed and recorded. Results: The prevalence of maxillary canine impaction was 119 (6.78%) with 89 unilateral impaction and 30 bilateral impaction resulting in a total of 149 impacted canines. Regarding the gender, impaction was more evident in females 70 than in males 49 with no statistical significant difference. For the side, impaction was more prevalent on the left (77) than on the right (72), also with no statistical difference (p>0.05). Following the analysis of the four prognostic factors, most of the cases, 117 (78.5%) had at least one prognostic factor to be poor. Although 82 (55%) of the cases had at least one prognostic factor to be good, only 4 had all the prognostic factors to be good. Conclusion: Although the cases that had a potentially good prognosis were little (4 cases), interceptive extraction of primary canines would mostly be beneficial for these patients as it will minimize the treatment time, cost and complications.

MORDIDA CRUZADA ANTERIOR: POSSIBILIDADES DE TRATAMENTO NA DENTIÇÃO DECÍDUA E MISTA / ANTERIOR CROSSBITE: TREATMENT POSSIBILITIES IN DECIDUOUS AND MIXED DENTITION

A mordida cruzada anterior (MCA) refere-se a uma maloclusão cuja relação vestíbulo-lingual entre incisivos superiores e inferiores é anormal, com sobressaliência negativa. Esta alteração pode promover comprometimento da estética dento-facial e das funções do sistema estomatognático. A MCA pode ser classificada em 3 tipos: Dentária (MCAD), Funcional (MCAF) e esquelética (MCAE). O objetivo deste trabalho foi, por meio de uma revisão de literatura, apresentar as diferentes possibilidades de tratamento da MCA nas dentições decídua e mista. O tratamento da MCAD tem como objetivo a correção das inclinações anormais dos elementos envolvidos. O tratamento da MCAF pode ser realizado por movimentação dentária pelas pistas diretas preconizadas por Planas. A abordagem da MCAE tem como objetivo a correção esquelética e dependerá do grau de displasia óssea e da idade de início do tratamento. Concluiu- se que a MCA deve ser tratada tão logo seja diagnosticada, por meio das diferentes formas de tratamento apresentadas, de acordo com a etiologia e apresentação clínica. Todos os tratamentos propostos apresentam altos índices de sucesso se corretamente planejados e executados.

Anterior crossbite (MCA) refers to a malocclusion whose vestibular- lingual relationship between upper and lower incisors is abnormal, with a negative overjet. This alteration may promote impairment of dento-facial aesthetics and functions of the stomatognathic system. The MCA can be classified into 3 types: Dental (MCAD), Functional (MCAF) and skeletal (MCAE). The objective of this literature review was to present the different possibilities of MCA treatment in the deciduous and mixed dentitions. The treatment of MCAD aims at correcting the abnormal inclinations of the involved elements. The treatment of MCAF can be performed with composite as an inclined plane tracks recommended by Planas. The MCAE approach aims at skeletal correction and depends on the degree of bone dysplasia and the age at which treatment begins. According this study, we can conclude that the MCA should be treated as soon as diagnosed, by the different forms of treatment presented, according to etiology and clinical presentation. All the proposed treatments may have high success rates if correctly planned and executed.

Rapid maxillary expansion in the treatment of the functional posterior crossbite: joint noise and electromyographic activity analysis / Expansão rápida da maxila no tratamento da mordida cruzada posterior: análise de ruídos articulares e atividade eletromiográfica

Abstract Introduction The rapid maxillary expansion (RME) reduces the risk of developing structural and functional disorders in the stomatognathic system. Objective To examine the effects of the RME as a treatment for the posterior crossbite, related with the electromyographic activity of the masticatory muscles and the TMJ noises in a population of children. Material and method 13 girls and 7 boys, regardless of the type of malocclusion, with a mean age of 9 years old (± 3), were treated with RME. The electrovibratography analyzed the TMJ noise, and the electromyography analyzed the masticatory muscles before treatment (T0) and after three months of a short-term follow-up (T1). The comparisons of the affected and unaffected sides by the crossbite were performed using Mann-Whitney's test, and to compare data before and after treatment the Wilcoxon's test was used (level of significance: 5%). Result No significant differences were found in the parameters of joint noise in comparison to the sides affected and unaffected by the crossbite, in both T0 and T1 (p>0.05); only the side without the crossbite observed decrease in the peak amplitude of the joint noises after treatment. In the static electromyographic analysis, inter-side differences were observed before and after treatment, since the deliberate unilateral chewing showed greater asymmetry activity in T0 for both sides, which has been corrected after treatment, improving the functional chewing. Conclusion The proposed treatment did not lead to the occurrence of joint noises and improved the functional pattern of electromyographic activity during chewing at the end of treatment.

Resumo Introdução A expansão rápida da maxila (RME) reduz o risco de desenvolvimento de distúrbios estruturais e funcionais no sistema estomatognático. Objetivo Analisar os efeitos desta intervenção como tratamento para a mordida cruzada posterior, relacionados à ocorrência de ruídos nas articulações temporomandibulares e à atividade eletromiográfica dos músculos masseter e temporal anterior. Material e método 13 meninas e 7 meninos, independentemente do tipo de maloclusão, com idade média de 9 anos (±3), foram tratadas com RME. Por meio de eletrovibratografia analisou-se ruídos nas articulações temporomandibulares, e de eletromiografia de superfície a atividade dos músculos mastigatórios antes (T0) e após 3 meses do final do tratamento proposto (T1). As comparações entre os lados afetado e não afetado pela mordida cruzada foram realizadas utilizando-se o teste de Mann-Withney. As comparações de antes e após o tratamento foram realizadas pelo teste de Wilcoxon (nível de significância: 5%). Resultado Não houve diferença significativa na eletrovibratografia entre os lados afetado e não afetado pela mordida cruzada, tanto em T0 como em T1 (p>0.05); do lado sem mordida cruzada observou-se diminuição do pico de amplitude dos ruídos articulares após a expansão rápida da maxila (p<0.05). Na análise da eletromiografia estática foram observadas diferenças inter-lados antes e após o tratamento, uma vez que a mastigação deliberada unilateral apresentou maior atividade de assimetria em T0 para ambos os lados, o que foi corrigido após o tratamento (p<0.05), melhorando a mastigação funcional padrão. Conclusão O tratamento proposto para mordida cruzada posterior funcional não levou à ocorrência de ruídos articulares e melhorou o padrão funcional da atividade eletromiográfica durante a mastigação ao final do tratamento.

A review of the effectiveness and long-term stability of the functional appliance / 中华口腔医学杂志

The orthopedic treatment of the orthodontics is a typical and crucial technique and method that uses functional appliances to fully work out the potentials of the jaws and muscles, and accordingly to correct the functional or mild skeletal malocclusions in pre-pubertal children and adolescents. A successful orthopedic treatment involves its short-time effectiveness and its long-term stability. For many years, however, the effectiveness of the functional appliance is controversial and the long-term stability of the functional appliance has always been overlooked. Thus, with an aim of presenting guidelines on orthopedic treatment, the effectiveness and the long-term stability of the functional appliance are discussed in this article.

Effects of rapid maxillary expansion with six months of retention and no further orthodontic treatment / Efeitos da expansão rápida da maxila com 6 meses de contenção e sem posterior tratamento ortodôntico

Previous investigations addressing the long-term effects of rapid or slow expansion on the face and teeth involved the use of a orthodontic fixed appliance following expansion therapy. The present study evaluated changes in dentoskeletal aspects following rapid maxillary expansion (RME) and determine the stability of these changes over three years of follow up. Ten children with bilateral posterior crossbite were evaluated (experimental group). Dental casts and lateral cephalograms were evaluated prior to RME (T0) as well as three months (T1), one year (T2) and three years (T3) after RME. The measures were compared to a control group composed of 21 individuals using ANOVA and the Student's t-test (p > 0.05). Changes on the transverse plane revealed significant expansion of the upper dental arch three months after RME, stable after three years. Expansion at the cusp level was similar to that at the gingival level. No significant changes were found in the angular and linear cephalometric measures among T0, T1, T2 and T3, and in comparison to the control group (p > 0.05). We concluded that early RME produces stable transverse increases in the upper arch after three years without significantly altering sagittal and vertical dentoskeletal relationships, and neither inclined teeth.

A expansão rápida ou lenta da maxila seguida do uso de aparelhos ortodônticos fixos altera a face e os dentes. Este estudo avaliou as mudanças dentoesqueléticas após a expansão rápida da maxila (ERM) e determinou a estabilidade dessas mudanças em três anos de acompanhamento. Dez crianças com mordida cruzada posterior bilateral foram avaliadas (grupo experimental). Modelos de estudo e telerradiografias laterais foram avaliadas antes da ERM (T0), assim como três meses (T1), um ano (T2) e três anos (T3) após a ERM. As medidas foram comparadas às de um grupo controle composto de 21 pacientes por meio do teste ANOVA e teste t Student (p > 0,05). As mudanças no plano transversal revelaram uma expansão significante no arco superior três meses após a ERM, que se manteve estável após três anos. A expansão ao nível das cúspides foi similar à do nível gengival. Mas nenhuma diferença significante foi encontrada estre as medidas cefalométricas angulares e lineares ao longo dos períodos T0, T1, T2, e T3 e nem quando se comparou essas medidas às do grupo controle (p > 0,05). Conclui-se que A ERM precoce produz aumentos transversais estáveis no arco superior sem alterar significantemente as relações sagitais e verticais dentoesqueléticas e nem inclinar dentes.

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.

Diagnóstico e tratamento precoce da Classe III: relato de caso clínico / Class III diagnosis and early treatment: case report

No estudo das más oclusões, podem estar presentes tanto alterações dentárias como esqueléticas. Nos casos de má oclusão Classe III pode-se observar retrusão maxilar, protrusão mandibular ou a combinação destes sinais, e, muitas vezes associadas a uma atresia maxilar que geralmente se manifesta por mordidas cruzadas anteriores, posteriores, uni ou bilaterais. Este relato de caso clínico tem como objetivo avaliar os efeitos no perfil facial e na oclusão da terapia ortodôntica interceptativa. O tratamento realizado com expansão do arco superior e protração maxilar foi executado em idade bastante jovem para que atuasse efetivamente no sistema sutural circumaxilar e o efeito ortopédico fosse facilitado. A máscara facial utilizada apoia-se em dois pontos da face e permite um reposicionamento maxilar anterior. A colaboração do paciente é importante para alcançar o sucesso do tratamento, isto porque o tempo de uso da máscara ainda nesta fase de crescimento e desenvolvimento é primordial para que os efeitos faciais e oclusais aconteçam. É importante ressaltar que os pacientes com má oclusão de Angle Classe III devem ser acompanhados até o final do crescimento...

In malocclusion studies, may happen not only dental discrepancies but even skeletal discrepancies. In Class III malocclusion can be observed underdeveloped maxilla, mandible protraction or both of them, and, in most of the times associated with a narrow maxilla that causes anterior or posterior crossbites, in one side or in two sides. The aim of this case report is to evaluate the facial profile and occlusal effects of interceptive orthodontics therapy. The treatment with upper arch expansion and maxilla protraction was done in an early age to be effective in the circummaxillary sutural system and to make the orthopedic effect easier. The facial mask used is positioned on two facial points and allows an anterior maxillary replacement. Patients' compliance is important to reach treatment success, this because using the mask still in this growth and development phase is essential to make the facial and occlusal effects happen. It is important to mention that patients with Angle Class III malocclusion need to be followed till the end of their growth...

Space management during dentition development: a case report / Supervisão do espaço durante o desenvolvimento da dentição: relato de caso clínico

This case report describes a significant follow-up of a patient who had ectopic eruption. A 10-year-old child presenting a lower right second premolar with an eruption deviation was passively corrected. The 11 years follow-up showed the tooth with good root length, closed apex and functionally active. For proper positioning of the permanent tooth, the developmental phases of dentition as well as its eruption sequence, symmetry, and chronology were early observed by the practitioner. This unusual long-term follow-up case showed that space management during dentition development and opportune diagnosis can avoid more complicated orthodontic treatments in some cases.

Este caso clínico descreve um significativo acompanhamento de uma paciente com erupção ectópica. A paciente, com 10 anos de idade, apresentava o segundo pré-molar inferior direito com desvio de erupção, que foi passivamente corrigido. O acompanhamento de 11 anos do caso mostrou o dente com bom comprimento de raiz, ápice fechado e funcionalmente ativo. Para o correto posicionamento do dente permanente, as fases de desenvolvimento da dentição, assim como a sequência de erupção, simetria e cronologia foram observadas desde o início pelo profissional. Este interessante caso com acompanhamento em longo prazo demonstrou que a supervisão de espaço durante desenvolvimento da dentição e o diagnóstico oportuno podem evitar tratamentos ortodônticos mais complicados em alguns casos.

Influência da expansão rápida da maxila na rizólise dos caninos decíduos usados como ancoragem / Influence of rapid maxillary expansion on the root resorption of primary canines used as anchorage

OBJETIVOS: o presente estudo radiográfico, retrospectivo e longitudinal objetivou determinar se a ancoragem do aparelho expansor fixo tipo Haas, modificado para as dentaduras decídua e mista, interfere na velocidade de rizólise e esfoliação dos caninos decíduos. MÉTODOS: foi feita uma avaliação quantitativa da rizólise do canino decíduo mediante a medição do comprimento coroa-ápice dos caninos decíduos superiores, dos lados direito e esquerdo. Para essa avaliação, 24 crianças submetidas à expansão rápida da maxila (ERM) na dentadura decídua ou no início da dentadura mista foram comparadas com 15 crianças que não passaram por esse procedimento. A medição do comprimento coroa-ápice dos caninos decíduos foi realizada com o programa computadorizado CEF-X Cefalometria Digital, produzido pela CDT Informática, que permitiu calibrar o tamanho dos dentes pela uniformização das imagens radiográficas digitalizadas. RESULTADOS: os dados estatísticos revelaram que não houve diferença na velocidade de rizólise dos caninos decíduos entre as crianças do grupo controle e as do grupo submetido à ERM. CONCLUSÕES: é possível inferir que o aparelho expansor fixo tipo Haas ancorado em dentes decíduos não influencia a rizólise dos caninos decíduos usados como ancoragem.

AIM: The current radiographic, retrospective longitudinal study aim was to demonstrate whether the Haas fixed appliance, modified for the primary and mixed dentitions, interferes in the velocity of the root resorption and exfoliation of the primary canines. METHODS: It was evaluated the amount of root resorption of primary canines on the basis of measurements of the apex-crown length of right and left upper primary canines. For this measurement twenty-four children submitted to rapid maxillary expansion (RME) in the primary and mixed dentition were compared to 15 children who did not undergo such a procedure. The measurement of the apex-crown length of the primary canines was achieved with the CEF-X program that allowed the calibration and standardization of the image size. RESULTS: Statistical data revealed that no difference was found in the velocity of root resorption of the primary canines between the control and experimental groups. CONCLUSIONS: The findings of this study allow us to conclude that root resorption of primary canines has no relationship with RME.