Virtual orthodontic setup in orthodontic camouflage planning for skeletal Class III malocclusion

ABSTRACT The purpose of this paper was to emphasize the importance of the orthodontic setup in treatment planning for skeletal Class III malocclusion correction in an adult patient with moderate lower anterior crowding and anterior crossbite associated with two supernumerary lower incisors.

RESUMO O objetivo desse artigo é enfatizar a importância do setup ortodôntico no planejamento do tratamento da má oclusão de Classe III esquelética de uma paciente adulta com apinhamento anteroinferior moderado e mordida cruzada anterior associada à presença de dois incisivos inferiores supranumerários.

Periodontal and dental effects of surgically assisted rapid maxillary expansion, assessed by using digital study models

OBJECTIVE: The present study assessed the maxillary dental arch changes produced by surgically assisted rapid maxillary expansion (SARME). METHODS: Dental casts from 18 patients (mean age of 23.3 years) were obtained at treatment onset (T1), three months after SARME (T2) and 6 months after expansion (T3). The casts were scanned in a 3D scanner (D-250, 3Shape, Copenhagen, Denmark). Maxillary dental arch width, dental crown tipping and height were measured and assessed by ANOVA and Tukey's test. RESULTS: Increased transversal widths from T1 and T2 and the maintenance of these values from T2 and T3 were observed. Buccal teeth tipping also showed statistically significant differences, with an increase in all teeth from T1 to T2 and a decrease from T2 to T3. No statistically significant difference was found for dental crown height, except for left first and second molars, although clinically irrelevant. CONCLUSION: SARME proved to be an effective and stable procedure, with minimum periodontal hazards. .

OBJETIVOS: o presente estudo teve o objetivo de avaliar as alterações dentárias e periodontais decorrentes da Expansão Rápida da Maxila Assistida Cirurgicamente (ERMAC). MÉTODOS: foram obtidos os modelos de gesso de 18 pacientes (média de idade de 23,3 anos), ao início (T1), 3 meses após a ERMAC (T2) e 6 meses após a expansão (T3). Os modelos foram digitalizados (Scanner 3D 3Shape D-250) e mensuraram-se as distâncias transversais, bem como a inclinação e a altura da coroa clínica dos dentes posteriores. Para análise dos resultados, aplicou-se a análise de Variância e o teste de Tukey. RESULTADOS: nas distâncias transversais, observou-se um aumento de T1 para T2 e uma manutenção de T2 para T3. As inclinações dentárias demonstraram diferenças estatisticamente significativas em alguns dentes; porém, numericamente tenderam a um aumento de T1 para T2 e a uma diminuição de T2 para T3. Não se observou diferença estatisticamente significativa na altura da coroa clínica, exceto nos primeiros e segundos molares do lado esquerdo, porém, clinicamente irrelevante. CONCLUSÕES: a ERMAC demonstrou ser um procedimento efetivo e estável, com mínima repercussão periodontal. .

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion

INTRODUCTION: This study assessed the three-dimensional changes in the dental arch of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusions at three different periods. METHODS: Landmarks previously identified on upper and lower dental casts were digitized on a three-dimensional digitizer MicroScribe-3DX and stored in Excel worksheets in order to assess the width, length and depth of patient's dental arches. RESULTS: During orthodontic preparation, the maxillary and mandibular transverse dimensions measured at the premolar regions were increased and maintained throughout the follow-up period. Intercanine width was increased only in the upper arch during orthodontic preparation. Maxillary arch length was reduced during orthodontic finalization, only. Upper and lower arch depths were stable in the study periods. Differences between centroid and gingival changes suggested that upper and lower arch premolars buccaly proclined during the pre-surgical period. CONCLUSIONS: Maxillary and mandibular dental arches presented transverse expansion at premolar regions during preoperative orthodontic preparation, with a tendency towards buccal tipping. The transverse dimensions were not altered after surgery. No sagittal or vertical changes were observed during the follow-up periods. .

INTRODUÇÃO: esse estudo avaliou as alterações tridimensionais ocorridas na morfologia das arcadas dentárias de pacientes submetidos ao tratamento ortodôntico-cirúrgico para a correção da má oclusão de Classe II, em três períodos distintos: (T1) modelos iniciais, (T2) modelos pré-cirúrgicos imediatos (de 1 a 15 dias antes da cirurgia) e (T3) modelos pós-cirúrgicos (mínimo de 6 meses após a remoção do aparelho ortodôntico). MÉTODOS: pontos previamente demarcados em cada modelo foram digitalizados por meio do digitalizador tridimensional MicroScribe-3DX, cujas coordenadas, armazenadas em planilhas do programa Excel, deram origem a valores que possibilitaram a avaliação da largura, comprimento e profundidade das arcadas dentárias. RESULTADOS: durante o preparo ortodôntico, houve aumentos nas distâncias transversais superiores e inferiores medidas na região de pré-molares que se mantiveram no período total de acompanhamento. Apenas a distância intercaninos superior apresentou alterações de aumento durante o preparo ortodôntico, assim como a largura da arcada superior, que diminuiu durante a fase de finalização. A profundidade de ambas as arcadas manteve-se estável nas fases avaliadas. Diferenças entre as mudanças dos pontos centroide e gengival sugerem que os pré-molares superiores e inferiores inclinaram para vestibular durante o preparo ortodôntico pré-cirúrgico. CONCLUSÇÕES: conclui-se que as arcadas dentárias superiores e inferiores sofreram expansão transversal na região de pré-molares durante o preparo ortodôntico pré-cirúrgico, com tendência à inclinação vestibular de todos os dentes posteriores. Após a cirurgia, as dimensões transversais ...

Pattern and management of palatine bone fractures

The aim of this study was to determine pattern of palatal fractures, review management options and find out other injuries associated with it. This retrospective study was carried out in the Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Peshawar over a period of three years. All the patients having maxillofacial injuries were evaluated for the presence of palatal fractures. Orthopantomogram [OPG] and Para Nasal sinus [PNS] views were advised to each patient. CT scan and 3D CT scan were advised in cases with pan facial trauma and comminuted fractures. All the data were entered in specially designed proforma. A diagnosis of palatal fracture was made after correlating clinical and radiographic signs. The pattern of palatal fractures was determined along with associated facial injuries. A total of 65 cases of palatal fractures were found in this study. Majority of patients [33.8%] were in the 3rd decade of life. Regarding the pattern of fracture, majority [65%] were sagittal fractures. Most of these fractures [54%] occurred with maxillary Le Fort fractures, regarding management, 9% of the cases were treated with open reduction while 81% were managed with closed reduction techniques. Palatal fracture is often overlooked and is a cause of post op malocclusion in trauma patients. Patients with palatal bone fractures were mostly males in their 3rd decade of life. Sagittal fractures were common and the Le Fort fractures were associated with it. Closed reduction was done in most of the cases of palatal bone fractures

Flexural strength of mini-implants developed for Herbst appliance skeletal anchorage: a study in Minipigs br1 cadavers

OBJECTIVE: The present study was designed to verify if mini-implant prototypes (MIP) developed for Herbst appliance anchorage are capable of withstanding orthopedic forces, and to determine whether the flexural strength of these MIP varies depending on the site of insertion (maxilla and mandible). METHODS: Thirteen MIP were inserted in three minipig cadavers (six in the maxilla and seven in the mandible). The specimens were prepared and submitted to mechanical testing. The mean and standard deviation were calculated for each region. A two-way Student's t test was used to compare the strength between the sites. A one-way Student's t test was performed to test the hypothesis. Orthopedic forces above 1.0 kgf were considered. RESULTS: The MIP supported flexural strength higher than 1.0 kgf (13.8 ± 2.3 Kg, in the posterior region of the maxilla and 20.5 ± 5.2 Kg in the anterior region of the mandible) with a significantly lower flexural strength in the anterior region of the mandible (P < 0.05). CONCLUSION: The MIP are capable of withstanding orthopedic forces, and are more resistant in the anterior region of the mandible than in the posterior region of the maxilla in Minipigs br1 cadavers.

OBJETIVO: o presente estudo foi delineado para verificar se protótipos de mini-implantes (PMI) desenvolvidos para a ancoragem esquelética do aparelho de Herbst são capazes de suportar forças ortopédicas e, também, determinar a variação da força de flexão desses PMI de acordo com o local de inserção (maxila ou mandíbula). MÉTODOS: após o cálculo do tamanho da amostra, 13 PMI foram colocados em três cadáveres de Minipigs br1 (seis na maxila e sete na mandíbula). Os corpos de prova foram preparados e submetidos a um teste mecânico. Cálculos da média e o do desvio-padrão foram realizados para cada região. O teste t de Student para duas amostras não pareadas foi utilizado para comparar a resistência dos PMI entre as regiões de inserção. O teste t de Student para uma amostra foi realizado para o teste de hipótese. Foram consideradas forças ortopédicas aquelas acima de 1,0kgf. RESULTADOS: os PMI foram capazes de suportar forças de flexão maiores que 1,0kgf (13,8 ± 2,3Kg na região posterior da maxila, e 20,5 ± 5,2Kg na região anterior da mandíbula), apresentando significativa menor força de flexão na região anterior da mandíbula (p < 0,05). CONCLUSÃO: os PMI são capazes de suportar forças ortopédicas, sendo mais resistentes quando utilizados na região anterior da mandíbula do que na posterior da maxila, em cadáveres de Minipigs br1.

Survival of dental implants in native and grafted bone in irradiated head and neck cancer patients: A retrospective analysis.

Aim: To study the long-term survival of dental implants placed in native or grafted bone in irradiated bone in subjects who had received radiation for head and neck cancer. Materials and Methods: A retrospective chart review was conducted for all patients who received dental implants following radiation treatment for head and neck cancer between May 1, 1987 and July 1, 2008. Only patients irradiated with a radiation dose of 50 Gy or greater and those who received dental implants in the irradiated field after head and neck radiation were included in the study. The associations between implant survival and patient/implant characteristics were estimated by fitting univariate marginal Cox proportional hazards models. Results: A total of 48 patients who had prior head and neck radiation had 271 dental implants placed during May 1987-July 2008. There was no statistically significant difference between implant failure in native and grafted bone (P=0.76). Survival of implants in grafted bone was 82.3% and 98.1% in maxilla and mandible, respectively, after 3 years. Survival of implants in native bone in maxilla and mandible was 79.8% and 100%, respectively, after 3 years. For implants placed in the native bone, there was a higher likelihood of failure in the maxilla compared to the mandible and there was also a tendency for implants placed in the posterior region to fail compared to those placed in the anterior region. Conclusion: There was no significant difference in survival when implants were placed in native or grafted bone in irradiated head and neck cancer patients. For implants placed in native bone, survival was significantly influenced by the location of the implant (maxilla or mandible, anterior or posterior).

Characteristics of malocclusion in Iraqi orthodontic patients anteroposterior dental arch relationship

The aim of the study was to determine variability of anteroposterior dental arch relationship in orthodontic patients and type of treatment used. A group of pretreated orthodontic patients were examined clinically for the classification of malocclusion [the anteroposterior relationship] according to Angles classification and type of treatment needed in a group of 1550 patient. The results showed that there was no significant differences in anteroposterior relationship according to gender and there was a decrease in rate of class I, and an increase in class II both divisions and thus an increase in the severity of malocclusion during the last decade and a need for more complicated orthodontic procedures

Tratamento cirúrgico conservador de cisto dentígero / Conservative surgical treatment of a dentigerous cyst

Os autores descrevem um caso de cisto dentígero em um paciente de 8 anos de idade, no qual se realizou marsupializaçäo da lesäo e manutençäo do comprimento do arco dental, o que permitiu a erupçäo dos dentes permanentes associados sem tracionamento ortodôntico. O paciente foi rigorosamente acompanhado e verificou-se perfeita reparaçäo óssea do local da lesäo

Expansäo rápida da maxila cirúrgicamente assistida / Rapid maxillary expansion with surgical assistance

A expansäo rápida da maxila é atualmente procedimento rotineiro na clínica ortodôntica. Conceitualmente, as dificuldades para sua execuçäo aumentam com a idade em funçäo da progressiva obliteraçäo sutural que, iniciada ao final do crescimento maxilar, confere uma resistência esqueletal significativa, principalmente ao nível das suturas maxilo zigomática e maxilo frontal. A liberaçäo cirúrgica destes fatores limitantes têm sido adotada e a descriçäo da técnica e sua indicaçäo apresentada neste artigo

Influência de duas técnicas cirúrgicas diferentes sobre a forma do arco dentário de portadores de fissura transforame incisivo unilateral / The influence of two different surgical techniques on the dental arch form of unilateral complete cleft lip and palate patients

Duas condutas cirúrgicas diferentes - a primeira compreendendo queiloplastia realizada, em média, aos 6,6 meses, e palatoplastia, aos 18,8 meses, e, a segunda, queiloplastia executada, em média, aos 5,6 meses, palatoplastia anterior aos 21,6 meses e palatoplastia posterior aos 30 meses - foram realizadas no reparo de fissuras transforme incisivo unilateral. A influência dessas condutas distintas sobre a morfologia dos arcos dentários foi avaliada em modelos de gesso de crianças com idade entre 8 e 12 anos, encontrando-se resultados muito similares entre os dois grupos fissurados. Esses resultados foram comparados com um grupo de crianças näo fissurados com oclusäo normal