Relationship between the polymorphism in the interleukin 1-β and the treatment time of patients subjected to a modified piezocision technique / Relación entre el polimorfismo en la interleucina 1-β y el tiempo de tratamiento de pacientes sometidos a una técnica de piezocisión modificada

Abstract Aim: We aimed to evaluate the correlation between the polymorphism of the interleukin 1-Beta (IL1-β, +3954 C>T) and tooth movement, in a group of Colombian patients undergoing surgically accelerated orthodontic tooth movement. Methods: The study was nested to a controlled clinical trial. Blood samples were taken from 11 women and 29 healthy Colombian male volunteers between 18 and 40 years old, after 1 year of starting orthodontic treatment. The patients presented malocclusion class I, with grade II or III. To detect the genetic polymorphism of the nucleotide +3954 C to T in the IL-1β gene, we used a real-time PCR assay. Results: Eleven individuals presented the allele 2 (T) heterozygous with the allele 1 (T/C) and 19 individuals were homozygous for the allele 1 (C/C). When analyzing the presence of the SNP, no significant differences were found in any of the variables. The best treatment was reflected in Group 3 (selective upper and lower alveolar decortication and 3D collagen matrix) and Group 4 (only selective alveolar decortication in the upper arch, with 3D collagen matrix), with 27% and 35% more speed respectively than in the control group. Conclusions: Our analyses indicated that a reduction in the total treatment time can be mostly potentiated by using decortication and collagen matrices and not for the presence of the allele 2 in the IL-1β. Nevertheless, it is important that further studies investigate if the polymorphism could be associated with the speed of tooth movement and analyze the baseline protein levels.

Resumen Objetivo: Evaluar la correlación entre el polimorfismo de la interleucina 1-Beta (IL1-β, +3954 C> T) y el movimiento de los dientes, en un grupo de pacientes colombianos sometidos a un movimiento dental ortodóncico acelerado quirúrgicamente. Métodos: Este fue un estudio secundario derivado de un ensayo clínico aleatorio controlado. Se tomaron muestras de sangre de 11 mujeres y 29 voluntarios varones colombianos sanos entre 18 y 40 años, después de 1 año de comenzar el tratamiento de ortodoncia. Los pacientes presentaron maloclusión clase I, con grado II o III. Para detectar el polimorfismo genético del nucleótido +3954 C a T en el gen IL-1β, se usó un ensayo de PCR en tiempo real. Resultados: 11 individuos presentaron el alelo 2 (T) heterocigoto con el alelo 1 (T / C) y 19 individuos fueron homocigotos para el alelo 1 (C / C). Al analizar la presencia del SNP, no se encontraron diferencias significativas en ninguna de las variables. El mejor tratamiento se reflejó en el Grupo 3 (decorticación alveolar superior e inferior selectiva y matriz de colágeno 3D) y el Grupo 4 (solo decorticación alveolar selectiva en el arco superior, con matriz de colágeno 3D), con un 27% y un 35% más de velocidad, respectivamente, que en el grupo de control. Conclusiones: Los análisis indicaron que una reducción en el tiempo total de tratamiento puede potenciarse principalmente mediante el uso de decorticación y matrices de colágeno y no por la presencia del alelo 2 en la IL-1β. Sin embargo, es importante que otros estudios investiguen si el polimorfismo podría estar asociado con la velocidad del movimiento de los dientes y analizar los niveles de proteína de referencia.

Relationship between the occlusal and sociodemographic characteristics of patients of a latin american postgraduate program in orthodontics / Relación entre las características oclusales y sociodemográficas de los pacientes de un posgrado latinoamericano de ortodoncia

Objective: To describe and compare the occlusal characteristics, and to determine their relationship with the sociodemographic characteristics in subjects who began treatment in the Postgraduate Program in Orthodontics at the University of Antioquia (Medellín-Colombia) between 2012-2016. Materials and Methods: This descriptive study included 106 patients (14-60 years, 52 women and 54 men). A calibrated investigator (Bland Altman: <1, Kappa: ≥0.8) evaluated the discrepancy index (DI), the dental aesthetic index (DAI) and sociodemographic variables in standardized initial records. Correlations and associations between them were established. Results: The DAI mean was 35.62±12.76 and the DI mean was 20.37±13.78. The great majority of patients (92.4%) belonged to low and medium-low socioeconomic strata. Differences were observed regarding oral breathing (p=0.02) and atypical swallowing (p=0.01) indices. Discussion: Despite the severity and high complexity in the index scores, contrary to what was expected, no correlation was found between them. It seems that malocclusions do not have a particular sociodemographic characterization, with aesthetics being the main reason for consultation. Conclusions: The patients evaluated had a high degree of treatment complexity according to the DI and a high severity of malocclusion according to the DAI. No relationships were found between the indices and sociodemographic variables, except for habits of oral breathing and atypical swallowing.

Objetivo: describir y comparar las características oclusales, y determinar su relación con las características sociodemográficas en los sujetos que iniciaron tratamiento en el Posgrado de Ortodoncia de la Universidad de Antioquia (Medellín-Colombia) entre 2012-2016. Materiales y métodos: este estudio descriptivo incluyó 106 pacientes (14-60 años, 52 mujeres y 54 hombres). Un investigador calibrado (Bland Altman: <1, Kappa: ≥0.8) evaluó en las ayudas iniciales estandarizadas el índice de discrepancia (DI), el índice de estética dental (DAI) y las variables sociodemográficas en la historia clínica. Se establecieron las correlaciones y asociaciones entre ellas. Resultados: el promedio DAI fue 35,62±12,76 y el promedio DI fue 20,37±13,78. El 92,4% pertenecía a estratos socioeconómicos bajo y medio bajo. Se observaron diferencias en los índices en los pacientes con respiración oral (p=0,02) y deglución atípica (p=0,01). Discusión: a pesar de la severidad y alta complejidad reflejadas en los puntajes de los índices, contrario a lo esperado, no se encontró correlación entre estos. Parece ser que la maloclusiones no tienen una caracterización sociodemográfica, siendo la estética el motivo de consulta principal. Conclusiones: los pacientes evaluados tuvieron un alto grado de complejidad de tratamiento según el DI y una alta severidad de la maloclusión según el DAI. No se encontraron relaciones entre los índices y las variables sociodemográficas excepto para hábito de respiración oral y deglución atípica

El concepto de umbral craneofacial y su código de lectura ABC / The concept of craniofacial threshold and its ABC reading code

Durante el crecimiento y desarrollo de la cabeza, ésta lo hace en diferentes direcciones y proporciones, habiendo un límite entre la armonía /desarmonía conocido como umbral. Se hace referencia a este concepto, la forma de escribirlo y leerlo por medio de un código que lo simboliza. Objetivo: Poner al alcance de la comunidad médica un código de lectura e identificación de fenotipos craneofaciales sindrómicos y no sindrómicos. Conclusiones: Se considera que este concepto de umbral craneofacial y su código de lectura pueden ser usados en la enseñanza e investigación de la armonía-desarmonía durante el crecimiento y desarrollo de la cabeza, resultando ser de gran utilidad en la comprensión rápida y sencilla de la lectura del fenotipo craneofacial (AU)

During the growth and development of the head, it does so in different directions and proportions, there being a limit between the harmony / disharmony known as threshold. Reference is made to this concept, the way of writing it and reading it by means of a code that symbolizes it. Objective: To put within reach of the medical community, a code of reading and identification of syndromic and non-syndromic craniofacial phenotypes. Conclusions: It is considered that this concept of a craniofacial threshold and its reading code can be used in the teaching and research of harmony / disharmony during the growth and development of the head, being very useful in the quick and easy comprehension of the reading of the craniofacial phenotype (AU)

Oclusión en niños con dentición mixta, estudio de patrón facial y tipo de oclusión en Ecuador / Occlusion in children with mixed dentition, facial pattern study and type of occlusion in Ecuador

Resumen Objetivo: Determinar la morfología facial y la asociación sagital interarcos en niños con dentición mixta. Materiales y método: Estudio descriptivo, observacional y transversal realizado en 100 escolares de 6 a 12 años de edad. La valoración clínica del perfil facial de la oclusión se realizó, mediante fotografías extraorales e intraorales y modelos de estudio por dos evaluadores examinadores con una confiabilidad en su criterio diagnóstico, considerando los criterios de Capelozza. Resultados: Se constató una relación estrecha entre el patrón facial con la clase molar y canina. Excepto el patrón II, en el cual sí existió correlación con la clase II molar, pero no con la clase II canina. Se evidenció mayor heterogeneidad en la distribución de las clases del patrón I. En el patrón II, las clases se presentaron más homogéneas con más del 70% de individuos con clase II, en su relación molar. La prueba Chi Cuadrado de Pearson determinó un p= 0,678 al considerar la relación canina de ambos lados. Conclusiones: El estudio reveló prevalencia de clase I canina decidua en ambos géneros. Clase I y II molar permanente en iguales proporciones en ambos géneros. Respecto a la edad, aquellos de entre 6 a 10 años fueron más tendientes a la clase II molar.

Abstract Objective: Define facial morphology and sagittal association in children with mixed dentition. Materials and methods: Descriptive, observational and cross-sectional study of 100 students aged 6 to 12 years. The clinical evaluation of the facial profile of the occlusion was made through extraoral and intraoral photographs and study models by two examining evaluators with a reliability in their diagnostic criteria, considering the Capelozza criteria. Results: A close relationship was found between the facial pattern with the molar and canine class. Except pattern II, in which there was correlation with class II molar, but not with canine class II. The heterogeneity in the distribution of the classes of pattern I was evidenced. In class II, the classes were more homogeneous with more than 70% of class II individuals in their molar relationship.The Pearson Chi Square test determined a p = 0.678 when considering the canine relationship on both sides. Conclusions: The study revealed prevalence of canine class I deciduous in both genders. Class I and II molar permanent in equal proportions in both genders. With regard to age, those between 6 and 10 years were more tending to class II molar.

Relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular. Artículo de revisión / Relation between the Syndrome type II division 2 malocclusions and the temporomandibular joint dysfunction. Review article

Introducción: Los pacientes con el Síndrome de clase II división 2, además de presentar clínicamente una relación de molares y caninos en disto-oclusión, muestran una retroinclinación de los incisivos centrales superiores con proinclinación de los laterales y sobremordida profunda, lo cual puede llegar a convertirse en un factor de riesgo que provoca disfunción temporomandibular. Objetivo: Identificar la relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular. Material y Métodos: Se realizó una revisión bibliográfica automatizada en las bases de datos de los sistemas MEDLINE, PubMed, Hinari y Google; se utilizó un total de 17 artículos. Desarrollo: Por las características clínicas de la oclusión en los pacientes con este síndrome, el rango de movimiento mandibular está limitado, y produce un efecto traumático que se relaciona con una posición de los cóndilos desplazados hacia atrás e intruidos en la fosa glenoidea. Este desplazamiento más distal produce la presión del espacio retrodiscal ricamente inervado y sería causa de inflamación de los tejidos circundantes y afectación de la función de la articulación por elongación de los ligamentos discales o adelgazamiento del disco que afecta el complejo cóndilo-disco. Conclusiones: Los estudios consultados muestran la relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular, dada las características clínicas presentes en este síndrome, que afectan el funcionamiento de la articulación temporomandibular y que al sobrepasar las capacidades adaptativas del paciente producen la disfunción en la misma(AU)

Introduction: Patients with Syndrome type II division 2 malocclusions, besides presenting a clinically established relationship between molars and canines in a distal occlusion, show a retro-inclination of the upper front teeth with pro-inclination of the lateral incisors and a deep overbite, which can result in a risk factor of temporomandibular dysfunction. Objective: To identify the relationship between Syndrome type II division 2 malocclusions and the temporomandibular dysfunction. Material and Methods: A bibliographic review was carried out through a search of databases such as MEDLINE, PubMed, Hinari, and Scholar Google. A total of 17 articles were used. Development: Because of the clinical characteristics of the occlusion in the patients with this syndrome, the range of jaw movement is limited, producing a traumatic effect that is related with a position of the condyles displaced backward and with glenoid fossa intrusion. This more distal displacement produces the pressure of the richly innervated retrodiscal tissue, which could be the cause of inflammation of the surrounding tissues and the affectation of the joint function due to an elongation of the discal ligaments or a thinning of the disc affecting the disc-condyle complex. Conclusions: The studies conducted demonstrate the relationship between the Syndrome type II division 2 and the temporomandibular joint dysfunction, given the clinical characteristics that are present in this syndrome, which affect the functioning of the temporomandibular joint, and produce its dysfunction when exceeding the adaptive capacities of the patient(AU)

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

Pacifier use modifies the association between breastfeeding and malocclusion: a cross-sectional study

Abstract This study aimed to evaluate the influence of breastfeeding and pacifier use on the occlusal status of preschool children. A cross-sectional study was conducted with children (n = 489) aged 2-5 years in private and public schools in Pelotas, South Brazil. Mothers answered a questionnaire on demographic, socioeconomic and behavioral variables, including breastfeeding and non-nutritive sucking habits. Malocclusion was classified as normal/mild and moderate/severe, according to WHO criteria. The association between breastfeeding and pacifier use with malocclusion was tested using multivariate logistic regression. The prevalence of malocclusion was 37.83% (95%CI 33.52-42.14), and 57.87% of the children used a pacifier. A total of 46.01% of the sample was exclusively breastfed for 6 months, and 24.74% were never breastfed. Malocclusion was associated with pacifier use, and with both non-exclusively breastfed and never breastfed. After adjustments for demographic and socioeconomic variables, the children who used a pacifier and were never breastfed (OR = 19.08; 95%CI 8.54-42.63), or who used a pacifier and were not exclusively breastfed (OR = 13.74; 95%CI 6.11-30.92), showed worse occlusal conditions, compared with the children who were exclusively breastfed and never used a pacifier. Pacifier use modifies the relationship between breastfeeding and occlusal status.

Subjective facial analysis and its correlation with dental relationships

ABSTRACT INTRODUCTION: Subjective facial analysis is a diagnostic method that provides morphological analysis of the face. Thus, the aim of the present study was to compare the facial and dental diagnoses and investigate their relationship. METHODS: This sample consisted of 151 children (7 to 13 years old), without previous orthodontic treatment, analyzed by an orthodontist. Standardized extraoral and intraoral photographs were taken for the subjective facial classification according to Facial Pattern classification and occlusal analyses. It has been researched the occurrence of different Facial Patterns, the relationship between Facial Pattern classification in frontal and profile views, the relationship between Facial Patterns and Angle classification, and between anterior open bite and Long Face Pattern. RESULTS: Facial Pattern I was verified in 64.24% of the children, Pattern II in 21.29%, Pattern III in 6.62%, Long Face Pattern in 5.96% and Short Face Pattern in 1.99%. A substantial strength of agreement of approximately 84% between frontal and profile classification of Facial Pattern was observed (Kappa = 0.69). Agreement between the Angle classification and the Facial Pattern was seen in approximately 63% of the cases (Kappa = 0.27). Long Face Pattern did not present more open bite prevalence. CONCLUSION: Facial Patterns I and II were the most prevalent in children and the less prevalent was the Short Face Pattern. A significant concordance was observed between profile and frontal subjective facial analysis. There was slight concordance between the Facial Pattern and the sagittal dental relationships. The anterior open bite (AOB) was not significantly prevalent in any Facial Pattern.

RESUMO INTRODUÇÃO: a análise facial subjetiva é um método diagnóstico que privilegia a avaliação morfológica da face; assim, o principal objetivo do presente trabalho foi comparar os diagnósticos faciais e dentários e investigar a correlação entre eles. MÉTODOS: a amostra consistiu de 151 crianças (7 a 13 anos de idade), sem nenhum tratamento ortodôntico prévio, analisadas por um ortodontista. Foram realizadas fotografias padronizadas extrabucais e intrabucais, para a classificação subjetiva dos Padrões Faciais e das relações dentárias segundo a classificação de Angle. Investigou-se a ocorrência de diferentes tipos de Padrões Faciais, em vistas frontal e de perfil; a relação entre os Padrões Faciais e as relações dentárias de Classe e, também, entre a má oclusão de mordida aberta anterior e o Padrão Face Longa. RESULTADOS: o Padrão Facial I (PF I) esteve presente em 64,24% das crianças; o PF II, em 21,29%; o PF III, em 6,62%; o PF Face Longa, em 5,96% e o PF Face Curta, em 1,99%. Observou-se concordância substancial entre a avaliação do PF na vista frontal e na de perfil, igual a 84% (Kappa = 0,69). Houve concordância entre a avaliação da relação dentária de Classe e do PF em 63% da amostra (Kappa = 0,27). O PF Face Longa não demonstrou maior prevalência da má oclusão de mordida aberta. CONCLUSÃO: os Padrões Faciais I e II foram os mais prevalentes em crianças, enquanto o menos prevalente foi o Padrão Face Curta. Verificou-se concordância significativa entre as análises faciais frontal e de perfil. Existe uma ligeira concordância entre o Padrão Facial e a relação sagital dentária. A mordida aberta anterior não se apresentou mais prevalente em nenhum tipo de Padrão Facial.

Un nuevo recurso para generar expansión transversal en los maxilares / A new resource to generate transversalexpansion in the jaws

La filosofía de la bioadaptación transversal de los maxilares preconiza una nueva forma de generar crecimiento a nivel de los tejidos dento alveolares, a través de una mecánica ortodoncia biológicamente más segura a la hora de realizar expansión transversal. El principio básico de esta filosofía no es soloel uso de brackets autoligantes, ni marcas comerciales específicas, ya que puede utilizarse cualquiera de ellas; se trata de no generar daños colaterales denominados “costos biológicos”, frecuentemente ligados a fuerzas excesivas. Se pretende proporcionar una menor fricción entre bracket y arco, reduciendo así el uso de aparatos auxiliares y el tiempo de tratamiento, aprovechando los beneficios de cada componente. Para generar el crecimiento transversal del maxilar es fundamental el uso de gomas intermaxilares, teniendo como tutores a los segundos molares superiores que son los menos afectados por las disfunciones. Podemos decir que después del correcto estímulo de una fuerza que inicie el proceso de desequilibrio y consecuente respuesta tisular, las fuerzas naturales de la musculatura oral, más las existentes en el sistema de brackets, serán suficientes para definir la necesaria bioadaptación dentoalveolar individual del paciente.

The transverse bioadaptation philosophy of the jaws advocates a new way of generating growth at thelevel of dentoalveolar tissues, through a biologically safer orthodontic mechanics when carrying outtransversal expansion. The basic principle of this philosophy is not only the use of self-ligating bracketsor specific trademarks, since any of them can be used, but also not to generate collateral damagescalled "biological costs" frequently due to excessive forces. Aiming at providing less friction betweenbracket and bow, thus reducing the use of auxiliary appliances and treatment time, taking advantageof the benefits of each component. In order to generate maxilla transversal growth the use ofintermaxillary gums is fundamental, having as tutor the upper second molars that are the least affectedby the dysfunctions. It can be stated that after the correct stimulus of a force that initiates the process of imbalance and consequent tissue response, the natural forces of the oral musculature plus thoseexisting in the bracket system will be sufficient to define the necessary individual dento alveolar bioadaptation of the patient.

Prevalencia de maloclusiones asociadas a trastornos temporomandibulares (TTM): análisis fotográfico / Prevalence of temporomandibular disorders (TMD) associated malocclusions: a photographic analysis

Los trastornos temporomandibulares (TTM) son alteraciones del funcionamiento del sistema estomatognático. Tienen etiologíamultifactorial y sintomatología variada. El objetivo del trabajo fue determinar la prevalencia de maloclusiones que se consideran asociadasal desarrollo de TTM en pacientes pre-ortodóncicos. Se analizaron 261 estudios fotográficos iníciales de pacientes entre 11 y 45 años, deambos sexos, que ingresaron a la Cátedra de Ortodoncia de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA). Se determinó la presencia o ausencia de las siguientes maloclusiones asociadas a TTM (MATTM): mordida invertida posteriorunilateral (MIPU), mordida invertida posterior bilateral (MIPB), mordida en tijera (MT), mordida invertida anterior (MIA), mordida abierta anterior (MAA) y mordida profunda (MP). De los 261 pacientes, se registraron 51(19,54 por ciento) sin MATTM, 154 pacientes(59 por ciento) presentaron al menos una MATTM, 52 pacientes (19,92 por ciento) presentaron dos MATTM, 3 pacientes (1,15 por ciento) presentaron tres MATTM y 1 paciente (0.39 por ciento) cuatro MATTM, 72 pacientes(27.58 por ciento) presentaron mordida invertida uni lateral (MIUL), 70 pacientes (26.82 por ciento) presentaron M.P, 46 pacientes (17.62 por ciento) presentaron MIA, 38 pacientes(14.55 por ciento) presentaron MAA, 33 pacientes (12.64 por ciento) presentaron MIBL y 12 pacientes (4.59 por ciento) presentaron MT. Se concluye que es importante realizar un minucioso examen clínico para evaluar la presencia de TTM previamente al tratamiento ortodóncico, ya que sólo el 19,54 por ciento de lospacientes evaluados no registró mal oclusiones asociadas a TTM, mientras que el 59 por ciento presentó al menos una. La maloclusión a pesar de que solo es uno de los factores etiológicos dentro de la etiología multifactorial del desarrollo de TTM, es importante tenerla en cuenta y darle una solución, idealmente de manera interdisciplinaria.

Temporomandibular disorders (TMD) are pathologies of the function of the stomatognathic system. They have a multifactorial etiologyand diverse symptomatology. The aim of the study was to determine the prevalence of malocclusions that are considered associated withTMD development in pre-orthodontic patients. A total of 261 initial photographic diagnostic studies were analyzed; these comprisedpatients between the ages of 11 and 45 from the Department of Orthodontics, FOUBA. The presence and absence of the followingTTM (MATTM) associated malocclusions was analyzed detected: unilateral posterior Crossbite (UPC), bilateral posterior Crossbite(BPC), scissor bite (SB), anterior Crossbite (AC), anterior open bite (AOB) and deep bite (DB). The findings in the 261 patientstreated were: 51 patients (19, 54%) presented MATMD, 154 patients (59%) presented at least one MATTM, 52 patients (19,92%)presented two MATTMs, 3 patients (1,15%) presented three MATTMs and 1 patient (0,39%) presented four MATTMs, 72patients (27,58%) presented IUPO, 70 patients (26,82%) presented DB, 46 patients (17,62%) presented (AC), 38 patients(14,55%) presented AOB, 33 patients (12,64%) presented BPC and 12 patients (4.59%) presented SB. It is concluded that it isimportant to carry out a thorough clinical examination to evaluate the presence of TMD prior to orthodontic treatment, as only 19,54%of the patients treated showed no malocclusions associated with TMD, while 59% presented at least one. Although malocclusions are onlysome of the etiological factors in the multifactorial etiology of TMD development, it is important to take them into account and provide asolution for them, ideally an interdisciplinary solution.

O impacto psicossocial da estética facial em crianças e adolescentes e apossibilidade de intervenções precoces: relato de dois casos clínicos / The psychosocial impact of facial aesthetics in children and adolescents and the possibility of early intervention: report of two clinical cases

Desarmonias do complexo craniofacial têm um profundo impacto na saúde psicossocial de crianças e adolescentes. Alterações de comportamento podem ser observadas em 24,7% dos indivíduos portadores dessas desarmonias. Aqui são discutidos os fatores envolvidos e relatados dois casos de duas crianças: uma portadora de severa classe II de Angle em dentição mista, e a outra portadora de severa classe III em dentição temporária. O restabelecimento da harmonia facial gerou alterações significativas no comportamento.

Disharmonies of the craniofacial complex have a profound impact on the psychosocial health of children and adolescents. Psichological changes can be observed in 24.7% of patients presenting these alterations. Here we discussed the factors involved reporting two cases of two children: One patient with severe Angle class II in mixed dentition and the other showing severe class III in temporary dentition. The reestablishment of facial harmony generated significant changes in psychosocial behavior.

Impacto del perfil facial en la apreciación de la personalidad / Impact of facial profile on personality assessment

Objetivo: determinar el impacto de los perfiles faciales y analizar si contribuyen a calificar a una persona de agradable, positiva, negativa, simpática, exitosa, alegre o amargada. Materiales y métodos: se modificó la fotografía de una paciente a fin de obtener cinco tipos de perfiles faciales, los cuales fueron evaluados mediante la escala de Likert por estudiantes de odontología, Los resultados fueron volcados en tablas con el programa Excel (Microsoft) y analizados mediante la prueba de ANOVA. Resultados: losperfiles de clase III fueron asociados a personas amargadas, menos exitosas, poco simpáticas y negativas. Los perfiles de clase II, a personas agradables, simpáticas, alegres y positivas. Los perfiles de clase I, a personas exitosas. Conclusiones: el perfil facial influye en la percepción de las personas. El perfil de clase III es asociado a valores socialmente negativos.

Validity of the Psychosocial Impact of Dental Aesthetics Questionnaire for use on Brazilian adolescents

ABSTRACT Introduction: The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is a multi-item psychometric instrument used to assess patients' perspective of the impact specifically related to Orthodontics. The cross-culturally adapted Brazilian version of the PIDAQ has demonstrated good reliability, validity and acceptability. Objective: The aim of the present study was to test the validity and reliability of the Brazilian version of the PIDAQ for use among adolescents aged between 11 and 14 years old. Methods: Having established the possibility of maintaining the operational characteristics of the Brazilian version of PIDAQ for the target age group, 194 individuals in the city of Belo Horizonte, Brazil, completed the questionnaire. The subjects were examined for the presence/absence of malocclusion based on the criteria of the Dental Aesthetic Index (DAI) to test discriminant validity. Internal consistency was measured by means of Cronbach's alpha coefficient which ranged from 0.59 to 0.86 for the subscales. Test-retest reliability was assessed by means of intraclass correlation coefficient which ranged from 0.54 to 0.89 for aesthetic concern and psychological impact. Results: Discriminant validity revealed that subjects without malocclusion had different PIDAQ scores in comparison to those with malocclusion. Conclusion: These findings suggest that the Brazilian version of PIDAQ for adolescents has satisfactory psychometric properties and is applicable to this age group in Brazil.

RESUMO Introdução: o Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) é um instrumento psicométrico utilizado para avaliar a qualidade de vida relacionada à saúde bucal (QVSB), especificamente no que diz respeito à má oclusão do paciente. A versão brasileira adaptada culturalmente do PIDAQ demonstrou boa confiabilidade, validade e aceitabilidade. Objetivo: o objetivo do presente estudo foi verificar a validade e confiabilidade da versão brasileira do PIDAQ para uso em adolescentes brasileiros na faixa etária de 11 a 14 anos. Métodos: tendo-se estabelecido a possibilidade de manter a versão brasileira do PIDAQ que havia sido validada, esse questionário foi aplicado em 194 indivíduos, da faixa etária-alvo, residentes na cidade de Belo Horizonte, Brasil. Para testar a validade discriminante, os adolescentes foram examinados quanto à presença ou ausência de má oclusão, com base nos critérios do Dental Aesthetic Index (DAI). A confiabilidade foi medida pela consistência interna do instrumento (alfa de Cronbach = 0,59-0,86) e pelo teste-reteste, por meio do coeficiente de correlação intraclasse (ICC), que apresentou valores superiores a 0,8 para os domínios autoconfiança, impacto social e impacto psicológico, o que indica uma concordância satisfatória entre as avaliações. Resultados: a validade discriminante revelou uma diferença estatisticamente significativa entre os escores médios para os domínios de autoconfiança dentária e impacto psicológico, entre os grupos com e sem má oclusão. Conclusão: esses resultados sugerem que a versão brasileira do PIDAQ para adolescentes tem propriedades psicométricas satisfatórias e é aplicável a esse grupo etário no Brasil.

Parent-assessed quality of life among adolescents undergoing orthodontic treatment: a 12-month follow-up

Objective: To assess parents' and caregivers' view of the first twelve months of adolescents' orthodontic treatment with fixed appliances and to assess the evaluative properties of the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) in the orthodontic setting.Methods:Data from a sample of 96 parents and caregivers of adolescents undergoing orthodontic treatment with fixed appliances were collected by means of P-CPQ. Assessments were performed before banding and bracket bonding (T1) and 12 months after placement of fixed appliances (T2). Statistical analysis included Wilcoxon signed-rank test for the overall P-CPQ score and Bonferroni correction for P-CPQ subscales. The evaluative properties of the P-CPQ were assessed through responsiveness calculation and the minimally clinical important difference (MCID).Results: Among the 96 participants, 76 were mothers of patients, 16 were fathers, and four were other family members. Adolescents' mean age was 11.49 ± 0.50 years. Most families earned equal to or less than three times the Brazilian monthly minimum wage. There was significant improvement in the emotional and social well-being subscales (p< 0.001), which contributed to improve patient's overall quality of life (p< 0.001). Reductions in scores were associated with clinically meaningful moderate changes in the overall score as well as in the emotional and social well-being subscales. The MCID was 6.16 for the P-CPQ overall score.Conclusion:Parents and caregivers reported significant improvement in the quality of life of adolescents undergoing orthodontic treatment with fixed appliances.

Objetivo: avaliar as percepções de pais e cuidadores com relação à qualidade de vida de adolescentes durante os primeiros 12 meses de tratamento ortodôntico com aparelhos fixos, e examinar as propriedades técnicas da versão brasileira do questionário Parental-Caregiver Perceptions Questionnaire(P-CPQ) no cenário ortodôntico.Métodos:dados de uma amostra de 96 pais e cuidadores de adolescentes em tratamento ortodôntico com aparelhos fixos foram coletados através do questionário P-CPQ. As avaliações foram realizadas antes da bandagem e colagem de braquetes (T1) e 12 meses após a colocação do aparelho fixo (T2). A análise estatística incluiu o teste Wilcoxon signed rankpara o escore total do P-CPQ e a correção de Bonferroni para as subescalas do questionário. As propriedades técnicas do P-CPQ foram examinadas por meio do cálculo da responsividade e da mínima diferença clinicamente importante (MDCI).Resultados:dos 96 participantes, 76 eram mães de pacientes, 16 eram pais e 4 possuíam outra relação familiar. A idade média dos adolescentes foi de 11,49 ± 0,50 anos. A maioria das famílias tinha uma renda mensal igual ou menor a três salários mínimos brasileiros. Houve uma melhora significativa nas subescalas de bem-estar emocional e bem-estar social, que contribuíram para uma melhora do escore total de qualidade de vida (p< 0,001). As reduções dos escores do P-CPQ foram associadas com alterações clinicamente moderadas para o escore total e para as subescalas de bem-estar emocional e bem-estar social. A MDCI para o escore total do P-CPQ foi de 6,16.Conclusões: pais e cuidadores relataram uma melhora significativa na qualidade de vida de adolescentes em tratamento ortodôntico com aparelhos fixos.

Association between Bolton discrepancy and Angle malocclusions

This study aimed to assess and compare the overall and anterior ratios of tooth size discrepancies in all Angle malocclusion groups. The following null hypothesis (H0) was tested: no difference between tooth size discrepancies (overall and anterior) would be observed among Angle malocclusion groups. The sample comprised of 711 pre-orthodontic treatment study casts of Brazilian patients with a mean age of 17.42 years selected from private practices in Brazil. The casts were divided into 3 groups according to the type of malocclusion: Class I (n = 321), Class II (n = 324), and Class III patients (n = 66). The measurement of the greatest mesiodistal width of the teeth was performed using a centesimal precision digital caliper directly on the study casts, from the distal surface of the left first molar to the distal surface of the right first molar. The overall and anterior ratios between the maxillary and mandibular teeth were evaluated using Bolton’s method. The following statistical tests were applied: chi-square, independent t-test, and one-way ANOVA. Results showed that all Angle malocclusions groups exhibited a ratio compatible with those recommended by Bolton. With respect to the overall and anterior ratios among the malocclusion groups, no statistically significant differences were found. The null hypothesis was accepted because the results showed no differences in the overall and anterior ratios of tooth size discrepancies among different Angle malocclusion groups.

Björk-Jarabak cephalometric analysis on CBCT synthesized cephalograms with different dentofacial sagittal skeletal patterns

OBJECTIVE: The objective of this study was to evaluate the Björk and Jabarak cephalometric analysis generated from cone-beam computed tomography (CBCT) synthesized lateral cephalograms in adults with different sagittal skeletal patterns. METHODS: The sample consisted of 46 CBCT synthesized cephalograms obtained from patients between 16 and 40 years old. A Björk and Jarabak cephalometric analysis among different sagittal skeletal classes was performed. Analysis of variance (ANOVA), multiple range test of Tukey, Kruskal-Wallis test, and independent t-test were used as appropriate. RESULTS: In comparison to the standard values: Skeletal Class III had increased gonial and superior gonial angles (P < 0.001). This trend was also evident when sex was considered. For Class I males, the sella angle was decreased (P = 0.041), articular angle increased (P = 0.027) and gonial angle decreased (P = 0.002); whereas for Class III males, the gonial angle was increased (P = 0.012). For Class I females, the articular angle was increased (P = 0.029) and the gonial angle decreased (P = 0.004). Björk's sum and Björk and Jabarak polygon sum showed no significant differences. The facial biotype presented in the three sagittal classes was mainly hypodivergent and neutral. CONCLUSIONS: In this sample, skeletal Class III malocclusion was strongly differentiated from the other sagittal classes, specifically in the mandible, as calculated through Björk and Jarabak analysis. .

OBJETIVO: o objetivo deste estudo foi avaliar a análise cefalométrica de Björk-Jarabak realizada com base em telerradiografias sintetizadas a partir de tomografia computadorizada de feixe cônico (TCFC) em adultos com diferentes padrões esqueléticos sagitais. MÉTODOS: a amostra foi composta de 46 telerradiografias sintetizadas a partir de TCFC obtidas de pacientes entre 16 e 40 anos de idade. A análise cefalométrica de Björk-Jarabak foi conduzida entre as diferentes classes esqueléticas sagitais. Análise de variância (ANOVA), teste de Tukey, de Kruskal-Wallis e teste t independente também foram realizados. RESULTADOS: em comparação a valores padrão, a má oclusão de Classe III esquelética apresentava ângulos goníacos aumentados (p < 0,001). Essa tendência também foi evidente quando o sexo dos pacientes foi considerado. Pacientes Classe I do sexo masculino tiveram o ângulo sela diminuído (p = 0,041), o ângulo articular aumentado (p = 0,027) e o ângulo goníaco também diminuído (p = 0,002). Já os pacientes Classe III tiveram o ângulo goníaco aumentado (p = 0,012). Pacientes Classe I do sexo feminino tiveram o ângulo articular aumentado (p = 0,029) e o ângulo goníaco diminuído (p = 0,004). A soma de Björk e a soma dos polígonos de Björk-Jarabak não revelaram diferenças significativas. O biótipo facial presente nas três classes sagitais foi hipodivergente e neutro. CONCLUSÕES: na amostra do presente estudo, a má oclusão esquelética de Classe III foi fortemente diferenciada de outras classes sagitais, ...

Dissatisfaction with dentofacial appearance and the normative need for orthodontic treatment: determinant factors

OBJECTIVE: This study aims at assessing the normative need for orthodontic treatment and the factors that determine the subjective impact of malocclusion on 12-year-old Brazilian school children. METHODS: A total of 451 subjects (215 males and 236 females) were randomly selected from private and public schools of Juiz de Fora, Brazil. The collected data included sociodemographic information and occlusal conditions. The esthetic subjective impact of malocclusion was assessed by means of the Orthodontic Aesthetic Subjective Impact Score - OASIS, whereas the malocclusion and the need for orthodontic treatment were assessed by means of the Dental Aesthetic Index (DAI) and the Index of Orthodontic Treatment Need-Aesthetic Component (IOTN-AC). RESULTS: Prevalence of normative need for orthodontic treatment was 65.6% (n = 155), and prevalence of orthodontic esthetic subjective impact was 14.9%. The following variables showed significant association with esthetic subjective impact of malocclusion: female (p = 0.042; OR = 0.5; CI = 0.2-0.9), public school student (p = 0.002; OR = 6.8; CI = 1.9-23.8), maxillary overjet ≥ 4 mm (p = 0.037; OR = 1.7; CI = 1-3) and gingival smile ≥ 4 mm (p = 0.008; OR = 3.4; CI = 1.3-8.8). CONCLUSION: The normative need for orthodontic treatment overestimated the perceived need. Occlusal and sociocultural factors influenced the dissatisfaction of schoolchildren with their dentofacial appearance. .

OBJETIVO: o objetivo desse estudo foi avaliar a necessidade normativa de tratamento ortodôntico e os fatores que determinam o impacto subjetivo da má oclusão, em escolares brasileiros de 12 anos. MÉTODOS: um total de 451 indivíduos (215 homens e 236 mulheres) foi selecionado aleatoriamente de escolas públicas e particulares de Juiz de Fora, Minas Gerais. Os dados coletados incluíam informações sociodemográficas e condições oclusais. O impacto estético subjetivo da má oclusão foi avaliado pelo Orthodontic Aesthetic Subjective Impact Score (OASIS). A avaliação da má oclusão e a necessidade de tratamento ortodôntico foram avaliadas pelo Dental Aesthetic Index (DAI) e pelo Index of Orthodontic Treatment Need-Aesthetic Component (IOTN-AC). RESULTADOS: a prevalência da necessidade normativa de tratamento ortodôntico foi de 65,6% (n = 155) e a prevalência do impacto estético ortodôntico subjetivo foi de 14,9%. As seguintes variáveis mostraram associação significativa com impacto estético subjetivo da má oclusão: sexo feminino (p = 0,042, OR = 0,5, IC = 0,2-0,9); aluno de escola pública (p = 0,002, OR = 6,8, IC = 1,9-23,8); ≥ 4mm (p = 0,037, OR = 1,7; ICI = 1-3); e sorriso gengival ≥ 4mm (p = 0,008, OR = 3,4, IC = 1,3-8,8). CONCLUSÃO: a necessidade normativa de tratamento ortodôntico superestimou a necessidade percebida. Fatores oclusais e socioculturais influenciaram a insatisfação de escolares com a aparência dentofacial. .

Características de la oclusión en niñas y niños malienses, cubanos y venezolanos de 5 a 9 años: estudio descriptivo / A descriptive study of malocclusion in Malian, Cuban and Venezuelan 5-9 year-old children

Introducción El conocimiento del estado de salud bucal de la población es indispensable para la correcta planificación, organización, dirección y control de la atención estomatológica. Su evaluación periódica permite conocer los logros alcanzados en la aplicación de programas de atención primaria y hacer los ajustes necesarios para el cumplimiento de los objetivos y estrategias. En este contexto, la intervención con ortodoncia temprana permite promover el desarrollo favorable de la oclusión y suprimir los cambios desfavorables. Objetivos El presente estudio busca explorar las características de la oclusión dentaria en niñas y niños malienses, cubanos y venezolanos; provenientes de Bamako, Malí, en África (en el período 2006 a 2008), en el estado de Portuguesa en Venezuela (de 2011 a 2013), y en el municipio Bartolomé Masó de Granma, Cuba (desde 2009 hasta 2011). Además pretende determinar la prevalencia, clasificar las maloclusiones según la categorización de Angle e identificar los factores de riesgos asociados a las oclusiones. Materiales y métodos Se realizó un estudio descriptivo-transversal, utilizándose el muestreo probabilístico aleatorio simple-estratificado, dependiendo de la edad del paciente, del tiempo transcurrido en cada misión –que fue de dos años- y el lugar donde se efectuó el estudio. Dentro de los pacientes que acudieron a los servicios odonto-estomatológicos para su atención básica, se seleccionaron aquellos que tenían entre cinco y nueve años cumplidos, recogiendo los datos en un formulario confeccionado para estos efectos. Resultados La maloclusión más observada se produce en los niños cubanos con 79,1 por ciento, le siguen los venezolanos que presentaron 67,2 por ciento y los malienses 40 por ciento. En relación a la clasificación de Angle, sigue siendo la clase I la que predomina por sobre las demás, con registros de 50,2 por ciento en malienses, 58,5 por ciento en venezolanos y 78,7 por ciento en los cubanos.

Introduction Awareness of the oral health status of a population is indispensable to correctly plan, organize, direct and supervise dental care. Its periodic evaluation allows monitoring the progress of primary dental care programs, and introducing necessary adjustments in order to accomplish dental care goals. In this context, early orthodontic intervention allows correct development of oral occlusion and prevents complications. Objective The purpose of this study is to study dental occlusion characteristics in Malian, Cuban, and Venezuelan children from Bamako, Mali (between 2006 and 2008), the state of Portuguesa, Venezuela (between 2011 and 2013), and Bartolome Maso in Granma, Cuba (between 2009 and 2011). It also aims to determine prevalence, to classify malocclusion according to Angle criteria, and to identify risk factors for this condition. Methods A descriptive cross-sectional study was conducted using simple or stratified random sampling depending on the patient’s age, the time period of the mission (two years) and the place where the study was conducted. Among the patients seeking basic dental care, those who were between five and nine years old were included and their data collected in a form designed for that purpose. ResultsMalocclusion is most frequently found in Cuban children (79.1 percent), followed by Venezuelan children (67.2 percent) and Malian children (40 percent). Angle type I malocclusion predominates with 50.2 percent in Malian, 58.5 percent in Venezuelan, and 78.7 in Cubans. One of the most important risk factors was dental cavities in the three groups: 91.8 percent in Malian, 78.26 percent in Venezuelan, and 34.7 percent in Cubans. Deforming oral habits were also observed from 40.7 percent, 65.5 percent up to 72.1 percent. Premature tooth loss appeared between 60 percent and 84.1 percent and was directly related to dental cavities. Interproximal cavities and defective dental restorations were also observed.

Comparative evaluation of cephalometric and occlusal characteristics between the Long Face pattern and Pattern I

OBJECTIVE: To compare the cephalometric and intraoral characteristics between Long Face pattern and Pattern I patients, besides evaluating associations between subjective facial patterns, cephalometric facial patterns and the intraoral characteristics. METHODS: Through evaluation of frontal and right side extraoral photographs, three previously calibrated and experienced examiners selected 30 Long Face patients (Group 1) and 30 Pattern I patients (Group 2), aged between 9 and 19 years, of both genders. The cephalometric characteristics were assessed by the following variables: SN.GoGn, NS.Gn, AIFH, SNA, SNB, ANB, 1.1, 1.NA,1-NA, 1.NB, 1-NB, NA.Po, nasolabial angle and H-Nose. Clinical evaluations were also performed to determine the presence of posterior crossbite, anterior open bite and type of Angle's malocclusion. The cephalometric data were compared by independent t test. The chi-square test was used to evaluate the association between qualitative variables. RESULTS: Significant differences were observed between groups regarding the variables SN.GoGn, NS.Gn, AIFH, ANB, NA.Pog, 1-NA, 1.NB and 1-NB, with an increase of these measures in Group 1. There were also significant differences between groups on variable 1.1, being lower in Group 1 than in Group 2. CONCLUSIONS: The Long Face was associated to Angle Class II malocclusion, to the presence of posterior crossbite and to anterior open bite. The Long Face subjective facial pattern was associated to dolichofacial cephalometric pattern.

OBJETIVO: comparar características cefalométricas e intrabucais entre pacientes Padrão Face Longa e Padrão I, além de avaliar as associações entre os padrões faciais subjetivos, os padrões faciais cefalométricos e as características intrabucais. MÉTODOS: por meio da avaliação das fotografias extrabucais frontal e lateral direita, três examinadores experientes e previamente calibrados selecionaram 30 pacientes Padrão Face Longa (grupo 1) e 30 pacientes Padrão I (grupo 2), com idades entre 9 e 19 anos, de ambos os sexos. As características cefalométricas foram avaliadas por meio das seguintes variáveis: SN.GoGn, NS.Gn, AFAI, SNA, SNB, ANB, 1.1, 1.NA, 1-NA, 1.NB, 1-NB, NA.Pog, ângulo nasolabial e H-Nariz. Também foram realizadas avaliações clínicas para determinar a presença de mordida cruzada posterior, mordida aberta anterior e o tipo de má oclusão segundo Angle. Os dados cefalométricos obtidos foram comparados pelo teste t independente. Utilizou-se o teste c² para avaliar a associação entre as variáveis qualitativas. RESULTADOS: foram observadas diferenças estatisticamente significativas entre os grupos em relação às variáveis cefalométricas SN.GoGn, NS.Gn, AFAI, ANB, NA.Pog, 1-NA, 1.NB e 1-NB, com um aumento dessas medidas para o grupo 1. Ainda houve diferença significativa entre os grupos na variável 1.1, sendo menor no grupo 1 do que no grupo 2. CONCLUSÕES: o padrão face longa apresentou-se associado à má oclusão de Classe II de Angle, à presença de mordida cruzada posterior e à mordida aberta anterior. O padrão facial subjetivo face longa apresentou-se associado ao padrão facial cefalométrico dolicofacial.

Skeletal maturation of the cervical vertebrae: association with various types of malocclusion

The identification of the skeletal maturation stage of the cervical vertebrae has proven an important reference for orthodontic diagnosis. The aim of the present study was to determine the association between the skeletal maturation stage of the cervical vertebrae and types of malocclusion according to the age and gender of participants. A total of 361 individuals (168 males and 193 females) between 8 and 14 years of age were selected from a convenience sample. Malocclusions were diagnosed through study models using the Angle classification. Maturation stages of the cervical vertebrae were determined using the method proposed by Hassel and Farman. Statistical analysis involved the chi-square test (p £ 0.05) and multiple logistic regression (forward stepwise procedure). Significant differences were observed between the stage of skeletal maturation of the cervical vertebrae and gender at ages 11, 12 and 14 years. Males with Class II malocclusion were twice as likely to be in Stage 1 or 2 of cervical vertebra maturation than individuals with Class I malocclusion (OR = 2.1 [CI 95%, 1.33-3.18]). There were no differences between individuals with Class I and Class III malocclusions. The association between skeletal maturation of the cervical vertebrae and type of malocclusion was significant, suggesting a skeletal component in the determination of Class II malocclusions.