Incidence of Dental Caries and Associated Factors in the School Period in a Municipality in Southern Brazil

Abstract Objective: To estimate the incidence of dental caries and associated factors in the school period from six/seven to ten years of age. Material and Methods: A longitudinal study involving 168 children was followed up between 2015 and 2019 in the municipality of Palhoça, Brazil. The dependent variable was the caries incidence rate in the mixed dentition. The independent variables included information regarding demographic and socioeconomic status. Multivariate analyzes were carried out using Poisson Regression with a robust estimator. Variables with p <0.20 in the bivariate analysis were included in the adjusted model. Relative risks were estimated, as well as 95% confidence intervals. Results: Of 168 followed schoolchildren, 32 developed the disease, providing an incidence rate of 19.0%. Female children had a 10% higher risk [RR = 1.10 (95% CI 1.03; 1.18)] of developing caries than males. Also, children born from fathers with ≤ 8 years of schooling at baseline had a 9% higher risk [RR = 1.09 (95% CI 1.01; 1.16)] of developing dental caries compared to fathers with higher education. Conclusion: The incidence of dental caries in a four-year period was 19.0%. Females and children born from fathers with a lower level of education showed higher incidence rates.

Duración de la erupción dental prefuncional temporal y permanente en la población de Villa Clara / Duration of temporary and permanent prefunctional tooth eruption in Villa Clara population

Introducción: En Cuba ha sido poco estudiado el tiempo que demora el diente, desde que aflora a la cavidad bucal hasta que alcanza el plano oclusal. Objetivo: Determinar la duración de la erupción clínica prefuncional temporal y permanente en la población de Villa Clara. Métodos: Se realizó un estudio epidemiológico descriptivo entre los años 2014 a 2018. Mediante un muestreo polietápico aleatorio simple se obtuvo una muestra de 2 584 niños y adolescentes (520 entre tres meses y cuatro años para la dentición temporal, y 2 064 entre cuatro y 14 años para la permanente), nacidos en la provincia, sin alteraciones del crecimiento general y craneofacial; se observó el brote; se calcularon por medio de la regresión de probit, las edades medias para los dientes brotados sin contacto oclusal y las que habían alcanzado la oclusión. La duración de la erupción clínica prefuncional fue calculada restando las medianas de ambas variables. Resultados: En los dientes temporales demoró más la erupción clínica prefuncional en los 1ros molares (superiores, 0,63; inferiores, 0,62); en los permanentes, en los incisivos centrales inferiores de hombres y mujeres, 1 y 1,07, respectivamente. Conclusiones: La erupción clínica prefuncional para los dientes permanentes osciló entre cuatro meses y un año; para los temporales, entre cuatro y siete meses con diferencias dentarias. Se elaboró una tabla de duración de la erupción clínica prefuncional de los dientes temporales y permanentes ajustada a la población villaclareña.

Introduction: the time the tooth takes to emerge from the oral cavity until it reaches the occlusal plane has been little studied in Cuba. Objective: to determine the duration of temporary and permanent prefunctional clinical tooth eruption in Villa Clara population. Methods: a descriptive and epidemiological study was carried out from 2014 to 2018. A sample of 2,584 children and adolescents who were born in the province without alterations in general and craniofacial growth was obtained through simple random multistage sampling (520 between three months and four years for temporary dentition and 2,064 between four and 14 years for permanent one); the outbreak was observed; the mean ages for teeth eruption without occlusal contact and those that had reached occlusion were calculated by means of probit regression. The duration of the prefunctional clinical eruption was calculated by subtracting the medians of both variables. Results: prefunctional clinical eruption took longer in temporary (upper, 0.63 and lower, 0.62) 1st molars, as well as in permanent lower central incisors of men and women (1 and 1.07, respectively). Conclusions: prefunctional clinical eruption for permanent teeth ranged from four months to one year and for temporary ones between four and seven months presenting dental differences. A table of the duration of the prefunctional clinical eruption of temporary and permanent teeth was created according to Villa Clara population.

Uso del twin-block en niños de 5 a 12 años con maloclusión Clase II y III. Revisión de la literatura / Use of the twin-block in patients aged 5 to 12 years with class II and III malocclusion. Literature Review

Introducción: las maloclusiones Clase II y III pueden ser tratadas desde edades tempranas y su manejo oportuno incluye el reconocimiento, diagnóstico y tratamiento adecuado. Desde la visión ortopédica, teniendo en cuenta la presencia de momentos de crecimiento y desarrollo, podrían planificarse diversas aparatologías removibles, ortopédicas, miofuncionales y/o fijas. El twin-block está constituido por bloques de mordida superior e inferior con un plano inclinado que dirige la fuerza de oclusión a fomentar la función mandibular normal. Objetivo: efectuar una revisión de la literatura sobre el uso del twin-block y su efectividad en pacientes de 5 a 12 años con maloclusión Clase II y III. Métodos: se realizó una revisión de literatura en las bases de datos electrónicas en inglés PUBMED/MEDLINE, Elsevier, Epistemonikos y Google Schoolar; y en idioma español, imbiomed. org, Scielo.org y Google académico. Se incluyeron un total de 16 artículos. Los años límites para la búsqueda fueron enero de 2011 a junio de 2022. La revisión abarcó aspectos referidos al uso del twin-block en niños con maloclusión Clase II y III. Resultados: los estudios reportaron resultados favorables al uso efectivo del twin-block para la corrección de las maloclusiones, con cambios esqueléticos y dentoalveolares en dentición permanente y mixta. Conclusiones: la evidencia científica revisada sugiere que el uso del twin-block es efectivo en pacientes pediátricos con maloclusión Clase II o III.

Introduction: Class II and III malocclusions could be treated from early ages and their timely management includes recognition, diagnosis and adequate treatment; this from the orthopedic view due to the presence of moments of growth and development, various removable, orthopedic, myofunctional and/or fixed appliances could be planned. The twinblock consists of upper and lower bite blocks with an inclined plane that directs the occlusal force to promote normal mandibular function. Objective: To review the literature on the use of the twin-block in patients 5 to 12 years of age with class II and III malocclusion. Methods: A descriptive, retrospective research was carried out in the electronic databases PUBMED/MEDLINE, Elsevier, Epistemonikos and Google Scholar; and in the Spanish language imbiomed.org, Scielo.org and Google Scholar a total of 16 articles were included. The years for the search were January 2011 to June 2022. The review covered aspects referring to the effectiveness of the use of the twin-block in children with type II and III malocclusion. Results: The studies reported favorable results for the effective use of the twin-block for the correction of malocclusions producing skeletal and dentoalveolar changes in permanent and mixed dentition. Conclusions: The scientific evidence reviewed suggests that the use of the twin-block is effective in pediatric patients with class II or III malocclusion

Ortodoncia interceptiva con alineadores en un paciente con mordida cruzada en período de dentición mixta / Interceptive orthodontics with clear aligners in a patient with crossbite in a mixed dentition period

La mordida cruzada es una maloclusión que debe recibir tratamiento precoz ya que es potencial causa de desviaciones mandibulares, asimetría facial y trastornos de disfunción temporomandibular. En general se acompaña de la necesidad de estimulación del desarrollo transversal del maxilar superior. En este artículo presentamos un caso clínico tratado con alineadores en el que se planteó como objetivo de primera fase la expansión transversal, con el fin de corregir su mordida cruzada lateral y mejorar la posición de los caninos permanentes en etapa pre-eruptiva en una paciente de 9 años. Luego de dos etapas cortas de tratamiento con alineadores, los resultados fueron satisfactorios. El caso se acompaña de fotos, radiografías y renders iniciales y finales.

Crossbite is a type of malocclusion that must receive early treatment due to its potentiality of causing mandibular deviations, facial asymmetry, and temporomandibular disorders. Generally, it is accompanied by the need to stimulate the transverse development of upper jaw. In the following article, a clinical case will be presented in which a nine-year-old patient was treated with clear aligners in the first phase with the aim of performing the transversal expansion, to correct the lateral crossbite and improving the position of the permanent impacted canines in pre-eruptive stages. After two short treatment stages with clear aligners, the results were positive. The clinical case is complemented with its pertinent clinical photos, radiographies, and renders, both initial and final.

Cierre de diastema con alineadores en dentición mixta / Diastema closure with aligners in mixed dentition

En la dentición mixta y permanente temprana, el diastema puede ser una preocupación estética importante para los pacientes y/o sus padres. Este artículo describe el tratamiento de ortodon cia con placas alineadoras, realizado en una pacien- te de 9 años de edad, con diastema interincisivo. Luego de 10 meses de tratamiento, se lograron los objetivos propuestos. El caso se acompaña con fotos, radiografías y renders iniciales y finales(AU)

In mixed and early permanent dentition, diastema can be a major aesthetic concern for patients and their parents. This article describes the orthodontic treatment with aligning plates, performed on a 9-year-old patient with an interincisal diastema. After ten months of treatment, the proposed objectives were achieved. The case is accompanied by photos, x-rays and initial and final renders.

Mesiodens en dentición temporal y mixta: informe de casos / Mesiodens in primary and mixed dentition: case reports

Objetivo: Presentar una serie de casos clínicos de me- siodens en niños con dentición temporal y mixta, su trata- miento y seguimiento. Casos clínicos: Se muestra el manejo clínico de tres casos de mesiodens en dentición temporal y un caso en den- tición mixta, los cuales fueron diagnosticados en un examen radiográfico de rutina (AU)

Aim: To present a series of clinical cases of mesiodens in children with primary and mixed dentition, their treatment and follow-up. Clinical cases: This paper describes the clinical man- agement of three cases of mesiodens in primary dentition and one case in mixed dentition which were diagnosed in routine radiographic examinations (AU)

What Factors are Associated with Health-Related Quality of Life in Mixed Dentition Children?

Abstract Objective: To associate the OHRQoL and HRQoL in mixed dentition children with the influence on age range, socioeconomic and clinical variables. Material and Methods: A cross-sectional study was carried out with 1,240 children between 6 and 12 years of age. HRQoL was assessed by the Quality of Life Assessment Scale, considered an outcome variable. OHRQoL was determined using specific questionnaires related to the age group: Oral Health Impact Scale in Early Childhood, Child Perceptions Questionnaire for 8 to 10 years, and 11 to 12 years. Dental caries and malocclusion were diagnosed. The socioeconomic class was evaluated. A multiple negative binomial regression analysis was used to test the relationship between HRQoL, OHRQoL scores and socioeconomic and clinical variables. Correlation analyses were performed between the total HRQoL and OHRQoL, with a significance level of 5%. Results: The HRQoL is inversely related to the impact of OHRQoL (p<0.05), modulated by the age group. There was a significant weak negative correlation between the HRQoL scores and the impact of OHRQoL (p<0.05). Conclusion: The OHRQoL impacts the HRQoL, modulated by the age group and with minor influence from socioeconomic and clinical variables (AU).

Maloclusiones funcionales y su relación con hábitos orales en niños con dentición mixta / Functional malocclusions and their association with oral habits in children with mixed dentition

Objetivo: Relacionar la prevalencia de maloclusiones funcionales con hábitos orales en niños con dentición mixta. Materiales y métodos: La muestra estuvo constituida por 61 pacientes que asistieron a la Facultad de Odontología de la UNNE entre los meses de abril y noviembre de 2018, seleccionados mediante un muestreo al Azar Sistemático. Se evaluó en ellos la presencia de maloclusiones funcionales como mordidas abiertas y cruzadas, líneas medias desviadas, apiñamiento dentario, resalte maxilar. Como hábitos orales se consideró la succión digital, interposición lingual y deglución atípica, interposición de labios y objetos, respiración bucal, onicofagia. Se realizó un análisis descriptivo empleando el software estadístico InfoStat Versión 2019 y para conocer la asociación entre las maloclusiones funcionales y los hábitos orales se emplearon pruebas de Chi cuadrado (nivel de signi- ficación de P ≤0,05). Resultados: Se observó la presencia de maloclusiones funcionales en un 64% de los niños, y se encontró que el api- ñamiento dentario fue el predominante con un 39%. La pre- valencia de hábitos orales fue de 66%, la interposición labial y de objetos fue la que se detectó con mayor frecuencia con un 39%. Se observó mayor presencia de mordida abierta en pacientes con hábitos parafuncionales como ser succión digi- tal e interposición lingual. La asociación entre maloclusiones funcionales y hábitos orales fue estadísticamente significativa (χ 2 = 6,17, P = 0.0130). Conclusión: Se identificó una alta prevalencia de malo- clusiones funcionales en niños con dentición mixta, asociadas a hábitos orales (AU)

Aim: To determine the association between prevalence of functional malocclusions and oral habits in children with mixed dentition. Materials and methods: The sample consisted of 61 patients who attended the UNNE School of Dentistry from April to November 2018, selected through systematic random sampling. Presence of functional malocclusions such as open bite, crossbite, deviated midlines, dental crowding, and maxil- lary protrusion were evaluated. The oral habits of finger suck- ing, lingual interposition and atypical swallowing, interposi- tion of lips and objects, mouth breathing, and onychophagia were considered. A descriptive analysis was performed using the Statistical Software InfoStat Version 2019. Chi-square tests were used to determine the association between function- al malocclusions and oral habits (significance level P ≤0.05). Results: Functional malocclusions were present in 64% of the children, with dental crowding being the most prevalent, in 39%. Prevalence of oral habits was found in 66%, with la- bial and object interposition having the highest frequency, in 39%. Open bite was more frequent in patients with parafunc- tional habits such as finger sucking and lingual interposition. The association between functional malocclusions and oral habits was statistically significant (χ2 = 6.17, P = 0.0130). Conclusion: High prevalence of functional malocclu- sions was identified in children with mixed dentition, associ- ated with oral habits (AU)

Valoración de las dimensiones del paladar y su relación con alteraciones verticales / Avaliação das dimensões do palato e sua relação com alterações verticais / Assessment of palate dimensions and its relation with vertical alterations

Objetivos: La presente investigación tuvo como objetivo establecer la correlación entre la presencia de maloclusiones a nivel vertical con el índice del paladar y con la altura palatina. Materiales y Métodos: Estudio de tipo transversal. La población de estudio fue conformada por 134 modelos de yeso con dentición mixta, 81 mujeres y 53 hombres, seleccionados por conveniencia y obtenidos desde el 2014 hasta el 2018 del área de clínica de odontopediatría y ortodoncia en la Escuela Nacional de Estudios Superiores Unidad León. La muestra de estudio fue dividida en 3 categorías según la oclusión; mordida abierta (37), mordida profunda (32) y normoclusión (65). Se realizaron mediciones del ancho intermolar y altura del paladar con el uso de un calibrador digital, posteriormente se obtuvo el índice del paladar y se correlacionó con los parámetros expuestos por Korkhaus mediante la prueba estadística de Spearman. Resultados: La prueba estadística de Spearman refleja que no hay correlación entre la magnitud de los valores del índice del paladar propuestos por Korkhaus con la presencia de maloclusiones a nivel vertical. De igual manera las pruebas estadísticas indican que no existe correlación notable entre la altura del paladar y la oclusión en relación vertical. Conclusiones: El resultado obtenido al usar el índice del paladar no fue capaz de corresponder a los parámetros propuestos por Korkhaus como normales, posiblemente al ser usado durante la etapa de la dentición mixta pues durante este periodo suceden cambios constantes relacionados al crecimiento.

Objetivos: Os objetivos a presente investigação buscou valor uma correlação entre a presença de más oclusões em nível vertical com o índice do palato e com a altura palatina. Materiais e Métodos: Estudo do tipo transversal. A população do estudo foi composta por 134 modelos de gesso com dentição mista, 81 mulheres e 53 homens, selecionados por conveniência e obtidos de 2014 a 2018 na área de Odontopediatria e Ortodontia na Escola Nacional de Ensino Superior Unidade de León. A amostra do estudo foi dividida em 3 categorias de acordo com a oclusão; mordida aberta (37), mordida profunda (32) e normoclusão (65). A medida da largura intermolar e da altura do palato foi feita com o uso de um paquímetro digital, o índice de palato foi posteriormente obtido e relacionado aos parâmetros expostos por Korkhaus por meio do teste estatístico de Spearman. Resultados: O teste estatístico de Spearman mostra que não há correlação entre a magnitude dos valores do índice de palato proposta por Korkhaus e a presença de más oclusões verticais. Da mesma forma, os testes estatísticos indicam que não há correlação notável entre a altura do palato e a oclusão na relação vertical. Conclusões: O resultado obtido com o uso do índice de palato não foi capaz de corresponder aos parâmetros propostos por Korkhaus como normais, possivelmente quando usado durante o estágio de dentição mista, porque durante este período há mudanças constantes relacionadas ao crescimento

Purpose: The aim of the present study is to assess the relation between vertical malocclusions with palatal index and palatal height. Materials and Methods: Transversal study. The sample consisted in 134 stone models within mixed dentition, 81 females and 53 males, they were convenience selected and obtained from the pediatric and orthodontic dentistry medical center at the National School for Superior Studies Unit León since 2014 to 2018. The stone models were divided into three categories according to their kind of occlusion: open bite (37), deep bite (32) and normal bite (65). Palatal width and height were measure by using a digital caliper. Subsequently the palatal index was obtained and it was related with the parameters exposed by Korkhaus using the Spearman statistical test. Results: The Spearman statistical test indicated there is no a clearly relationship between palatal index values exposed by Korkhaus with the presence of vertical malocclusions and in the same way there is no a relationship between palatal height and vertical malocclusions.Conclusions: The result obtained by using the palatal index was no able to indicate an agreement with Korkhaus parameters. Probably this disagreement was due to the constant changes that occur during the period of the mixed dentition.

Prevalence and Associated Factors of Dental Trauma in Six-Year-Old School-Children

ABSTRACT Objective: To estimate the prevalence and associated factors of dental trauma in 6-year-old school children in the city of Palhoça, Brazil. Material and Methods: Cross-sectional study nested in a cohort study. It involved a representative sample of school children born in 2009, residing in the municipality and regularly enrolled in public and private schools (n = 1,102). Clinical data were obtained through oral exams. To evaluate the incisal overjet, the distance in millimeters was measured horizontally from the labial surface of the lower central incisor to the labial surface of the upper incisor. Bivariate analyses were performed using the Chi-square test, with a p-value <0.05 considered statistically significant. Multivariate analyses using Poisson Regression were performed to identify independent associations between the prevalence and the independent variables studied. Results: Prevalence of dental trauma was 4.2% (95% CI 3.0-5.4). Dental trauma was statistically associated with studying in a private school (PR = 1.03; 95% CI 1.01-1.06) (p=0.016) and with inadequate lip coverage (PR = 1.08; 95% CI 1.01-1.14) (p=0.016). Conclusion: The prevalence of 4.2% of dental trauma in six-year-old children, associated with inadequate and greater lip coverage in children from private schools should be taken into account, since most teeth at this stage are newly erupted.

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 study of age-related sensory innervation of the anterior hard palate / 华西口腔医学杂志

OBJECTIVES@#The present study aimed to explore the innervation of the anterior hard palatine and its relationship with individual development stage. Specifically, the effects of anesthesia on patients of different ages were observed, and neurodevelopment in the maxillofacial region was invesitgated. References that are helpful in selecting local anesthesia were provided.@*METHODS@#A total of 182 patients with mixed dentition were randomly divided into the nasopalatine nerve block and greater palatine nerve block groups. Then, 219 patients with permanent dentition were divided into an adolescent group (13-18 years old) and adult group (over 19 years old), all of whom underwent bilateral greater palatine nerve block. Palatal mucosal pain sensation was tested pre- and post-anesthesia with Von Frey hairs.@*RESULTS@#Among the children with mixed dentition, bilateral greater palatine nerve block tended to result in better anesthetic effects than nasopalatine nerve block (@*CONCLUSIONS@#The sensation of the anterior hard palatine seems mainly dominated by the greater palatine nerve until mixed dentition and gradually shifted to the nasopalatine nerve in conjunction with maxillary development and tooth replacement. Hence, the innervation of the anterior hard palatine induce a secondary development during the development of the maxilla.

Importance of orthodontic intervention of the Class III malocclusion in mixed dentition

ABSTRACT Introduction: Supervising the development of occlusion, managing problems during the transition from mixed to permanent dentition, as well as controlling environmental factors that contribute to establishing malocclusion, are important actions to achieve a Class I occlusion with facial balance. Among these problems, the malocclusions associated with dysfunctions such as mouth breathing or obstructive sleep apnea syndrome (OSAS), atypical swallowing and abnormal tongue position, open bites, crossbites and maxillomandibular discrepancies, and especially the Class III malocclusion can be listed. Objective: The purpose of this article is to present and discuss the main aspects relevant to the benefits of performing the treatment of Class III malocclusion in patients with growth.

RESUMO Introdução: A supervisão do desenvolvimento da oclusão e o gerenciamento de problemas durante a transição da dentição mista para a permanente, bem como o controle de fatores ambientais que contribuem para estabelecer a má oclusão, são importantes ações para se obter uma oclusão de Classe I com equilíbrio facial. Entre esses problemas, pode-se considerar más oclusões associadas às disfunções como respiração bucal ou síndrome da apneia obstrutiva do sono (SAOS), deglutição atípica, posição anormal da língua, mordidas abertas e mordidas cruzadas e discrepâncias maxilomandibulares, especialmente, a má oclusão de Classe III. Objetivo: O objetivo do presente artigo é apresentar e discutir os principais aspectos pertinentes aos benefícios de se realizar o tratamento da má oclusão de Classe III em pacientes com crescimento.

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.

Morphological changes of frankel functional regulator III in mixed dentition with class III malocclusion / Cambios morfológicos del regulador funcional frankel III en dentición mixta con maloclusión clase III

The aim of this study was to evaluate the hard and soft tissue profile changes following treatment of functional and mild skeletal class III malocclusion in mixed dentition by means of the Frankel functional regulator (FR-3) appliance, and to reveal the mechanism and effectiveness of treatment with FR-3 appliance. Twenty-six patients (chronological mean age, 8.7±1.4 years; mean treatment duration, 10.3±1.3 months) with functional and mild skeletal class III malocclusion were selected and treated with FR-3 appliances. Lateral cephalogram was taken pre- and post-treatment, and the data was analyzed by paired-samples t test with SPSS22.0 software package. Differences were considered statistically significant at P < 0.05. The results demonstrated that the FR-3 appliance produced a statistically significant decrease in L1-NB, L1-MP, U1-L1 (P<0.01) and an increase greatly in ANB, MP-FH, Y axis, ANSMe, ANS-Me/N-Me and overjet (P<0.01). SNA, SNB were increased significantly (P<0.05). Meanwhile, N'-Sn-Pog', ULSn-SN, LLSiSN increased, S-N'-Si, LL-EP decreased with significant difference (P<0.01). S-N'-Sn, Cm-Sn-UL, UL-EP, Sn-Mes and Ns-Mes increased with significant difference (P<0.05). Therefore it was concluded that after FR-3 treatment, the position of mandible may rotate clockwise backwards and downwards, with the labioversion of upper incisors and linguoversion of lower incisors. Although point A moved mesially, the length and position of the maxilla did not change significantly. With the protrusion of upper lip and the retrusion of lower lip, the relationship among nose, upper lip, lower lip and chin become harmonious, the profile of soft tissue is more coordinated and attractive.

El objetivo de este estudio fue evaluar los cambios en el perfil de los tejidos duros y blandos después del tratamiento de la maloclusión funcional y leve de la clase III esquelética en la dentición mixta mediante el aparato regulador funcional Frankel (FR-3), y revelar el mecanismo y efectividad del tratamiento con el aparato FR-3. Veintiseis pacientes (edad media 8,7 ± 1,4 años; duración media del tratamiento, 10,3 ± 1,3 meses) con maloclusión funcional y leve de clase esquelética III fueron seleccionados y tratados con aparatos FR-3. El cefalograma lateral se tomó antes y después del tratamiento, y los datos se analizaron mediante la prueba t de muestras con el software SPSS22.0. Las diferencias se consideraron estadísticamente significativas a P <0,05. Los resultados demostraron que el dispositivo FR-3 produjo una disminución estadísticamente significativa en L1-NB, L1MP, U1-L1 (P <0,01) y un gran aumento en ANB, MP-FH, eje Y, ANS-Me, ANS -Me / N-Me y overjet (P <0,01). SNA, SNB se incrementaron significativamente (P <0,05). Mientras tanto, N'Sn-Pog', ULSn-SN, LLSi-SN aumentaron, S-N'-Si, LL-EP disminuyeron con una diferencia significativa (P <0,01). S-N'-Sn, Cm-Sn-UL, UL-EP, Sn-Mes y Ns-Mes aumentaron con una diferencia significativa (P <0,05). Por lo tanto, se concluyó que después del tratamiento con FR-3, la posición de la mandíbula puede girar en sentido reloj hacia atrás y hacia abajo, con labioversión de los incisivos superiores y linguoversión de los incisivos inferiores. Aunque el punto A se movió mesialmente, la longitud y la posición del maxilar no cambiaron significativamente. Con la protuberancia del labio superior y la retrusión del labio inferior, la relación entre la nariz, el labio superior, el labio inferior y el mentón se armoniza, el perfil del tejido blando es más coordinado y atractivo.

Diagnóstico precoz de la estrechez del maxilar superior en la dentición mixta / Early diagnosis of the maxillary´s narrowness in the mixed dentition

Las compresiones del maxilar superior son alteraciones transversales por discrepancia óseo-dentaria. .En la dentición mixta temprana puede establecerse la estrechez mediante índices que relacionan el tamaño dental con el ancho transversal del arco dentario. Se analizaron 33 modelos superiores de niños en el tercer período de desarrollo clínico según Barnett. Se estableció la estrechez realizando el análisis métrico del arco dental mediante el índice de Pont. Se describió la anomalía de posición anterior según las siguientes variables: A) Apiñamiento dentario: 1-Escalón de los dientes anterosuperiores; 2-Rotación mesial de los cuatro incisivos; 3-Rotación mesial de los incisivos centrales y rotación distal de los incisivos laterales y 4-Rotación distal de los incisivos centrales. B) Ausencia de apiñamiento: 1-Reabsorción atípica y 2- Ausencia de reabsorción atípica. Las anomalías de posición y/o reabsorciones atípicas anteriores en este período de desarrollo clínico se asocian a estrechez transversal del maxilar superior Siendo la malposición más frecuente la rotación mesial de los cuatro incisivos, siguiendo las reabsorciones atípicas y el escalón de los dientes anterosuperiores, luego la rotación mesial de los incisivos centrales y distal de los laterales y por último la rotación distal de los incisivos centrales (AU)

Inside the traverse alteration of the maxillary the compressions are described as uni or bilateral where an imbalance is settled down between the dental size and the size of the maxillary causing alterations in the position of the teeth. In the early mixed teething the narrowness of the maxillary can be settled by means of indexes that relate the dental size with the traverse width of the dental arch. Thirty models of the maxillary of children according to Barnett's third development period were analyzed. The metrical analysis of the dental arch form was carried out through Pont's index. The theoretic values were compared with the real ones establishing the deviations of the norm that is to say the narrow nest. Out of the 30 cases analyzed, 40% presented mesial rotation of the 4 incisors; 27% showed a stop of the front teeth; 27% atypical reabsorption; 20% mesial rotation of the central incisors and distal rotation of the lateral incisors and the 10% presented a distal rotation of the central incisors. With regard to the front atypical discrepancy 36.66% of the cases had a discrepancy above 6 mm and the 23.33% below 3 mm (AU)