Implications of occlusal plane in diagnosis and treatment of malocclusion / 浙江大学学报·医学版

Occlusal plane (OP) is one of the essential factors affecting craniofacial morphology and function. The OP not only assists in diagnosing malocclusion but also serves as an important reference for making treatment plans. Patients with different types of malocclusions have different forms of OP. Compared with patients with standard skeletal facial type, the occlusal plane of patients with skeletal class Ⅱ and high angle is steeper, while that of patients with skeletal class Ⅲ and low angle is more even. In orthodontic treatment, adjusting and controlling the OP can promote the normal growth and development of the mandible in most patients with malocclusion during the early stage of growth, while causing favorable rotation of the mandible in some adults with mild-to-moderate malocclusion. For moderate-to-severe malocclusion, the OP rotation by orthodontic-orthognathic treatment can achieve better long-term stability. This article reviews the evolution of the definition of OP and its implications for diagnosing and the guiding treatment of malocclusion.

Orthodontists' preferences in the use and timing of appliances for the correction of malocclusions in growing patients / Preferencias de los ortodoncistas en el uso y momento oportuno de uso de aparatos para la corrección de maloclusiones en pacientes en crecimiento

Objective: To evaluate orthodontists' preferences in the use and timing of appliances for the correction of Class II and Class III malocclusions in growing patients and the sociodemographic factors that influence these preferences. Material and Methods: Active members of the Colombian Orthodontics Society (SCO) were invited to complete a previously validated survey on the use of Class II and Class III correctors in growing patients. Results: 180 orthodontists responded (80 male, 100 female). The appliances used most frequently in the treatment of Class II malocclusion were Planas indirect tracks (32.78%) and Twin-blocks (30.56%). Facemasks (62.22%) and Progenie plates (25%) were the most prevalent appliances used in the treatment of Class III malocclusions. Regarding treatment timing, 52% of the orthodontists stated that Class II malocclusions must be treated during late mixed dentition or early permanent dentition, 42% stated that treatment for Class III malocclusions should occur during early mixed dentition. Appliance use and treatment timing were significantly associated with sex (p= 0.034), years of practice (p= 0.025), and area of work (private clinics or public institutions), (p= 0.039). Conclusion: Twin-blocks and Facemask appliances were the preferred appliances for Class II and Class III treatment, respectively, in growing patients. Most of the orthodontists believed that Class II malocclusions must be treated during late mixed dentition and that Class III malocclusions must be treated during early mixed dentition. Sociodemographic variables are related factors that influence orthodontists' preferences in the use of these appliances.

Objetivo: Evaluar las preferencias de los ortodoncistas en el uso y momento oportuno de uso de aparatología para la corrección de maloclusiones Clase II y Clase III en pacientes en crecimiento y los factores sociodemográficos que influyen en estas preferencias. Material y Métodos: Se invitó a miembros activos de la Sociedad Colombiana de Ortodoncia (SCO) a completar una encuesta previamente validada, sobre el uso de correctores para Clase II y Clase III en pacientes en crecimiento. Resultados: Respondieron un total de 180 ortodoncistas (80 hombres, 100 mujeres). La aparatología más utilizada en el tratamiento de las maloclusiones de Clase II fueron pistas indirectas de Planas (32,78%) y bloques gemelos (30,56%). La máscara facial (62,22%) y las placas progenie (25%) fueron los aparatos más utilizados en el tratamiento de las maloclusiones de Clase III. En cuanto al momento oportuno del tratamiento, el 52% de los ortodoncistas afirmó que las maloclusiones de Clase II deben tratarse durante la dentición mixta tardía o la dentición permanente temprana, el 42% afirmó que el tratamiento para las maloclusiones de Clase III debe ocurrir durante la dentición mixta temprana. El uso de aparatos y el momento oportuno del tratamiento se asociaron significativamente con el sexo (p= 0,034), los años de práctica (p= 0,025) y el área de trabajo (clínicas privadas o instituciones públicas) (p= 0,039). Conclusión: Los aparatos bloques gemelos y la máscara facial fueron los preferidos para el tratamiento de Clase II y Clase III, respectivamente, en pacientes en crecimiento. La mayoría de los ortodoncistas consideran que las maloclusiones de Clase II deben tratarse durante la dentición mixta tardía y que las maloclusiones de Clase III deben tratarse durante la dentición mixta temprana. Las variables sociodemográficas son factores relacionados que influyen en las preferencias de los ortodoncistas en el uso de estos aparatos.

Etiology, diagnosis and treatment of infraoccluded primary second molars / 中华口腔医学杂志

Infraocclusion is a phenomenon that the relative occlusal growth of a tooth stops after the period of active eruption and then the tooth becomes depressed below the occlusal plane. Infraocclusion occurred more commonly in children and the mostly affected teeth were the primary mandibular second molars. The occlusal problem caused by infraocclusion may progressively worsen with age. This review summarizes the etiology, diagnosis and treatment of infraoccluded second primary molars, so as to provide reference for the dental clinicians.

Morphology changes of maxillary molar distalization by clear aligner therapy / Cambios de la morfología en la distalización de molares maxilares mediante terapia con alineadores transparentes

SUMMARY: To evaluate the skeletal, dento-alveolar and soft tissue morphology changes after maxillary molar distalization by clear aligner therapy and identify the significant efficacy of molar distalization,18 patients in conformity with the inclusion criteria were selected. Pre- and post-treatment Cone Beam Computed Tomography (CBCT) were examined to measure the angular and linear parameters. All subjects were completed non-extraction clear aligner treatment by distalizing molars. A paired-t test and independent-samples t-test were performed to observe the difference between before and after treatment and the difference between the first molar and second molar respectively. P-values <0.05 were considered statistically significant. Predicted movement rate was calculated by the formula: (actual movement(mm)/planned movement(mm)) x100%. Most variables of pre- and post-treatment showed no statistical difference(P<0.05), excepting SNA angle (P<0.05) and Upper lip/E-line linear (P<0.01) due to incisor retraction. The first and second molar revealed a translation movement without significant tipping and vertical movement. Clear aligners provided a high predictability (83.44 %) of distalization the maxillary first molar, and 85.14 % of the maxillary second molar. Clear aligners can effectively achieve distal displacement of molars.

RESUMEN: Se seleccionaron 18 pacientes, de acuerdo con los criterios de inclusión, para evaluar los cambios en la morfología esquelética, dentoalveolar y de los tejidos blandos después de la distalización de los molares maxilares, mediante la terapia con alineadores transparentes e así identificar la significativa eficacia de la distalización de los molares. Se examinó a través de tomografía computarizada de haz cónico (CBCT) antes y después del tratamiento para medir los parámetros angulares y lineales. Todos los sujetos completaron el tratamiento con alineadores transparentes sin extracción mediante la distalización de los molares. Se realizó una prueba t pareada y una prueba t de muestras independientes para observar la diferencia entre antes y después del tratamiento y la diferencia entre el primer molar y el segundo molar, respectivamente. Los valores de p<0,05 se consideraron estadísticamente significativos. La tasa de movimiento prevista se calculó mediante la fórmula: (movimiento real (mm)/movimiento planificado (mm)) x 100 %. La mayoría de las variables de pre y postratamiento no mostraron diferencia estadística (P<0,05), excepto el ángulo SNA (P<0,05) y el labio superior/línea E lineal (P<0,01) debido a la retracción del incisivo. El primer y segundo molar revelaron un movimiento de traslación sin inclinación significativa y movimiento vertical. Los alineadores transparentes proporcionaron una alta previsibilidad (83,44 %) de la distalización del primer molar superior y del 85,14 % del segundo molar superior. Los alineadores transparentes pueden lograr efectivamente el desplazamiento distal de los molares.

Orthodontic Treatment Need among Nepalese High School Students

Abstract Objective: To assess the need for orthodontic treatment among Nepalese high school students. Material and Methods: This is a quantitative, cross-sectional descriptive study. The sample comprises 938 children (537 males and 401 females) with an age group above 14 years. The subjects were selected voluntarily from seven different schools of Kathmandu valley using a multistage sampling technique. The Index of Orthodontic Treatment Need comprises two components: Dental Health Component (DHC) and Aesthetic Component (AC). Two trained and calibrated examiners performed the oral examination. Results: On analysis of the DHC component, it was found that 21% had no need, 18.1% had mild/little need, 24.3% had moderate/borderline need, 35.8% had severe need, and 0.7% had extreme treatment need. Similarly on analysis of AC component, it was found that 33% were AC-1, 30.8% were AC-2, 7.2% were AC-3, 8.2% were AC-4, 2.1% were AC-5, 3.6% were AC-6, 1.8% were AC-7, 7.4% were AC-8, 1.8% were AC-9, and 3.9% were AC-10. Conclusion: The Index of Orthodontic Treatment Need can be used as a tool for planning dental health resources and prioritizing the treatment need of different populations (AU).

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

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

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

Correlation of the need for orthodontic treatment between the self-perception of chilean adolescents aged 14 to 18 years and the dentist's diagnosis / Correlación de la necesidad de tratamiento ortodóncico entre la autopercepción de adolescentes chilenos de 14 a 18 años con la observación del odontólogo

Background: To correlate the need for orthodontic treatment between the self-perception of Chilean adolescents from 14 to 18 years old with the observation of a dentist using the same assessment scale, as well as to determine if covariates such as gender, age and type of school influence the self-perception of the adolescent and the examiner. Material and Methods: Cross-sectional descriptive study of adolescents aged 14 to 18 years from public, subsidized and private schools in Temuco, Chile. The probability sample is stratified by course, from first to fourth year, a total of 414 students participated, according to the eligibility criteria. The photographic score of the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was used. The statistical analysis of the data was performed with the SPSS Statistics program v.23. Results: 94.9% of the adolescents perceived themselves as having good aesthetics. The examiner considered that 77% presented this condition, p<0.00. Males perceived themselves better than females. At age 15, 1.7% of students considered themselves to have poor aesthetics, p<0.01. From the examiner's perspective, aesthetics are related to type of school, p<0.00. Conclusion: Adolescents perceive themselves better aesthetically than do the evaluators. The school type factor, according to the IOTN-AC examiner, shows a higher proportion of students with no need for orthodontic treatment in private schools, and a threshold need in municipal and subsidized institutions.

Correlacionar la necesidad de tratamiento ortodóncico, entre la autopercepción de adolescentes con el diagnóstico de un evaluador odontólogo, utilizando la misma escala de valoración, así también determinar si las variables como el género, la edad y la dependencia educacional influyen en la autopercepción del adolescente y la observación del examinador. Material y Métodos: Estudio descriptivo de corte transversal, en adolescentes de 14 a 18 años de escuelas públicas, subvencionadas y privadas de Temuco-Chile. Muestreo probabilístico estratificado por cursos, de primero a cuarto medio con una muestra de 414 estudiantes, según los criterios de elegibilidad. Se utilizó el score fotográfico del componente estético (AC) del Índice de Necesidad de Tratamiento de Ortodoncia (INTO). El análisis estadístico de los datos fue realizado con el programa SPSS Statistics v.23. Resultados: El 94,9% de los adolescentes se autoperciben con una buena estética, el examinador considera que un 77% presenta esta condición, p<0,00. Los varones se perciben mejor que las damas. Los adolescentes de 15 años un 1,7% considera tener mala estética, p<0,01. Desde la perspectiva del examinador la estética se relaciona con la dependencia educacional, <0,01. Conclusión: Los adolescentes se autoperciben mejor estéticamente que lo diagnosticado por evaluadores odontólogos. El factor dependencia educacional según INTO-AC examinador, muestra mayor proporción de estudiantes sin necesidad de tratamiento ortodóncico en los establecimientos privados, y necesidad límite en los públicos y subvencionados.

Skeletal posterior crossbite in patient with mandibular asymmetry: an alternative solution

ABSTRACT Introduction: Skeletal posterior crossbite (SPCB) has a multifactorial etiology, as it may be caused by parafunctional habits, atypical position of the tongue, tooth losses and maxillary or mandibular transverse skeletal asymmetries. Skeletal involvement may lead to facial changes and an unfavorable aesthetic appearance. The treatment of SPCB diagnosed in an adult patient should be correctly approached after the identification of its etiologic factor. Surgically-assisted rapid maxillary expansion (SARME), one of the techniques used to correct SPCB in skeletally mature individuals, is an efficient and stable procedure for the correction of transverse discrepancies that may be performed in the office or in a hospital. Objective: This study discusses the results of asymmetrical SARME used to correct unilateral SPCB associated with transverse mandibular asymmetry. Conclusion: The treatment alternative used in the reported case was quite effective. At the end of the treatment, the patient presented adequate occlusion and facial aesthetics.

RESUMO Introdução: A mordida cruzada posterior esquelética (MCPE) apresenta etiologia multifatorial, podendo ser causada por hábitos parafuncionais, posição atípica da língua, perdas dentárias e assimetrias esqueléticas transversais da maxila ou da mandíbula. Alterações faciais podem estar presentes quando há envolvimento esquelético, levando a estética desfavorável. O tratamento da MCPE, quando diagnosticada no paciente adulto, requer abordagem correta, com identificação do fator etiológico. Entre as técnicas utilizadas para correção da MCPE em pacientes esqueleticamente maduros, cita-se, em especial, a Expansão Rápida de Maxila Assistida Cirurgicamente (ERMAC). Essa modalidade tem se mostrado bastante eficiente na correção dos problemas transversais, apresenta estabilidade e pode ser realizada em ambiente ambulatorial ou hospitalar. Objetivo: O objetivo do presente trabalho será discutir os resultados da ERMAC assimétrica para correção da MCPE unilateral associada a assimetria transversal da mandíbula. Conclusão: A alternativa de tratamento utilizada no caso relatado mostrou-se bastante eficiente. Ao fim do tratamento, o paciente apresentou adequada oclusão e boa estética facial.

Ortodontia em saúde coletiva: epidemiologia das oclusopatias e da necessidade de tratamento ortodôntico em adolescentes / Orthodontics in public health: epidemiology of malocclusions and the need for orthodontic treatment in adolescents

A Epidemiologia tornou-se um ramo da ciência muito utilizado para a verificação das necessidades da população, o planejamento de ações e a organização dos serviços em saúde. Para isso, primeiramente, é fundamental realizar o diagnóstico situacional, a partir de dados específicos, em busca da compreensão e atuação sobre os problemas de saúde encontrados em coletividade. As oclusopatias têm sido uma das condições bucais mais prevalentes e, em consequência, houve o crescimento da demanda por tratamento ortodôntico. Nesta perspectiva, índices oclusais foram elaborados para medir a ocorrência das oclusopatias tendo em vista a priorização da necessidade de tratamento. O conhecimento da temática em escala global permitiu uma visão ampliada do problema e das estratégias desenvolvidas em saúde bucal. Neste contexto, a presente pesquisa teve os seguintes objetivos: 1) realizar uma revisão sistemática das evidências científicas existentes sobre a prevalência da necessidade de tratamento ortodôntico em adolescentes na faixa etária de 12 à 15 anos de idade; 2) investigar a prevalência das oclusopatias e a necessidade normativa de tratamento ortodôntico em adolescentes de 12 anos de idade. Na revisão sistemática foram incluídos trabalhos nacionais e internacionais publicados nas bases de dados Cochrane, Embase, Portal Regional da Biblioteca Virtual em Saúde (BVS), PubMed, Scientific Electronic Library Online (Scielo), Scopus e Web of Science (WOS). A busca inicial não se limitou a nenhum filtro disponível nas bases de dados e utilizou os seguintes descritores: prevalence, epidemiology, malocclusion, index orthodontic treatment need, child e adolescent. Termos utilizados na literatura científica também foram empregados: orthodontic treatment need, index for need of orthodontic treatment, index of orthodontic treatment needs, IOTN index, dental aesthetic index e DAI index. Foram incluídas publicações que avaliaram a prevalência da necessidade de tratamento ortodôntico em adolescentes entre 12 à 15 anos de idade utilizando o Índice de Estética Dentária (DAI) e/ou Índice de Necessidade de Tratamento Ortodôntico (IOTN) em estudos epidemiológicos transversais, sem restrições de ano do periódico e idioma. Do total de artigos encontrados (n=2255), 525 estudos permaneceram após a remoção por duplicidade. Os títulos e resumos destas publicações foram avaliados e aplicando os critérios de exclusão, selecionou-se 38 artigos. Para elegibilidade, os critérios de inclusão foram empregados e 11 estudos foram eleitos. Os textos completos destas publicações foram obtidos para leitura e análise da qualidade metodológica. Com relação aos achados da necessidade de tratamento ortodôntico global, houve variabilidade nos resultados, mas observou-se que a prevalência foi considerada alta. Quanto às ações desenvolvidas, foram sugeridas a educação em saúde bucal para os adolescentes e pais com foco na prevenção e no tratamento interceptativo precoce das oclusopatias, bem como, inserção da ortodontia nos programas de saúde com a implantação de mais centros especializados. A segunda etapa desta pesquisa consistiu em um estudo observacional e transversal, realizado com 461 adolescentes de 12 anos de idade, matriculados em escolas públicas de um município de médio porte do Estado de São Paulo. A oclusão e a necessidade de tratamento ortodôntico foram avaliadas por meio da Classificação de Angle e do DAI. Os dados foram analisados utilizando estatística descritiva e as distribuições absolutas e percentuais das variáveis categóricas foram tabuladas. A verificação da associação entre os resultados dos exames clínicos para diagnóstico de oclusopatias utilizando a Classificação de Angle e o DAI foi realizada por meio do teste G, adotando-se um nível de significância de 5%. O processamento e a análise dos dados foram realizados com auxílio do Programa Epi-InfoTM versão 7.2. (Center for Disease Control and Prevention). O diagnóstico da oclusão, segundo a Classificação de Angle, mostrou que 8,89% apresentavam oclusão normal, 56,83% oclusopatia em Classe I, 24,08% em Classe II e 10,20% em Classe III. A prevalência da necessidade de tratamento ortodôntico, segundo o DAI, foi de 52,69% dos adolescentes considerando tratamento eletivo à obrigatório. Houve associação entre os resultados dos exames clínicos para diagnóstico de oclusopatias utilizando a Classificação de Angle com o DAI (p <0,0001). A prevalência das oclusopatias e da necessidade normativa de tratamento ortodôntico foi elevada, sendo 18,44% dos adolescentes com necessidade de tratamento obrigatório. Os índices foram eficazes para a identificação das oclusopatias, entretanto por avaliarem aspectos clínicos distintos, poderiam ser utilizados concomitantemente para aprimorar o diagnóstico das oclusopatias(AU)

Epidemiology has become a branch of science widely used to define the needs of the population, plan actions and organize health services. For this, first, it is essential to perform the situational diagnosis, based on specific data, in search of understanding and acting on the health problems found in the community. Malocclusion has been one of the most prevalent oral conditions and, as a result, there has been an increase in demand for orthodontic treatment. In this perspective, occlusal indexes were developed to measure the occurrence of malocclusions in order to prioritize the need for treatment. The knowledge of the theme on a global scale allowed an expanded view of the problem and the strategies developed in oral health. In this context, the present research had the following objectives: 1) to carry out a systematic review of the existing scientific evidence on the prevalence of the need for orthodontic treatment in adolescents aged 12 to 15 years old; 2) to investigate the prevalence of malocclusions and the normative need for orthodontic treatment in 12-year-old adolescents.The systematic review included national and international works published in the Cochrane, Embase, Regional Portal of the Virtual Health Library (VHL Regional Portal), PubMed, Scientific Electronic Library Online (Scielo), Scopus and Web of Science (WOS) databases. The initial search was not limited to any filter available in the databases and used the following descriptors: prevalence, epidemiology, malocclusion, index orthodontic treatment need, child and adolescent. In addition, terms used in the scientific literature were also used: orthodontic treatment need, index for need of orthodontic treatment, index of orthodontic treatment needs, IOTN index, dental aesthetic index and DAI index. Were included publications that evaluated the prevalence of the need for orthodontic treatment in adolescents between 12 and 15 years of age using the Dental Aesthetic Index (DAI) and / or Orthodontic Treatment Needs Index (IOTN) in cross-sectional epidemiological studies, without restrictions on year of the journal and language. Of the total articles found (n = 2255), 525 studies remained after removal due to duplication. The titles and abstracts of these publications were evaluated and applying the exclusion criteria, 38 articles were selected. For eligibility, the inclusion criteria were used and 11 studies were elected. The complete texts of these publications were obtained for reading and analysis of methodological quality. As for the actions developed, oral health education recommendations were suggested for adolescents and parents with a focus on prevention and early interceptive treatment of malocclusions, as well as insertion of orthodontics in health programs with the implementation and development of specialized centers. The second stage of this research consisted of an observational, crosssectional, survey-type study conducted with 461 12-year-old adolescents enrolled in public schools in the medium-sized municipality of the State of São Paulo. Occlusion and the need for orthodontic treatment were assessed using the Angle Classification and the DAI. The data were analyzed using descriptive statistics and the absolute and percentage distributions of categorical variables were tabulated. The verification of the association between the results of clinical exams for the diagnosis of malocclusions using the Angle Classification and the DAI was performed using the G test, adopting a significance level of 5%. Data processing and analysis were performed using the Epi-InfoTM version 7.2 program. (Center for Disease Control and Prevention). The diagnosis of occlusion, according to the Angle Classification, showed that 8.89% had normal occlusion, 56.83% occlusion Class I, 24.08% Class II and 10.20% Class III. The prevalence of the need for orthodontic treatment, according to the DAI, was 52.69% of adolescents considering elective treatment to mandatory treatment. There was an association between the results of clinical examinations for the diagnosis of malocclusions using the Angle Classification with the DAI (p <0.0001). The prevalence of malocclusions and the normative need for orthodontic treatment was high, with approximately 18,44% of adolescents in need of mandatory treatment. The indices were effective for the identification of malocclusions, however, by evaluating different clinical aspects, they could be used concomitantly to improve the diagnosis of malocclusions(AU)

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.

Orthodontic retreatment: positive effects on the patient's self-esteem and quality of life

ABSTRACT Introduction: An increasing percentage of the world's population has had access to orthodontic treatment within the last few decades. Consequently, a larger number of patients seeking for correction of their malocclusions, nowadays, present with a history of previous orthodontic therapy. Orthodontists performing retreatments in their practice may have to face additional difficulties, and one of them is treating individuals that may be even more demanding for excellent results and efficient treatments. Objectives: This manuscript discusses the challenges faced when performing orthodontic retreatments. It illustrates a two-phase retreatment of a pre-adolescent and the ortho-surgical retreatment of a young adult with high demands for fast and exceptional results. Finally, this paper elaborates on the positive impacts that these retreatments had on the patients' self-esteem and quality of life.

RESUMO Introdução: Um percentual crescente da população mundial vem tendo acesso ao tratamento ortodôntico ao longo das últimas décadas. Consequentemente, hoje em dia, um maior número de pacientes em busca da correção de suas más oclusões apresenta um histórico de tratamento ortodôntico prévio. Ortodontistas que realizam retratamentos ortodônticos podem enfrentar dificuldades adicionais, e uma delas é ter que lidar com indivíduos que apresentam demandas e expectativas ainda maiores em relação à obtenção de resultados excelentes e de forma bastante eficiente. Objetivos: O presente artigo discute os desafios e os impactos positivos do retratamento ortodôntico causados na autoestima e na qualidade de vida dos pacientes, e ilustra o retratamento em duas fases de uma pré-adolescente, e o retratamento ortodôntico-cirúrgico de uma paciente adulta jovem que tinha demandas muito elevadas para a obtenção de resultados rápidos e excelentes.

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.

Expansion treatment using Invisalign®: Periodontal health status and maxillary buccal bone changes. A clinical and tomographic evaluation / Tratamiento de expansión con Invisalign®: estado de salud periodontal y cambios óseos maxilares. Evaluación clínica y tomográfica

ABSTRACT The aim of this study was to evaluate changes in periodontal status and maxillary buccal bone by considering clinical and tomographic parameters during the first year of orthodontic expansion with Invisalign® aligners. Upper first (1PM) and upper second (2PM) premolars of 19 patients with orthodontic expansion requirement treated with Invisalign® aligners were evaluated. Plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) and cone beam tomographic (CBCT) records were collected at 76 sites before starting treatment (T0) and at 12 months (T1). Bone height was measured from cementoenamel junction (CEJ) to the crest cortical bone (CC). Bone thickness was measured at two levels: 4 mm (CEJ+4) and 6 mm (CEJ+6) apical to the CEJ. A descriptive analysis was made of the variations of bone thickness and height in a series of cases. The average expansion was 1.93 mm for 1PM and 167 mm for 2PM. Arithmetic mean of distance CEJ-CC in 1PM was 3.05 mm at T0, and remained at 3.05 mm at T1. Arithmetic mean of distance CEJ-CC in 2PM was 2.06 mm at T0 and 2.31 at T1. Post-expansion, most of the analyzed sites (86%) exhibited a bone thickness of ≥0.5 mm. The greatest variations between T0 and T1 were observed at the level of 1PM CEJ+ 4 and 2PM CEJ+ 6. The minimal changes in the clinical records (GI, PI, PPD and CAL) between T0 and T1 were compatible with the maintenance of gingivalperiodontal health. Invisalign® for expansion movements did not produce substantial changes in the evaluated periodontal clinical parameters or in the bone measurements. Removable appliances reduce plaque retentive factors and favor adequate oral hygiene.

RESUMEN El objetivo de este estudio fue evaluar los cambios en el estado periodontal y hueso facial maxilar a través de parámetros clínicos y tomográficos durante la expansión ortodóncica con alineadores Invisalign® en el primer año de tratamiento. Se evaluaron los primeros (1PM) y segundos (2PM) premolares superiores pertenecientes a 19 pacientes con requerimiento de expansión ortodóncica tratados con alineadores Invisalign®. Se registraron los índices de placa (IP), índice gingival (IG), profundidad al sondaje (PS) y nivel de inserción (NI) y registros tomográficos de haz cónico (CBCT) en 76 sitios antes de comenzar el tratamiento (T0) y a los 12 meses (T1). Se midió la altura ósea desde el límite amelocementario (LAC) hasta la cortical de la cresta (CC) y el espesor en dos niveles; a 4 mm (LAC+4) y a 6 mm (LAC+6) hacia apical del LAC. Se realizó un análisis descriptivo de las variaciones de la altura y espesor óseo en una serie de casos. La expansión promedio para 1PM fue de 1,93 mm y para 2PM fue de 1,67 mm. La media aritmética de LAC-CC en primeros premolares fue de 3,05 mm en T0 y se mantuvo el valor de 3,05 mm en T1. La media aritmética de LAC-CC en segundos premolares fue de 2,06 mm en T0 y 2,31 en T1. Post expansión, la mayoría de los sitios (86%) analizados exhibieron un espesor óseo ≥0,5 mm. Las mayores variaciones entre T0 y T1 se observaron a nivel de 1PM CEJ+4 y 2PM CEJ+6. Los registros clínicos (PI, GI, PPD y CAL) evidenciaron mínimos cambios entre T0 y T1, compatibles con el mantenimiento de la salud gíngivo-periodontal. El uso de Invisalign ® para movimientos de expansión no produjo cambios sustanciales en los parámetros clínicos periodontales evaluados ni en las mediciones óseas. La aparatología removible reduce los factores retentivos de placa bacteriana y facilita una adecuada higiene oral.

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.

Corrección de la maloclusión y de la postura / Correction of malocclusion and posture

La maloclusión dentaria se encuentra en íntima relación con la postura del paciente y la dinámica funcional, la resolución de estos tres aspectos solo podrá ser efectiva y estable en el tiempo con un tratamiento de forma integral. Por lo tanto, a los objetivos ortodóncicos ­que hablan de: estética facial, estética dentaria, salud periodontal, estabilidad de la ATM, oclusión funcional, motivo de la consulta­ debemos agregar, estabilidad postural.

Retenciones múltiples. Reporte de un caso / Multiple retention. Case report

RESUMEN La retención dentaria es común encontrarla en la clínica de ortodoncia, los caninos maxilares son los de mayor solicitud de tratamiento por su importancia estética. Sin embargo, no es frecuente la retención de dientes temporales. Su etiología no está bien definida pero se considera de carácter multifactorial. Se presentó una paciente del sexo femenino de 12 años y medio de edad, con ausencia de 15 y 13, presencia de 53 y mesogresión del 16. Al examen radiográfico se observó retención de 55, 15 y 13, este último en transposición incompleta con el 12. Después de un profundo análisis se decidió exéresis del 55 y alineación al arco dentario de 15 y 13, mediante colocación de un dispositivo, con el empleo del sistema de cementado directo en el acto quirúrgico. Se estableció una oclusión funcional y estética aceptable, con particular cuidado de la integridad de los dientes vecinos y sus tejidos blandos. Las retenciones constituyen maloclusiones dentarias complejas y de difícil pronóstico y tratamiento, más aún cuando son múltiples. Se requiere de estudio y tratamiento multidisciplinario (AU).

ABSTRACT It is common to find teeth retention in Orthodontics clinic; maxillary canines, due to their esthetical importance, are the ones the patients ask to be treated more frequently. Nevertheless, temporary teeth retention is not frequent. Its etiology is not clear, but it is considered multifactorial. The authors present the case of a female patient, aged 12 years and a half, without 15 and 13 teeth, presence of 53 and mesogression of 16. At the radiographic examination, the retention of 55, 15 and 13 was found, and also the incomplete transposition of 13 and 12. After deeply analyzing the case, the orthodontists decided the removal of 55 and aligning 15 and 13 to dental arch, placing a device with the system of direct cementing at the moment of the surgery. It was established a functional occlusion and an acceptable esthetics, particularly caring for the neighboring teeth and their soft tissues. Retentions are complex dental malocclusions, of difficult prognosis and treatment, mainly when they are multiple. They require study and multidisciplinary treatment (AU).

Tratamiento de Ortodoncia en un paciente con síndrome de Down / The Orthodontics treatment in a patient with Down syndrome

RESUMEN El tratamiento de Ortodoncia en pacientes con síndrome de Down, ha sido un tema debatido durante muchos años por los especialistas debido a las deficiencias físicas, mentales y a la dificultad de estos en la cooperación con el tratamiento. El objetivo de este trabajo es mostrar resultados adecuados de tratamiento ortodóncico en una paciente femenina de 12 años de edad con síndrome de Down. La niña acudió a consulta acompañada de su mamá y de su abuela solicitando tratamiento por presentar los dientes virados. En el examen clínico se observó rotación marcada de 11 y 21 mayor de 900 que afecta su estética facial. Se explicó a la familia lo difícil que podía resultar el tratamiento a esta adolescente con necesidades especiales, a la que habría que aplicar una fuerza ortodóncica que genera marcada molestia y pudiera presentarse una escasa tolerancia al dolor. La familia aseguró su cooperación. Se decidió emprender la terapia para lo cual se diseñó un plan de tratamiento en dos etapas. En una primera etapa se empleó aparatología ortodóncica removible y en una segunda etapa aparatología fija. Al concluir el tratamiento se logró resolver de manera satisfactoria el motivo de consulta con buena cooperación por parte de la paciente y su familia. El éxito del tratamiento se debió a la satisfactoria cooperación de la paciente y al establecimiento de una relación favorable ortodoncista-paciente-familia (AU).

ABSTRACT The Orthodontics treatment in patients with Down syndrome has being a theme debated by specialist during many years, due to the physical and mental deficiencies of this kind of patients and their difficulty in cooperating with the treatment. The aim of this article is showing the adequate results of the orthodontic treatment in a female patient aged 12 years with Down syndrome. The girl assisted to consultation with her mother and grandmother asking treatment for having crooked teeth. At the physical examination it was observed a remarked rotation of 11 and 21 of more than 900, affecting her facial esthetics. Doctors explained to relatives that the treatment could result very difficult to this teenager with special requirements due to the application of an orthodontic force generating great discomfort in this girl, possibly having a scarce tolerance to pain. The relatives agreed to cooperate. They decided to start the therapy, and a two-stage plan was designed. In the first stage, removable orthodontic braces were used, and fixed ones were used in the second stage. At the end of the treatment the cause of the consultation was successfully solved with a good cooperation of the patient and her relatives. The success of the treatment was achieved due to the satisfactory cooperation of the patient and the establishment of a favorable relationship orthodontist-patient-family (AU).

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.

La vertical verdadera al punto A´(blando), al Pg´(blando), al Labrale superior y al Labrale inferior en posición ideal asistida de la cabeza (PIAC) / The true vertical from point A´(soft), to Pg´ (soft), to superior Labrale and inferior Labrale in Ideal Assisted Head Position (PIAC)

El 81,3% de una encuesta realizada a 96 ortodoncistas y ortopedistas calificados y técnicos radiólogos consultados informan que ubican la cabeza del paciente en una posición ideal, subjetiva del profesional instruido que lo asiste, ya que muchas de sus fotografías y telerradiografías no son posiciones naturales de la cabeza genuinas. Se ha utilizado la vertical verdadera como parámetro para mediciones, todas angulares, para definir la disposición ánteroposterior del punto A´ (de construcción) para el cuerpo del labio superior, el punto Pg´para el mentón, el Labrale superior y el Labrale inferior para el bermellón de cada labio, con la finalidad de planificar correcciones ortopédicas, ortodóncicas u ortodóncicas-quirúrgicas de acuerdo a la anomalía detectada (AU)

Prevalência de oclusopatias em jovens de 12 anos de idade: impactos físicos, sociais e emocionais / Prevalence of malocclusions in 12-year-olds: physical, social and emotional impacts

As oclusopatias representam um importante problema de saúde pública por apresentarem alta prevalência, possibilidade de prevenção, tratamento e promoverem prejuízos significantes na qualidade de vida dos indivíduos acometidos. Assim, torna-se fundamental a realização de estudos que investiguem a distribuição, a severidade e as consequências das oclusopatias em diferentes populações, visando contribuir para o desenvolvimento de estratégias e políticas públicas que minimizem a instalação e o agravamento das oclusopatias. Entretanto, nota-se que não há consenso sobre qual índice de oclusopatias melhor se adequa para a realização de estudos epidemiológicos, oferecendo critérios completos para classificar a presença, severidade e a necessidade de tratamento ortodôntico. Nesse contexto, a presente pesquisa teve como objetivos: realizar uma revisão de literatura sobre os índices de oclusopatias e analisar suas aplicações na saúde pública; e investigar a prevalência, severidade e necessidade de tratamento das oclusopatias e seus impactos na qualidade de vida relacionada à saúde bucal em adolescentes de 12 anos de idade. A revisão incluiu trabalhos nacionais e internacionais publicados nas bases de dados Pubmed, SciELO, Web of Science, Scopus, Bireme e Embase. A busca nas bases de dados considerou o período de 1899 a 2019 e utilizou os seguintes termos: saúde pública, métodos epidemiológicos, índices, levantamentos epidemiológicos, odontologia preventiva, maloclusão, oclusopatias e ortodontia. Foram incluídas publicações sobre o desenvolvimento e uso de índices de oclusopatias em estudos clínicos e epidemiológicos, sem restrições de metodologia e linguagem. Os títulos e resumos dos artigos encontrados foram avaliados e as versões completas das publicações elegíveis foram obtidas para leitura e análise. Cinquenta e dois índices e suas variações foram identificados e, desses, a maioria destinava-se a avaliações individuais, portanto sua utilização em saúde pública foi dificultada pelos requisitos de sua aplicação, como a necessidade de especialistas, análise de modelos de gesso, exames complementares como radiografias cefalométricas e fotografias, equipamentos específicos, necessidade de acompanhamento longitudinal dos casos, e avaliações exclusivamente objetivas ou subjetivas. Os índices apresentaram aspectos positivos ao analisarem parcialmente as condições físicas, funcionais, psicológicas e sociais, entretanto, ainda é um desafio encontrar um índice unânime para avaliação da necessidade de tratamento ortodôntico e os impactos das oclusopatias sobre a qualidade de vida dos indivíduos, com aplicabilidade em saúde pública. A segunda etapa desta pesquisa consistiu em um estudo observacional, transversal, analítico, do tipo inquérito, realizado com 453 adolescentes de 12 anos, matriculados em escolas públicas do município de Araçatuba-SP. A oclusão foi avaliada por meio do Índice de Estética Dental (DAI), enquanto o Child Perceptions Questionnaire11-14 (CPQ11-14) foi utilizado para avaliar a qualidade de vida relacionada à saúde bucal. Os escores do CPQ11-14 foram comparados de acordo com o sexo e presença de oclusopatia por meio do teste de Mann-Whitney. A análise segundo a severidade da oclusopatia foi realizada por meio do teste de Kruskal-Wallis. A correlação entre a severidade da oclusopatia e a qualidade de vida relacionada à saúde bucal foi avaliada com base nos resultados dos escores do DAI e do CPQ11-14 por meio do teste de correlação de Spearman. A prevalência de oclusopatia definida ou superior foi de 53,86%, enquanto a oclusopatia muito grave ou incapacitante foi observada em 18,76% dos adolescentes. Houve correlação positiva significativa (r = 0,7006; p <0,0001) entre os escores do DAI e do CPQ11-14. Adolescentes com oclusopatias apresentaram escores totais do CPQ11-14, assim como escores dos domínios bem-estar emocional e social, significativamente maiores (p <0,05) comparados àqueles sem oclusopatia. O escore total do CPQ11-14 foi significativamente maior (p = 0,0251) nos adolescentes do sexo feminino (16,91 + 10,52) em relação aos do sexo masculino (14,61 + 9,70). A presença de oclusopatias foi elevada, com predomínio de oclusopatias classificadas como definidas, e com necessidade de tratamento eletivo. Essa condição impactou negativamente a qualidade de vida relacionada à saúde bucal dos adolescentes, principalmente os aspectos emocionais e sociais. O impacto das oclusopatias em diferentes aspectos da qualidade de vida deve ser considerado na elaboração de estratégias de diagnóstico e tratamento(AU)

Malocclusion represents an important public health problem because it has a high prevalence, possibility of prevention, treatment and promotes significant losses in the life of affected individuals. Thus, it is essential to carry out studies that investigate the distribution, severity and consequences of malocclusions in different populations, aiming to contribute to the development of strategies and public policies that minimize the installation and aggravation of malocclusions. However, it is noted that there is no consensus on which rate of malocclusion is best suited to carry out epidemiological studies, offering complete criteria to classify the presence, severity, and the need for orthodontic treatment. In this context, the present research had as objectives: to carry out a literature review on the rates of malocclusion and to analyze its applications in public health; and to investigate the prevalence, severity and need for treatment of malocclusions and their impact on oral health-related quality of life in 12-year-old adolescents. The review included national and international works published in the databases Pubmed, SciELO, Web of Science, Scopus, Bireme and Embase. The search in the databases considered the period from 1899 to 2019 and used the following terms: public health, epidemiological methods, indexes, epidemiological surveys, preventive dentistry, malocclusion, and orthodontics. Publications on the development and use of malocclusion indexes were included in clinical and epidemiological studies, without restrictions on methodology and language. The titles and abstracts of the articles found were evaluated and the full versions of the eligible publications were obtained for reading and analysis. Fifty-two indices and their variations were identified and, of these, most were intended for individual evaluations, therefore their use in public health was hampered by the requirements of their application, such as the need for specialists, analysis of plaster models, complementary exams such as cephalometric radiographs and photographs, specific equipment, the need for longitudinal monitoring of cases, and exclusively objective or subjective evaluations. The indices showed positive aspects when partially analyzing physical, functional, psychological and social conditions, however, it is still a challenge to find a unanimous index to assess the need for orthodontic treatment and the impacts of malocclusions on the quality of life of individuals, with applicability in public health. The second stage of this research consisted of an observational, cross-sectional, analytical, survey-type study carried out with 453 12- year-old adolescents enrolled in public schools in the city of Araçatuba-SP. Occlusion was assessed using the Dental Aesthetics Index (DAI), while the Child Perceptions Questionnaire11-14 (CPQ11-14) was used to assess oral health-related quality of life. The scores of CPQ11-14 were compared according to gender and presence of malocclusion using the Mann-Whitney test. The analysis according to the severity of the malocclusion was performed using the Kruskal-Wallis test. The correlation between the severity of malocclusion and oral health-related quality of life was assessed based on the results of the DAI and CPQ11-14 scores using the Spearman correlation test. The prevalence of defined or higher malocclusion was 53.86%, while very severe or disabling malocclusion was observed in 18.76% of adolescents. There was a significant positive correlation (r = 0.7006; p <0.0001) between the DAI and CPQ11-14 scores. Adolescents with malocclusions had total CPQ11-14 scores, as well as scores in the emotional and social well-being domains, significantly higher (p <0.05) compared to those without malocclusion. The total score of CPQ11-14 was significantly higher (p = 0.0251) in female adolescents (16.91 + 10.52) compared to male adolescents (14.61 + 9.70). The presence of malocclusions was high, with a predominance of malocclusions classified as defined, and in need of elective treatment. This condition had a negative impact on the quality of life related to the adolescents' oral health, especially the emotional and social aspects. The impact of malocclusions on different aspects of quality of life must be considered when developing diagnostic and treatment strategies(AU)