Resolución de caso clínico de Clase II sin extracciones. "De Clase II a Clase I sin escalas y solo con resorte", filosofía CCO / Resolution of Class II clinical case without extractions. "From Class II to Class I without scales and only with spring", CCO philosophy

Como hemos visto, la Odontología ha evolucionado constantemente con el paso de los años, y por supuesto la Ortodoncia ­magníficamente desarrollada por el Dr. Angle­ y los brackets diseñados desde hace décadas no son la excepción, ya que han sufrido muchas modificaciones al día de la fecha. Hemos pasado por un sinnúmero de cambios, prescripciones, conceptos que nos brindan un amplio abanico de posibilidades, siempre en busca de lo mejor para nuestros pacientes y para nosotros, disminuyendo los tiempos de tratamiento y también el tiempo de sillón, que no es un tema menor. Este caso de revisión clínica confirma que podemos hacer ortodoncias eficientes y simples con excelentes resultados y en corto plazo.

As we have seen, dentistry has constantly evolved over the years, and of course orthodontics is no exception, from the braces designed in the 30s to date we have gone through a number of changes, prescriptions , concepts and modifications that offer us a wide range of possibilities, always looking for the best for our patients and for us, reducing chair times. This clinical review case confirms that we can do efficient and simple orthodontics with excellent results and in the short term.

Analysis of biofilm formation by Candida albicans in different types of orthodontic fixed appliances and devices / Análise da formação de biofilme por Candida albicans em diferentes tipos de aparelhos e dispositivos ortodônticos fixos

Objective: in this study, biofilm formation by Candida albicans in fixed orthodontic appliances was evaluated. Material and Methods: a total of 300 conventional metal brackets (MC), ceramic (CB), self-ligation (SLB), nickel-titanium (NiTi), and nickel-chromium (NiCr) wires, and ligatures types were organized into thirty groups (n=10). To induce biofilm formation, brackets, wires, and ligatures were joined, sterilized, placed in 24-well plates, contaminated with standardized suspensions of C. albicans (107 cells/mL), and incubated at 37 °C for 48 h with shaking. The biofilms formed were detached using an ultrasonic homogenizer, and suspensions were serially diluted and plated on Sabouraud dextrose agar to determine colony-forming units per mL. Scanning electron microscopy was performed before and after the biofilm formation. Results: lower amount of biofilm formation was observed in the MC group than in the CB and SLB groups (p<0.0001). SLB and CB showed similar biofilm formation rates (p=0.855). In general, the cross-sectional wires .018"x.025" showed higher biofilm formation when associated with the three types of brackets. When brackets, wires, and ligatures were associated, the sets with NiCr wires and SSL ligatures with MC brackets (p=0.0008) and CB (p=0.0003) showed higher biofilm formation. Conclusion: thus, brackets of MC with NiTi and NiCr wires showed lower biofilm formation, regardless of the ligature and cross-sectional or gauge of the wire and, MC and CB brackets with NiCr wires and SSL ligatures were more likely to accumulate biofilms (AU)

Objetivo: neste estudo, a formação de biofilme por Candida albicans em aparelhos ortodônticos fixos foi avaliada. Material e Métodos: um total de 300 bráquetes metálicos convencionais (MC), cerâmicos (CB), autoligados (SLB), com fios de níquel-titânio (NiTi) e níquel-cromo (NiCr) e tipos de ligaduras foram organizados em trinta grupos (n=10). Bráquetes, fios e ligaduras foram unidos, esterilizados, colocados em placas de 24 poços, contaminados com suspensões padronizadas de C. albicans (107 células/mL) e incubados a 37°C por 48 h para a formação de biofilmes. Os biofilmes formados foram rompidos por meio de um homogeneizador ultrassônico e suspensões foram diluídas e semeadas em ágar Sabouraud-dextrose para determinar as unidades formadoras de colônias por mL. A microscopia eletrônica de varredura foi realizada antes e após a formação do biofilme. Resultados: foi observada menor formação de biofilme no grupo MC em comparação aos grupos CB e SLB (p<0,0001). A formação de biofilme foi semelhante nos grupos SLB e CB (p=0,855). Em geral, os fios de seção transversal .018"x.025" apresentaram maior formação de biofilme quando associados aos três tipos de bráquetes. Os conjuntos com fios de NiCr e ligaduras SSL com bráquetes MC (p=0,0008) e CB (p=0,0003) apresentaram maior formação de biofilme. Conclusão: bráquetes MC com fios de NiTi e NiCr apresentaram menor formação de biofilme, independente da ligadura e secção transversal ou bitola do fio e, braquetes MC e CB com fios de NiCr e ligaduras SSL foram mais propensos a acumular biofilmes.(AU)

Class I and Class II Patients Treated with Damon System: A Study of Transversal, Sagittal and Torque Values Variations

ABSTRACT Objective: To analyze the transversal and anterior-posterior changes obtained in patients treated only with the Damon system. Material and Methods: 51 patients with either class I or class II division 1 sagittal relationship treated with the Damon system and the same archwire sequence were retrospectively selected. Dental casts of each patient before (T0) and after treatment (T1) were scanned and analyzed using NEMOCAST 3D software. Inter-molar, inter first-premolar, inter-second premolar and inter-canine distances were measured in both upper and lower arches. Initial and final lateral cephalograms were traced using the OrisCeph program. Pre and post-treatment measurements were compared using the t-test for repeated measurements. The Pearson Correlation Index and Linear Regression Analysis were used to determine the dependence between continuous variables. The significance level was set at 0.05. Results: Transversal diameters in the upper arch increase statistically significantly, especially in the bicuspid area. Initial intra-arch diameter was the only statistically significant variable correlated with the final expansion obtained. A linear negative correlation between the initial latero-posterior torque and the final expansion was observed in both arches. Conclusion: Using identical arches in patients with very different initial characteristics, the changes in bicuspids' diameters remain the most predominant. Patients with initial more negative torque in the posterior region had a higher expansion amount.

Prevalencia de Porphyromonas gingivalis en un grupo de pacientes con aparatología fija de ortodoncia / Prevalence of Porphyromonas gingivalis in a group of patients with fixed orthodontic appliances

Introducción: existen diversos patógenos que pueden afectar no sólo la salud periodontal, sino también la salud general de los pacientes. Objetivo: determinar la Porphyromonas gingivalis (PG) en el primer molar superior derecho de adolescentes, de entre 12 y 18 años, con al menos un mes de tratamiento de ortodoncia con aparatología fija. Material y métodos: se realizó un estudio observacional, descriptivo, transversal de casos en un grupo de 26 adolescentes con tratamiento de ortodoncia, compuesto de brackets metálicos, tubos o bandas, arcos NiTi termoactivos, módulos, cadenas o ligaduras; sin importar sexo, edad, tiempo de tratamiento o maloclusión. Se formaron dos pares de grupos 1 y 2 (15 mujeres y 11 hombres), A y B (13 mujeres y 13 hom- bres) comparando los resultados obtenidos entre los grupos. Resulta- dos: dentro del grupo 1 y 2 la detección molecular de microorganismos arroja que 80% fueron positivas a la PG, 58.33% presenta maloclusión y en promedio 89% de las pacientes son positivas a PG. La detección molecular del grupo A y B indica que 54.54% fueron positivos a PG, mientras que 83.3% presenta maloclusión y en promedio 47% son positivos a PG. Conclusión: la explicación de los eventos moleculares que se desencadenan en la cavidad oral y los sistemas afectados por PG contribuyen a la prevención de complicaciones al tener una mejor comprensión de los fenómenos infecciosos (AU)

Introduction: there are various pathogens that can affect not only periodontal health, but also the general health of patients. Objective: to determine Porphyromonas gingivalis (PG) in the upper right first molar of adolescents, between 12 and 18 years old, with at least one month of orthodontic treatment with fixed appliances. Material and methods: a cross-sectional descriptive observational study of cases was carried out in a group of 26 adolescents with orthodontic treatment, consisting of metal brackets, tubes or bands, thermoactive NiTi archwires, modules, chains or ligatures; regardless of sex, age, treatment time or malocclusion. Two pairs of groups 1 and 2 (15 women and 11 men), A and B (13 women and 13 men) were formed, comparing the results obtained between the groups. Results: within group 1 and 2, the molecular detection of microorganisms shows that 80% were positive for PG, 58.33% presented malocclusion and an average of 89% of patients were positive for PG. The molecular detection of group A and B indicates that 54.54% were positive for PG while 83.3% presented malocclusion and on average 47% were positive for PG. Conclusion: the explanation of the molecular events that are triggered in the oral cavity and the systems affected by PG contribute to the prevention of complications by having a better understanding of the infectious phenomena (AU)

Ortodoncia estética. Tratamientos híbridos o combinados: ortodoncia lingual y vestibular / Aesthetic orthodontics. Hybrid or combined treatments: lingual and vestibular orthodontics

La ortodoncia lingual ha acercado a la consulta ortodóncica a pacientes que nunca antes hubie- ran aceptado un tratamiento ortodóncico. Los tratamientos estéticos son una de las opciones más solicitadas en este siglo por los pacientes adultos, que no solo desean un resultado estético sino que solicitan, también, aparatología estética. Se presenta el caso de una paciente adulta para el que se eligió un tratamiento híbrido: aparatología superior lingual (brackets linguales 2D) y apara- tología inferior vestibular (brackets autoligables, prescripción Roth pasiva-activa). Los brackets 2D son de autoligado, por lo que se utilizan fuerzas biológicas, suaves, constantes y continuas. Es importante en estos casos que ambos maxilares se trabajen con el mismo tipo de fuerzas.

Lingual orthodontics has brought to the orthodontic consultation patients who would never have accepted orthodontic treatment before. In this century, aesthetic treatments are one of the most requested options by adult patients who not only want an aesthetic result but also aesthetic appliances. It is presented the case of an adult patient to which a hybrid treatment was chosen: upper lingual appliances (2D lingual brackets) and lower vestibular appliances (self-ligating brackets, passive-active Roth prescription). 2D brackets are self-ligating, so constant and continuous biological gentle forces are used. In these cases, it is important that both jaws are worked with the same type of forces.

Evaluation of Self-Adhering Flowable Composites on Repeated Bracket Bonding Process: An In Vitro Study

ABSTRACT@#Duration of orthodontic treatment becomes major concern. The present study compared shear bond strength (SBS) and adhesive remnant index (ARI) values of different adhesive systems with different application methods on rebonding process of retrieved orthodontic brackets. Eighty premolar teeth were equally divided into five groups. Transbond XT (TXT) which belongs to total-etch system was used in Group 1 as the control group. Nova Compo-SF (NC) and Vertise Flow (VF) (Kerr Dental, Italy) which are self-adhering flowable composites were used in Group 2 (NC+etch) and Group 3 (VF+etch) respectively with additional etching before application. Group 4 (NC) and Group 5 (VF) were used by following instructions of each brand. The brackets were debonded with a bracket removing plier and rebonded with the same procedures after sandblasting of the bracket and surface cleaning of the enamel. SBS and ARI were measured for each sample. Comparison between all groups was performed by Kruskal-Wallis test and chisquare test. The highest SBS was observed in NC+etch (median = 11.44, mean = 13.49±9.42), followed by NC (median = 10.17, mean = 11.35±6.55), TXT (median = 6.36, mean = 8.06±6.33), VF+etch (median = 5.68, mean = 6.75±4.58), and VF (median = 2.62, mean = 2.92±2.57), respectively. ARI 1 was observed in 81.3% of TXT whereas 62.5% of NC+etch. ARI 1, 2, and 3 were equally distributed in VF+etch group (31.3%). ARI 5 was observed in 37.5% of NC and 62.5% of VF. Analyses referred to statistically significant differences between five groups regarding both SBS and ARI (p < 0.001). As NC showed the highest SBS on rebonding process, it can be a promising alternative to TXT which is the gold standard.

Effectiveness of Chewing Gum Containing CPP-ACP for Remineralisation of Demineralised Enamel around Orthodontic Brackets: An in Situ Study

Abstract Objective: To evaluate the effectiveness of chewing gums containing CPP-ACP in remineralisation of demineralised enamel around orthodontic brackets. Material and Methods: Enamel blocks from 120 bovine incisors were used. The blocks were flattened and polished, followed by the development of incipient subsurface caries. The blocks have been subjected to a baseline microhardness analysis. Orthodontic brackets were bonded to the exposed area of the blocks, reserving an area for hardness analysis. An in situ crossover (three-way crossover phases of 21 days with an interval of one week between them), controlled, randomised and blind experimental model was used, with the participation of 12 volunteers divided into groups: G1 - negative control group, without chewing gum; G2 - conventional sugar-free chewing gum, without CPP-ACP (placebo); and G3 - sugar-free chewing gum with CPP-ACP. The following parameters were analysed: superficial linear (Ra), volumetric roughness (Sa), and superficial structural loss, which was indicated by Gap measurement (difference between the healthy and treated area). Statistical tests used were the Friedman, Wilcoxon and Shapiro-Wilk, Kruskal Wallis' nonparametric tests and ANOVA. Results: There was a significant reduction in enamel microhardness after demineralisation in all the groups (p<0.05). This deleterious effect was attenuated in the three groups after the final evaluation, although there were no statistical differences (p<0.05); however, the final values did not return to the baseline values (p<0.05). Conclusion: Chewing gum containing CPP-ACP did not promote in situ remineralisation of demineralised enamel around orthodontic brackets.

Bond strength of different orthodontic brackets produced with different materials and fabrication methods / Resistência de união de bráquetes ortodônticos produzidos com diferentes materiais e métodos de fabricação

Objective: The aim of this study was to evaluate the effects of material and processing methods on the bond strength of orthodontic brackets. Material and Methods: Five types of brackets were tested: Conventional metallic (CM), metallic sandblasted (SB), ceramic (C), polycarbonate (PC), and metallic fabricated by melting injection molding (MIM). Shear bond strength (SBS) was conducted to check bond strength of the brackets bonded to bovine teeth (n=10/group), and tensile bond strength (TBS) (20 brackets/group) to check bracket retention to bonding material (n=20/group). Both, SBS and TBS were conducted with 1mm/min crosshead speed in a universal testing machine. Bond strength was calculated in Megapascal (MPa) based on force (N) and bracket area (mm 2). Data normality was verified, and One-way ANOVA was the statistical test with Tukey post-hoc (α=0.05). Results: SB and MIM presented higher SBS compared to C, PC, and CM (p<0.05). SB and MIM also presented significantly higher TBS compared to CM and PC (p<0.05). However, MIM was not different of C for TBS. Conclusion: The type of material and method of fabrication are determinant factors that affect bond strength of orthodontic brackets and melting injection molding (MIM) is a remarkable technology to improve brackets retention during the orthodontic treatment. (AU)

Objetivo: O objetivo deste estudo foi avaliar os efeitos dos materiais e métodos de processamento na resistência de união de bráquetes ortodônticos. Material e Métodos: Cinco tipos de bráquetes foram testados: Convencionais metálicos (CM), metálicos jateados (SB), cerâmico (C), policarbonato (PC), e metálico fabricado por injeção de metal fundido em molde (MIM). A resistência de união ao cisalhamento (SBS) foi conduzida para verificar a resistência de união dos bráquetes aderidos a dentes bonivos (n=10/grupo) e a resistência à tração (TBS) (20 bráquetes/grupo) para verificar a retenção do bráquete ao material adesivo (n=20/grupo). SBS e TBS foram conduzidas com relação carga/velocidade de 1mm/min em uma máquina de ensaios universal. A resistência de união foi calculada em Megapascal (MPa) com base na força (N) pela área do bráquete (mm 2). A normalidade dos dados e a estatística foi realizada utilizando One-way ANOVA e Tukey post-hoc (α=0.05). SB e MIM apresentaram os maiores valores de SBS comparados com C, PC e CM (p<0.05). Resultados: SB e MIM também apresentaram valores significativamente maiores de TBS comparados com CM e PC (p<0.05). Contudo, os valores de TBS para o grupo MIM não foram significativamente diferentes de C. Conclusão: O tipo de material e o método de fabricação são fatores determinantes que afetam a resistência de união de bráquetes ortodônticos e a injeção de metal fundido em molde (MIM) é uma tecnologia relevante para melhorar a retenção dos bráquetes durante o tratamento ortodôntico. (AU)

Effectiveness of different orthodontic adhesives and a universal bonding resin on the bond strength of brackets to different ceramics / Eficácia de diferentes adesivos ortodônticos e uma resina de ligação universal na resistência adesiva de bráquetes à diferentes cerâmicas

Objective: The aim of this study was to evaluate the effectiveness of different adhesives on the shear bond strength (SBS) of brackets bonded to different ceramic materials. Material and Methods: Fifty disk-shaped specimens were produced from lithium disilicate (IPS e.max CAD) and monolithic zirconia (Cercon) materials. Each specimen was polished with a three-step diamond polishing system. The polished ceramic surfaces were conditioned with universal bonding resin (Assure Plus) without pre-treatment, except for two specimens. Central brackets were bonded onto different ceramic specimens with different adhesives as follows: group 1: conventional adhesive onto the lithium disilicate; group 2: one-step adhesive onto the lithium disilicate; group 3: conventional adhesive onto the monolithic zirconia; group 4: one-step adhesive onto the monolithic zirconia. After thermal cycling, the specimens were subjected to the SBS test. The adhesive remnant index (ARI) scores were also recorded to evaluate bond failure type. Kruskal­Wallis and Mann-Whitney U tests were used for statistical analysis. Results: There were statistically significant differences among the SBS values (p˂0.05). The monolithic zirconia group with universal bonding resin and conventional orthodontic adhesive demonstrated the highest SBS value (6.34 MPa) and ARI scores. The lithium disilicate group showed the lowest SBS value (2.17 MPa) with the same protocol. No adhesive remained on the lithium disilicate specimens. Conclusion: One-step adhesive and universal bonding resin combination should not be considered as an alternative for lithium disilicate and monolithic zirconia restorations. Conventional adhesive and universal bonding resin application can be effective on non-pretreated ceramic surfaces during orthodontic bonding (AU)

Objetivo: o objetivo deste estudo foi avaliar a eficácia de diferentes adesivos na resistência ao cisalhamento (SBS) de bráquetes colados a diferentes materiais cerâmicos. Material e métodos: Cinquenta espécimes em forma de disco foram produzidos a partir de materiais de dissilicato de lítio (IPS e.max CAD) e zircônia monolítica (Cercon). Cada amostra foi polida com um sistema de polimento de diamante de três passos. As superfícies cerâmicas polidas foram condicionadas com resina de ligação universal (Assure Plus) sem pré-tratamento, exceto para dois corpos-de-prova. Bráquetes centrais foram colados em diferentes corpos de prova cerâmicos com diferentes adesivos da seguinte forma: grupo 1: adesivo convencional sobre dissilicato de lítio; grupo 2: adesivo de uma etapa sobre o dissilicato de lítio; grupo 3: adesivo convencional sobre zircônia monolítica; grupo 4: adesivo de uma etapa sobre a zircônia monolítica. Após a ciclagem térmica, os corpos-de-prova foram submetidos ao teste SBS. Os escores do índice de remanescente adesivo (ARI) também foram registrados para avaliar o tipo de falha de adesão. Os testes U de Kruskal-Wallis e Mann-Whitney foram usados para análise estatística. Resultados: Houve diferenças estatisticamente significativas entre os valores de SBS (p˂0,05). O grupo de zircônia monolítica com resina de colagem universal e adesivo ortodôntico convencional demonstrou o maior valor de SBS (6,34 MPa) e escores de ARI. O grupo de dissilicato de lítio apresentou o menor valor de SBS (2,17 MPa) com o mesmo protocolo. Nenhum adesivo permaneceu nas amostras de dissilicato de lítio. Conclusão: A combinação de adesivo de uma etapa e resina de ligação universal não deve ser considerada como uma alternativa para restaurações de dissilicato de lítio e zircônia monolítica. A aplicação de adesivo convencional e resina de colagem universal podem ser eficazes em superfícies de cerâmica não pré-tratadas durante a colagem ortodôntica (AU)

Comparative Study of the Shear Bond Strengths and Bracket Failure Rates of Two Orthodontic Adhesive Systems

Abstract Objective: To evaluate and compare the shear bond strengths (SBS) and bracket failure rates (BFR) of orthodontic brackets bonded with Light Cure adhesive against those bonded with Self Cure adhesive. Material and Methods: The study had in vitro and in vivo parts. In the in vitro part to determine SBS of Light Bond(LB)(R) and Rely.a.Bond(RB)(R) adhesives used in bonding brackets to 88 extracted teeth, each adhesive type was used to bond 44 brackets. The clinical study was conducted to determine the BFR of the LB(R) and RB(R) adhesives by bonding 256 teeth using each adhesive type. A standardized bonding procedure was followed in both the in vitro and in vivo parts of the study. Data were analyzed using frequency, percentage, mean, independent t-test, chi-square, and Pearson Correlation statistics. A p-value of ≤ 0.05 was considered significant. SPSS version 21.0 was used to analyze the data generated. Results: There was a significantly higher mean SBS 10.6MPa for LB(R) adhesive than the 7.0MPa of the RB(R) adhesive. In the in vivo study, (LB)(R) had a greater but not significant BFR of 9.0% than RB(R) (8.0%). No significant relationship existed between the SBS of either adhesive type (as determined in vitro) and their BFR in vivo. Conclusion: Higher SBS of LB(R) did not translate to less BFR in the clinic, nor did a lower SBS of RB(R) translate to more BFR in the clinic (AU).

Estabilidad: Análisis de la inclinación del incisivo inferior luego del tratamiento ortodóncico / Stability: Analysis of the inclination of the lower incisor after orthodontic treatment

Este trabajo de investigación tiene como finalidad comparar la inclinación del incisivo inferior pre y post-tratamiento en pacientes tratados ortodóncicamente con técnicas Roth y técnica Damon a los cuales no se les realizó exodoncias. El grupo de estudio estuvo conformado por 150 pacientes adultos con dentición permanente completa que han sido atendidos en el Círculo Argentino de Odontología. Para medir la inclinación se utilizó la fórmula de Tweed: ángulo IMPA, eje axial del incisivo inferior con el plano mandibular. Los valores tomados de los trazados pre y post-tratamiento fueron sometidos a un test de Student apareado utilizando el programa Infostat v 2010. Se encontró una diferencia significativa en la inclinación axial del incisivo inferior post tratamiento cualquiera sea la técnica utilizada, aumenta en ambos casos. No se realizó discriminación de torques (Roth ­ 1°, Damon torque estándar ­ 3°, Damon bajo torque - 11°) (AU)

This research work aims to compare the inclination of the lower incisor before and after treatment in patients treated orthodontically with Roth techniques and Damon technique to which no exodontics were performed. The study group consisted of 150 adult patients with complete permanent dentition who have been treated in Circulo Argentino de Odontología. To measure the inclination the Tweed formula was used: IMPA angle, axial axis of the lower incisor with the mandibular plane. The values taken from the pre and post-treatment plots were subjected to a Student test paired using the Infostat v 2010 program. A significant difference was found in the axial inclination of the lower incisor post treatment whatever the technique used, it increases in both cases. No torques discrimination was performed (Roth - 1 °, Damon standard torque - 3 °, Damon under torque - 11 °) (AU)

In vitro effect of experimental nanocomposites solutions on the prevention of dental caries around orthodontic brackets

Abstract This study aimed to evaluate the in vitro effect of a single application of experimental nanocomposite solutions on the prevention of dental caries around orthodontic brackets. The specimens were exposed to mesoporous silica (MS) nanocomposites containing fluoride by association with titanium tetrafluoride (TiF4) or sodium fluoride (NaF). Nanocomposites also could contain calcium and groups were described as MSCaTiF4, MSTiF4, MSCaNaF, MSNaF, and controls (TiF4, and NaF). Specimens were subjected to the formation of a multispecies biofilm to generate a cariogenic challenge. After 24h, both pH and total soluble fluoride concentration of the culture medium were assessed. Mineral loss was evaluated by percentage of surface mineral loss (%SML), mineral volume variation (ΔZ) of inner enamel and polarized light microscopy (PL). Linear (Ra) and volumetric (Sa) surface roughness and scanning electronic microscopy (SEM) were used to assess enamel topography. Statistical analyses were conducted considering p<0.05. MSNaF had the highest value of culture medium pH after cariogenic challenge, similarly to MSTiF4. All nanocomposite solutions released less fluoride than their controls NaF and TiF4 (p<0.05). All nanocomposite solutions presented lower %SML compared to their respective control groups (p<0.05). Lower Ra, Sa and ΔZ were observed for experimental groups compared to TiF4 (p<0.05). The results were confirmed by PL and SEM analysis. The experimental nanocomposite solutions contributed for lower enamel demineralization around orthodontic brackets.

RESUMO Este estudo teve como objetivo avaliar o efeito in vitro de uma única aplicação de soluções experimentais de nanocompósitos na prevenção de cárie dentária em braquetes ortodônticos. Os espécimes foram expostos a nanocompósitos de sílica mesoporosa (MS) contendo fluoreto por associação com tetrafluoreto de titânio (TiF4) ou fluoreto de sódio (NaF). Os nanocompósitos também podem conter cálcio e os grupos foram descritos como MSCaTiF4, MSTiF4, MSCaNaF, MSNaF e controles (TiF4 e NaF). Os espécimes foram submetidos à formação de um biofilme multiespécie para gerar um desafio cariogênico. Após 24h, o pH e a concentração de flúor solúvel total do meio de cultura foram avaliados. A perda mineral foi avaliada pela porcentagem de perda mineral superficial (% SML), variação do volume mineral (ΔZ) do esmalte interno e microscopia de luz polarizada (PL). A rugosidade superficial linear (Ra) e volumétrica (Sa) e a microscopia eletrônica de varredura (MEV) foram utilizadas para avaliar a topografia do esmalte. As análises estatísticas foram realizadas considerando p <0,05. MSNaF apresentou o maior valor de pH do meio de cultura após o desafio cariogênico, semelhante ao MSTiF4. Todas as soluções de nanocompósitos liberaram menos flúor do que seus controles NaF e TiF4 (p <0,05). Todas as soluções de nanocompósitos apresentaram% SML menor em comparação com seus respectivos grupos de controle (p <0,05). Ra, Sa e ΔZ menores foram observados para os grupos experimentais em comparação ao TiF4 (p <0,05). Os resultados foram confirmados por análises PL e SEM. As soluções experimentais de nanocompósitos contribuíram para a menor desmineralização do esmalte ao redor dos braquetes ortodônticos.

Caracterización morfológica de caninos en premolares, un caso de anodoncia parcial de caninos maxilares / Morphological characterization of canine teeth done in first bicuspid, a maxillary canine partial anodontia case report

En este informe de caso clínico se muestra el tratamiento exitoso de un paciente con anodoncia parcial de órganos dentales 13 y 23 debido a que fueron extraídos por presentar impactación y mal pronóstico de tracción. En este artículo se presenta un paciente masculino de 29 años clase I esquelética con un perfil convexo, maloclusión de clase III, overjet disminuido, ausencia de guías funcionales, discrepancia oseodentaria positiva en arcada superior y negativa en arcada inferior. El tratamiento se realizó con extracciones de los órganos dentales 34 y 44 para nivelar las discrepancias óseo dentarias interarcadas, se llevó a cabo mediante un cierre de espacios recíproco por medio de cadenas elásticas para ambas arcadas, con lo que se logró crear un overjet y overbite adecuados. La creación de las guías caninas funcionales se consiguió mediante el cambio de morfología de los órganos dentales 14 y 24, los cuales fueron llevados a la posición de los caninos ausentes. El tiempo total de tratamiento para este paciente fue de 24 meses. Se realizaron ameloplastias positivas, la aplicación de agregados de resina para mejorar la funcionalidad y proveer salud articular. Se sugiere que ante casos de anodoncia de caninos en la arcada superior, un tratamiento favorable se puede llevar a cabo mediante el cierre de espacios, la caracterización morfológica de los caninos ausentes mediante ameloplastias positivas en premolares (AU)

This case report shows the successful treatment of a patient with partial anodontia of dental organs 13 and 23 because they have been extracted due to present impactation and poor traction prognosis. This article presents a 29-year-old male class I skeletal patient with convex profile, class III malocclusion, overjet reduction, absence of functional guidance, positive bone-teeth discrepancy in the upper arch and negative in the lower arch. The treatment was carried out with the extractions of the dental organs 34 and 44 for correcting oral dental discrepancies between upper and lower arches; it was done using reciprocal closing of spaces by using elastic chains for both arches in order to achieve a suitable overjet and overbite. The creation of the canine guides was achieved by changing the morphology of the dental organs 14 and 24, which were taken to the position of the absent canines. The total treatment timing for this patient was 24 months. Positive ameloplasties were performed by application of resin aggregates to improve functionality and provide joint health. A favorable treatment for these kinds of cases of canine anodontics in the upper arch is carried out by closing spaces and the morphological characterization of the absent canines by positive in-premolar ameloplasties (AU)

Morphometric evaluation of the slot of aesthetic orthodontic brackets / Evaluación morfométrica de la ranura de brackets estéticos ortodóncicos

Introduction: Dental malocclusion is a public health problem and orthodontics is the specialty in charge of diagnosing and treating it, aesthetic brackets are an alternative, the costs are varied, which makes its precision doubtful. Objective: Evaluate the measurement and geometry of the slot of three brands of aesthetic brackets and verify their precision. Material and Methods: Twenty-four aesthetic Roth prescription 0.022" slot polycrystalline ceramic brackets were evaluated in three brands: American Orthodontics (United States), Morelli (Brazil) and Class One (China). Eight samples were measured per group in a specialized laboratory certified in measurement and calibration, the measurements of internal and external height were verified, per mesial and distal; and the parallelism of the slot of each bracket. The results were processed with SPSS 22 and tests of variance (ANOVA), Tukey and Student's t were used. Results:The measurements of the brackets' grooves do not correspond to the measurements announced by the manufacturers, these are greater, however, American Orthodontics is within the tolerance range (p<0.01); the slots in the mesio-distal direction and the lingual vestibule are not parallel in Morelli and Class One. Conclusion: The results of this study indicate that the slots of the supports are oversized, their geometry is not precise and varies greatly between brands and prices. The three-dimensional control of the tooth could be compromised.

Introducción: La maloclusión dental es un problema de salud pública y la ortodoncia es la especialidad encargada de diagnosticarla y tratarla, los brackets estéticos son una alternativa, los costos son variados lo que hace dudar su precisión. Objetivo: Evaluar la medida y geometría de la ranura de tres marcas de brackets estéticos y corroborar su precisión. Material y Métodos: Se evaluaron 24 brackets estéticos cerámicos policristalinos de ranura 0,022" prescripción Roth en tres marcas: American Orthodontics (Estados Unidos), Morelli (Brasil) y Class One (China). Se midieron ocho muestras por grupo en un laboratorio especializado y certificado en medición y calibración, se verificaron las medidas de altura interna y externa, por mesial y distal; y el paralelismo de la ranura de cada brackets. Los resultados fueron procesados con SPSS 22 y se utilizaron pruebas de varianza (ANOVA), Tukey y t de Student. Resultados: Las medidas de las ranuras de los brackets no se corresponden con la medida anunciada por los fabricantes, estas son mayores, sin embargo, American Orthodontics y Morelli se encuentra dentro del rango de tolerancia (p<0,01); las ranuras en sentido mesio distal y vestíbulo lingual no son paralelas estadísticamente en Morelli y Class One. Conclusión: Los resultados de este estudio indican que las ranuras de los soportes se encuentran sobredimensionadas, su geometría no es precisa y varía mucho entre marcas y precios. El control tridimensional del diente se podría ver comprometido.

Análisis comparativo in vitro de la resistencia adhesiva al cizallamiento de brackets metálicos adheridos a superficies dentarias tratadas con diferentes agentes blanqueadores / Comparative in vitro analysis of the adhesive resistance to the shear bond strength of metal brackets adhered to dental surfaces treated with different bleaching agents

RESUMEN: Objetivo: Evaluar y comparar el efecto de tres agentes blanqueadores en la resistencia adhesiva al cizallamiento de brackets metálicos. Método: Se cementaron 76 brackets en premolares humanos extraídos por indicación de ortodoncia. Se establecieron 4 grupos: (0) control, (1) esmalte tratado con Peróxido de Carbamida al 16%, (2) Peróxido de Hidrógeno al 35% y (3) tiras de blanqueamiento con Peróxido de Hidrógeno al 10%. Los brackets fueron cementados con Transbond XT (3M Unitek, EE.UU.). Se realizaron 5.000 ciclos de termociclado, luego se evaluó la resistencia adhesiva mediante una máquina Bisco y la cantidad de material adhesivo remanente según el índice adhesivo remanente (ARI). El análisis estadístico incluyó pruebas de Shapiro- Wilk, Kruskal -Wallis y Mann-Whitney. Resultados: Los grupos 0, 1, 2, 3 obtuvieron fuerzas de resistencia de 12.64, 11.06, 6.4 y 9.34 Mpa respectivamente con diferencia estadística entre los grupos (p <0.05). El ARI fue significativamente diferente en algunos grupos (p <0.05), indicando fallas adhesivas para el grupo 2 (p <0.05), cohesivas para el grupo control y de ambos tipos para los grupos 1 y 3. Conclusiones: El peróxido de hidrógeno al 35% reduce la resistencia adhesiva al cizallamiento en brackets metálicos sometidos a termociclado 24 horas luego del blanqueamiento.

ABSTRACT: Aim: To evaluate and compare the effect of three bleaching agents on the shear bond strength of metallic brackets. Method: Brackets were cemented on 76 human premolars extracted for orthodontic reasons. 4 groups were evaluated: (0) Control, (1) enamel treated with Carbamide Peroxide 16%, (2) Hydrogen Peroxide 35% and (3) Hydrogen Peroxide 10% "Whitening strips". All brackets were cemented using Transbond XT adhesive system (3M, Unitek, USA). All samples were thermocycled (5.000 cycles). Shear bond strength was evaluated with a Bisco machine and the amount of adhesive material at the base of the brackets and enamel surface was assessed using the adhesive remnant index (ARI). The statistical analysis included Shapiro-Wilk, Kruskal-Wallis and Mann-Whitney U tests. Results: The results of shear bond strength for groups 0, 1, 2, and 3 were 12.64, 11.06, 6.4 and 9.34 MPa respectively, with statistically significant differences between groups (p <0.05). ARI index was significantly different in some groups (p <0.05), indicating cohesive failure for control, adhesive failure for group 2 (p <0.05), adhesive and cohesive failure for groups 1 and 3. Conclusions: The 35% hydrogen peroxide office bleaching agent reduces adhesion values in the metal brackets thermocycled 24 hours after bleaching.

CO2 laser irradiation for debonding ceramic orthodontic brackets

Abstract This study evaluated shear bond strength (SBS), adhesive remnant index (ARI) and fracture mode of chemically and mechanically retained ceramic brackets bonded with different composite resins and irradiated with CO2 laser. The null hypothesis was that ceramic brackets bonded with different composite resins and irradiated with CO2 laser would have similar SBS values. Ninety human premolars were divided into four experimental groups according to the combination of type of composite resin (Transbond XT and Z 250) and type of ceramic bracket (Fascination and Mystique), and two control groups (n=15). In the four experimental groups, the brackets were irradiated with CO2 laser at 10 W for 3 seconds before SBS testing. Enamel surface ARI was calculated after debonding under electron microscopy scanning. ANOVA and the Mann-Whitney test were used for statistical analysis. The laser groups had lower SBS values than the non-irradiated groups (control) (p<0.05). The mechanically retained brackets (Mystique) had the higher (p<0.05) and Z250 had the lower SBS values after CO2 laser irradiation. The groups bonded with Z250 had the highest ARI. Adhesive fractures were the most prevalent. The null hypothesis was rejected. CO2 laser decreased SBS efficiently and facilitated debonding of mechanically and chemically retained ceramic brackets.

Resumo O objetivo do estudo foi avaliar a resistência de união ao cisalhamento da colagem (RCC), o índice de remanescente de adesivo (IRA) e o modo de fratura de bráquetes cerâmicos com retenção química e mecânica colados com diferentes compositos e irradiados com laser de CO2. A hipótese nula testada foi que bráquetes colados com diferentes compósitos e irradiados com laser de CO2 apresentam valores semelhantes de RCC. Noventa pré-molares humanos foram divididos em 6 grupos (n=15): 2 controles e 4 experimentais que se diferenciaram pelo tipo de bráquete ceramic (Fascination and Mystique) e pelo compósito de fixação (Transbond XT e Z 250). Nos quatro grupos experimentais, os bráquetes foram irradiados com laser de CO2 com 10W por 3 segundos anteriormente ao teste de RCC. O IRA das superficies de esmalte foram avaliados após a descolagem e submetidos a análise em microscopia electrônica de varredura (MEV). Para análise estatística foram utilizados ANOVA e o teste de mann-Whitney. Os grupos laser mostraram valores de RCC menores que os grupos não irradiados (controles) (p<0.05). Os bráquetes com retenção mecânica (Mystique) mostraram alta RCC (p<0.05) e o compósito Z 250 obteve os mais baixos valores de RCC após irradiação com laser. Os grupos colados com o compósito Z 250 apresentaram os mais altos escores do IRA. O modo de fratura mais prevalente foi a adesiva. A hipótese nula foi rejeitada. O laser de CO2 foi eficaz para diminuir os valores de RCC e facilitou a descolagem dos bráquetes cerâmicos de retenção química e mecânica

Eficacia del cementado indirecto / Indirect bonding efficiency

La aparición de aparatología preadjustada ha colaborado en la efectividad de los tratamientos de ortodoncia, pero para que la expresión de esta aparatología se logre, es necesario una correcta colocación de los brackets y la permanencia de estos en boca durante todo el tratamiento. La precisión en la colocación mejora con la técnica de cementado indirecta, ya que permite el acceso a las zonas posteriores, a lugares donde se ve disminuida la visión y además disminuye la condensación de aliento y contaminación salival. Si bien esta técnica requiere tiempo extra de laboratorio, es más rápida en la etapa clínica (AU)

Influence of dental erosion on shear bond strength of ceramic brackets bonded with two different adhesive systems: an in vitro study

This study aimed to analyze the shear bond strength (SBS) of ceramic orthodontic brackets bonded with two different adhesive systems to intact and eroded teeth. Ceramic brackets were bonded to 72 bovine central incisors divided into four groups, defined by two study factors: enamel condition (control group, kept in artificial saliva; and experimental group, eroded by using immersion cycles in Coke™ for 90 seconds, every six hours for five days), and adhesive system type (Transbond™ XT or Transbond™ Plus Color Change). Polycrystalline ceramic brackets were adhesively fixed on all specimens using the same light curing protocol. SBS was tested using 0.5 mm/min and the failure mode was classified. SBS data was analyzed using two-way ANOVA followed by Tukey test. The adhesive remnant index (ARI) scores were analyzed using Kruskal-Wallis test with Dunn's post-hoc pairwise comparison (α=0.05). Percentages of ARI scores between the groups were compared by Fisher's exact test. Spearman's correlation coefficient was applied to investigate the correlation between ARI scores and SBS values. Only the adhesive system factor had significant effect on SBS (p=0.014), Transbond™ Plus Color Change showing higher values. No significance was found for enamel condition (p=0.665) or the interaction between adhesive system and enamel condition (p=0.055). ARI scores frequencies differed between groups (p<0.001). The median ARI scores were statistically different for most comparisons among the groups. However, no significant correlation was found between ARI scores and SBS. In conclusion, the type of adhesive system affected the SBS of ceramic brackets to dental enamel, but the enamel condition, intact or eroded, had no significant effect. There was no correlation between ARI scores and SBS values, although eroded enamel tended to retain more adhesive after bracket removal.

Chromatic analysis of orthodontic resin bonding agents exposed to different antiseptic mouthrinses

ABSTRACT Objective: To assess the color of different orthodontic resin bonding agents exposed to three antiseptic mouthrinses for a prolonged time interval (10-year aging simulation). Methods: 160 specimens were distributed into four groups, according to the orthodontic resin bond agent (Concise, Transbond XT, Transbond Plus Color Change, and Natural Ortho). Each group was exposed to different antiseptic mouthrinses: alcohol-based (Listerine®), alcohol-free (Oral-B®), chlorhexidine (Periogard®) and distilled water as the control. Specimens were submitted to two cycles of staining and artificial aging. Color was evaluated by means of a digital spectrophotometer at the beginning of the experiment and after every cycle. The system used to assess color changes was the CIE L*a*b*. Data was analyzed using the ANOVA and Tukey post-hoc test. Results: After simulation of 10 years of aging, Transbond XT and Natural Ortho composites presented no statistically significant differences in ∆E when exposed to different mouthrinses. The Concise composite specimens exposed to alcohol-free mouthrinse presented a significant difference when compared with specimens from the same group exposed to other antiseptic mouthrinses. Transbond Plus Color Change specimens exposed to chlorhexidine mouthrinse and to alcohol-containing mouthrinse presented a significant difference when compared with the specimens from the group exposed to water and alcohol-free antiseptic. Conclusion: All orthodontic resin bonding agents tested presented clinically perceptible color changes when exposed to at least one of the mouthrinses, except for the Natural Ortho composite. The Concise composite exposed to the alcohol-free solution was the resin that presented the highest color change values.

RESUMO Objetivo: Avaliar a cor de diferentes resinas ortodônticas expostas a três enxaguantes bucais, por um intervalo de tempo prolongado (simulação de 10 anos de envelhecimento). Métodos: 160 espécimes foram distribuídos em quatro grupos, de acordo com a resina de colagem ortodôntica (Concise, Transbond XT, Transbond Plus Color Change e Natural Ortho). Cada grupo foi exposto a diferentes tipos de enxaguantes bucais: à base de álcool (Listerine®), isento de álcool (Oral-B®), clorexidina (Periogard®) ou água destilada, como controle. Os espécimes foram submetidos a dois ciclos de manchamento e envelhecimento artificial. A cor foi avaliada por meio de um espectrofotômetro digital no início do experimento e após cada ciclo. O sistema utilizado para avaliar as alterações de cor foi o CIE L*a*b*. Os dados foram analisados utilizando-se o teste ANOVA e o teste post-hoc de Tukey. Resultados: Após a simulação de 10 anos de envelhecimento, as resinas Transbond XT e Natural Ortho não apresentaram diferenças estatisticamente significativas no ∆E, quando expostas a diferentes enxaguantes bucais. Os espécimes do grupo Concise expostos ao enxaguante bucal sem álcool apresentaram diferença significativa quando comparados aos espécimes do mesmo grupo expostos aos outros enxaguantes bucais. Os espécimes do grupo Transbond Plus Color Change expostos à clorexidina e ao enxaguante bucal à base de álcool apresentaram diferença significativa quando comparados aos espécimes dos grupos expostos à água e ao enxaguante bucal sem álcool. Conclusão: Todas as resinas ortodônticas avaliadas apresentaram alterações de cor clinicamente perceptíveis quando expostas a pelo menos um dos enxaguantes bucais, com exceção da resina ortodôntica Natural Ortho. A resina Concise exposta à solução isenta de álcool foi a que apresentou os maiores valores de alteração de cor.