Manejo odontológico en paciente con síndrome de Cornelia de Lange / Dental treatment of a patient with Cornelia de Lange syndrome

El síndrome de Cornelia de Lange (SCdL) es un trastorno genético poco frecuente y se atribuye principalmente a mutaciones en los genes NIPBL, SMC3 y SMC1A. Sus principales características clínicas son múltiples anomalías congénitas, dimorfismo facial, hirsutismo, hipertricosis, retraso psicomotor, discapacidad intelectual, restricción del crecimiento prenatal y postnatal, anomalías de manos y pies, así como malformaciones congénitas que afectan a distintos órganos. En pacientes con SCdL es necesario hacer hincapié en la higiene oral debido a la discapacidad intelectual que puede presentarse y asegurarse de que se realiza una adecuada valoración y saneamiento dental de forma periódica con el fin de prevenir enfermedades bucodentales. El objetivo de este reporte de caso es describir el manejo odontológico de un paciente de 10 años con SCdL y revisar las características clínicas y hallazgos radiológicos presentes en la cavidad oral (AU)

Cornelia de Lange syndrome (CdLS) is a rare genetic disorder and is principally attributed to mutations in the NIPBL, SMC3 and SMC1A genes. The main clinical characteristics are multiple congenital anomalies, facial dimorphism, hirsutism, hypertrichosis, psychomotor retardation, intellectual disability, prenatal and postnatal growth restriction, hand and foot anomalies, as well as congenital malformations affecting different organs. In patients with CDLS, it is necessary to focus on oral hygiene due to the intellectual disability that may be present and to ensure that adequate dental valuation and hygiene is routinely performed in order to prevent oral diseases. The aim of this case report is to describe the dental management of a 10-year-old patient with CDLS and review the clinical characteristics and radiological findings that are present in the oral cavity (AU)

Harmonização do sorriso: aliando ortodontia e estética / Smile harmonization: combining orthodontics and aesthetics

Atualmente é evidente a demanda contínua por padrões de beleza, cada vez mais impecáveis, um sorriso alinhado e harmônico com dentes brancos para se sorrir com confiança. O tratamento odontológico interdisciplinar tem como intuito proporcionar uma boa saúde periodontal, restabelecer a estética e a função do sistema estomatognático. Objetivo: apresentar um relato de caso clínico envolvendo harmonização do sorriso como cirurgia plástica periodontal para alinhamento da margem gengival na região anterior e restaurações diretas em resina composta após a finalização do tratamento ortodôntico, evidenciando a importância da abordagem conservadora e multidisciplinar no âmbito do tratamento estético. Relato de caso: Realizamos o tratamento ortodôntico com aparelho autoligado cerâmico para alinhamento do arco dental e intrusão do elemento 13, em sequência executamos um recorte gengival nos elementos 12 e 22, clareamento dental associado após 15 dias, subsequentemente, reanatomização dentária no elemento 44 para que o elemento 13 não voltasse a extruir pela falta de contato oclusal, e por fim, remodelação dental fazendo uso de resina composta nos elementos 12, 21 e 22 devido a manchas de hipocalcificação dental. Conclusão: Contudo, a estética bucal tem a capacidade de possibilitar a melhoria na autoestima, devolvendo à função, proporcionando satisfação e bem-estar ao indivíduo, enaltecendo o sorriso.

Currently, the continuous demand for increasingly impeccable beauty standards is evident, an aligned and harmonic smile with white teeth to smile with confidence. Interdisciplinary dental treatment aims to provide good periodontal health, restore the aesthetics and function of the stomatognathic system. Objective: to present a clinical case report involving smile harmonization as periodontal plastic surgery for aligning the gingival margin in the anterior region and direct composite resin restorations after completion of orthodontic treatment, highlighting the importance of a conservative and multidisciplinary approach in the field of aesthetic treatment . Case report: We performed orthodontic treatment with a self-ligating ceramic appliance for aligning the dental arch and intruding element 13, then performed a gingival cutout on elements 12 and 22, associated tooth whitening after 15 days, subsequently, dental reanatomization on element 44 to that element 13 would not extrude again due to the lack of occlusal contact, and finally, dental remodeling using composite resin in elements 12, 21 and 22 due to dental hypocalcification stains. Conclusion: However, oral aesthetics has the ability to improve self-esteem, returning to function, providing satisfaction and well-being to the individual, enhancing the smile.

Tratamiento integral de una adolescente con dentinogénesis imperfecta tipo I / Comprehensive treatment of an adolescent with type I dentinogenesis imperfecta

La dentinogénesis imperfecta (DI) es un desorden hereditario de carácter autosómico dominante, que se origina durante la etapa de histodiferenciación en el desarrollo dental y altera la formación de la denti-na. Se considera una displasia dentinaria que puede afectar ambas denticiones con una incidencia de 1 en 6000 a 8000 nacimientos. El tratamiento del pa-ciente con DI es complejo y multidisciplinario, supone un desafío para el odontólogo, ya que por lo general están involucradas todas las piezas dentarias y afec-ta no solo la salud buco dental sino el aspecto emo-cional y psicológico de los pacientes. Objetivo: des-cribir el tratamiento integral y rehabilitador realiza-do en una paciente adolescente con diagnóstico de DI tipo I. Relato del caso: Paciente de sexo femenino de 14 años, que concurrió en demanda de atención a la Cátedra de Odontología Integral Niños de la FOU-BA derivada del Hospital "Prof. Dr. Juan P. Garrahan" con diagnóstico de osteogénesis imperfecta tipo III (OI). Nunca recibió atención odontológica y el motivo de consulta fue la apariencia estética de sus piezas dentarias. Se realizó el examen clínico y radiográfico arrojando el diagnóstico de DI tipo I asociada a OI. Conclusión: El tratamiento rehabilitador de la DI tipo I en los pacientes en crecimiento y desarrollo debe estar dirigido a intervenir de manera integral y tem-prana para resolver la apariencia estética y funcio-nal, evitar las repercusiones sociales y emocionales y acompañar a los pacientes y sus familias (AU)

Dentinogenesis imperfecta (DI) is an autosomal dominant inherited disorder that originates during the histodifferentiation stage of tooth development and alters dentin formation. It is considered a den-tin dysplasia that can affect both dentitions with an incidence of 1 in 6000 to 8000 births. The treatment of patients with DI is complex and multidisciplinary, it is a challenge for the dentist, since in general all the teeth are involved and it affects not only oral health but also the emotional and psychological aspect of the patients. Objective: To describe the comprehen-sive and rehabilitative treatment carried out in an adolescent patient with a diagnosis of DI type I. Case report: A 14-year-old female patient, who required dental attention at the Department of Pediatric Den-tistry of FOUBA and was referred from the Hospital "Prof. Dr. Juan P. Garrahan" with a diagnosis of os-teogenesis imperfecta type III (OI). The patient never received dental care and the reason for consultation was esthetic appearance of her teeth. A clinical and radiographic examination was performed, resulting in a diagnosis of DI type I associated with OI. Conclu-sion: Rehabilitative treatment of DI in growing and developing patients will be aimed at early and com-prehensive intervention to resolve esthetic and func-tional appearance, avoid social and emotional reper-cussions and accompany patients and their families (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.

The Effect of Chlorhexidine on Bacterial Contamination of Hall Technique Elastomeric Orthodontic Separators and Gingival Health: A Pilot Study

ABSTRACT Objective: To study the effect of chlorhexidine on elastomeric orthodontic separators (EOS) bacterial-colonisation and gingival-health in Hall technique (HT) patients. Material and Methods: Prospective in-vivo pilot clinical study of EOS bacterial colonisation and primary-molar gingival health assessment in 20 patients (mean age 5.45±1.27 years) requiring bilateral HT crowns (40 teeth). One side received 1-minute 0.12% chlorhexidine-soaked-EOSs (Chx-EOSs), and the other side dry-EOSs (NoChx-EOSs). The EOSs were removed five-days later and underwent a bacterial enumeration technique. Plaque (PI) and Gingival (GI) indices were assessed pre-, five-days and three-months post-treatment. Wilcoxon-Signed-Rank/McNemar-Chi-square statistics were used (p<0.05). Results: Baseline unused/packaged EOSs' sterility check yielded zero colony-forming-units (CFU) per millilitre, but 100% of the used EOSs became colonised by oral-microorganisms. An overall trend of lower mean CFU count in Chx-EOSs (3.415± 0.78 x105 CFU/ml) compared to NoChx-EOSs (6.157±1.48 x105 CFU/ml) was observed (p=0.009). Both NoChx-EOSs and Chx-EOSs insertion sites showed evidence of gingivitis with no difference between PI and GI indices by site over time. Conclusion: There was a lower trend of bacterial colonization in chlorhexidine treated EOSs and an occurrence of gingivitis pre/post HT-treatment regardless of EOS type. The lack of difference in the gingival health may be inconclusive due to this pilot's low power suggesting the need for robust large scale studies.

Mandibular advancement with clear aligners and functional appliances in the treatment of skeletal ClassⅡmalocclusion: a systematic review and meta-analysis / 华西口腔医学杂志

OBJECTIVES@#This study aimed to conduct a meta-analysis of the efficacy of mandibular advance clear alig-ners with traditional functional appliances as the control group.@*METHODS@#PubMed, Web of Science, Embase, Cochrane Library, China Biomedical Abstracts Database, China Knowledge Network Database, Wanfang Database, and Weipu Database were used in this study. The two groups of researchers screened the literature and extracted data based on the inclusion and exclusion criteria established by PICOS entries, and used the ROBINS-I scale for quality evaluation. Revman 5.4 and Stata 17.0 software were used for meta-analysis.@*RESULTS@#Nine clinical controlled trials were included in this study with a total sample size of 283 cases. No significant difference was found in SNA, SNB, ANB, Go-Pog, U1-SN, Overjet, and other aspects between the invisible group and the traditional group in the treatment of skeletal class Ⅱ ma-locclusion patients; there was a 0.90° difference in mandibular plane angle between the two groups; the growth of the mandibular ramus (Co-Go) in the traditional group was 1.10 mm more than that in the invisible group; the lip inclination of the lower teeth in the invisible group was better controlled, 1.94° less than that in the control group.@*CONCLUSIONS@#The invisible group can better control the lip inclination of the mandibular anterior teeth when guiding the mandible. Furthermore, the mandibular plane angle (MP-SN) can remain unchanged, but the growth of the mandibular ramus is not as good as the traditional group, and auxiliary measures should be taken to improve it in clinical practice.

Correlação entre os estágios de maturação da sutura palatina mediana e das vértebras cervicais / Correlation between the maturation stages of the median palatal suture and cervical vertebrae

Introdução: Atualmente, a avaliação da maturação da sutura palatina mediana (MSPM) em pacientes que precisam ser submetidos à expansão rápida da maxila é realizada por meio de tomografias computadorizadas de feixe cônico (TCFC). No entanto, doses adicionais de radiação são induzidas ao paciente para a aquisição desse exame. Objetivo: Correlacionar os estágios de MSPM com os estágios de maturação das vértebras cervicais (MVC). Material e métodos: Um total de 268 TCFC da região da cabeça e do pescoço de indivíduos de ambos os sexos e com idades variando entre 5 e 76 anos foram analisadas de forma cega por uma única examinadora. O estágio de MSPM foi avaliado por meio da observação da maxila no corte axial e foi classificado como A, B, C, D ou E. Por outro lado, o estágio de MVC foi avaliado por meio do corte sagital das vértebras cervicais e foi classificado como CS1, CS2, CS3, CS4, CS5 ou CS6. A concordância intraexaminador foi avaliada por meio do Coeficiente Kappa. O teste de Correlação de Spearman foi utilizado para avaliar a correlação entre os estágios de MSPM e os estágios de MVC. Resultados: Uma correlação positiva forte foi encontrada entre os estágios de MSPM e MVC. Os estágios A e B mostraram correlação com os estágios CS1, CS2 e CS3. Diferentemente, o estágio C se correlacionou com maior frequência com os estágios CS4 e CS5. Por fim, os estágios D e E, se mostraram mais frequentes em indivíduos nos estágios CS5 e CS6 de forma similar. Conclusão: A predição da MSPM por meio da MVC em telerradiografias laterais pode ser uma alternativa viável à avaliação sutural na TCFC em pacientes nos estágios CS1, CS2 e CS3. A partir do estágio CS4, uma TCFC é recomendável para avaliar com maior segurança o estágio de MSPM e definir a melhor modalidade de expansão (AU).

Introduction: Currently, the assessment of maturation of the midpalatal suture (MPSM) in patients who need to undergo rapid maxillary expansion is performed using cone-beam computed tomography (CBCT). However, additional doses of radiation are induced to the patient for the acquisition of this exam. Objective: To correlate the stages of MPSM with the stages of maturation of the cervical vertebrae (CVM). Material and methods: A total of 268 CBCT of the head and neck of individuals of both sexes and aged between 5 and 76 years were analyzed blindly by a single examiner. The MPSM stage was assessed by observing the maxilla in the axial view and was classified as A, B, C, D or E. On the other hand, the CVM stage was assessed in the sagittal view of the cervical vertebrae and was classified as CS1, CS2, CS3, CS4, CS5 or CS6. Intraexaminer agreement was analyzed using the Kappa coefficient. Spearman's Correlation test was used to assess the correlation between MPSM and CVM stages Results: A strong positive correlation was found between MPSM and CVM stages. Stages A and B showed correlation with stages CS1, CS2 and CS3. Differently, stage C correlated more frequently with stages CS4 and CS5. Finally, stages D and E were more frequent in individuals in stages CS5 and CS6, similarly. Conclusion: The prediction of MPSM by assessing CVM in lateral cephalograms seems to be a viable alternative to the sutural evaluation in CBCT in patients in stages CS1, CS2 and CS3. From the CS4 stage onwards, a CBCT is recommended to assess the MPSM stage and define the most adequate expansion modality for patients (AU).

Access and financial impacts of public orthodontic provision on global health systems: integrative review / Acesso e impactos financeiros da provisão ortodôntica pública nossistemas de saúde mundiais: revisão integrativa / Acceso e impactos financieros de la provisión pública de ortodoncia en los sistemas de salud globales: revisión integradora

Introduction:The supply of public orthodontic services is still unable to meet the demand for treatment of malocclusions. The resources available are sometimes mismanaged and significant financial impacts contribute to limited access to the services. Objective:To carry out an integrative review regarding the access and financial impacts of public orthodontic service among the various health systems worldwide, considering social inequalities and the referral and counter-referral systems for services. Methodology:A survey was conducted using the BVS (Biblioteca Virtual em Saúde / Virtual Health Library), PubMed, and Cochrane databases, including articles available from 1970 to 2019, which elucidated the guiding question "How does access work and what are the financial impacts of the provision of orthodontic services in different public health systems worldwide?". Results:211 articles were found, of which 20 were analyzed. The chronological distribution was relatively uniform. The topic 'access to orthodontic services' was most frequently reported and there was a predominance of studies addressing the provision of treatment for children and adolescents. Conclusions:There are significant financial impacts and demographics have a strong influence on access to services. The provision of orthodontic treatments by the private sector predominates, preventive approaches are scarce, and an optimization in the use of available resources is necessary. Primary Care has much to contribute in increasing access, reducing costs, and making the referral / counter-referral system effective (AU).

Introdução:A oferta de serviços ortodônticos públicos ainda não consegue suprir a demanda de tratamento de má oclusões. Os recursos disponíveis, por vezes, mal alocados e os impactos financeiros significativos contribuem para a restrição do acesso aos serviços.Objetivo:Realizar uma revisão integrativa pertinente ao acesso e aos impactos financeiros da provisão ortodôntica pública nos diversos sistemas de saúde mundiais, sob a luz das iniquidades sociais e dos sistemas de referência e contrarreferência de serviços.Metodologia:Foi realizado um levantamento nas bases de dados BVS (Biblioteca Virtual em Saúde), PubMed e Cochrane Reviews, incluindo os artigos disponíveis no período de 1970 a 2019, que elucidavam a questão norteadora "Como se dá a provisão de serviços ortodônticos nos diversos sistemas públicos de saúde mundiais?".Resultados:Foram encontrados 211 registros, dos quais 20foram analisados. A distribuição temporal foi relativamente uniforme. A temática "acesso aos serviços ortodônticos" foi mais frequentemente relatada e houve um predomínio de estudos abordando a oferta de tratamentos a crianças e adolescentes. Conclusões:Há impactos financeiros significativos e os determinantes sociais exercem forte influência sobre o acesso aos serviços. Predomina a oferta de tratamentos ortodônticos pelo setor privado, abordagens preventivas são escassas e é necessária uma otimização no uso de recursos disponíveis. A Atenção Básica tem muito a contribuir para aumento do acesso, diminuição de custos e efetivação do sistema dereferência/contrarreferência dos serviços (AU).

Introducción: La provisión de servicios públicos de ortodoncia aún no puede satisfacer la demanda de tratamientos de maloclusión. Los recursos disponibles a veces están mal asignados y los impactos financieros significativos contribuyen a restringir el acceso a los servicios.Objetivo: Realizar una revisiónintegradora pertinente al acceso y los impactos económicos de la provisión pública de ortodoncia en los diferentes sistemas de salud a nivel mundial, a la luz de las inequidades sociales y los sistemas de derivación y contrarreferencia de servicios.Metodología: Se realizó una encuesta en las bases de datos de la BVS (Virtual Health Library), PubMed y Cochrane Reviews, incluidos los artículos disponibles desde 1970 hasta 2019, que dilucidó la pregunta orientadora "¿Cómo es la prestación de servicios de ortodoncia en los diferentes sistemas públicos?".Resultados: Se encontraron 211registros, de los cuales se analizaron 20.La distribución temporal fue relativamente uniforme. El tema "acceso a servicios de ortodoncia" fue el que se informó con mayor frecuencia y hubo un predominio de estudios que abordan la provisión de tratamientos a niños y adolescentes.Conclusiones: Hay impactos económicos significativos y los determinantes sociales tienen una fuerte influencia en el acceso a los servicios. Predomina la oferta de tratamientos de ortodoncia por parte del sector privado, los abordajes preventivos son escasos y es necesario optimizar el uso de los recursos disponibles. La Atención Primaria tiene mucho que contribuir para aumentar el acceso, reducir costos e implementar el sistema de derivación / contrarreferencia de servicios (AU).

Manejo de defectos tipo recesiones múltiples luego de la terapia de ortodoncia: un caso reportado basado en la evidencia científica / The management of multiple recession like defects after orthodontic therapy: report of a case based on scientific evidence

Por qué en este caso hay nueva in- formación? - Este caso demostró métodos basado en la evidencia para el manejo de severas recesiones gingivales luego de la terapia or- todóntica. - La modificación del grosor gin- gival lleva a resultados estables a largo plazo estéticos y funcio- nales. - Este caso demostró beneficios clínicos usando injertos tomados desde el mismo sitio donador en diferentes momentos de tiempo. Cuales son las claves de éxito para manejar este caso? - Sólidos conocimientos de la anatomía periodontal - Identificación de las caracterís- ticas de RC relacionadas con las causas de la terapia ortodóntica. - ITCSE su toma del paladar. - Uso de colgajos sin tensión. - Incremento del grosor gingival para promover resultados a largo plazo. Cuales son las limitaciones prima- rias del éxito en este caso? - Necesidad de tomas de paladar en ambos lados - Anatomía de las RG y la fina en- cía que puede limitar la extensión del colgajo - Experiencia clínica (AU)

Odontomas: un reto para el tratamiento interdisciplinario del paciente de ortodoncia / Odontomas: a challenge for the interdisciplinary treatment of the orthodontic patient

El objetivo del presente trabajo es describir las técnicas para el diagnóstico y tratamiento de 3 casos clínicos de odontoma en pacientes ortodóncicos. En el caso 1, se trató a un paciente masculino de 17 años, que acudió para interconsulta con el servicio de ortodoncia, ya que no había erupcionado el canino superior izquierdo y el primer premolar superior izquierdo. El estudio anatomopatológico reveló odontoma complejo con áreas pindborgoides y acumulación de células fantasma. En al caso 2 se trató a un paciente femenino de 15 años. El estudio anatomopatológico reveló odontoma complejo. En el caso 3, se trató a un paciente masculino de 28 años que acudió a rehabilitación integral de su boca, y fue derivado a la cátedra de ortodoncia. En la radiografía panorámica se observó una imagen compatible con odontoma. Se remitió una muestra a anatomía patológica que confirmó el diagnóstico de odontoma. Conclusión: el conocimiento adecuado de las características clínicas, radiológicas y patológicas es necesario para un correcto diagnóstico y tratamiento. Es importante el trabajo interdisciplinario ortodoncista - cirujano para tratar estos casos (AU)

The objective of this work is to describe the techniques for the diagnosis and treatment of 3 clinical cases of odontoma in orthodontic patients. In case 1, a 17-year-old male patient was treated who came for consultation with the orthodontic service, since the upper left canine and the upper left first premolar had not erupted. Pathological study revealed complex odontoma with pindborgoid areas and accumulation of ghost cells. In case 2, a 15-year-old female patient was treated. The anatomopathological study revealed a complex odontoma. In case 3, a 28-year-old male patient was treated who attended comprehensive rehabilitation of his mouth and was referred to the orthodontic department. In the panoramic radiography, an image compatible with odontoma was observed. A sample was sent to pathological anatomy, which confirmed the diagnosis of odontoma. Conclusion: Adequate knowledge of the clinical, radiological and pathological characteristics is necessary for a correct diagnosis and treatment. Interdisciplinary orthodontist-surgeon work is important to treat these cases (AU)

Revisión de los principales manejos ortodónticos interceptivos y correctivos no quirúrgicos de la maloclusión clase III / Review of the main non-surgical interceptive and corrective orthodontic management of Class III malocclusion

La maloclusión clase III se considera un reto en la práctica de todo ortodoncista. Una de las principales dudas al respecto reside en ¿cuándo es el mejor momento para intervenir? Exis- ten dos enfoques en el manejo ortodóntico del paciente: 1) la ortodoncia interceptiva; y 2) la ortodoncia correctiva. La or- todoncia interceptiva busca la prevención del establecimiento de la malolcusión. En este grupo, se encuentra el uso de más- cara facial con disyunción maxilar y el de aparatología fija (2x4 o 2x6). Por otro lado, la intervención correctiva hace re- ferencia al camuflaje de las características que trae consigo la maloclusión clase III ya establecida; dentro de este enfoque se encuentran las extracciones de piezas, el uso de minitornillos extraalveolares y la filosofía MEAW. Se puede concluir que el adecuado manejo de la maloclusión clase III radica en el oportuno y correcto diagnóstico, que debe realizarse a través de la minuciosa inspección de las características y hallazgos intra y extraorales de los pacientes (AU)

Class III malocclusion is considered a challenge in the practice of every orthodontist. One of the main questions is: when is the best time to intervene? There are 2 approaches to the orthodontic management of the patient: 1) interceptive orthodontics, and 2) corrective orthodontics. Interceptive or- thodontics seeks to prevent the establishment of malocclusion by means of the use of a facial mask with maxillary disjunc- tion, or the use of fixed appliances (2x4 or 2x6). Corrective intervention refers to camouflaging the characteristics of a Class III malocclusion that is already established. This ap- proach uses tooth extraction, extra-alveolar mini screws or the MEAW philosophy. To conclude, proper management of Class III malocclu- sion is based on timely, correct diagnosis, which must be made through careful inspection of the characteristics and intraoral and extraoral findings in patients (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)

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.

Mucositis periimplantaria asociada a ortodoncia correctiva / Peri-implant mucositis associated to corrective orthodontics

Introducción: Los minitornillos de ortodoncia son dispositivos temporales de anclaje utilizados ampliamente en ortodoncia correctiva. Sin embargo, se ha reportado en la literatura que su tasa clínica de éxito no es completa debido a que pueden existir fallas relacionadas con la pérdida de su estabilidad. Varios factores pueden comprometer el anclaje y están relacionados con el tipo de implante, su manejo quirúrgico y el hospedero. Dentro de este último, se encuentra la inflamación del tejido periimplantario o mucositis que, aunque reversible, es necesario su tratamiento temprano para evitar su progresión a la afectación de tejido duro (periimplantitis). Objetivo: Describir un caso clínico de mucositis periimplantaria asociada a un dispositivo de anclaje ortodóntico temporal. Presentación del caso: Paciente femenina que acudió a la consulta por presentar dolor en la zona anterior del maxilar superior. Durante el examen intraoral se observó que usaba aparatos de ortodoncia con mecanismo de anclaje: dos minitornillos de ortodoncia ubicados al nivel de los caninos superiores. Se realizó la remoción quirúrgica de los minitornillos de ortodoncia, se le indicó el uso de antibióticos y se realizó estudio histopatológico para descartar malignidad. Se diagnosticó con mucositis periimplantaria. Conclusiones: La remoción quirúrgica de los minitornillos de ortodoncia es una excelente alternativa para evitar la progresión de la lesión hacia los tejidos duros. A través de esta técnica lograron eliminar signos de dolor, enrojecimiento y sangrado(AU)

Introduction: Orthodontic miniscrews are temporary anchorage devices widely used in corrective orthodontics. However, it has been reported in the literature that their clinical success rate is not high, due to failures related to the loss of stability. Anchorage may be affected by factors associated to the type of implant, its surgical management and the host. Host-related factors include peri-implant tissue inflammation or mucositis, which though reversible, its early treatment is necessary to prevent expansion into and damage to the hard tissue (peri-implantitis). Objective: Describe a clinical case of peri-implant mucositis associated to a temporary orthodontic anchorage device. Case presentation: A female patient attends clinical consultation with pain in the anterior zone of her upper maxilla. Intraoral examination revealed the presence of orthodontic appliances with an anchorage mechanism: two orthodontic miniscrews located at the level of the upper canines. Surgical removal was performed of the orthodontic miniscrews, antibiotics were indicated and histopathological testing was conducted to rule out malignancy. The patient was diagnosed with peri-implant mucositis. Conclusions: Surgical removal of orthodontic miniscrews is an excellent alternative to prevent the progress of the lesion into hard tissues. Pain signs, reddening and bleeding were all eliminated with the technique applied(AU)

A cirurgia ortognática no tratamento da DTM em pacientes classe II / The orthognatic surgery in treatment of TMJ in class II patients

Introdução: A má oclusão Classe II pode influenciar negativamente na qualidade de vida dos pacientes, tanto na aparência facial, quanto função oral ou até ambas. Atualmente, o tratamento ortodôntico-cirúrgico é comumente utilizado em pacientes com discrepâncias esqueléticas graves. Objetivo: Este estudo tem como objetivo analisar os resultados da cirurgia ortognática associada ao tratamento ortodôntico nos pacientes que possuem DTM e má oclusão de Classe II por retrognatismo mandibular. Metodologia: Foi realizada uma pesquisa bibliográfica nas plataformas de buscas científicas Google Acadêmico, CAPES/MEC, PubMed/Medline, Scielo, Elsevier, e nas revistas AJO-DO (American Journal of Orthodontics and Dentofacial Orthopedics) e The Angle Orthodontist (An International Journal of Orthodontics and Dentofacial Orthopedics), utilizando as seguintes palavras chave: retrognatismo, cirurgia ortognática e transtornos da ATM. Conclusão: A maioria dos pacientes que apresentam sinais e sintomas de DTM pré-operatórios melhoram a disfunção e diminuem os níveis de dor com o tratamento ortognático. Além disso, o tratamento ortodôntico é de suma importância para se obter o sucesso do procedimento cirúrgico, assim como na estabilidade pós-cirúrgica.(AU)

Introduction: Class II malocclusion can negatively influence patients in quality of life, in the facial and oral appearance or both. Currently, orthodontic-surgical treatment is commonly used in patients with severe skeletal discrepancies. Objective: The objective of this study was to analyze the results of orthognathic surgery associated with orthodontic treatment in patients who have TMD and Class II malocclusion due to mandibular retrognathism. Methodology: A bibliographic search was performed in the scientific search platforms Google Scholar, CAPES/MEC, PubMed/Medline, Scielo, Elsevier, AJO-DO (American Journal of Orthodontics and Dentofacial Orthopedics) and in The Angle Orthodontist (An International Journal of Orthodontics and Dentofacial Orthopedics), using the keywords: retrognathism, orthognathic surgery and TMJ disorders. Conclusion: With orthognathic treatment, most patients who had preoperative DTM signs and symptoms showed an improvement and a decrease in pain levels. In addition, orthodontic treatment is important for the success of the surgical procedure, as well as for post-surgical stability.(AU)

Endodoncia y ortodoncia. Parte 2: casos clínicos / Endodontics and orthodontics. Part 2: clinical cases

Objetivo: Describir el tratamiento endodóncico de cuatro casos clínicos de reabsorción radicular desarrollada durante o tras un tratamiento ortodóncico. Casos clínicos: Después de la preparación y la desinfección de los conductos radiculares, estos fueron obturados por un tiempo prudencial con una medicación intraconducto de hidróxido de calcio, que luego fue reemplazada por MTA. Luego de un período de entre uno y cuatro años, según el caso, los tratamientos fueron evaluados clínica y radiográficamente. Los dientes que debieron ser extraídos fueron analizados histológicamente. Según la evolución clínica y radiográfica de los casos presentados, el uso inicial de hidróxido de calcio y su posterior reemplazo por MTA parecería ser un protocolo adecuado para completar el proceso de reparación de los tejidos apicales y perirradiculares en casos de reabsorciones radiculares provocadas por fuerzas ortodóncicas excesivas. Las enfermedades sistémicas deben ser tenidas en cuenta para la elección de la terapéutica (AU)

Aim: To describe the endodontic treatment of four clinical cases of permanent teeth suffering root resorption during or after orthodontic treatment. Clinical cases: Four clinical cases of permanent teeth with root resorption were endodontically treated. After the root canals were prepared and disinfected, they were medicated with calcium hydroxide. After an appropriate observation period, the canals were finally filled with MTA. The treatment outcomes were clinically and radiographically assessed at an interval between one to four years according to the clinical case. The histological findings of teeth that required extraction was also described. Our clinical and radiographic observations suggest that a temporary filling with calcium hydroxide and further obturation with MTA can provide a favorable intracanal environment for apical and periradicular tissue reparation. The clinician needs a full medical history to be aware of the systemic diseases in patients with root resorption that will be of importance for the proper selection of treatment (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.

Accuracy of cone-beam CT in detecting vertical root fractures in teeth with post-endodontic restorations: an in vitro study

The aim of this study was to evaluate the accuracy of cone-beam CT (CBCT) for the detection of artificially created vertical root fractures (VRF) in extracted teeth restored with metallic (MP) and fiberglass (FGP) posts. After root canal obturation, 60 extracted human premolars were scanned by using the highest-resolution settings of a CBCT unit. Theprepared roots were randomly divided into three groups: group C (control group): non-restored and non-endodontically treated teeth (n = 20); group MP (n = 20); group FGP (n = 20). In all groups, 10 teeth were artificially fractured. Two external and independent observers blindly recorded the presence or absence of VRF. Sensitivity, specificity, accuracy, intra-and interobserver agreement were calculated. Kappa value for inter-and intraobserver agreement was 0.82 and 0.84 respectively, demonstrating goodagreement. The highest values for sensitivity (0.80 -0.90), specificity (1.00) and accuracy (0.90 -0.95) were found in the control group. The teeth with FGP restoration presented the lowest sensitivity (0.30 -0.50) and accuracy (0.60 -0.65) values. Both examiners had a good performance in the diagnosis of fractures in teeth with MP, with accuracy ranging between 0.85 -0.90. The presence of MP did not influence accuracy; however, the presence of FGP reduced the diagnostic capacity of CBCT.

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.