Interdisciplinary treatment to replace missing upper lateral incisors, 4.5 years follow up / Tratamiento interdisciplinario para reposición de incisivos laterales superiores faltantes, seguimiento de 4,5 años

Introduction: Multidisciplinary diagnosis and planning are essential to define the treatment option that will provide the best individual results for patients with congenitally missing upper lateral incisors. Objective: To determine the function and aesthetics after the therapeutic use of osseintegrated implants to replace congenitally missing upper lateral incisors in a young female at 4.5 years follow-up. Case report: The patient was a 13 years old female (at beginning of treatment) with congenitally missing upper lateral incisors condition. Five months after the orthodontic active treatment, the space for placing the implants was achieved. After 2 years of Orthodontic treatment and the evaluation of the craniomandibular growth term by hand radiography, two implants were placed with an expanded bone technique in the position of the upper lateral incisors. After 4 months, osseointegration was clinically confirmed and two screw retained temporary crowns were performed using temporary plastic abutments and acrylic teeth and recalled at 4.5 years to control. Conclusions: Our results showed predictable esthetics and functional results in a patient with congenitally missing upper lateral incisors. This was possible due to a multidisciplinary approach between the diagnosis and treatment performed (Orthodontics, Implantology and Prosthodontics(AU)

Introducción: El diagnóstico y la planificación multidisciplinarios son esenciales para definir la opción de tratamiento que proporcionará los mejores resultados individuales para los pacientes con incisivos laterales superiores que faltan congénitamente. Objetivo: Fue determinar la función y la estética después del uso terapéutico de implantes osteointegrados para reemplazar los incisivos laterales superiores ausentes congénitamente en una mujer joven a los 4,5 años de seguimiento. Presentación del caso: La paciente, mujer de 13 años (al inicio del tratamiento) con una condición congénita de incisivos laterales superiores ausentes. Cinco meses después del tratamiento activo de ortodoncia, se logró el espacio para la colocación de los implantes. Después de 2 años de tratamiento de Ortodoncia y la evaluación del término de crecimiento cráneo-mandibular corroborado mediante radiografía de mano, se colocaron dos implantes con técnica de hueso expandido en la posición de los incisivos laterales superiores. Después de 4 meses, se confirmó clínicamente la osteointegración y se realizaron dos coronas provisionales atornilladas utilizando pilares de plástico provisionales y dientes acrílicos y se controlaron a los 4,5 años de seguimiento. Conclusiones: Nuestros resultados mostraron resultados estéticos y funcionales predecibles en un paciente con incisivos laterales superiores ausentes congénitamente. Esto fue posible gracias a un abordaje multidisciplinar entre el diagnóstico y el tratamiento realizado (Ortodoncia, Implantología y Prostodoncia(AU)

Congruencia entre modelos dentales impresos 3D y el archivo digital de origen: estudio in vitro comparativo de 5 impresoras 3D / Congruence between 3D printed dental models and the original digital file: comparative in vitro study of 5 3D printers

Este trabajo tuvo como objetivo conocer la fiabilidad de la impresora 3D (i3D) aditiva por Matriz de Proceso Digital de Luz (MDLP) Hellbot modelo Apolo®, a través de verificar la congruencia dimensional entre las mallas de modelos impresos (MMi) y su correspondiente archivo digital de origen (MMo), obtenido del software de planificación ortodontica Orchestrate 3D® (O3D). Para determinar su uso en odontología y sus posibilidades clínicas, fue comparada entre cinco i3D de manufactura aditiva, dos DLP, dos por estereolitografía (SLA) y una por Depósito de Material Fundido (FDM). La elección de las cinco i3D se fundamentó en su valor de mercado, intentando abarcar la mayor diversidad argentina disponible. Veinte modelos fueron impresos con cada i3D y escaneados con Escáner Intraoral (IOS) Carestream modelo 3600® (Cs3600). Las 120 MMi fueron importadas dentro del programa de ingeniería inversa Geomagic® Control X® (Cx) para su análisis 3D, consistiendo en la superposición de MMo con cada una de las MMi. Luego, una evaluación cualitativa de la desviación entre la MMi y MMo fue realizada. Un análisis estadístico cuidadoso fue realizado obteniendo como resultado comparaciones en 3d y 2d. Las coincidencias metrológicas en la superposición tridimensional permitieron un análisis exhaustivo y fácilmente reconocible a través de mapas colorimétricos. En el análisis bidimensional se plantearon planos referenciados dentariamente desde la MMo, para hacer coincidir las mediciones desde el mismo punto de partida dentaria. Los resultados fueron satisfactorios y muy alentadores. Las probabilidades de obtener rangos de variabilidad equivalentes a +/- 50µm fueron de un 40,35 % y de +/- 100µm un 71,04 %. Por lo tanto, te- niendo en cuenta las exigencias de congruencia dimensional clínicas de precisión y exactitud a las cuales es sometida nuestra profesión odontológica, se evitan problemas clínicos arrastrados por los errores dimensionales en la manufactura (Cam) (AU)

The objective of this study was to determine the reliability of the Hellbot Apollo® model additive 3D printer (i3D) by Matrix Digital Light Processing (MDLP) by verifying the dimensional congruence between the printed model meshes (MMi) and their corresponding digital source file (MMo), obtained from the Orchestrate 3D® (O3D) orthodontic planning software. A comparison was made between five i3D of additive manufacturing, two DLP, two by stereolithography (SLA), and one by Fused Material Deposition (FDM), to determine its use in dentistry and its clinical possibilities. The choice of the five i3D was based on their market value, trying to cover most of the Argentinean diversity available. Twenty models were printed with each i3D and scanned with Carestream Intraoral Scanner (IOS) model 3600® (Cs3600). The 120 MMi were imported into the reverse engineering program Geomagic® Control X® (Cx) for 3D analysis, consisting of overlaying MMo with each MMi. Then, a qualitative evaluation of the deviation between MMi and MMo. Also, a careful statistical analysis was performed, resulting in 3d and 2d comparisons. Metrological coincidences in three-dimensional overlay allowed a comprehensive and easily recognizable analysis through colorimetric maps. In the two-dimensional analysis, dentally referenced planes were proposed from the MMo, to match the measurements from the same dental starting point. The results were satisfactory and very encouraging. The probabilities of obtaining ranges of variability equivalent to +/- 50µm were 40.35 % and +/- 100µm 71.04 %. Therefore, considering the demands of clinical dimensional congruence, precision, and accuracy to which our dental profession it is subjected, clinical problems caused by dimensional errors in manufacturing (Cam) are avoided (AU)

Oral health status after orthodontic treatment: a retrospective study / Estado de salud bucal después del tratamiento de ortodoncia: un estudio retrospectivo

ABSTRACT: Orthodontic appliances in the oral cavity may cause problems such as white spot lesions, dental plaque, periodontal disease and root resorption. The aim of this study was to investigate the association between orthodontic treatment and oral health parameters including visible dental plaque, gingival recession and white spot lesions (WSLs). A total of 170 patients (86 females, 84 males) were randomly selected to determine visible dental plaque, gingival recession and white spot lesions by using pre-treatment and post-treatment oral photographs. Except of previously extracted teeth, maxillary and mandibular incisors, canine, 1st and 2nd premolars and 1st molar were evaluated. There was a significant difference between the T0 (before treatment) and T1 (after treatment) groups in visible plaque (P< 0.001). The distribution of gingival recession frequencies according to Miller classification before treatment did not differ from the after treatment (P=082). A statistically significant increase in the severity of WSL was detected between the two time points (P< 0.001). Males have been shown to have higher WSL incidence after treatment. In conclusion, the present study showed that visible dental plaque and white spot lesions significant increase after orthodontic treatment. Considering the relationship between oral health and orthodontic treatment, clinicians and patients should know the risks and take precautions.

RESUMEN: Los aparatos de ortodoncia en la cavidad oral puede causar problemas como lesiones de mancha blanca, placa dental, enfermedad periodontal y reabsorción radicular. El objetivo de este estudio fue investigar la asociación entre el tratamiento de ortodoncia y los parámetros de salud bucal, incluida la placa dental visible, la recesión gingival y las lesiones de mancha blanca (LMB). Un total de 170 pacientes (86 mujeres, 84 hombres) fueron seleccionados al azar para determinar la placa dental visible, la recesión gingival y las lesiones de manchas blancas mediante el uso de fotografías orales antes y después del tratamiento. Excepto los dientes extraídos previamente, se evaluaron incisivos maxilares y mandibulares, caninos, premolares y primeros molares. Hubo una diferencia significativa entre los grupos T0 (antes del tratamiento) y T1 (después del tratamiento) en la placa visible (P<0.001). La distribución de las frecuencias de recesión gingival según la clasificación de Miller antes del tratamiento no mostraron diferencias significativas con respecto al postratamiento (P=0.082). Se detectó un aumento estadísticamente significativo en la gravedad de LMB entre los dos puntos de tiempo (P<0.001). Se ha demostrado que los hombres tienen una mayor incidencia de LMB después del tratamiento. En conclusión, el presente estudio mostró que la placa dental visible y las lesiones de manchas blancas aumentaron significativamente durante el tratamiento de ortodoncia. Teniendo en cuenta la relación entre la salud bucal y el tratamiento de ortodoncia, los médicos y los pacientes deben conocer los riesgos y tomar precauciones.

Satisfacción con el servicio de posortodoncia de la Universidad Santo Tomás según métricas Lean-Six-Sigma / SatisfactionService Post-Orthodontic University Santo Tomas According ToLean-Six-Sigma Metrics

Introducción: La metodología Lean-Six-Sigma es utilizada actualmente en el área de la salud con el objeto de mejorar la calidad y competitividad de los servicios; pero aún no se tienen reportes de su uso en el área de ortodoncia. Objetivo: Determinar la satisfacción posortodoncia por medio de niveles sigma de los pacientes que asisten a una clínica docente-asistencial en Bucaramanga, Colombia. Métodos: Estudio observacional, descriptivo, transversal. La población estuvo constituida por 100 pacientes de ambos sexos, que ya habían concluido el tratamiento de ortodoncia. Se seleccionó toda la población que hubiera finalizado el tratamiento entre julio de 2017 y junio 2018 de acuerdo con criterios de inclusión y exclusión. Se realizó una encuesta telefónica de 17 preguntas y siete dimensiones de satisfacción. La confiabilidad del cuestionario se evaluó con la consistencia interna del cuestionario mediante el alpha de Cronbach en el que se obtuvo 0,87, y para la validez se utilizó el método de Lawshe. Se usó la metodología Lean-Six-Sigma para evaluar la calidad de la satisfacción; se presentan los resultados en porcentaje y niveles sigma. Resultados: La calidad en satisfacción en el servicio fue de 91,27 por ciento (medido convencionalmente) y 1,36 sigmas; en el grupo de 16-19 años fue de 93,6 por ciento y 1,52 sigmas; y para el grupo de más de 27 años, 84,9 por ciento y 1,03 sigmas. El sexo femenino reportó un 88,57 por ciento y 1,2 sigmas, mientras que el masculino, 93,46 por ciento y 1,51 sigmas. Conclusiones: Los resultados de satisfacción en ortodoncia, medidos por métodos convencionales, mostraron porcentajes aceptables, pero mostraron resultados incompetentes al medirse con niveles sigma, lo cual indica que existen problemas ocultos por identificar y que corresponderían a una siguiente investigación(AU)

Introduction: The Lean-Six-Sigma methodology is currently used in the health area in order to improve the quality and competitiveness of services; but there are still no reports of its use in the orthodontic area. Objective : to determine the post-orthodontic satisfaction by means of sigma levels of the patients who attend a teaching-assistance clinic in Bucaramanga, Colombia. Methods: Observational descriptive cross-sectional study. Population: 100 patients (female and male) who finish orthodontic treatment. Sample selection method: the entire population that had completed the treatment between July 2017 and June 2018 was selected according to inclusion and exclusion criteria. A telephone survey of 17 questions and seven dimensions of satisfaction was carried out. The reliability of the questionnaire was evaluated with the internal consistency of the questionnaire by means of the Cronbach's alpha in which 0.87 was obtained, and the Lawshe method was used for validity. The Lean-Six-Sigma methodology was used to assess the quality of satisfaction; Results are presented in percentage and sigma levels. Results: The quality of service satisfaction was 91.27 percent (conventionally measured) and 1.36 sigmas; in the group of 16 to 19 years it was 93.6 percent and 1.52 sigmas; and for the group over 27 years old, 84.9 percent and 1.03 sigma. The female sex reported 88.57 percent and 1.2 sigmas, and the male reported 93.46 percent with 1.51 sigmas. Conclusions: The satisfaction results in orthodontics, measured by conventional methods, showed acceptable percentages, but showed incompetent results when measured with sigma levels, which indicates that there are hidden problems to be identified and that they would correspond to a subsequent investigation(AU)

Laserterapia de baixa intensidade no manejo da dor provocada por separadores elastoméricos: uma revisão integrativa / Low-level laser therapy in the management of pain evoked by elastomeric separators: an integrative review

Introdução: O uso de separadores elastoméricos durante o tratamento ortodôntico pode provocar dor e a laserterapia de baixa intensidade tem sido empregada no manejo deste desfecho. Objetivo: Apresentar as evidências sobre o efeito da laserterapia de baixa intensidade no manejo da dor provocada pelo uso de separadores elastoméricos. Métodos: Foi desenvolvida uma revisão integrativa de estudos clínicos nas bases de dados PubMed, Web of Science, Scopus, BVS, SciELO e clinicaltrials.gov utilizando uma estratégia PICo elaborada com descritores, incluindo estudos publicados nos últimos dez anos, sem restrição de idioma. Foram rastreados 68 artigos e 12 foram revisados. Revisão de literatura: Considerando a laserterapia, a maioria dos estudos utilizou arsenieto de gálio e alumínio (Ga-Al-As), com comprimento de onda entre 808nm e 940nm, bem como a potência entre 40.6mW e 200mW. A escala visual analógica (EVA) foi utilizada pela maioria dos estudos para mensurar a dor. Dois estudos não verificaram diferenças significativas da laserterapia de baixa intensidade na dor provocada pelos separadores elastoméricos, oito estudos encontraram diferenças significantes entre os grupos de intervenção, de controle e o placebo (quando utilizado) e dois estudos não foram totalmente conclusivos e apontaram diferenças estatística parciais entre os grupos em questão. As técnicas de aplicação foram demasiadamente heterogêneas nos estudos incluídos nesta revisão e não permitem uma síntese quantitativa. Conclusão: O laser de baixa intensidade pode demonstrar efeitos benéficos na redução da dor provocada por separadores elastoméricos. Entretanto, ainda não é possível determinar qual a melhor técnica de aplicação.

Introduction: The use of elastomeric separators during orthodontic treatment can cause pain and low-level laser therapy has been used to manage this outcome. Objective:To present the evidence on the effect of low-level laser therapy in the management of pain caused by the use of elastomeric separators. Methods: An integrative review of clinical studies was carried out in the PubMed, Web of Science, Scopus, BVS, SciELO and clinicaltrials.gov data-bases using a PICo strategy developed with descriptors, including studies published in the last ten years, without language restriction. 68 articles were tracked and 12 were reviewed. Literature review: Considering laser therapy, most studies used gallium and aluminum arsenide (Ga-Al-As), with a wavelength between 808nm and 940nm, as well as power between 40.6mW and 200mW. The visual analog scale (VAS) was used by most studies to measure the pain. Two studies did not find significant differences in low-level laser therapy in pain caused by elastomeric separators, eight studies found significant differences between the intervention, control and placebo groups (when used) and two studies were not fully conclusive and pointed out partial statistical differences between the groups in question. The application techniques were too heterogeneous in the studies included in this review and do not allow a quantitative synthesis. Conclusion: The low-level laser therapy can demonstrate beneficial effects in reducing pain caused by elastomeric separators. However, it is not yet possible to determine the best application technique.

Percepción del dolor, rasgos de personalidad y actitud del paciente hacia el tratamiento ortodóntico / Pain perception, personality traits and patient attitude toward orthodontic treatment

Introducción: El dolor inducido por los aparatos de ortodoncia es una de las principales razones que desalientan a los pacientes a buscar tratamiento ortodóntico y puede afectar negativamente su cooperación. Objetivo: Determinar la relación de la percepción del dolor, rasgos de personalidad y la actitud del paciente hacia el tratamiento ortodóntico. Métodos: Estudio transversal y observacional. La muestra estuvo conformada por dos grupos: I) 200 sujetos no tratados (78 varones y 122 mujeres; edad promedio 20,02 ± 2,67 años) y II) 200 sujetos tratados (64 varones y 136 mujeres; edad promedio 20,29 ± 3,88 años). El instrumento para la recolección de datos fue un cuestionario que incluía la evaluación de la expectativa del dolor para sujetos no tratados, experiencia de dolor para sujetos tratados, los perfiles de personalidad de los pacientes y actitudes hacia el tratamiento de ortodoncia. Resultados: No se encontró relación entre la percepción del dolor, los rasgos de personalidad y actitud del paciente hacia el tratamiento ortodóntico (p > 0,05). El estado de tratamiento (presentar ortodoncia) afectó la percepción del dolor hacia el tratamiento ortodóntico (p < 0,05), el género no afectó la percepción del dolor. El estado de tratamiento y el género masculino afectaron la actitud del paciente hacia el tratamiento ortodóntico (p < 0,05). Conclusiones: Los pacientes con mejor actitud mostraron menos dolor y los pacientes con mayor percepción del dolor mostraron una actitud negativa. Los niveles bajos de amabilidad tienen efecto sobre la percepción del dolor del paciente hacia el tratamiento ortodóntico(AU)

Introduction: The pain induced by orthodontic appliances is one of the main reasonswhy patients are reluctant to seek orthodontic treatment, and may negatively affect their cooperation. Objective: Determine the relationship between pain perception, personality traits and patient attitude toward orthodontic treatment. Methods: A cross-sectional observational study was conducted of a study sample composed of two groups: I) 200 untreated subjects (78 male and 122 female; mean age 20.02 ± 2.67 years) and II) 200 treated subjects (64 male and 136 female; mean age 20.29 ± 3.88 years). The data collection tool was a questionnaire including an evaluation of pain expectation for untreated subjects, pain experience for treated subjects, patients' personality profiles and attitudes toward orthodontic treatment. Results: No relationship was found between pain perception, personality traits and patient attitude toward orthodontic treatment (p > 0.05). Treatment status (untreated or treated) affected pain perception and the attitude toward orthodontic treatment (p < 0.05); gender did not affect pain perception. Treatment status and male gender affected patient attitude toward orthodontic treatment (p < 0.05). Conclusions: Patients with a better attitude experienced less pain, whereas patients with a greater pain perception showed a negative attitude. Low levels of kindness have an effect on pain perception and patient attitude toward orthodontic treatment(AU)

Research on a segmentation and evaluation method combining tooth morphology features / Investigación sobre un método de segmentación y evaluación que combina características morfológicas dentales

SUMMARY: To explore a new semi-automatic method to segment the teeth from the three-dimensional volume data which acquired from cone beam computed tomography (CBCT) scanner. Scanned dental cast models are used to evaluate the segmentation accuracy. The CBCT data are loaded to ORS software. Based on gray value, a semi-automatic method was used to segment teeth and then the segmented teeth were saved in STL format data. Smooth the mesh data in the Geomagic Studio software. The upper and lower dental cast models were scanned by a white light scanner and the data was saved in STL format too. After registering the model data to teeth data, the deviation between them was analyzed in the Geomagic Qualify. All teeth could be obtained, the method is simple to use and applied in orthodontic biomechanics. The entire process took less than 30 minutes. The actual measured Root Mean Square (RMS) value is 0.39 mm, less than 0.4 mm. This method can segment teeth from the jaw quickly and reliably with a little user intervention. The method has important significance for dental orthodontics, virtual jaw surgery simulation and other stomatology applications.

RESUMEN: El objetivo de este estudio fue explorar un nuevo método semiautomático para segmentar los dientes a partir de datos de volumen tridimensional adquiridos mediante escáner de tomografía computarizada de haz cónico (CBCT). Los modelos escaneados de moldes dentales se utilizan para evaluar la precisión de la segmentación. Para los datos CBCT se utilizó el software ORS, y basado en el valor gris, se usó un método semiautomático para segmentar los dientes los que posteriormente se guardaron en datos de formato STL. Los datos se ingresaron en el software Geomagic Studio. Los modelo dentales superior e inferior se escanearon con un escáner de luz blanca y la información también se guardó en formato STL. Después del registro y comparación de los datos del modelo y los datos de los dientes, la desviación entre estos se analizó en el programa Geomagic Qualify. Usando este método fue posible obtener de forma fácil todos los dientes y además aplicar en la biomecánica de ortodoncia. El proceso completo demoró menos de 30 minutos. El valor real medido de la raíz cuadrada media fue de 0,39 mm, menos de 0,4 mm. Este método puede segmentar los dientes mandibulares de forma rápida y confiable, con una mínima intervención del usuario. El método tiene una importancia crítica para la ortodoncia, simulaciones virtuales de las cirugías de la mandíbula y otras aplicaciones en estomatología.

Medidas de piezas dentarias para el posicionamiento correcto de brackets en una población latina (Argentina) / Measures for positioning teeth correct brackets in a Latin population (Argentina)

Introducción: El posicionamiento preciso de los brackets de ortodoncia en las diferentes situaciones clínicas es esencial. Para ello, se utiliza la tabla de McLaughlin-Bennett, realizada sobre una población anglosajona. Dada la gran variabilidad que puede existir en los diferentes grupos poblacionales, para estandarizar las medidas en la colocación de los brackets, sería necesario emprender un análisis de la población local y determinar cuáles serán las alturas de las coronas clínicas de todas las piezas dentarias para nuestra población. Materiales y método: Se estudiaron 200 modelos de estudio de individuos argentinos, caucásicos, de ambos sexos, con dentición permanente completa hasta el segundo molar inclusive, entre 13 y 25 años, que no recibieron tratamiento ortodóncico previo. Resultados: Las diferencias estadísticas existentes, con respecto a lo propuesto por McLaughlin y Bennett, en el maxilar superior fueron: altamente significativas (p = 0,0001) en el incisivo central, incisivo lateral y segundo molar; significativas en el canino (p = 0,0128) y en el primer molar (p = 0,018) y no significativas en el primer premolar (p = 0,239) y segundo premolar (p = 0,1741). En el maxilar inferior: altamente significativas (p = 0,0001) en el segundo molar y no significativas en el resto de las piezas dentarias. Conclusión: Los valores que se obtuvieron con el estudio, dada la variabilidad regional de la muestra, no coinciden con los valores que arroja la tabla de McLaughlin-Bennett, de origen anglosajón. Se sugiere la creación de una tabla acorde con las medidas de los pacientes locales(AU)

Accurate positioning of dental braces in different clinical situations is essential. To that end, it is used the chart developed by McLaughlin and Bennett, which was made in the Anglo-Saxon population. Due to the considerable variability among different population groups, an analysis of the local population would be necessary to be carried out in order to standardize the measurements for the positioning of braces and to determine the clinical crown height of teeth in our population. Two hundred Caucasian, Argentine male and female study models, aged between 13 and 25 with full permanent dentition, fully erupted second molars with no previous orthodontic treatment were studied. Existing statistical differences with regard to the guidelines proposed by McLaughlin and Bennett in the maxilla were: highly significant (p = 0.0001) for second molars, central and lateral incisors; significant for canines (p = 0.0128) and first molars (p = 0.018); and non-significant for first premolars (p = 0.239) and second premolars (p = 0.1741). In the mandible the differences were: highly significant (p = 0.0001) for second molars and non-significant for the other teeth. The values that were obtained in the study, given the regional variability of the sample, do not correspond to the values that are shown in the chart by McLaughlin and Bennett, of Anglo Saxon origin. It is suggested the creation of a new chart in line with the measurements of local patients(AU)

Láser de baja potencia en Ortodoncia / Low-level laser in orthodontics

Introducción: durante los últimos años la Ortodoncia demanda tratamientos más cortos. La duración del tratamiento depende del diagnóstico, complejidad del caso, plan de tratamiento, aparatología, experiencia clínica y cooperación del paciente, entre otros, y generalmente oscila entre 24 y 36 meses. Existen estudios que avalan el láser de baja potencia acelera el movimiento ortodóntico, sin embargo, los mecanismos de la fotobiomodulación asociados a esto están claros. Objetivo: describir la evidencia asociada a la fotobiomodulación por láser de baja potencia en el movimiento ortodóntico y sus mecanismos. Métodos: se realizó una revisión bibliográfica sobre la relación existente entre la fotobiomodulación por láser de baja potencia en el movimiento ortodóntico y sus mecanismos en MEDLINE, PubMed y SciELO. La búsqueda se orientó a artículos publicados fundamentalmente en los últimos 5 años sin hacer distinciones de idioma. Los tópicos consultados en la revisión estuvieron referidos a estudios experimentales en humanos, animales e in vitro que incluyeran los láseres que emiten luz infrarroja (780-820 nm), debido a que la absorción infrarroja de la hemoglobina es menor que la del rojo visible. Los láseres que emiten luz infrarroja (780-820 nm) son los mejores para estimular las células óseas porque sus longitudes de onda penetran más profundamente en el tejido blando, alcanzando el tejido óseo. Resultados: se profundiza en el tema de la fotobiomodulación y las bases modulares del empleo de esta técnica en Ortodoncia. El láser de baja potencia acelera el movimiento ortodóntico, sin embargo, no se ha determinado una ventana terapéutica específica para la dosimetría y el mecanismo de acción a nivel de tipos de células individuales. Conclusiones: la evidencia sugiere que el láser de baja potencia acelera el movimiento ortodóntico. Sobre los mecanismos celulares implicados en el movimiento ortodóntico cuando son irradiados con láser, aún la evidencia clínica es insuficiente(AU)

Introduction: recent years have witnessed a demand for ever shorter treatments in orthodontics. Treatment duration depends on diagnosis, case complexity, treatment plan, equipment, clinical experience and patient cooperation, among other factors, and generally ranges between 24 and 36 months. Some studies support the idea that low-level laser speeds up orthodontic movement; however, the photobiomodulation mechanisms involved are clear. Objective: describe the evidence of low-level laser photobiomodulation in orthodontic movement and its mechanisms. Methods: a bibliographic review was conducted in MEDLINE, PubMed and SciELO about the relationship between low-level laser photobiomodulation in orthodontic movement and its mechanisms. The search was aimed at papers published in any language mainly in the last five years. The topics consulted in the review had to do with experiments on humans, animals and in vitro in which infrared lasers (780-820 nm) were used, since infrared absorption of hemoglobin is lower than that of visible red. Infrared lasers (780-820 nm) are the best to stimulate bone cells, because their wavelengths go deeper into soft tissue, reaching the bone. Results: details are provided about photobiomodulation and the modular bases of the use of this technique in orthodontics. Low-level laser speeds up orthodontic movement; however, a specific therapeutic window has not been determined for its dosimetry and mechanism of action in individual cell types. Conclusions: evidence suggests that low-level laser speeds up orthodontic movement. Clinical evidence is still insufficient about the cellular mechanisms involved in orthodontic movement when laser radiation is used(AU)

Evaluation of the prototype of a new bracket-positioning gauge

ABSTRACT Objective: The purposes of this study were to present a prototype of a bracket-positioning gauge, which makes vertical inclination of the instrument difficult, allowing a reduction of vertical bracket positioning error, and to test its accuracy in bracket positioning by groups of individuals with different clinical experience and in specific groups of teeth. Methods: For the testing of the prototype, four groups of six participants each were used: Group 1 was composed of undergraduate students in the dental school, who had no previous experience in bonding orthodontic attachments; Group 2 was composed of orthodontic graduate students in the dental school; Group 3 consisted of orthodontists with a maximum of 5 years of clinical experience; Group 4 comprised orthodontists with more than 5 years of clinical experience. A typodont was simulated with a Class I crowded malocclusion, which reproduced the same occlusal characteristics for all groups to be bonded. All participants were instructed to bond 0.022×0.028-in Edgewise brackets on the labial surfaces of the upper and lower incisors, canines, and premolars at a height of 4 mm from the incisal edge or the labial cusp tip. Results: Only the mean value of Group 1 showed statistically significant difference in the comparison with the standard measurement. In the groups of teeth, the difference was significant for the premolar and incisor groups. Conclusion: Clinical experience interfered with the accuracy of vertical positioning of orthodontic attachments. As for the groups of teeth, premolars, followed by canines and incisors had the closest mean values to the standard measurement.

RESUMO Objetivos: os objetivos deste estudo foram apresentar um protótipo de posicionador de braquetes ortodônticos que dificulte a inclinação no sentido vertical, possibilitando a redução dos erros de altura no posicionamento desses acessórios; além de testar sua precisão na colagem, realizada por grupos de indivíduos com diferentes tempos de experiência clínica em Ortodontia e em grupos específicos de dentes. Métodos: para os testes do protótipo desenvolvido, quatro grupos de seis participantes foram formados. O Grupo 1 foi composto por alunos do curso de Odontologia sem qualquer prática com colagem em Ortodontia; o Grupo 2, por estudantes em Ortodontia; o Grupo 3, por ortodontistas com menos de cinco anos de experiência clínica; e o Grupo 4, por ortodontistas com mais de cinco anos de experiência clínica em Ortodontia. Em um typodont, foi simulada uma má oclusão Classe I com apinhamento, com as mesmas características para todas as colagens realizadas. Todos os participantes foram instruídos a colar braquetes Edgewise 0,022" x 0,028" na superfície vestibular dos incisivos, caninos e pré-molares superiores e inferiores, na altura de 4mm da borda incisal ou cúspide vestibular. Resultados: somente a média do Grupo 1 apresentou diferença estatisticamente significativa na comparação com a medida padrão. Nos grupos de dentes, a diferença foi significativa para o grupo dos pré-molares e incisivos. Conclusão: o tempo de experiência clínica interferiu na precisão do posicionamento vertical do acessório ortodôntico e, quanto aos grupos de dentes, as médias mais próximas à medida padrão foram dos pré-molares, seguidas pelos caninos e incisivos.

Una Aproximación Epidemiológica sobre Patologías Orales desde la Perspectiva de la Radiología / An Epidemiological Approach to Oral Pathologies from a Radiology Perspective

RESUMEN: La cavidad de oral es susceptible de alteraciones de diversa índole, que presentan patrones epidemiológicos variables. La caries y la enfermedad periodontal se reconocen como las de mayor prevalencia, pero sobre otras anormalidades que afectan a las estructuras óseas y los dientes se tienen menos datos. El objetivo del trabajo fue determinar la prevalencia de hallazgos radiográficos sugestivos de patología en 10,000 imágenes panorámicas digitales de adultos, obtenidas en diferentes centros de radiología en Bogotá. Se recolectaron radiografías de pacientes mayores de 18 años, de bajo grado de distorsión, con estructuras completas, y adecuado contraste y densidad que permitieran la lectura de las variables a estudiar. La mayoría de las radiografías pertenecen a pacientes de género femenino, y su promedio de edad es de 39 años. El edentulismo parcial es el hallazgo de mayor prevalencia afectando a un 61 % del grupo, seguido de la presencia de tratamientos de endodoncia con un 45 % y en tercer lugar las inclusiones dentales 24,1 %. Otros hallazgos corroboran que las lesiones apicales son las lesiones quísticas de mayor prevalencia y un aumento en la rehabilitación con prótesis fija e implantes. Este estudio refleja los efectos de la caries y la enfermedad periodontal que afectan a la población estudiada y su principal consecuencia el edentulismo parcial que afecta a todos los grupos de edad examinados. La endodoncia, sugerente de patología pulpar, también es de alta prevalencia y en gran porcentaje asociada a lesiones apicales, pero en general el estudio sugiere la necesidad de programas de prevención para el adulto, para cumplir con las metas de la Organización Mundial de la Salud con miras a disminuir la perdida de dientes.

ABSTRACT: The oral cavity is susceptible to alterations of diverse nature that present variable epidemiological patterns. Caries and periodontal disease are recognized as having the highest prevalence, but thereare less data on other abnormalities that affect bone structures and teeth. The objective of the study was to determine the prevalence of radiographic findings suggestive of pathology in 10,000 digital panoramic images of adults, obtained at different radiology centers in Bogotá. Radiographs were collected from patients over 18 years of age, with a low degree of distortion, with complete structures, and adequate contrast and density to allow the reading of the variables to be studied. Most of the radiographs belong to female patients, and their average age is 39 years. Partial edentulism is the most prevalent finding affecting 61 % of the group, followed by the presence of endodontic treatments with 45 % and thirdly the dental inclusions 24.1 %. Other findings corroborate that the apical lesions are the cystic lesions with a higher prevalence and an increase in rehabilitation with fixed prostheses and implants. This study reflects the effects of caries and periodontal disease that affect the population studied and its main consequence is the partial edentulism that affects all age groups examined. Endodontics, suggestive of pulpal pathology, is also of high prevalence and a large percentage associated with apical lesions, but in general the study suggests the need for adult prevention programs to meet the goals of the World Health Organization with a view to reducing tooth loss.

Comparative study of root resorption between two methods for accelerated orthodontic tooth movement

Objective: the aim of this study was to assess apical root resorption (RR) following the application of micro-osteoperforation (MOP) and piezocision (PzC) assisted orthodontics for the acceleration of tooth movement (TM). materials and methods: a total number of 16 patients seeking orthodontic therapy were included in this study. all patients had undergone 1st premolars extraction and were indicated for canine retraction. these patients were divided into two groups; one was treated using MOP in one side while the other side served as control. in the other group PzC was performed in one side with no intervention done on the other side. cone-beam computed tomography (CBCT) scans were obtained for every patient before and after canine retraction in order to evaluate amount of RR. results: in the MOP group, there was no significant difference in canine root length between experimental and control sides. whereas, in the PzC group, there was a statistically significant decrease in root length in the experimental side compared with the control side. when comparing both groups, the experimental PzC side showed a statistically significant decrease in root length compared to experimental MOP side postoperatively. conclusion: experimental PzC showed statistically significant decreases in canine root length compared to both experimental MOP and control side after canine retraction.

Tratamiento del escalón mesial y su influencia en variables morfológicas en niños de cinco años (Parte II) / Treatment of mesial step and its influence on morphological variables in five-year-old children (Part II)

Se realizó una investigación cuasiexperimental. La muestra quedó constituida por 16 niños de cinco años de edad, que acudieron a la clínica «Victoria de Santa Clara¼ para recibir tratamiento ortodóntico; al realizar los exámenes clínico y funcional presentaban escalón mesial, mordida cruzada anterior e interferencias deflexivas con deslizamientos. La muestra se dividió en dos grupos: experimental y control, con ocho niños, respectivamente. Los primeros fueron tratados con las pistas planas indirectas previa psicoterapia, mioterapia, tallado selectivo y control de los hábitos deletéreos, mientras que al grupo de control se le aplicó la misma terapéutica, excepto los aparatos. Los resultados más favorables en las variables morfológicas fueron: la eliminación del resalte incisivo negativo y el predominio de los planos terminales rectos. Las pistas planas indirectas y la terapia funcional constituyeron las herramientas de elección para el tratamiento temprano de las mesioclusiones de origen funcional

A quasi-experimental intervention study was carried out. Sample was constituted by sixteen children aged 5 years who came to receive orthodontic treatment at "Victoria de Santa Clara" Clinic; mesial step, anterior crossbite and occlusal interferences with slidings were observed during clinical and functional examinations. Sample was divided into two groups: experimental and control group with eight children, respectively. The first ones were treated after psychotherapy, myotherapy, selective carving and control of deletereous habits with indirect plain tracks, while the same therapy was applied to the control group, with the exception of orthodontic appliances. The most favourable results among the morphological variables were elimination of negative overjet and predominance of straight terminal planes. The indirect plain tracks and the functional therapy constitute the used tools for the early treatment of mesiocclusions of functional origin

Protocolo de Atención Ortodóncica en Pacientes con Trastorno del Espectro Autista (TEA) / Orthodontic Care Protocol for Patients with Autistic Spectrum Disorder (ASD)

RESUMEN: Actualmente se observa un aumento en el número de personas con necesidades especiales en atención en salud, dentro de ellos, aquellos pacientes diagnosticados con trastorno del espectro autista, quienes presentan altos requerimientos de tratamiento ortodóncico a causa de maloclusiones. A pesar de que padres y/o cuidadores se encuentran motivados a mejorar su calidad de vida mediante el mejoramiento de la estética dento-facial y la función oral, también son pacientes que no son tratados en clínicas convencionales dado alguna dificultad en el comportamiento que presenten en una atención odontólogica. Por la enorme dificultad que se puede encontrar en la atención clínica, el presente trabajo indica un protocolo de atención ortodóncica en pacientes con trastorno del espectro autista, útil para realizar una completa ayuda de cada paciente que permita un adecuado diagnóstico, plan de tratamiento y pronóstico en la especialidad de ortodoncia.

ABSTRACT: There is currently an increase in the number of people with special oral health care needs, including those patients diagnosed with autism spectrum disorder who often require orthodontic treatment due to malocclusions. Although parents and / or caregivers are motivated to improve their quality of life by improving dento-facial aesthetics and oral function, these are also patients who do not receive treatment in conventional clinics due to behavioral problems they may present during dental care. In light of the difficulties that can be encountered during clinical dental care, the present study presents a protocol of orthodontic care in patients with autism spectrum disorder. The protocol is useful in that it allows an adequate diagnosis, treatment plan and prognosis in the orthodontic specialty required by each patient.

Digital models: How can dental arch form be verified chairside?

ABSTRACT Introduction: Plaster dental casts are routinely used during clinical practice to access maxillary dental arch form and assist on fabrication of individualized orthodontic archwires. Recently introduced, digital model technology may offer a limitation for the obtainment of a dental physical record. In this context, a tool for dental arch form assessment for chairside use is necessary when employing digital models. In this regard, paper print of the dental arch seems thus to be useful. Methods: In the present study, 37 lower arch models were used. Intercanine and intermolar widths and dental arch length measurements were performed and compared using plaster dental casts, digital models and paper print image of the models. Ortho Insight 3D scanner was employed for model digitalization. Results: No statistically significant differences were noted regarding the measurements performed on the plaster or digital models (p> 0.05). Paper print images, however, showed subestimated values for intercanine and intermolar widths and overestimated values for dental arch length. Despite being statistically significant (p< 0.001), the differences were considered clinically negligible. Conclusion: The present study suggests that paper print images obtained from digital models are clinically accurate and can be used as a tool for dental arch form assessment for fabrication of individualized orthodontic archwires.

RESUMO Introdução: os modelos de gesso são usados rotineiramente, durante a prática clínica, para avaliação da forma da arcada inferior e para auxiliar na confecção de arcos ortodônticos individualizados. A tecnologia dos modelos digitais, introduzida recentemente, pode oferecer uma limitação na obtenção de um registro físico da arcada dentária. Assim, quando se utilizam modelos digitais, faz-se necessária uma ferramenta clínica para obtenção da forma da arcada. Com essa finalidade, poderia-se imprimir, em papel, uma imagem da arcada dentária obtida a partir do modelo de gesso. Métodos: nesse estudo, 37 modelos da arcada inferior foram utilizados, nos quais foram realizadas medições das distâncias intercaninos, intermolares e comprimento da arcada; sendo, então, comparadas entre modelos de gesso, modelos digitalizados com um scanner Ortho Insight 3D e imagens impressas em folha de papel A4. Resultados: não foram encontradas diferenças estatisticamente significativas nas medidas realizadas nos modelos de gesso e modelos digitais (p > 0,05). As imagens impressas, contudo, mostraram valores subestimados para as distâncias intercaninos e intermolares, e superestimados para o comprimento da arcada. Apesar de serem estatisticamente significativas (p< 0,001), as diferenças foram consideradas clinicamente insignificantes. Conclusão: o presente estudo sugere que as imagens obtidas por meio dos modelos digitais e impressas em papel são clinicamente acuradas e podem ser utilizadas como uma ferramenta auxiliar na confecção dos arcos ortodônticos individualizados.

High-intensity laser application in Orthodontics

ABSTRACT Introduction: In dental practice, low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are mainly used for dental surgery and biostimulation therapy. Within the Orthodontic specialty, while LLLT has been widely used to treat pain associated with orthodontic movement, accelerate bone regeneration after rapid maxillary expansion, and enhance orthodontic tooth movement, HILT, in turn, has been seen as an alternative for addressing soft tissue complications associated to orthodontic treatment. Objective: The aim of this study is to discuss HILT applications in orthodontic treatment. Methods: This study describes the use of HILT in surgical treatments such as gingivectomy, ulotomy, ulectomy, fiberotomy, labial and lingual frenectomies, as well as hard tissue and other dental restorative materials applications. Conclusion: Despite the many applications for lasers in Orthodontics, they are still underused by Brazilian practitioners. However, it is quite likely that this demand will increase over the next years - following the trend in the USA, where laser therapies are more widely used.

As diferentes formas de ancoragem para o aparelho Herbst / Different forms of anchorage for Herbst appliance

Introdução: O aparelho ortopédico mecânico Herbst destaca-se entre os aparelhos que estimulam o avanço mandibular. Objetivo: Esse artigo demonstra diferentes formas de ancoragem para o aparelho Herbst. Método: Descrevem-se formas distintas de ancoragem, variando desde ancoragem com banda ortodôntica, com esplinte acrílico, com esplinte metálico, associadas ou não ao parafuso expansor. Conclusão: A escolha do tipo de ancoragem para o aparelho Herbst é dependente do plano de tratamento ortodôntico e definida de forma individual para cada paciente.

Introduction: Herbst mechanical orthopedic device stands out among the devices that stimulate the mandibular advancement. Objective: This paper describes different forms of Herbst appliance anchorage. Method: Distinct forms of Herbst appliance anchorage are described varying from orthodontic band, acrylic splint, metallic splint ancorage associated or not with expansion screw. Conclusions: The choice of Herbst appliance anchorage is dependent of orthodontic treatment planning and defined individually for each patient.

Prótesis y ortodoncia: rehabilitación de fisurado bilateral: caso clínico / Prosthesis and orthodontics: bilateral fissure repair: a clinical case

RESUMEN: El paciente fisurado labiopalatino muestra una falta de fusión de los procesos palatinos presentando una comunicación de la cavidad buconasal, anomalías de forma y/o la agenesia de los dientes cercanos a la fisura y un deficiente crecimiento sagital y transversal maxilar, esto es más complejo en la fisura bilateral, por ser el más severo de los subtipos de fisura. Se dificultan las funciones básicas como comer, hablar y relacionarse con los demás. Su tratamiento requiere del trabajo de un equipo transdisciplinario, coordinado y organizado, conformado por todos aquellos profesionales que colaboren en proporcionar un resultado integral. El objetivo de este artículo es exponer un caso clínico de rehabilitación protésica en conjunto con un tratamiento de ortodoncia en un paciente que presenta labio leporino bilateral y fisura palatina, además de una premaxila móvil, severamente extruida.

ABSTRACT: The cleft lip and palate patient is mainly characterised by the presence of an oronasal communication, malformation or agenesis of the teeth close to the cleft, and deficient sagittal and transverse growth of the maxilla. These patients require various treatments involving a multidisciplinary team, which may include a maxillofacial surgeon, an orthodontist, a speech therapist, a paediatrician, plastic surgeon, a general dentist, a prosthodontist, an ENT specialist, a psychologist, and all those professionals who can help provide functional, aesthetic and psychological improvement. This report describes a case of prosthetic rehabilitation in a patient with cleft lip and palate without alveolar bone in the cleft area, which prevented rehabilitation with an osseointegrated implant, in addition to a mobile and severely extruded pre-maxilla, which required an orthopaedic repositioning.