Validación y Comparación de un Nuevo Método para Predecir el Ancho Mesiodistal de Caninos y Premolares no Erupcionados en una Población Chilena de la Región de Valparaíso, Chile

Uno de los principales problemas durante la dentición mixta es la determinación de la futura discrepancia entre tamaño dentario y el espacio disponible. Para predecir el ancho mesiodistal de los dientes permanentes no erupcionados se han introducido diferentes métodos de análisis. Objetivo: El propósito de este estudio fue comparar el método Tanaka-Johnston con una nueva ecuación de regresión para predecir el ancho mesiodistal de caninos y premolares permanentes no erupcionados en una población de la región de Valparaíso, Chile. Material y método: Este estudio fue realizado en la Facultad de Odontología de la Universidad de Valparaíso, desde octubre de 2022 a junio de 2023 (8 meses), la muestra estuvo compuesta por 202 modelos de estudio del departamento de ortodoncia (91 hombres y 111 mujeres) en el rango de edad de 11 -20 años. Resultados: Se demostró que el método elaborado por Lara-Sandoval presenta mayor fiabilidad respecto a las medidas mesiodistales reales de los pacientes (ICC 0,773 para maxilar y 0,762 para mandíbula), en comparación con el método de Tanaka-Johnston (ICC 0,665 para maxilar y 0,623 para mandíbula). No existen diferencias significativas entre los valores reales y el método de Lara-Sandoval. Conclusión: El método de Lara-Sandoval es mejor que el propuesto por Tanaka-Johnston para determinar el ancho mesiodistal de caninos y premolares para esta muestra. Es necesario validar este método en otras regiones del país para ser utilizado con mayor seguridad que el ya existente como método estándar nacional.

One of the main orthodontic problems in mixed dentition is the determination of future tooth and size arch discrepancy. In order to predict the mesiodistal widths of unerupted permanent teeth different methods of analyses have been introduced. The aim of this study is to compare the Tanaka-Johnston analysis with a new regressive equation to predict the mesiodistal width of unerupted permanent canines and premolars in a Chilean population sample, from Valparaíso region. This study was conducted at the Universidad de Valparaíso Dental Faculty, from october 2022 to june 2023 (8 months), and the sample comprised historical dental casts from 202 patients (91 boys and 111 girls) in the age range of 11-20 from the orthodontics department. All the patients are from the Valparaíso region, Chile. The results show that the predictions of the new regressive equation method are closer to the actual mesiodistal measurements of the patients (ICC 0,773 for maxilla and 0,762 for mandible), compared to the Tanaka- Johnston method (ICC 0,665 for maxilla and 0,623 for mandible). There are no significant differences between the real values and the Lara-Sandoval method. Lara-Sandoval method is better than the one proposed by Tanaka-Johnston to determine the mesiodistal width of canines and premolars in this sample population. It is necessary to validate this method in other regions of the country to be used with greater security than the ones that already exists as a national standard method.

Can lingual spurs alter the oral health-related quality of life during anterior open bite interceptive treatment? A systematic review

ABSTRACT Introduction: The use of lingual spurs has been described as one efficient option, with great stability of results, but with scarce information of toleration for use in the mixed and permanent dentition phases. Objective: The purpose of this study was to assess the impact of lingual spurs on the oral health-related quality of life of children and/or adolescents during anterior open bite treatment. Methods: The review was recorded in the PROSPERO database. Eight electronic databases and partial gray literature were searched, without restrictions until march 2022. A manual search was also performed in the references of the included articles. Studies assessing the impact of lingual spurs on the oral health-related quality of life were included. Risk of bias was assessed using JBI or ROBINS-I tool, according to the study design. The level of evidence was assessed through GRADE. Results: Five studies met the eligibility criteria. Two non-randomized clinical trials had a serious risk of bias. Of the case-series studies, two had a low risk of bias and the other, a moderate risk of bias. The certainty of the evidence was classified as very low for all the evaluated results. In general, the studies reported an initial negative impact with the use of lingual spurs, however this was transitory in nature. A quantitative analysis was not performed due to the great heterogeneity between the studies. Conclusion: Current evidence, although limited, suggests that lingual spurs have an initial transient negative impact during interceptive treatment. Additional well-conducted randomized clinical trials are needed.

RESUMO Introdução: O uso de esporões linguais tem sido descrito como uma opção eficiente, com grande estabilidade de resultados, mas com poucas informações quanto à tolerância de seu uso nas fases de dentição mista e permanente. Objetivo: O objetivo deste estudo foi avaliar o impacto dos esporões linguais na qualidade de vida relacionada à saúde bucal de crianças e/ou adolescentes durante o tratamento da mordida aberta anterior. Métodos: Essa revisão foi registrada no banco de dados PROSPERO. Oito bases de dados eletrônicas e parte da literatura cinzenta foram pesquisadas, sem restrições, até março de 2022. Uma busca manual também foi realizada nas referências dos artigos incluídos. Estudos avaliando o impacto dos esporões linguais na qualidade de vida relacionada à saúde bucal foram incluídos. O risco de viés foi avaliado usando a ferramenta JBI ou ROBINS-I, de acordo com o desenho do estudo. O nível de evidência foi avaliado por meio do GRADE. Resultados: Cinco estudos preencheram os critérios de elegibilidade. Dois ensaios clínicos não randomizados apresentaram sério risco de viés. Dos estudos de série de casos, dois tiveram baixo risco de viés e o outro, risco moderado de viés. A certeza da evidência foi classificada como muito baixa para todos os resultados avaliados. Em geral, os estudos relataram um impacto negativo inicial com o uso dos esporões linguais; porém, de caráter transitório. Não foi realizada análise quantitativa, devido à grande heterogeneidade entre os estudos. Conclusão: As evidências atuais, embora limitadas, sugerem que os esporões linguais têm um impacto negativo transitório inicial durante o tratamento interceptativo. São necessários mais ensaios clínicos randomizados bem conduzidos.

Evaluación del canino maxilar permanente en niños entre 8 y 11 años en radiografía panorámica

RESUMEN: El canino maxilar permanente (CMP) es el segundo diente con mayor frecuencia de impactación debido a su largo descenso intraóseo y cronología de erupción. El objetivo de este estudio fue evaluar el grado de desarrollo dentario y posición del CMP entre los 8 años y los 11 años 11 meses con el fin de sugerir una edad cronológica óptima para su evaluación temprana en radiografía panorámica. Se realizó un estudio retrospectivo, en donde se analizaron 239 radiografías panorámicas de niños de 8 a 11 años. Éstas se agruparon según edad, género y área apical; luego se analizó el grado de desarrollo dentario y posición del vértice CMP izquierdo. En los resultados se observó que no existen diferencias significativas de la posición del CMP respecto a la edad cronológica. Además, entre los ocho años seis meses y nueve años seis meses un 61% de los caninos tuvieron más de la mitad de formación radicular. En conclusión, la evaluación temprana con radiografía panorámica del CMP se sugiere desde los ocho años seis meses a los nueve años seis meses, para alertar al clínico en casos donde el trayecto eruptivo se encuentre desviado.

ABSTRACT: The permanent maxillary canine (PMC) is the second most frequently impacted tooth due to its long intraosseous descent and eruption chronology. The objective of this study was to evaluate the degree of dental development and position of the PMC between the ages of 8 and 11 years 11 months in order to suggest an optimal chronological age for their early evaluation in panoramic radiography. A retrospective study was carried out, where 239 panoramic radiographs of children aged 8 to 11 years were analyzed. They were grouped according to age, gender and apical area; Then, the degree of dental development and position of the left PMC apex were analyzed. The results show that there are no significant differences in the position of the PMC with respect to chronological age. Furthermore, between eight years six months and nine years six months, 61% of the canines had more than half of the root formed. In conclusion, the early evaluation with panoramic radiography of the PMC is suggested from eight years six months to nine years six months, to alert the clinician in cases where the eruptive path is deviated.

Differential Maxillary Expander as an Alternative Device for Early Treatment of Posterior Crossbite: Case Report / Expansor Maxilar Diferencial como Dispositivo Alternativo Para o Tratamento Precoce da Mordida Cruzada Posterior: Relato de Caso

Rapid maxillary expansion (RME) is the protocol of choice for early treatment of transverse malocclusions and it is achieved with fixed expanders that produce heavy forces to achieve midpalatal suture opening. One third of patients with maxillary constriction have a greater transversal deficiency at the intercanine width than at the intermolar. The aim of this article is to present a protocol for early treatment of posterior crossbite with the use of the expander with differential opening (EDO) for RME. It is a new appliance to perform RME and its main advantage would be to allow the expansion individualization. EDO was proposed aiming to promote greater expansion on the anterior rather than on the posterior region. A 9 year-old female sought treatment. The interceptive treatment plan was based on using EDO for RME. The post-expansion orthopedic response showed an opening of 7.5 mm between the maxillary central incisors, at the level of the incisal edge. It was observed an opening of 4.8mm in the midpalatal suture. The opening at a distance of 10 mm and 20 mm from the crest to posterior at the midpalatal suture were 3.9mm and 2.8mm. The upper intercanine distance showed an increase of 9.31 mm. The upper intermolar distance had increased 8.04 mm. The upper arch perimeter showed a difference from 74.02 mm to 80.11 mm . And the upper arch length, from 29.83 mm to 31.56 mm. The posterior crossbite was 2 mm overcorrected. Early diagnosis and treatment of posterior crossbite has a very favorable prognosis. (AU)

A expansão rápida da maxila (ERM) é a técnica de escolha para o tratamento precoce das más oclusões transversais e é ativada com expansores fixos que produzem forças pesadas para possibilitar a abertura da sutura palatina mediana. Um terço dos pacientes com atresia maxilar apresenta uma maior deficiência transversal na região intercaninos do que na região intermolares. O objetivo desse artigo é apresentar um protocolo de tratamento precoce para a mordida cruzada posterior utilizando o expansor maxilar Diferencial (EMD) para realizar a ERM. EMD é um novo dispositivo que pode ser empregado para realização da ERM e sua principal vantagem seria permitir a individualização da expansão. EMD foi proposto para proporcionar maior expansão na região anterior do que na região posterior da maxila. Uma menina de 9 anos de idade buscou tratamento. O plano de tratamento interceptativo proposto foi ERM utilizando o dispositivo EMD. A resposta ortopédica pós expansão mostrou uma abertura de 7,5 mm entre os incisivos centrais superiores, ao nível da borda incisal. Foi observada uma abertura de 4,8 mm na sutura palatina mediana. A abertura a uma distância de 10 mm e 20 mm da crista para posterior na sutura palatina mediana foi de 3,9 mm e 2,8 mm. A distância intercaninos superior apresentou aumento de 9,31 mm. A distância intermolares superiores aumentou 8,04 mm. O perímetro do arco superior apresentou diferença de 74,02 mm para 80,11 mm. E o comprimento do arco superior, de 29,83 mm para 31,56 mm. A mordida cruzada posterior foi sobrecorrigida em 2 mm. O diagnóstico precoce e o tratamento da mordida cruzada posterior tem um prognóstico muito favorável. (AU)

Is there a better interceptive treatment for unerupted palatally displaced canines? A network meta-analysis

Abstract This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12-9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31-10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09-1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11-1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00-1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC.

Immediate skeletal effects of rapid maxillary expansion at midpalatal suture opening with Differential, Hyrax and Haas expanders

ABSTRACT Objective: The aim of this study was to test the null hypothesis that there is no difference at the midpalatal suture opening after rapid maxillary expansion (RME) using Expander with Differential Opening (EDO), Hyrax-type and Haas-type expanders. Methods: Occlusal radiographs of 52 patients (19 males and 33 females; average age= 9.46?1.20 years) treated with RME were divided into three groups, according to the expander used: EDO (n=17), Hyrax-type (n=21) and Haas-type (n=14). The evaluated variables were: A) Distance between the maxillary central incisors at the incisal edge; B) Distance between the alveolar ridges at the midpalatal suture; C) Suture opening at 10-mm distance from the crest to posterior, at the midpalatal suture; D) Suture opening at 20-mm distance from the crest to posterior, at the midpalatal suture; and E) Suture opening at 30-mm distance from the crest to posterior, at the midpalatal suture. To assess the normality of variables, the Shapiro-Wilk test was performed. For intergroup comparison, ANOVA with a significance level of 5% was used. Results: At the region A, Hyrax-type (4.66 mm) and EDO (4.87 mm) groups presented larger openings than the Haas-type group (3.43 mm). In regions B and C, EDO showed a statistically significant greater opening than the Haas-type group. In region D, a smaller opening of the midpalatal suture was observed in the Haas-type group, compared to the Hyrax-type and EDO groups. Conclusions: EDO and Hyrax-type produced greater immediate skeletal effects, compared with Haas-type, but these differences were about 1 mm and might not be clinically significant.

RESUMO Objetivo: O objetivo do presente estudo foi testar a hipótese nula de que não existe diferença na abertura da sutura palatina mediana após a expansão rápida da maxila (ERM) usando os expansores Diferencial, tipo Hyrax e tipo Haas. Métodos: Radiografias oclusais de 52 pacientes (19 do sexo masculino e 33 do sexo feminino; idade média: 9,46 ? 1,20 anos) tratados com ERM foram divididas em três grupos, de acordo com o tipo de expansor usado: Diferencial (n = 17), tipo Hyrax (n = 21) e tipo Haas (n = 14). As variáveis avaliadas foram: A) distância entre os incisivos centrais superiores na borda incisal; B) distância entre os rebordos alveolares na sutura palatina mediana; C) abertura da sutura a 10 mm de distância da crista para posterior, na sutura palatina mediana; D) abertura da sutura a 20 mm da crista para posterior, na sutura palatina mediana; e E) abertura da sutura a 30 mm da crista para posterior, na sutura palatina mediana. Para verificar a normalidade das variáveis, utilizou-se o teste de Shapiro-Wilk. Para comparação intergrupos, usou-se a ANOVA com nível de significância de 5%. Resultados: Na região A, os grupos tipo Hyrax (4,66 mm) e Diferencial (4,87 mm) apresentaram uma abertura maior do que o grupo tipo Haas (3,43 mm). Nas regiões B e C, o Diferencial mostrou abertura significativamente maior do que o grupo tipo Haas. Na região D, uma abertura menor da sutura palatina mediana foi observada no grupo tipo Haas, comparado aos grupos tipo Hyrax e Diferencial. Conclusões: Os expansores Diferencial e tipo Hyrax produziram maiores efeitos esqueléticos imediatos, comparados ao tipo Haas, mas essas diferenças foram de aproximadamente 1 mm e podem não ser clinicamente significativas.

Very early orthodontic treatment: when, why and how?

ABSTRACT Introduction: Several orthodontic problems should already be treated at an early age to prevent the necessity of future complex and expensive procedures. Scientific evidence suggests that posterior crossbites, mild to moderate Class III, as well as certain Class II malocclusions, open bites and arch length discrepancies can benefit from simple, but efficient interceptive therapy. Objective: To summarize the existing evidence-based literature on early orthodontic treatment, and to illustrate its application and effectiveness by showcasing multiple clinical examples. Conclusion: Early short-term interceptive orthodontic treatment with simple appliances, in the deciduous or early mixed dentition phase, can efficiently correct certain malocclusions and help to either reduce the complexity or even avoid the necessity of complex and expensive procedures during puberty. For certain patients with significant arch length discrepancy the concept of serial extractions should be part of the orthodontic armamentarium.

RESUMO Introdução: Vários problemas ortodônticos devem ser tratados já em idade precoce, para evitar a necessidade de procedimentos futuros de maior complexidade e custo. A evidência científica sugere que as seguintes más oclusões podem se beneficiar de terapias interceptivas simples mas eficientes: mordidas cruzadas posteriores, Classe III leve a moderada, certas más oclusões de Classe II, mordidas abertas e discrepâncias no tamanho das arcadas. Objetivo: Resumir a evidência científica existente sobre o tratamento ortodôntico precoce e ilustrar sua aplicação e efetividade, por meio da exposição de múltiplos casos clínicos. Conclusão: O tratamento ortodôntico interceptivo precoce de curto prazo com aparelhos simples na fase da dentição decídua ou início da dentição mista pode corrigir eficientemente certas más oclusões e ajudar a reduzir a complexidade ou, até mesmo, evitar a necessidade de procedimentos complexos e onerosos durante a puberdade. Para certos pacientes com discrepância significativa no comprimento das arcadas, o conceito de extrações seriadas deve fazer parte do arsenal de recursos ortodônticos.

Tratamiento ortodóncicoquirúrgico de canino inferior derechotransmigrado / Orthodontic-surgical approach in the treatment of a transmigrated lower right canine

RESUMEN Introducción: Si un canino impactado cruza la línea media desde su posición normal al lado contrario, se denomina transmigración. Esta presenta bajos rangos de prevalencia por lo que se le considera una condición rara. El tratamiento ortodóncico quirúrgico es una de sus opciones terapéuticas. Objetivo: Describir los resultados del tratamientoortodóncico quirúrgico en un pacientecon canino inferior derecho transmigrado. Caso clínico: Paciente masculino de 11 años de edad con antecedentes de salud que acudió a consulta de Estomatología General Integral por tener los dientes botados y por la falta de uno que mudó y el sucesor aún no ha brotado. El caso se refiere al servicio de Ortodoncia. Al examen bucal destacó la ausencia clínica del 43, sin espacio necesario para su ubicación en la arcada. El paciente clasificó como síndrome de clase II división 1 de Moyers. Se indicó estudio radiográfico y se confirmó el diagnóstico de canino incluido, transmigrado y mesioangular en región mentoniana. Se decidió realizar tratamiento ortodóncico quirúrgico para colocar el canino en su posición. Conclusiones: El tratamiento ortodóncico quirúrgico devolvió al paciente la función y la estética, mediante la correcta ubicación del canino en la arcada. Este puede ser considerado como una alternativa terapéutica en el caso de canino mandibular transmigrado que presenta patrón tipo 1.

ABSTRACT Introduction: If an impacted canine tooth crosses the midline towards the opposite side, it is considered as dental transmigration. It is a rare condition with low ranges of prevalence. The surgical-orthodontic treatment is one of the therapeutic options. Objective: To describe the orthodontic-surgical treatment results, in a patient, with transmigrated lower right canine. Case report: An 11-year-old male patient attended the general practitioner for dental evaluation, his chief complaint was the absence of one deciduous tooth and the permanent still un-erupted and the tipping of the upper incisors. During the orthodontic examination was noted insufficient space to tooth 43 in the arch. The patient was diagnosed with Moyers' class II malocclusion division 1 syndrome. The radiographic examination confirmed the diagnosis of impacted and transmigrated lower right canine, mesioangular position across the midline within the chin area. Orthodontic-surgical treatment was carried out to bring the canine tooth to its functional position. Conclusions: Orthodontic-surgical treatment restored the function and aesthetics to the patient, through the right positioning of the canine in the arch. It could be considered as a therapeutic alternative in the case of transmigrated mandibular canine with type 1 pattern.

Bio-Exercise (BioEx) - A biocreative orofacial myofunctional therapy: preliminary cephalometric study and clinical application

ABSTRACT Objective: To introduce newly structured and developed orofacial myofunctional therapy (OFMFT) protocols named Bio-Exercise (BioEx), and evaluate the treatment effect of this method, using lateral cephalometric analysis on malocclusion with low tongue posture in young patients. Methods: A retrospective preliminary study was performed using orthodontic records from 28 patients (mean age of 8.41±1.45-year-old, 13 males, 15 females) treated with BioEx therapy using tongue elevators for 18.14±9.04 months (range: 6 to 37 months). Pretreatment (T0) and post-BioEx therapy (T1) lateral cephalograms were subsequently analyzed for tongue posture changes by linear, anteroposterior and vertical measurements. The data were analyzed by paired t-test, considering a 5% significance level. Results: The tongue length (TGL) and tongue height (TGH) increased statistically significant between T0 and T1. The decrease of the dorsum of the tongue perpendicular to the palatal plane (Td-PP value) was statistically significant. The increase of the tip of the tongue perpendicular to the pterygomaxillary vertical line (TT-PMV) was not statistically significant. Conclusions: These preliminary cephalometric results indicate that BioEx can be an effective OFMFT modality in increasing the tonicity of the tongue muscles to establish more normalized tongue position at rest.

RESUMO Objetivo: Introduzir protocolos de terapia miofuncional orofacial (TMO) recém-estruturados e desenvolvidos, denominados Bio-Exercise (BioEx), e avaliar o efeito do tratamento com esse método, usando análise cefalométrica em radiografias laterais de jovens com má oclusão e postura baixa da língua. Métodos: Foi realizado um estudo preliminar retrospectivo com registros ortodônticos de 28 pacientes (idade média de 8,41±1,45 anos, 13 homens, 15 mulheres) tratados com terapia BioEx usando elevadores de língua por 18,14±9,04 meses (intervalo: 6 a 37 meses). As radiografias cefalométricas laterais pré-tratamento (T0) e pós-tratamento com BioEx (T1) foram analisadas quanto às alterações na postura da língua, por meio de medidas lineares, anteroposteriores e verticais. Os dados foram analisados pelo teste t pareado, considerando-se um nível de significância de 5%. Resultados: O comprimento da língua (CL) e a altura da língua (AL) aumentaram entre T0 e T1, com significância estatística. A diminuição do dorso da língua perpendicular ao plano palatino (valor Td-PP) foi estatisticamente significativa. O aumento da ponta da língua perpendicular à linha vertical pterigomaxilar (PL-PMV) não foi estatisticamente significativo. Conclusões: Esses resultados cefalométricos preliminares indicam que o BioEx pode ser uma modalidade de TMO eficaz no aumento da tonicidade dos músculos da língua, para estabelecer uma postura de língua adequada em repouso.

Frequency of pediatric dentomaxilar anomalies in Orthodontics Barros Luco Trudeau healthcare complex, Chile / Frecuencia de anomalías dentomaxilares pediátricas en ortodoncia perteneciente al complejo asistencial Barros Luco Trudeau, Chile

ABSTRACT Introduction: Dentomaxilar anomalies (DMA) are the third most common oral pathology in Chile. Objective: To determine the frequent of dentomaxilar anomalies observed in patients treated in the Department of Orthodontic of Dental Specialties Service (DSS) belonging to the Barros Luco Trudeau Healthcare Complex, Santiago, Chile. The population belongs to pediatric patients between 5 and 15 years, who have DMA, treated in the southern metropolitan health service. Method: The sample of 250 patients with DMA was chosen from April to September of the year 2019, therefore, the data was extracted from the clinical records of the patients. The classification of the anomalies was carried out using the Bonn's biogenetic method, modified by the University of Chile. Result: It was observed that the most frequent intermaxillary DMA of the sample is in the transverse direction and corresponds to the unilateral crossbite, on the other hand, the most frequent intramaxillary DMA is the alteration of dentoalveolar per large tooth. All intermaxillary DMA agreed to be more frequent at the age of 9 years. Conclusion: It was possible to define the frequency of the DMA in patients treated in the DSS, this being in the transverse direction, corresponding to unilateral crossbite. With the present study it is intended to make a contribution for future studies that use similar methodologies.

RESUMEN Introducción: Las anomalías dentomaxilares (ADM) son la tercera patología bucal más frecuente en Chile. Objetivo: Determinar la distribución de frecuencia de anomalías dentomaxilares observadas en los pacientes atendidos por el Departamento de Ortodoncia dentro del Servicio de Especialidades Odontológicas (SEO) perteneciente al Complejo Asistencial Barros Luco Trudeau, Santiago de Chile. La población pertenece a pacientes pediátricos entre 5 y 15 años de edad que presentan ADM, atendidos dentro del servicio de salud metropolitano sur. Método: La muestra de 250 pacientes con ADM fué recolectada a partir del mes de abril a septiembre del año 2019, por lo tanto, es una muestra por conveniencia, los datos fueron extraídos de las fichas clínicas de los pacientes. La clasificación de las anomalías estudiadas fue realizada mediante la clasificación biogenética de Bonn modificada por la cátedra de la Universidad de Chile. Resultado: Se observó que la ADM intermaxilar más frecuente de la muestra es en el sentido transversal y corresponde en el espacio lateral a la mordida cruzada unilateral, por otra parte, la ADM intramaxilar más frecuente es la alteración de tamaño dentoalveolar por diente grande. Todas las ADM intermaxilares coincidieron en ser más frecuentes a la edad de 9 años. Conclusión: Se logró determinar la distribución de las frecuencias de ADM en pacientes atendidos dentro del SEO, siendo esta en el sentido transversal, correspondiente a mordida cruzada unilateral. Con el presente estudio se pretende hacer una contribución para futuros estudios que utilicen metodologías similares.

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)

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.

Cooperation During Orthodontic Treatment of Patients with I Phase and Phase Orthodontic Treatment

ABSTRACT: To evaluate differences in cooperation of adolescent patients in active orthodontic treatment between those who received one phased treatment (no prior interceptive or early treatment) and two phased treatment (prior interceptive or early treatment and subsequent corrective treatment). A prospective cohort study was carried out in 132 patients undergoing orthodontic treatment between 10 and 17 years old at CES University Dental Clinics and in 9 private practices in Medellín Colombia; two groups of 66 patients were defined; one that received two phased treatment and one that received one phased treatment. The Orthodontic Patient Cooperation Scale (OPCS) was applied to all individuals every three months during the first year of treatment in order to assess cooperation. Statistical differences between both groups were assessed using the SSPS® software program. Significantly greater cooperation (M = 4.6) was observed in patients who had received two phased treatment compared with those who were only subjected to one phased treatment (M = 2.3). Patient cooperation during orthodontic treatment does not seem to be affected by two phased treatment and to the contrary seems to have a positive impact when comparing it with individuals with one phased treatment. The most important factors found to influence cooperation were correlated with attitude, interest and commitment to treatment, patient and parental motivation. The OPCS scale proved to be useful for evaluating cooperation and making comparisons with other studies.

RESUMEN: Evaluar las diferencias en la cooperación de los pacientes adolescentes en el tratamiento de ortodoncia activa entre los que recibieron una fase de tratamiento (sin tratamiento interceptivo previo o temprano) y los que recibieron el tratamiento de dos fases (tratamiento interceptivo previo o temprano y tratamiento correctivo posterior). Se realizó un estudio de cohorte prospectivo en 132 pacientes sometidos a tratamiento de ortodoncia entre 10 y 17 años en la clínica odontológica de la Universidad CES y en 9 consultorios privados en Medellín Colombia; se definieron dos grupos de 66 pacientes; uno que recibió dos fases de tratamiento y otro que recibió una fase de tratamiento. La Escala de Cooperación del Paciente de Ortodoncia (OPCS) se aplicó a todas las personas cada tres meses durante el primer año de tratamiento para evaluar la cooperación. Las diferencias estadísticas entre ambos grupos se evaluaron utilizando el programa de software SSPS®. Se observó una cooperación significativamente mayor (M = 4.6) en pacientes que habían recibido tratamiento dos fases en comparación con aquellos que solo fueron sometidos a una fase de tratamiento. (M = 2.3). La cooperación del paciente durante el tratamiento de ortodoncia no parece verse afectada por el tratamiento en dos fases y, por el contrario, parece tener un impacto positivo cuando se compara con individuos con un tratamiento en una fase. Los factores más importantes que influyeron en la cooperación se correlacionaron con la actitud, el interés y el compromiso con el tratamiento, la motivación del paciente y de los padres. La escala OPCS demostró ser útil para evaluar la cooperación y hacer comparaciones con otros estudios.

Stability of early anterior open bite treatment: a 2-year follow-up randomized clinical trial

Abstract This 2-year-follow up study compared and evaluated the stability of early anterior open bite (AOB) treatment based on different appliances. Children from 7 to 10 years with Angle Class I, AOB larger than 1.0 mm and fully erupted maxillary and mandibular permanent central incisors were eligible. The initial sample was 99 patients distributed, by simple randomization, into four groups: BS (bonded spurs), CC (chincup), FPC (fixed palatal crib) and RPC (removable palatal crib). Cephalometric analysis was performed at baseline (T1), final (T2) and 2-year post-treatment (T3) by taking the overbite measurements as the main outcome. Blinding was possible to cephalometric analysis. At T3, with dropouts, there were 63 individuals, being BS (n=15; overbite 0.19 mm; 11.54 years; 10 female (F)/5 male (M)); CC (n=11; overbite -0.19 mm; 11.41 years; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 years; 15 F/6 M) and; RPC (n=16; overbite 0.73 mm; 11.67 years; 6 F/10 M). Changes in dentoskeletal variables and breaking deleterious oral habits during the follow up were statically analyzed with p<.05. Mandibular skeletal linear measurements and vertical dental components have gradually increased with age, manly at pubertal growth spurt and at the establishment of permanent dentition after treatment. Incisor teeth extrusion had impact on AOB correction and stability in 4 groups, which recorded a 1.15 mm-improvement of overbite after treatment (T3-T2). The experimental appliances were effective with stable results, being FPC the device recorded the highest AOB correction and the lowest patient withdrawal rate.

Resumo Os objetivos do presente estudo foram comparar e avaliar a estabilidade do tratamento precoce da mordida aberta anterior (MAA) com diferentes dispositivos. A amostra inicial foi composta por 99 pacientes randomizados em quatro grupos experimentais: BS - esporões colados; CC - mentoneira; FPC - grade palatina fixa; RPC - grade palatina removível. Análise cefalométrica foi realizada para avaliar os dados do período inicial (T1), final do tratamento (T2) e 2 anos após tratamento (T3), sendo a variável overbite o desfecho principal. Em T3, após perdas de seguimento, haviam 63 indivíduos, sendo BS (n=15; overbite 0.19 mm; 11.54 anos; 10 Feminino (F)/5 Masculino (M)); CC (n=11; overbite -0.19 mm; 11.41 anos; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 anos; 15 F/6 M) e; RPC (n=16; overbite 0.73 mm; 11.67 anos; 6 F/10 M). Comparações das alterações nas variáveis dentoesqueléticas e abandono de hábitos bucais deletérios durante o tempo de acompanhamento foram estatisticamente analisados com p<.05. Medidas esqueléticas lineares mandibulares e componentes verticais aumentaram gradualmente com a idade, principalmente com o surto de crescimento puberal e estabelecimento da dentição permanente no pós-tratamento. O overbite foi significantemente melhorado durante o tratamento, permanecendo estável com alterações positivas. A extrusão dos incisivos impactou na correção da MAA e estabilidade nos 4 grupos, que registraram uma melhora de 1.15 mm no pós-tratamento (T3-T2). Com suas limitações, todos dispositivos experimentais foram efetivos e mostraram resultados estáveis no tratamento precoce da MAA, sendo que a FPC apresentou a maior correção da MAA e o menor índice de desistência.

Percepción, conocimiento y actitud hacia la ortodoncia interceptiva en odontopediatras, ortodoncistas y cirujanos dentistas en Perú

Resumen Objetivos: Comparar la percepción, conocimiento y actitud hacia la ortodoncia interceptiva en odontopediatras, ortodoncistas y cirujanos dentistas. Métodos: La muestra se conformó por 52 hombres y 56 mujeres, con una edad de 39.75 ± 9.32 años e incluyó a 36 odontopediatras, 36 ortodoncistas y 36 cirujanos dentistas. Se utilizó un cuestionario de 14 preguntas con características de validez, consistencia interna y estabilidad. El instrumento fue enviado mediante el software Survey Monkey. El análisis de datos se realizó mediante prueba de Chi Cuadrado al 5% de significancia. Resultados: Los profesionales no mostraron diferencias en la percepción y en la actitud hacia el tratamiento (p>0.05). Existió una diferencia con respecto al nivel de conocimiento sobre aspectos puntuales del tratamiento interceptativo (p<0.05). Conclusiones: Los profesionales tuvieron similares percepciones y actitudes frente al tratamiento interceptativo. Sin embargo, existió una diferencia significativa con respecto al nivel de conocimientos entre odontopediatras, ortodoncistas y cirujanos dentistas.

Resumo Objetivos: Comparar a percepção, o conhecimento e a atitude em relação à ortodontia interceptiva em odontopediatras, ortodontistas e cirurgiões-dentistas. Métodos: A amostra foi composta por 52 homens e 56 mulheres, com idade de 39,75 ± 9,32 anos e incluiu 36 odontopediatras, 36 ortodontistas e 36 cirurgiões-dentistas. Foi utilizado um questionário de 14 questões com características de validade, consistência interna e estabilidade. O instrumento foi enviado usando o software Survey Monkey. A análise dos dados foi realizada por meio do teste Qui quadrado com significância de 5%. Resultado: Os profissionais não apresentaram diferenças de percepção e atitude em relação ao tratamento (p> 0,05). Houve diferença quanto ao nível de conhecimento sobre aspectos específicos do tratamento interceptativo (p <0,05). Conclusões: Os profissionais tiveram percepções e atitudes semelhantes em relação ao tratamento interceptativo. No entanto, houve diferença significativa quanto ao nível de conhecimento entre odontopediatras, ortodontistas e cirurgiões-dentistas.

Abstract Objectives: To compare the perception, knowledge, and attitude towards interceptive orthodontics among pediatric dentists, orthodontists, and dental surgeons. Methods: The sample included 52 men and 56 women, aged 39.75 ± 9.32 years: 36 pediatric dentists, 36 orthodontists, and 36 dental surgeons. The 14-question survey administered had validity, internal consistency, and stability. Survey Monkey was used to administer the survey. The data was analyzed using the chi-square test at a 5% significance level. Results: No differences were found among professionals regarding perception and attitude towards the treatment (p > 0.05). There was a difference regarding the level of knowledge about specific aspects of interceptive treatment (p < 0.05). Conclusions The professionals had similar perceptions and attitudes towards interceptive treatment. However, there was a significant difference regarding the level of knowledge of pediatric dentists, orthodontists, and dental surgeons.

Simplified Fixed Technique for Correction of Anterior Crossbite: A Case Series

ABSTRACT@#Anterior crossbites would normally require early intervention, especially when associated with mandibular displacements. The intervention would usually commence in children around the age of eight and nine, where treatment could be a challenge at this age. Therefore, a simple and quick treatment to this malocclusion would be desirable. This case series illustrates two cases of anterior crossbite with a functional shift that were successfully corrected using a simplified fixed technique, which involved a short-span nickel-titanium (Ni-Ti) aligning round archwire, composite resin and glass ionomer cement (GIC).

Clinical complications during early treatment of anterior open bite

Abstract The object of this study was to compare the clinical complications of 4 different appliances used in the early treatment of anterior open bite (AOB), and to test the null hypothesis that there is no difference in the number of complications among the appliances. Records from 99 Class I malocclusion patients with AOB treated using bonded spurs, BS, n = 25; chin cup, CC, n = 25; fixed palatal crib, FPC, n = 25; and removable palatal crib, RPC, n = 24) were examined. The total number and frequency of clinical complications that occurred over 12 months were described and compared by using chi-square and Kruskal-Wallis tests (Dunn's post-test) (α = 5%, CI = 95%). The incidence of clinical complications was 66.7%, comprising: breakage, bond failure, maladjustment, allergy, soft-tissue lesion, loss of removable appliance and abandonment. Eighteen patients gave up treatment; this occurred more frequently in the groups with removable appliances. Regarding the total number of complications per patient, Group BS exhibited a significantly higher number than the other groups (p < 0.0001). A low frequency of complications (1 to 3) was found in the groups, except for Group BS, in which 8% of the patients presented moderate frequency (4 to 6). In terms of appliance types (fixed or removable), there was no difference in the incidence of complications (p > 0.094). The null hypothesis was rejected, since the BS group exhibited the highest total number and frequency of complications. There was no difference between fixed and removable appliances in terms of incidence of clinical complications, although more patients using removable appliances abandoned their treatment.

Modified Arnold expander: an alternative for mandibular arch expansion

ABSTRACT Introduction: Due to the anatomical constraints of the mandible, mandibular dental arch usually serves as a guideline to determine the required changes in the maxillary transverse dimension. The Schwarz appliance and the Lip Bumper are the traditional orthodontic appliances for mandibular arch expansion in patients with borderline amounts of crowding, and/or transverse discrepancy. However, they often require patient cooperation, which may be a concern for orthodontists in daily practice. Objectives: This article illustrates a simple fixed orthodontic device as an alternative to achieve mandibular arch expansion in patients with moderate tooth-size/arch-length discrepancy. The four reported cases refer to 8 to 10-year-old patients in the mixed dentition, with an Angle Class I or Class II malocclusion, transverse deficiency in both arches, moderate crowding and/or posterior crossbite, combined with compromised smile aesthetics. The patients were treated with rapid maxillary expansion (RME) using Hass expander appliance and the modified Arnold expander (MAE). Conclusion: This low-cost compliance-free orthodontic appliance provided dentoalveolar decompensation by means of uprighting the posterior teeth, with minimal or no adjustments during treatment. The final results were achieved in only three to four months, and fulfilled all treatment objectives, such as an increase in the arch perimeter and width, and a better teeth alignment.

RESUMO Introdução: Devido aos limites anatômicos da mandíbula, a arcada dentária inferior geralmente serve como guia para determinar as alterações necessárias na dimensão transversal da maxila. O aparelho de Schwarz e o Lip Bumper são os aparelhos usados tradicionalmente para expansão da arcada inferior em pacientes com quantidades limítrofes de apinhamento e/ou discrepância transversal. No entanto, eles requerem a cooperação do paciente, o que pode ser uma preocupação para os ortodontistas na prática diária. Objetivos: O presente artigo ilustra uma alternativa diferente de aparelho fixo para se obter a expansão da arcada inferior em pacientes com discrepância moderada de tamanho dentário e/ou comprimento da arcada. Os quatro casos relatados referem-se a pacientes com 8 a 10 anos de idade, na dentição mista, com má oclusão de Classe I ou II de Angle, deficiência transversal em ambas as arcadas, apinhamento moderado e/ou mordida cruzada posterior, apresentando comprometimento da estética do sorriso. Os pacientes foram tratados com expansão rápida da maxila (ERM), usando aparelho expansor de Hass, e expansor Arnold modificado (EAM). Conclusão: O EAM, que é um aparelho de baixo custo e não depende da colaboração do paciente, promoveu uma descompensação dentoalveolar por meio da verticalização dos dentes posteriores, necessitando de mínimo ou nenhum ajuste durante o tratamento. Os resultados pretendidos foram alcançados em três a quatro meses e cumpriram todos os objetivos do tratamento, como aumento do perímetro e largura da arcada, assim como o melhor alinhamento dos dentes.

Tratamiento de mordida cruzada anterior con aparato de tracción extraoral Máscara Delaire en paciente con estrabismo: Reporte de caso / Anterior crossbite treatment with headgear: Delaire mask in a patient with strabismus: Case reportCitaciónAriza JA, Flórez AP, Hurtado ME. Tratamiento de mordida cruzada anterior con aparato de tracción extraoral Máscara Delaire en paciente con estrabismo: Reportede caso

In Class III malocclusion with anterior crossbite exist an altered relationship between maxilla and mandible: maxillary retrognathism, mandibular prognathism or a combination of these; this disharmony can alter facial aesthetics. The etiology is multifactorial; hereditary and environmental (habits, enlarged tonsils and mandibular posture). Considering the etiological factor is crucial to establish an adequate treatment plan and achieve long-term stability.An intervention at an early age can achieve a normal function and harmony in the relationship of the jaws, thus improving the aesthetics of the patient. There are several treatment options depending on age such as maxillary orthopedics, orthodontics and orthognathic surgery. This case report depictsa 9-year-old and 7-month-old female patient, with strabismus,whose mother consults because "her jaw is getting out";the clinical and cephalometric findings determine a class III malocclusion with maxillary retrognathism, anterior cross bite, vertical growth, mixed breathing with nasal predominance, atypical swallowingand sigmatism. The treatment was developed in 2 phases: first mechanical orthopedics with Hyrax and Delaire's facial mask for 11 months, in the second phase SN3 functional orthopedic appliance (small lower fins). The changes obtained with Delaire's facial mask are evidenced at the facial, dental and skeletal level, without compromising the strabismus alteration that the patient presents and handles with glasses.

En la maloclusión clase III con mordida cruzada anterior existe una alteración en la relación máxilo-mandibular: retrognatismo maxilar, prognatismo mandibular o combinada, esta desarmonía puede alterar la estética facial. Si se interviene a una edad temprana se puede lograr la normalidad de la funciones y armonía en la relación de los maxilares, llevando a mejorar la estética del paciente. Es importante tener en cuenta el factor etiológico para establecer un adecuado plan de tratamiento y lograr estabilidada largo plazo. La etiología es multifactorial; hereditaria y ambiental (hábitos, agrandamiento de las amígdalas y postura mandibular). Existen varias opciones de tratamiento dependiendo de la edad como ortopedia maxilar, ortodoncia y cirugía ortognática.Este reporte de caso,presenta una paciente de 9 años y 7 meses de edad, género femenino, con estrabismo, cuya madre consulta porque "se le está saliendo la mandíbula"; los hallazgos clínicos y cefalométricos determinan una maloclusión clase III con retrognatismo maxilar, mordida cruzada anterior, crecimiento vertical, respiración mixta con predominio nasal, deglución atípica y sigmatismo. El tratamiento que se realizó en este paciente fue en 2 fases: en la primera ortopedia mecánica con Hyrax y máscara facial de Delaire por 11meses y en la segunda fase aparato de ortopedia funcional SN3 (pequeñas aletas inferiores). Los cambios obtenidos con máscara facial de Delaire se evidencian a nivel facial, dental y esquelético, sin comprometer la alteración de estrabismo que la pacientepresenta y maneja con gafas.

Anterior open bite treated with palatine crib: a case report with cephalometric, speech and electromyography analyses

This case report describes an interceptive treatment of anterior open bite (AOB) with fixed palatine grid using clinical, cephalometric, electromyographic and speech analysis data. Case report: An 8-year-old girl, Angle Class I malocclusion presenting AOB. The complete orthodontic documentation was obtained and the perioral muscles were evaluated using the electromyography during blowing, sucking and smiling activities, before and after treatment. Speech acoustic evaluation was performed through the frequencies of the formants to assess the position of the tongue. Results: The AOB was corrected in six months with reduction of vertical transpass, decrease of cephalometric Angles 1: NA and 1: NB and increase of interincisal angle. During the smile movement, it was possible to observe the decrease of the muscular activity of the superior orbicularis muscle and the increase of the muscular activity of the inferior orbicularis. In the blow movement, there was a tendency to decrease muscle activity. Opposite directions were observed at the time of installation of the grid in the frequencies of the formants. When the grid was removed, the tongue was lowered and posteriorized in relation to the installation time. When compared the final and initial moments, it was noted a predominance of tongue lower position, besides posteriorization in some vowels and anteriorization in others. Conclusion: After the use of the fixed palatine crib as an interceptive treatment for AOB, the bite was closed and it was possible to observe an harmony in the patient profile and improvement in periorbital musculature and tongue positioning.

Objetivo: Este relato de caso descreve um tratamento interceptivo da mordida aberta anterior (MAA) com grade palatina fixa usando dados clínicos, cefalométricos, eletromiográficos e de fala. Relato do caso: Menina de 8 anos de idade apresentando maloclusão Classe I de Angle e MAA. A documentação ortodôntica completa foi obtida e os músculos periorais foram avaliados pela eletromiografia durante as atividades de sopro, sucção e sorriso, antes e após o tratamento. A avaliação acústica da fala foi realizada através das frequências dos formantes para avaliar a posição da língua. Resultados: O MAA foi corrigida em seis meses com redução do transpasse vertical, diminuição dos ângulos cefalométricos 1: NA e 1: NB e aumento do ângulo interincisivo. Durante o movimento do sorriso, foi possível observar a diminuição da atividade muscular do músculo orbicular superior e o aumento da atividade muscular do orbicular inferior. No movimento do sopro, houve uma tendência a diminuir a atividade muscular. Direções opostas foram observadas no momento da instalação da grade nas frequências dos formantes. Quando a grade foi removida, a língua foi abaixada e posteriorizada em relação ao tempo de instalação inicial do aparelho. Quando comparados os momentos final e inicial, observou-se predomínio da posição inferior da língua, além de posteriorização em algumas vogais e anteriorização em outras. Conclusão: Após o uso da grade palatina fixa como tratamento interceptivo para a MAA, a mordida foi fechada e foi possível observar harmonia no perfil da paciente e melhora da musculatura periorbital e posicionamento da língua.