Metrical analysis of disc-condyle relation with different splint treatment positions in patients with TMJ disc displacement

Abstract Objective: To evaluate the effect of bite positions characterizing different splint treatments (anterior repositioning and stabilization splints) on the disc-condyle relation in patients with TMJ disc displacement with reduction (DDwR), using magnetic resonance imaging (MRI). Material and Methods: 37 patients, with a mean age of 18.8±4.3 years (7 male and 30 females) and diagnosed with DDwR based on the RDC/TMD, were recruited. MRI metrical analysis of the spatial changes of the disc/condyle, as well as their relationships, was done in three positions: maximum intercuspation (Position 1), anterior repositioning splint position (Position 2), and stabilization splint position (Position 3). Disc/condyle coordinate measurements and disc condyle angles were determined and compared. Results: In Position 1, the average disc-condyle angle was 53.4° in the 60 joints with DDwR, while it was −13.3° with Position 2 and 30.1° with Position 3. The frequency of successful "disc recapture" with Position 2 was significantly higher (58/60, 96.7%) than Position 3 (20/60, 33.3%). In Positions 2 and 3, the condyle moved forward and downward while the disc moved backward. The movements were, however, more remarkable with Position 2. Conclusions: Anterior repositioning of the mandible improves the spatial relationship between the disc and condyle in patients with DDwR. In addition to anterior and inferior movement of the condyle, transitory posterior movement of the disc also occurred.

Class II malocclusion treatment with the Herbst appliance in patients after the growth peak

OBJETIVO: avaliar os efeitos dentoesqueléticos do tratamento da má oclusão de Classe II com o aparelho de Herbst em pacientes que se encontravam na fase pós-pico de crescimento. MÉTODOS: a amostra consistiu de 16 pacientes com má oclusão de Classe II com medianas das idades inicial e final de 14,04 (amplitude 11,50 - 35,66) e 17,14 anos (amplitude 13,68 - 38,64), respectivamente, que foram tratados por um período médio de 2,52 anos. Telerradiografias em norma lateral foram obtidas ao início e final do tratamento para avaliar as alterações decorrentes do tratamento. Os modelos de gesso iniciais foram utilizados para avaliar o trespasse horizontal e a severidade da relação anteroposterior existente entre os molares ao início do tratamento. As alterações cefalométricas entre as fases inicial e final foram comparadas pelo teste não-paramétrico de Wilcoxon. RESULTADOS: os resultados mostraram que o aparelho de Herbst não promoveu alterações significativas no componente maxilar, o comprimento efetivo da mandíbula aumentou significativamente, sem promover uma melhoria da relação maxilomandibular. As alterações dos componentes dentoalveolares superiores e inferiores mostraram que os incisivos superiores apresentaram uma retrusão e inclinação lingual, ao passo que os incisivos inferiores evidenciaram um aumento na protrusão e inclinação para vestibular. As relações dentárias apresentaram uma melhora significativa com o tratamento. CONCLUSÃO: com base nos resultados desse trabalho, concluiu-se que os efeitos da terapia com o aparelho de Herbst em pacientes na fase pós-pico de crescimento são de natureza predominantemente dentoalveolar.

OBJECTIVE: The objective of this study was to evaluate dentoskeletal effects in the treatment of Class II malocclusion performed with the Herbst appliance in patients at post-peak stage of growth. METHODS: The sample consisted of 16 patients with Class II malocclusion and average initial and final ages of 14.04 (ranging from 11.50 to 35.66) and 17.14 (ranging from 13.68 to 38.64) years, respectively, who were treated for an mean time of 2.52 years. Lateral cephalograms were obtained at treatment onset (T1) and completion (T2) to evaluate the effects of therapy. Initial dental casts were also used to evaluate the overjet and the anteroposterior severity of molar relationship at treatment onset. The cephalometric changes between initial and final stages were compared by means of the non-parametric Wilcoxon test. RESULTS: The results showed that the Herbst appliance did not promote significant changes in the maxillary component and the effective length of the mandible significantly increased without improving the maxillomandibular relationship. Changes in the maxillary and mandibular dentoalveolar components revealed that the maxillary incisors exhibited retrusion and lingual tipping, while the mandibular incisors presented increased protrusion and buccal tipping. The dental relationships exhibited significant improvements with the treatment. CONCLUSION: Based on the present results, it was concluded that the effects of treatment performed with the Herbst appliance in patients at post-peak stage of growth are predominantly of dentoalveolar nature.

Effects of mandibular protraction appliance associated to fixed appliance in adults

OBJECTIVE: This retrospective study aimed to conduct a cephalometric evaluation of the skeletal, dental and soft tissue effects resulting from treatment of adult patients presenting Class II malocclusion, performed with a Mandibular Protraction Appliance (MPA) combined with a fixed orthodontic appliance. METHODS: The sample consisted of teleradiographs obtained before and after treatment of 9 adult patients (initial mean age of 22.48 years) with bilateral Class II, division 1, malocclusion. Paired t test (p < 0.05) was applied to compare initial and final values. RESULTS: t test revealed an increase in anteroinferior facial height and posterior facial height. The dental changes include: extrusion of upper incisors, buccal inclination, protrusion of lower incisors, mesialization and extrusion of mandibular molars. Regarding the soft tissue component, there was an increase in nasolabial angle in addition to upper lip retrusion. CONCLUSIONS: The effects of treating Class II malocclusion adult patients, by means of using Mandibular Protraction Appliance (MPA) combined with a fixed appliance were mostly observed in the mandibular arch, and consisted of buccal inclination, protrusion and intrusion of incisors, and mesialization and extrusion of the molars.

OBJETIVO: esse estudo retrospectivo teve como objetivo avaliar, cefalometricamente, os efeitos esqueléticos, dentários e tegumentares decorrentes do tratamento com o Aparelho de Protração Mandibular em conjunto ao aparelho fixo em pacientes adultos para correção da má oclusão de Classe II. MÉTODOS: a amostra foi composta por telerradiografias pré- e pós-tratamento de nove adultos (idade inicial média de 22,48 anos), portadores de má oclusão de Classe II, divisão 1 bilateral. O teste t pareado (p < 0,05) foi empregado para comparação dos valores iniciais e finais. RESULTADOS: de acordo com o teste t, observou-se aumento da altura facial anteroinferior e da altura facial posterior. As alterações dentárias foram: extrusão dos incisivos superiores, inclinação para vestibular e protrusão dos incisivos inferiores; e mesialização e extrusão dos molares inferiores. Com relação ao componente tegumentar, houve aumento do ângulo nasolabial e retrusão do lábio superior. CONCLUSÃO: os efeitos do tratamento com o Aparelho de Protração Mandibular em conjunto com aparelho fixo em pacientes adultos para correção da má oclusão de Classe II foram direcionados, principalmente, à arcada inferior, com inclinação vestibular, protrusão e intrusão dos incisivos e mesialização e extrusão dos molares.

Sagittal changes in lower incisors by the use of lingual arch

OBJECTIVE: The objective of this study was to evaluate a sagittal variation on the lower incisors with the use of the lingual arch on the transition from mixed to permanent dentition. METHODS: The sample was constituted of 44 Caucasian patients (26 girls and 18 boys), divided in two groups: CG, control group, monitoring the lower arch space with no orthodontic/orthopedic treatment during the rated period (n = 14); EG, experimental group, presenting anterior inferior mild crowding and installation of the lingual arch for space maintenance (n = 30). The position of the lower incisors was analyzed on computerized cephalometric tracings performed at the beginning of the monitoring (T1) and at the end, on the permanent dentition (T2). In order to evaluate the position of the incisors it was used Tweed and Steiner measurements: IMPA, 1.NB and 1-NB. The alterations were analyzed through the "t" test for paired samples, while the differences between the groups were analyzed through the "t" test for independent samples, as for sexual dimorphism. RESULTS: The values in T2 were greater in relation to T1 for all measurements on EG (IMPA, p = 0.038; 1.NB, p = 0.007 and 1-NB, p < 0.0001). On comparing the differences (T2-T1) between CG and EG, it can be gauged differences significantly superior for measure 1.NB (p = 0.002) and 1-NB (p < 0.0001) on EG. There was no statisticaly significant difference between genres. CONCLUSION: It was concluded that the lower incisors were projected after using the lingual arch to control the space on the transition from mixed to permanent dentition, however, within acceptable standards, not having difference between genres.

OBJETIVO: avaliar a alteração sagital ocorrida nos incisivos inferiores com o uso do arco lingual no período de transição da dentição mista para a permanente. MÉTODOS: a amostra foi composta por 44 pacientes leucodermas (26 meninas e 18 meninos), divididos em dois grupos: (GC) grupo controle, no qual foi efetuado monitoramento do espaço da arcada inferior, sem tratamento ortodôntico/ortopédico no período avaliado (n = 14); (GE) grupo experimental, presença de suave apinhamento anteroinferior e instalação do arco lingual para manutenção do espaço (n = 30). A posição dos incisivos inferiores foi analisada em traçados cefalométricos computadorizados realizados ao início (T1) e ao final do acompanhamento, já na dentição permanente (T2). Para avaliar a posição dos incisivos foram utilizadas as medidas das análises cefalométricas de Tweed e de Steiner: IMPA, 1.NB e 1-NB. As alterações ocorridas foram analisadas pelo teste t para amostras pareadas, enquanto as diferenças entre os grupos foram avaliadas pelo teste t para amostras independentes, bem como para o dimorfismo sexual. RESULTADOS: os valores em T2 foram maiores em relação a T1 para todas as medidas no GE (IMPA, p = 0,038; 1.NB, p = 0,007; e 1-NB, p < 0,0001). Na comparação das diferenças (T2-T1) entre o GC e GE pôde-se aferir diferenças significativamente superiores para as medidas 1.NB (p = 0,002) e 1-NB (p < 0,0001) no GE. Não houve diferença significativamente estatística entre os sexos. CONCLUSÃO: concluiu-se que os incisivos inferiores foram projetados após a utilização do arco lingual para o controle do espaço no período de transição da dentição mista para a permanente, porém a projeção esteve dentro dos padrões aceitáveis, não havendo diferença entre sexos.

La filosofía MEAW y el rol de los terceros molares en el desarrollo y tratamientos de las mordidas abiertas / MEAW philosophy and the riole of third molars in the development and treatment of openbites

Multiloop Edgewise Archwire Technique es una técnica desarrollada en los años 60 por Young H. Kim, la cual ha tenido un fuerte desarrollo en los países de Asia, especialmente Japón y Corea, por el Prof. Sadao Sato de la Universidad de Kanagawa, Japón. En la experiencia de la filosofía MEAW se ha dado particular importancia al tratamiento no quirúrgico de clases III y mordidas abiertas esqueletales. La discrepancia posterior (CP), concepto nuevo para la ortodoncia occidental, es considerada para determinar la remoción temprana de los terceros molares debido a su importancia como factor coadyuvante en la recidiva de los tratamientos de ortodoncia, especialmente el apiñamiento incisivo y en particular en la orientación del Dr. Sato, debido a su importancia en el desarrollo de la DP, que como se ha mencionado, es un factor etiopatogénico en el desarrollo de las maloclusiones esqueletales y mordidas abiertas antes, durante y postratamiento de ortodoncia.

Peripheral fibroma obstructing the eruption pathway.

Reactive hyperplasias comprise a group of fibrous connective tissue lesions that commonly occur in oral mucosa secondary to injury. Peripheral fibroma is also a type of reactive hyperplasia. Peripheral fibroma is a reactive hyperplastic mass that occurs on the gingiva and is derived from connective tissue of the submucosa or periodontal ligament. It may occur at any age, although it does have a predilection for young adults. Females develop these lesions more commonly than do males. Here, we are presenting a case report of a child who is 6 years old and presented to us with a swelling in the lower anterior region which was providing discomfort to the child and also was obstructing the eruption pathway of the permanent central incisor in the region. The lesion was surgically excised.

Fracture resistance of bovine incisors restored with different glass fiber posts: Effect of the diameter of fiber post.

Aim: Compare the effect of three post designs on the fracture resistance and failure modes of composite core - fiber post - crownless tooth sets. Materials and Methods: Ninety bovine incisors were selected and divided into nine groups of 10 specimens. The teeth were assigned to three groups based on the post design: Cylindrical, tapered, and double-tapered. Each group was subdivided into three subgroups in accordance with the diameter of the post: Small (No.1), medium (No.2), and large (No.3). The Panavia F system was used for post cementation. The specimens were mounted in acrylic resin blocks with a layer of silicone rubber covering the roots. A universal testing machine compressively loaded the specimens from the palatal side at a crosshead speed of 1 mm/min and at an angle of 135Ί to the long axis of the teeth, until failure occurred. The failure mode was determined by a stereomicroscope inspection of all the specimens. Data were analyzed by one-way ANOVA and the Tukey test (P < 0.05). Results: The fracture resistance was affected by the type of post (P < 0.0001). A narrower diameter for all of the post systems allowed for higher resistance. The main failure mode in the large cylindrical group was catastrophic fractures, while the main failures in the other eight groups were favorable. Conclusion: Narrower diameter posts showed higher fracture resistance. The dominant failure pattern was repairable fracture, except for those with large cylindrical groups.

Aspectos clínicos y morfológicos de los dientes supernumerarios / Clinical and morphological aspects of the supernumerary teeth

La hiperdoncia es una anomalía dentaria de causa desconocida, caracterizada por el aumento del número de dientes. Ocurre con mayor frecuencia en la maxila, de preferencia en el sexo masculino, siendo más común en la dentición permanente. La presencia de dientes supernumerarios puede ser responsable por alteraciones en la dentición permanente, como por ejemplo, el atraso en la erupción y dislocamientos. Además, el paciente puede presentar oclusión anormal, reabsorción de dientes adyacentes y formación de quistes. El presente artículo describe en un paciente de sexo masculino, de 9 años de edad, la presencia de dos incisivos laterales superiores derechos y un incisivo lateral superior izquierdo, permanentes, parcialmente erupcionados. El examen radiológico reveló un segundo incisivo lateral superior izquierdo, no erupcionado. Se debe resaltar que tanto en la zona de la pieza 1.2 como en la 2.2, los dientes presentaron anatomía normal y no el aspecto conoide comúnmente observado en los dientes supernumerarios. En nuestro caso, con el propósito de efectuar tratamiento de ortodoncia, fue indicado extracción quirúrgica de los dientes mencionados.

The hyperdontia teeth is an anomaly of unknown cause, characterized by increased numbers of teeth. It occurs more frequently in the maxilla, preferably in males, and is more common in permanent dentition. The presence of supernumerary teeth can be responsible for alterations in the permanent dentition, such as the delay in the eruption and dislocations. In addition, the patient may have abnormal occlusion, resorption of adjacent teeth and cyst formation. This article describes in a male patient, 9 years old, the presence of two upper right lateral incisor and one upper left lateral incisor, permanent, partially erupted. Radiological examination revealed a second left upper lateral incisor, unerupted. It should be noted that both, in the region of the 1.2 as in 2.2, the teeth showed normal anatomy and not the conoid appearance commonly observed in supernumerary teeth. In our case, in order to perform orthodontic treatment surgical removal of the teeth noted above was indicated.

Effect of post type and restorative techniques on the strain and fracture resistance of flared incisor roots

Restoring flared endodontically treated teeth continues to be a challenge for clinicians. This study evaluated the effect of post types and restorative techniques on the strain, fracture resistance, and fracture mode of incisors with weakened roots. One hundred five endodontically treated bovine incisors roots (15 mm) were divided into 7 groups (n=15). The two control groups were (C) intact roots restored with Cpc (cast posts and core) or Gfp (glass fiber posts). The five experimental groups were (F) flared roots restored with GfpAp (Gfp associated with accessory glass fiber posts), GfpRc (anatomic Gfp, relined with composite resin), and GfpRcAp (anatomized Gfp with resin and accessory glass fiber posts). All teeth were restored with metal crowns. Mechanical fatigue was performed with 3x10(5)/50 N. Specimens were loaded at 45º, and the strain values (μS) were obtained on root buccal and proximal surfaces. Following that, the fracture resistance (N) was measured. One-way ANOVA and Tukey's HSD tests (α=0.05) were applied, and failure mode was checked. No significant difference in strain values among the groups was found. Cpc presented lower fracture resistance and more catastrophic failures in flared roots. Gfp associated with composite resin or accessory glass fiber posts seems to be an effective method to improve the biomechanical behavior of flared roots.

Restaurar dentes tratados endodonticamente continua sendo desafio para clínicos. Este estudo avaliou o efeito de pinos e técnicas na deformação, resistência à fratura e padrão de fratura de incisivos com canal radicular alargado. Cento e cinco raízes bovinas, tratadas endodonticamente (15 mm) foram divididas em 7 grupos (n=15). Os grupos controle (C), constituídos de raízes não alargadas, foram restauradas com Cpc (núcleo metálico fundido) ou Gfp (pino de fibra de vidro). Nos grupos experimentais os canais foram alargados (F) e restaurados com: GfpAp (Gfp associado com pinos de fibra de vidro acessórios); GfpRc (pino anatômico, reembasado com resina composta) e GfpRcAp (pino anatomizado com resina composta e pinos acessórios). Os dentes foram restaurados com coroas metálicas. Fadiga mecânica foi simulada com 3x10(5)/50 N ciclos. O teste foi realizado a 45º e a deformação (μS) obtida nas superfícies vestibular e proximal. Em seguida, a resistência à fratura (N) e o padrão de fratura foram verificados. Aplicou-se ANOVA e Teste de Tukey (α=0,05). Não houve diferença na deformação. Cpc resultou em menor resistência à fratura e com mais fraturas catastróficas em raízes fragilizadas. As técnicas de reembasamento do pino com resina composta ou o uso de pinos acessórios parecem ser efetivos para melhorar o comportamento biomecânico de raízes fragilizadas.

Timing and sequence of primary tooth eruption in children with cleft lip and palate

OBJECTIVE: To determine the timing and sequence of eruption of primary teeth in children with complete bilateral cleft lip and palate. MATERIAL AND METHODS: This cross-sectional study was conducted at the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo, Bauru, SP, Brazil, with a sample of 395 children (128 girls and 267 boys) aged 0 to 48 months, with complete bilateral cleft lip and palate. RESULTS: Children with complete bilateral clefts presented a higher mean age of eruption of all primary teeth for both arches and both genders, compared to children without clefts. This difference was statistically signifcant for all teeth, except for the maxillary first molar. Mean age of eruption of most teeth was lower for girls compared to boys. The greatest delay was found for the maxillary lateral incisor, which was the eighth tooth of children with clefts of both genders. Analyzing by gender, the maxillary lateral incisor was the eighth tooth to erupt in girls and the last in boys. CONCLUSION: The results suggest an interference of the cleft on the timing and sequence of eruption of primary teeth.

Fracture strength of flared bovine roots restored with different intraradicular posts

OBJECTIVE: The aim of this study was to evaluate the fracture strength and failure mode of flared bovine roots restored with different intraradicular posts. MATERIAL AND METHODS: Fifty bovine incisors with similar dimensions were selected and their roots were flared until 1.0 mm of dentin wall remained. Next, the roots were allocated into five groups (n=10): GI- cast metal post-and-core; GII- fiber posts plus accessory fiber posts; GIII- direct anatomic post; GIV- indirect anatomic post and GV- control (specimens without intraradicular post). A polyether impression material was used to simulate the periodontal ligament. After periodontal ligament simulation, the specimens were subjected to a compressive load at a crosshead speed of 0.5 mm/min in a servo-hydraulic testing machine (MTS 810) applied at 135¨¬ to the long axis of the tooth until failure. The data (N) were subjected to ANOVA and Tukey's post-hoc test (¥á=0.05). RESULTS: GI and GIV presented higher fracture strength (p<0.05) than GII. GIII presented intermediate values without statistically significant differences (p>0.05) from GI, GII and GIV. Control specimens (GV) produced the lowest fracture strength mean values (p<0.05). Despite obtaining the highest mean value, GI presented 100 percent of unfavorable failures. GII presented 20 percent of unfavorable failures. GIII, GIV and GV presented only favorable failures. CONCLUSIONS: Although further in vitro and in vivo studies are necessary, the results of this study showed that the use of direct and indirect anatomic posts in flared roots could be an alternative to cast metal post-and-core.

Influence of different post design and composition on stress distribution in maxillary central incisor: Finite element analysis.

Background: Post design and material has very important effects on dentinal stress distribution since the post placement can create stresses that lead to root fracture. Materials and Methods: In this study we use finite element analysis (FEA) to evaluate stress distribution on endodontically treated maxillary central incisors that have been restored with different prefabricated posts. Six models were generated from the image of anatomical plate: Four metallic posts (ParaPost XH, ParaPost XT, ParaPost XP, and Flexi-Flange) and one fiberglass post (ParaPost Fiber Lux). The sixth model was a control-a sound maxillary central incisor. We used CAD software and exported the models to ANSYS 9.0. All the materials and structures were considered elastic, isotropic, homogeneous, and linear except the fiberglass post which was considered orthotropic. The values for the mechanical properties were obtained by a review of the literature and the model was meshed with 8-node tetrahedral elements. A load of 2N was applied to the lingual surface at an angle of 135°. Results: The stress results were recorded by shear stress and von Mises criteria; it was observed that there was no difference for stress distribution among the titanium posts in the radicular portions and into posts. There was higher stress concentration on the coronary portion with the titanium posts than with the glass fiber post. It seems that the metallic posts' external configuration does not influence the stress distribution. Conclusion: Fiber posts show more homogeneous stress distribution than metallic posts. The post material seems to be more relevant for the stress distribution in endodontically treated teeth than the posts' external configuration.

Tracionamento de incisivo central superior retido por odontoma / Traction of maxillary central incisor retained by odontoma, using removable orthodontic appliances: a case report

Vários säo os motivos que causam a retençäo dental. Dentre os fatores patológicos, destaca-se a presença de odontomas, que, embora sejam uma alteraçäo benigna, podem causar alguns transtornos, como näo erupçäo de dentes permanentes, má posiçäo no arco, entre outras alteraçöes. Relatamos neste caso a presença de um incisivo central superior esquerdo retido por odontoma, em que foi realizado tratamento cirúrgico/ortodôntico, para posterior tracionamento do dente com auxílio de aparelho ortodôntico removível

Interferência da imobilizaçäo sobre o processo de reparaçäo após reimplante imediato de incisivo superior de ratos: estudo histomorfológico / Effect of splinting upont healing after immediate replantation of rat upper incisors: histomorphological study

No estudo de reimplantes de incisivo superior de rato, persistem dúvidas quanto à validade da imobilizaçäo do dente por um período relativamente curto. Neste trabalho foi estudada, em reimplante imediato, a interferência da imobilizaçäo no processo de reparaçäo das estruturas dentais e peridentais. Foram empregados 64 ratos, divididos em dois grupos de 32. No Grupo I, o incisivo superior direito, após sua extraçäo, foi reimplantado e mantido no alvéolo sem qualquer tipo de imobilizaçäo. No Grupo II, antes da extraçäo, foi realizado um sulco no esmalte no lado vestibular marginando a borda da gengiva com disco de carborundum. A extraçäo e o reimplante foram feitos de forma semelhante à do Grupo I. Após o reimplante, o dente foi imobilizado, com amarria circular envolvendo o incisivo superior esquerdo na altura do sulco realizado, com fio de seda que foi removido após 48 horas. Os animais, em número de oito para cada grupo, foram sacrificados aos 5, 10, 20 e 60 dias após o reimplante. As peças obtidas, após processamento laboratorial de rotina, foram incluídas em parafina para permitir a microtomia. Os cortes longitudinais e transversais obtidos foram corados pela hematoxilina e eosina e pelo tricômico de Masson para estudo histomorfológico. De acordo com os resultados obtidos, foi possível concluir que o tipo de imobilizaçäo empregado ocasiona: 1) compressäo do dente reimplantado contra a parede óssea mesial; 2) reabsorçäo cemento-dentinária e anquilose alvéolo-dental no nível do terço cervical no lado mesial; 3) intenso infiltrado inflamatório no nível do ligamento periodontal no lado distal junto ao terço cervical

Traçäo de incisivo superior impactado com aparelho removível / Traction of impacted maxillary incisive with removable appliance

O objetivo deste trabalho é descrever e discutir uma abordagem técnica relativamente pouco conhecida para a desinclusäo ortodôntica de dentes impactados. Constitui um relato clínico conduzido em nossa clínica de graduaçäo em pacientes tratados para desinclusäo de dentes impactados. Algumas consideraçöes etiológicas e cirúrgica e a fixaçäo de acessórios em dentes impactados é discutida, bem como as vantagens e desvantagens de se exercer força extrusiva por meio de um aparelho removível do tipo Hawley

Faceta indireta em porcelana: soluçäo estética para incisivos conóides / Porcelain laminated veneers: aesthetic solution for coned incisors

Os autores apresentam casos clínicos em que a desarmonia estética de incisivos laterais conóides foi solucionada com facetas indiretas de porcelana, sem a realizaçäo de nenhum tipo de preparo mecânico

Cambios foniátricos en niños de tres a cinco años por pérdida prematura de los incisivos superiores / Phoniatric alterations in children between 3 and 5 years, with premature loss of the upper incisors

Introducción. El propósito de este estudio fue detectar los cambios foniátricos que suceden a la pérdida prematura de los incisivos superiores. Material y Métodos. El grupo experimental se formó por 20 niños sanos de 3-5 años, independientemente del sexo y con un periodo de tres meses a un año de haber perdido los cuatro incisivos superiores. El grupo testigo estuvo formado por 20 niños sanos de 3-5 años de edad, independientemente del sexo y con integridad de los cuatro incisivos superiores. Ambos grupos fueron evaluados por un especialista en foniatría mediante la prueba de CEFI (Cuestionario de evaluación fonológica infantil). Resultados. Los pacientes con pérdida prematura de los incisivos superiores presentaron dislalia en un 67%(6) del grupo de mujeres y 100%(14) de hombres, mientras que el grupo control presentó dislalia en un 46%(8) de mujeres y 54%(12) de hombres. Conclusiones. Aunque en ambos grupos se presentaron más hombres que mujeres, al analizar la incidencia de casos con dislalia por medio de X2, los varones muestran mayor número de alteraciones. La pérdida prematura de los cuatro incisivos superiores es un factor predisponente para la presentación de dislalia. El tiempo que transcurre después de esta pérdida es proporcionalmente directo a la gravedad del problema foniátrico