Comparación Morfológica de Zonas de Inserción de Miniplacas Ortodóncicas en la Región Mandibular entre Edad, Sexo, Biotipo y Clase Esqueletal

El manejo del anclaje en los tratamientos de ortodoncia ha sido un reto constante, por lo que la utilización de miniplacas aparece como un rescate a esta interrogante. Determinar las diferencias morfológicas en la zona de inserción de miniplacas ortodóncicas en las regiones anterior y posterior mandibular, comparandolas entre edad, sexo, biotipo y clase esqueletal. Se estudiaron 40 registros de cone-beam de pacientes y se realizaron mediciones de grosor del hueso, donde se identificaron los sitios que permitan posicionar una miniplaca y fueron comparados entre sexo, grupos etarios, biotipo y clase esqueletal. Se observó diferencias significativas entre hombres y mujeres a nivel anterior mandibular, en los hombres se observaron mayores grosores óseos y corticales. No se observaron diferencias significativas entre pacientes adultos y jóvenes a nivel anterior mandibular, pero sí hubo diferencias a nivel mandibular posterior. La zona 3 mm debajo del 2do molar no es una zona confiable para la inserción de mini placas, ya que muchos de los pacientes no presentaban hueso en esa zona. Las miniplacas son un recurso seguro de anclaje las cuales deben ser adaptadas a cada paciente.

The anchorage management in orthodontic treatments has been a constant challenge, the use of miniplates may be a viable solution to this query. The objective of this study was to determine the morphological differences in the area of insertion of orthodontic miniplates in the anterior and posterior mandibular regions, comparing them between age, sex, biotype and skeletal class. In this analysis 40 cone-beam records of patients were studied, bone thickness measurements were carried out, the sites that allowed the positioning of a miniplate were identified and compared between sex, age groups, biotype and skeletal class. Significant differences were observed between men and women at the anterior mandibular level, in men greater bone and cortical thicknesses were observed. No significant differences were observed between adult and young patients at the anterior mandibular level, but there were differences at the posterior mandibular level. The area 3 mm below the 2nd molar was not a reliable area for the insertion of mini plates, since many of the patients had no bone in that area. Miniplates are a safe anchoring resource which must be adapted to each patient.

Biotipo facial y clasificación esquelética maxilomandibular en pacientes angolanos con anomalías dentomaxilofaciales

Fundamento las mediciones cefalométricas son un instrumento útil en la atención ortodóncica, pues junto a otras mediciones cefalométricas completan y guían el plan de tratamiento que el especialista puede trazar en función de la resolución de las anomalías dentomaxilofaciales. Objetivo determinar la comorbilidad entre el biotipo facial y la clasificación esquelética maxilomandibular en pacientes angolanos con anomalías dentomaxilofaciales. Métodos se realizó un estudio descriptivo transversal, en la Clínica Meditex, en Luanda, Angola, en el período agosto/2021-julio/2023. La población de estudio fue de 123 telerradiografías del perfil de pacientes con anomalías dentomaxilofaciales, ingresados en la consulta de Ortodoncia. Para el análisis de la telerradiografía de perfil se realizaron mediciones del cefalograma de Ricketts y de Steiner, y se utilizó el software Facad versión 3403. Se estudió la clasificación esquelética maxilomandibular (clase I, clase II, clase III) y el biotipo facial (dolicofacial, mesofacial, braquifacial). Resultados el 46,34 % de los pacientes presentó una clase II esquelética maxilomandibular. Mediante el índice VERT de Ricketts, el 49,59 % de los casos fue clasificado como dolicofacial, seguido del 42,27 % como braquifacial. El 83,60 % de los pacientes con biotipo dolicofacial se caracterizó por presentar una clase II esquelética maxilomandibular, y el 76,92 % de aquellos con biotipo braquifacial clasificó como clase III. Se encontró una asociación significativa entre el biotipo facial y la clasificación esquelética maxilomandibular (p= 0,000). Conclusiones en la mayoría de los pacientes con anomalías dentomaxilofaciales se evidenció una relación entre el biotipo dolicofacial y la clase II esquelética maxilomandibular, por lo que existe una comorbilidad entre ambas características esqueléticofaciales.

Foundation cephalometric measurements are a useful instrument in orthodontic care, since together with other cephalometric measurements they complete and guide the treatment plan that the specialist can draw up based on the resolution of dentomaxillofacial anomalies. Objective to determine the comorbidity between facial biotype and maxillomandibular skeletal classification in Angolan patients with dentomaxillofacial anomalies. Methods a cross-sectional descriptive study was carried out at the Meditex Clinic, in Luanda, Angola, from August/2021 to July/2023. The studied population was 123 patients' profile teleradiographs with dentomaxillofacial anomalies, admitted to the Orthodontic clinic. For the analysis of the profile teleradiography, measurements of the Ricketts and Steiner cephalogram were made, and the Facad software version 3403 was used. The maxillomandibular skeletal classification (class I, class II, class III) and the facial biotype (dolichofacial, mesofacial, brachyfacial) were studied. Results 46.34% of patients presented maxillomandibular skeletal class II. Using the Ricketts VERT index, 49.59% of cases were classified as dolichofacial, followed by 42.27% as brachyfacial. 83.60% of patients with dolichofacial biotype were characterized by having maxillomandibular skeletal class II, and 76.92% of those with brachyfacial biotype were classified as class III. A significant association was found between facial biotype and maxillomandibular skeletal classification (p= 0.000). Conclusions in the majority of patients with dentomaxillofacial anomalies, a relationship was evident between the dolichofacial biotype and the maxillomandibular skeletal class II, so there is a comorbidity between both skeletal-facial characteristics.

A bibliometric analysis of the 100 top-cited systematic review and meta-analysis in Orthodontics

ABSTRACT Objective: This bibliometric study aimed to analyze the citation metrics, journal and author characteristics, and subject domains of the 100 top-cited Systematic Reviews (SR) and Meta-Analysis (MA) in orthodontics. Material and Methods: An electronic database search was conducted for SR and MA in the Web of Science on 16th July 2023, without language and time restrictions. Of the 802 hits returned, the 100 top-cited orthodontic articles were shortlisted. They were analyzed for citation metrics, journal characteristics (journal, year of publication, impact factor-IF), author and affiliation characteristics (number, primary and corresponding author's affiliation, and country), study domain, and keywords. Results: These articles were published from 1996 to 2021 in 20 journals, with an impact factor of 1.9 to 10.5, by 351 researchers affiliated with 104 universities. Their citations ranged from 45 to 344, and 34 poised to be classified as classic (≥ 100 citations). The maximum number of articles was published in the American Journal of Orthodontics and Dentofacial Orthopedics (n=38), the European Journal of Orthodontics (n=18), and the Angle Orthodontist (n=8). The authors for individual papers ranged from 1 to 10, with 5 being the most common (n=58). Europe had the highest contribution regarding the number of corresponding authors, institutions, and citations. Bone anchorage and orthodontic tooth movement/Biomechanics were the most frequently researched domains (n=11 each). The most common keyword used was Orthodontics (n=19), followed by Systematic Review (n=16) and Meta-analysis (n=9). Conclusion: In general, the top cited SR and MA were published in high-impact orthodontic journals, were multi-authored, and reflected the collaborative work from different universities.

RESUMO Objetivo: Este estudo bibliométrico teve como objetivo analisar as métricas de citação, as características dos periódicos e dos autores, e os domínios temáticos das 100 Revisões Sistemáticas (RS) e Meta-Análises (MA) mais citadas em Ortodontia. Material e Métodos: Uma pesquisa em banco de dados eletrônico foi realizada para RS e MA na Web of Science no dia 16 de julho de 2023, sem restrições de idioma e data de publicação. Dos 802 resultados encontrados, foram selecionados os 100 artigos ortodônticos mais citados. Eles foram analisados quanto a métricas de citação, características do periódico (revista, ano de publicação e fator de impacto [FI]), características dos autores e afiliação (quantidade, afiliação dos autores principal e correspondente, e país), domínio do estudo e palavras-chave. Resultados: Esses artigos foram publicados entre 1996 e 2021 em 20 periódicos com fator de impacto de 1,9 a 10,5, por 351 pesquisadores afiliados a 104 universidades. Suas citações variaram de 45 a 344, com 34 prestes a serem classificados como clássicos (≥ 100 citações). A maior quantidade de artigos foi publicada na American Journal of Orthodontics and Dentofacial Orthopedics (n=38), na European Journal of Orthodontics (n=18), e no The Angle Orthodontist (n=8). A quantidade de autores por artigo variou de 1 a 10, sendo 5 o mais frequente (n=58). A Europa teve a maior contribuição em relação ao número de autores correspondentes, instituições e citações. Ancoragem óssea e movimentação dentária ortodôntica/Biomecânica foram os domínios mais abordados (n=11 cada). A palavra-chave mais utilizada foi Ortodontia (n=19), seguida de Revisão Sistemática (n=16) e Meta-análise (n=9). Conclusão: No geral, as RS e MA mais citadas foram publicadas em revistas ortodônticas de alto impacto, eram de autoria múltipla e refletiam o trabalho colaborativo de diferentes universidades.

Superimposition of virtual models using palatal rugae and maximum habitual intercuspation

ABSTRACT Introduction: The superimposition of 3 dimensions (3D) digital models has been increasingly used for evaluating dental changes resulting from orthodontic treatment, and different superimposition techniques have been described. Although the maxilla has areas with greater stability for superimposition, such as the palatal rugae, there is still no reliable method for superimposing models of the lower arch. Objective: Therefore, this article aims to describe a technique for superimposing virtual models. Methods: To evaluate pre- and post-orthodontic treatment changes, the Geomagic Qualify 2013 software (3D Systems®, Rock Hill, South Carolina, USA) was used, with reference points in the maxilla, including the rugae and a reference area in the palate and midpalatal raphe. The lower arch was superimposed using the maximum habitual intercuspation (MHI) model as reference. Results and Conclusion: 3D models superimposition using palatal rugae and MHI occlusion seems to offer satisfactory results in the interpretation of clinical changes at different follow-up moments in terms of development and/or orthodontic treatment.

RESUMO Introdução: A sobreposição de modelos digitais em três dimensões (3D) tem sido cada vez mais utilizada como forma de avaliar as alterações dentárias decorrentes do tratamento instituído, e diferentes técnicas de sobreposição têm sido descritas. Apesar de a maxila apresentar áreas de maior estabilidade para sobreposição dos modelos, como as rugas palatinas, ainda não existe um método confiável para a sobreposição da arcada inferior. Objetivo: O presente artigo tem como objetivo descrever uma técnica de sobreposição de modelos virtuais. Métodos: Para avaliar as alterações pré e pós-tratamento ortodôntico, foi usado o software Geomagic Qualify 2013 (3D Systems®, Rock Hill, Carolina do Sul, EUA) , utilizando pontos de referência na maxila na região das rugas palatinas e uma área de referência na zona do palato e rafe palatina mediana. Já a arcada inferior foi sobreposta utilizando o modelo em máxima intercuspidação habitual (MIH) como referência. Resultados e Conclusão: A sobreposição de modelos utilizando as rugas palatinas e a oclusão em MIH parece oferecer resultados satisfatórios na interpretação das alterações clínicas entre momentos diferentes de acompanhamento, seja do crescimento/desenvolvimento e/ou resultados do tratamento ortodôntico.

Soft skills in Orthodontics: an analysis in residents and experienced professionals

ABSTRACT Introduction: Soft skills represent a range of personal skills, attitudes and characteristics relevant to success and adequate work performance. Objective: This study aimed to evaluate the knowledge and usage of soft skills in Orthodontics. Methods: The participants answered a questionnaire containing 27 objective questions on awareness and frequency of soft skills in their professional activities. Participants were also asked to rank the soft skills in a crescent order of importance. The sample was divided into subgroups: A) residents in Orthodontics; B) orthodontists with less than 5 years of experience and C) orthodontists with more than 5 years of experience. Intergroup comparisons were performed using the Kruskal-Wallis test. Sexual differences were compared using Mann-Whitney test (p<0.05). Results: The sample of this observational study comprised 129 experienced orthodontists and residents in Orthodontics (92 women, 37 men) with mean age of 35.3 years. From the total sample, 54,6% of respondents reported no previous instructions on soft skills. All respondents reported using the analyzed soft skills with a similar frequency (median 4-5). Residents reported accessing reliable sources in bibliographic research less frequently (46%). Female orthodontists reported to seek help from teachers and other professionals more often than males. Ethics and communication were frequently ranked as the most important soft skills. Information management and leadership were frequently less ranked as important soft skills. Conclusion: Poor knowledge of soft skills was demonstrated by residents and orthodontists. Communication skill was highly used and frequently ranked as the most important soft skill.

RESUMO Introdução: As soft skills representam uma variedade de habilidades pessoais, atitudes e características relevantes para o sucesso e desempenho adequado no trabalho. Objetivo: Este estudo teve como objetivo avaliar o conhecimento e o uso das soft skills em ortodontistas. Métodos: Os participantes responderam a um questionário contendo 27 perguntas objetivas sobre conhecimento e frequência das soft skills em suas atividades profissionais. Os participantes também foram solicitados a classificar as soft skills em uma ordem crescente de importância. A amostra foi dividida em subgrupos: A) residentes em Ortodontia; B) ortodontistas com menos de 5 anos de experiência e C) ortodontistas com mais de 5 anos de experiência. As comparações intergrupos foram realizadas usando o teste de Kruskal-Wallis. Diferenças entre os sexos foram comparadas usando o teste de Mann-Whitney (p< 0,05). Resultados: A amostra deste estudo observacional compreendeu 129 ortodontistas experientes e residentes em Ortodontia (92 mulheres, 37 homens) com idade média de 35,3 anos. Entre os entrevistados, 54,6% relataram não ter recebido instruções prévias sobre as soft skills. Todos os entrevistados relataram usar as habilidades interpessoais analisadas com uma frequência semelhante (mediana 4-5). Os residentes relataram acessar com menos frequência (46%) fontes confiáveis de pesquisa bibliográfica. Ortodontistas do sexo feminino relataram buscar ajuda de professores e outros profissionais com mais frequência do que os do sexo masculino. Ética e comunicação foram frequentemente classificadas como as soft skills mais importantes. Com frequência, o gerenciamento de informações e a liderança foram classificados como soft skills menos importantes. Conclusão: Foi demonstrado pouco conhecimento sobre as soft skills por parte de residentes e ortodontistas. A habilidade de comunicação foi frequentemente utilizada e considerada a soft skill mais importante.

Patrón de variación de la forma del arco dentario mandibular en una muestra de la Región Metropolitana de Chile

Objetivos: Describir el patrón de variación de la forma de la arcada dentaria mandibular en una muestra de la Región Metropolitana mediante un estudio observacional, transversal. Métodos: Se digitalizaron 18 puntos de referencia en 134 fotografías estandarizadas de modelos de yeso y se realizó un análisis de Procusto para obtener los componentes de variación de la forma y el tamaño (tamaño del centroide= cs). Resultados: El tamaño de centroide en hombres es significativamente mayor que en mujeres. El análisis discriminante con validación cruzada no mostró diferencias significativas en los componentes de la forma según el sexo. Las diferencias en la forma de los arcos dentales, explicada por los dos primeros componentes de la forma correspondió al 73.4% de la varianza total (PC1= 50,14%, en el eje anteroposterior y PC2= 13,31% en el eje transversal). Conclusiones: De acuerdo con los resultados del presente estudio, se debe replantear el uso de plantillas preformadas en la determinación de la forma del arco dentario, dada la continuidad morfológica que se observa al realizar un análisis estadístico del patrón de variación en forma y tamaño del arco, como queda en evidencia al utilizar herramientas de morfometría geométrica.

Objetivos : Descrever o padrão de variação da forma do arco dentário mandibular em uma amostra populacional da Região Metropolitana, através de um estudo observacional transversal. Métodos : 18 pontos anatómicos em 134 fotografias padronizadas de moldes de gesso foram digitalizados e foi realizado uma análise Procrustes. Resultados : O tamanho do centróide nos homens é significativamente maior do que nas mulheres. A análise discriminante com validação cruzada de gênero não mostrou diferenças significativas nos componentes da forma. O padrão de variação na forma das arcadas dentárias é explicado principalmente por PC1 (50,1% da variação total, variação anteroposterior) e PC2 (13,3%, variação transversal). Conclusões : Dada a continuidade morfológica que se observa ao realizar uma análise estatística do padrão de variação da forma e tamanho da arcada, aplicando ferramentas morfométricas geométricas, o uso de templates pré-formados para determinação da forma da arcada dentária deve ser reconsiderado.

Objectives: Describe the pattern of shape variation of the mandibular dental arch in a sample from the Metropolitan Region through an observational, cross-sectional study. Methods: 18 landmarks on 134 standardized photographs of dental casts were digitized, and a Procrustes analysis was performed. Results: The size of the centroid in men was significantly larger than in women. Discriminant analysis with gender cross-validation did not show significant differences in the shape components. The variation pattern in the shape of the dental arches is mainly explained by PC1 (50.1% of the total variation, anteroposterior variation) and PC2 (13.3%, transverse variation). Conclusions: Given the morphological continuity that is observed when performing a statistical analysis of the variation pattern in shape and size of the arch applying geometric morphometric tools, the use of preformed templates for determining the shape of the dental arch should be reconsidered.

Methodological Quality of Systematic Reviews Addressing Orthodontic Interventions: Methodological Study

ABSTRACT Objective: To assess the methodological quality and characteristics of systematic reviews (SRs) of interventional studies in orthodontics and assess how the certainty of the evidence is reported using the GRADE approach. Material and Methods: Six electronic databases were searched, followed by a hand search of the reference lists of eligible studies (PROSPERO #CRD42020180852). The required study design was randomized and nonrandomized studies of interventions published between January 2019 and May 2020. The Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool was used for the quality appraisal of the included SRs. Paired reviewers independently screened the studies, extracted data, and appraised the methodological quality. Results: The study included 46 SRs; 19.5% had moderate to high methodological quality, and the remaining had low to critically low methodological quality. Fifty-four percent of the reviews assessed the certainty of evidence using the GRADE approach, and 34.8% followed all GRADE criteria. Conclusion: Most reviews had a good judgment of the AMSTAR2 items, although some critical items contributed to decreased overall quality. Half of the reviews used the GRADE approach to assess the certainty of the evidence, and this approach should be included in future systematic reviews of interventions.

Orthodontic treatment of a patient with special needs: a case report / Tratamento ortodôntico de um paciente com necessidades especiais: um relato de caso

ABSTRACT This report presents the case of an adult patient with mental and intellectual limitations, whose main complaint was dental aesthetics. Dental treatment was performed at the Piracicaba Dental School and approved by the Ethics Committee (CAAE: 65752322.2.0000.5418). Clinically, the patient had inadequacies in the dental arrangement, with periodontal involvement that put the dental elements at risk. In intraoral clinical aspects, the deficiency was identified as maxillary atresia. The buccolingual inclination of the mandibular anterior teeth highlighted the severe crowding and anterior crossing of these teeth. Dental treatment was carried out aiming at the remission of periodontal and orthodontic problems in an integrated manner and with approaches that allowed greater interaction, participation, and patient compliance during treatment. Supra and subgingival scrapings and extraction of the upper left lateral incisor were performed. After three months of periodontal treatment, orthodontic treatment was started with fixed orthodontic appliances. The main objective was to level and align the teeth in both arches to achieve better aesthetic and functional conditions. Due to the COVID-19 pandemic, treatment has been discontinued. This resulted in the regression of the results obtained, including regarding self-care. People with disabilities require dental care with specific strategies for their needs, which must be carried out by a multidisciplinary team. Despite the access limitation imposed by the pandemic, the patient reestablished his motivation to restart treatment, which was facilitated by the bond of trust established between him and the team.

RESUMO Este relato apresenta o caso de um paciente adulto com limitações mentais e intelectuais, cuja queixa principal era a estética dental. O tratamento odontológico foi realizado na Faculdade de Odontologia de Piracicaba e aprovado pelo Comitê de Ética (CAAE: 65752322.2.0000.5418). Clinicamente, o paciente apresentava inadequações no arranjo dentário, com comprometimento periodontal, que colocava em risco os elementos dentais. Nos aspectos clínicos intrabucais, a deficiência foi identificada como atresia maxilar. A inclinação vestíbulo-lingual dos dentes anteriores inferiores destacou o apinhamento severo e o cruzamento anterior desses dentes. O tratamento odontológico foi realizado visando à remissão dos problemas periodontais e ortodônticos de forma integrada e com abordagens que permitissem maior interação, participação e adesão do paciente durante o tratamento. Foram realizadas raspagens supra e subgengivais e extração do incisivo lateral superior esquerdo. Após três meses de tratamento periodontal, iniciou-se o tratamento ortodôntico com aparelhos ortodônticos fixos. O objetivo principal foi nivelar e alinhar os dentes em ambas as arcadas para alcançar melhores condições estéticas e funcionais. Devido à pandemia de COVID-19, o tratamento foi interrompido. Isso resultou na regressão dos resultados obtidos, inclusive quanto ao autocuidado. As pessoas com deficiência requerem atendimento odontológico com estratégias específicas para suas necessidades, que devem ser realizadas por uma equipe multidisciplinar. Apesar da limitação de acesso imposta pela pandemia, o paciente restabeleceu sua motivação para reiniciar o tratamento, o que foi facilitado pelo vínculo de confiança estabelecido entre ele e a equipe.

Evaluación del aparato funcional postratamiento de Waveney como alternativa en la contención del avance mandibular

Fundamento: Para la contención del avance mandibular es necesario utilizar un aparato que mantenga la mandíbula en la posición lograda por los aparatos activos y que su diseño no provoque movimientos dentarios indeseados. Objetivo: Describir los cambios clínicos y cefalométricos del aparato funcional postratamiento de Waveney como alternativa en la contención del avance mandibular. Metodología: Se realizó una investigación descriptiva observacional de corte transversal en el servicio Ortodoncia de la Clínica Estomatológica Docente Provincial Dr. Justo Ortelio Pestana Lorenzo de la provincia Sancti Spíritus, desde septiembre 2019 a febrero 2022. Se seleccionaron 20 pacientes que iniciaron su etapa de contención en este período y cumplieron los criterios de inclusión. Se utilizaron métodos del nivel empírico y estadístico. Se analizaron las variables: edad, sexo, variables morfológicas clínicas y cefalométricas, así como resultado de la contención. Resultados: Se constató una edad promedio de 15.6; el 65 % de los escolares pertenecían al sexo femenino. Al año de iniciada la contención se mantuvo el sobrepase incisivo en 2.95 mm, la relación molar de neutroclusión en el 65 %, ángulo SNB en 79°, el ángulo ANB en 2.80°, la posición del incisivo superior 2.45 mm, la posición del incisivo inferior en 1.90 mm y el perfil estético en 0.55 mm. Solo existió incremento en el valor promedio del resalte incisivo de 2.70 mm a 2.75 mm. Conclusiones: Al año de iniciada la contención con el aparato funcional postratamiento de Waveney no se observó modificación de las variables estudiadas, excepto el resalte incisivo con incremento de su valor promedio.

Background: For mandibular advancement containment, it is necessary to use an appliance that holds the jaw in the achieved position by active appliances and that its design does not provoke undesired dental movements. Objective: To describe the clinical and cephalometric changes of the Orthodontic Appliances after the Waveney treatment as an alternative in the mandibular advancement containment. Methodology: A descriptive observational cross-sectional research was conducted at the Dr. Justo Ortelio Pestana Lorenzo Provincial Teaching Stomatology Clinic orthodontic service in Sancti Spíritus province, from September 2019 to February 2022. 20 patients who started their containment stage in this period and fulfilled the inclusion criteria were selected. Empirical and statistical methods were used. The following variables were analyzed: age, sex, clinical morphological and cephalometric variables, as well as the containment result. Results: An average age of 15.6 was found; 65% of the schoolchildren were female. One year after the containment was started, the incisive overpass was maintained at 2.95 mm, the neutroclusion molar rate at 65%, SNB angle at 79°, the ANB angle at 2.80°, the upper incisor position 2.45 mm, the lower incisor position by 1.90 mm and the esthetic profile by 0.55 mm. There was only an average increase in the incisor protrusion value from 2.70 mm to 2.75 mm. Conclusions: One year after containment with the Waveney post-treatment Orthodontic Appliances was initiated no changes were observed in the studied variables, except for incisor protrusion with an increase in its average value.

Effect of various educational methods on increasing parents' awareness of their children's preventive orthodontic treatments

Aim: Like other fields of health, the main focus in dentistry has shifted from treatment to prevention of diseases. Parents have a vital role in deciding about their children's oral health issues. This study aims to investigate the effectiveness of four educational methods (including printed pamphlets, digital pamphlets, faceto-face education, and educational films) in increasing the awareness of parents about preventive orthodontic treatments. Methods: The study samples were selected from patients who were referred to the Pediatric Dentistry Department. 150 parents of children between 4-12 years old participated in the study. They filled out a questionnaire including demographic data and knowledge about orthodontic problems and their early treatments. Then they were divided into five groups (control, printed pamphlet, digital pamphlet, face-to-face, educational films) and after one month they repeated the test. Results: A total of 102 fathers and 48 mothers were evaluated. There was no statistical difference between different ages, sex, or income in terms of their awareness, but the awareness score between educational groups was different. There has been observed a significant increase in the awareness level of all four groups (except the control group) (P < 0.05). The highest score was seen in the video group. The difference between printed pamphlets and digital pamphlets was not significant. Conclusions: The results indicate that educational films are the most effective way of increasing awareness about preventive orthodontic treatments

Impact of fixed orthodontic retainers on oral health-related quality of life: a longitudinal prospective study

ABSTRACT Objective: The aim of the present study was to assess the impact of orthodontic retainers on oral health-related quality of life (OHRQoL) in the short and long terms after orthodontic treatment. Methods: Data from 45 patients up to three years after orthodontic treatment (T0) were analyzed. Patients were reassessed four years (T1) after T0. OHRQoL was measured using the OHIP-14 (Oral Health Impact Profile-14) questionnaire. The presence of a fixed retainer in the upper and/or lower arches, sex, and age were the predictive variables evaluated at T0 and T1. The occurrence of retainer fracture at T0 was clinically evaluated. Due to the COVID-19 pandemic, clinical examination on T1 was not possible, so the OHIP-14 and the self-perception of changes in teeth position and fracture of retainers were examined using an on-line questionnaire. Results: At the initial examination, the presence of upper retainers had a negative impact on quality of life (p=0.018). The OHIP-14 value increased significantly from T0 to T1 (p=0.014), regardless of the presence of retainers. The fracture or debonding of the retainer reported by the patient was the only variable that had a negative impact on OHRQoL (p=0.05). Conclusion: The use of fixed upper retainers suggests a negative impact on the quality of life of the orthodontic patient after the end of orthodontic treatment. This impact, however, is negligible in the long term, except when associated with fracture or debonding. This study emphasizes the need for continuous follow-up of orthodontic patients during the retention period.

RESUMO Objetivo: O objetivo deste estudo foi avaliar o impacto das contenções ortodônticas na qualidade de vida relacionada à saúde bucal (QVRSB) em curto e longo prazos após o tratamento ortodôntico. Métodos: Foram analisados dados de 45 pacientes até três anos após o tratamento ortodôntico (T0). Os pacientes foram reavaliados quatro anos (T1) após T0. A QVRSB foi mensurada usando o questionário OHIP-14 (Oral Health Impact Profile-14). A presença da contenção fixa nas arcadas superior e/ou inferior, o sexo e a idade foram as variáveis preditoras em T0 e T1. A ocorrência de quebra da contenção em T0 foi avaliada clinicamente. Em razão da pandemia da COVID-19, não foi possível o exame clínico em T1; assim, a autopercepção das alterações na posição dos dentes e a quebra ou descolagem das contenções foram registradas por meio de um questionário online. Resultados: No exame inicial, a presença da contenção superior apresentou um impacto negativo na qualidade de vida (p=0,018). Em T1, o valor de OHIP-14 aumentou significativamente em comparação a T0 (p=0,014), independentemente da presença das contenções. A quebra ou descolagem da contenção relatada pelo paciente foi a única variável que apresentou um impacto negativo na QVRSB (p=0,05). Conclusão: O uso de contenção fixa superior sugere um impacto inicial negativo na qualidade de vida do paciente após o fim do tratamento ortodôntico. Esse impacto, entretanto, é insignificante em longo prazo, exceto quando associado à descolagem ou quebra das contenções ortodônticas. Esse estudo enfatiza a necessidade de acompanhamento contínuo das contenções fixas após a finalização do tratamento ortodôntico.

Impact of orthodontic treatment on OHRQoL of adolescents: a longitudinal study

ABSTRACT Objective: The aim of this study was to evaluate the extent to which orthodontic treatment need is perceived by the patients and by the orthodontist, as well as the possible impacts on the OHRQoL (Oral Health-Related Quality of Life) over the course of conventional orthodontic treatment in adolescent patients. Methods: The sample consisted of 55 adolescents. The perception of patients and orthodontists relative to the malocclusion was evaluated by the IOTN (Index of Orthodontic Treatment Need). The OHRQoL was evaluated by the Child-OIDP (Child-Oral Impacts on Daily Performances) questionnaire before the conventional orthodontic appliance was bonded (T0); and at the following time intervals: after one week (T1), one month (T2), three months (T3), six months (T4), and after the end of orthodontic treatment (T5). Results: Adolescents who had large orthodontic treatment needs had a poor OHRQoL, according to their self-perception (p=0.003) and according to the orthodontist's perception (p<0.001), when compared with patients with small and moderate needs. There was statistically significant difference in the OHRQoL between the time intervals T0 and T1 (p=0.021), T2 and T3 (p<0.001), T3 and T4 (p=0.033), and T0 and T5 (p<0.002). At the end of treatment, all evaluated participants reported an improvement in OHRQoL. Conclusions: It was concluded that adolescents and orthodontists agreed with regard to the perception of orthodontic treatment need. In the first week and in the first month of orthodontic treatment, there was a negative impact on the OHRQoL. After three months, an improvement of OHRQoL was detected, which has progressed over time.

RESUMO Objetivo: O objetivo deste estudo foi avaliar o quanto a necessidade de tratamento ortodôntico é percebida pelos pacientes e pelo ortodontista, bem como os possíveis impactos na Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) ao longo do tratamento ortodôntico convencional em pacientes adolescentes. Métodos: A amostra foi composta por 55 adolescentes. A percepção dos pacientes e ortodontistas em relação à má oclusão foi avaliada pelo Índice de Necessidade de Tratamento Ortodôntico (IOTN). A QVRSB foi avaliada pelo questionário Child-OIDP (Child-Oral Impacts on Daily Performances) antes da colagem do aparelho ortodôntico convencional (T0); e nos seguintes intervalos de tempo: após uma semana (T1), um mês (T2), três meses (T3), seis meses (T4) e após o término do tratamento ortodôntico (T5). Resultados: Adolescentes que apresentavam grandes necessidades de tratamento ortodôntico apresentaram baixa QVRSB, segundo sua autopercepção (p=0,003) e segundo a percepção do ortodontista (p<0,001), quando comparados com pacientes com necessidades pequenas e moderadas . Houve diferença estatisticamente significativa na QVRSB entre os intervalos de tempo T0 e T1 (p=0,021), T2 e T3 (p<0,001), T3 e T4 (p=0,033) e T0 e T 5 (p<0,00 2 ). Ao final do tratamento, todos os participantes avaliados relataram melhora na QVRSB. Conclusões: Concluiu-se que adolescentes e ortodontistas concordaram quanto à percepção da necessidade de tratamento ortodôntico. Na primeira semana e no primeiro mês de tratamento ortodôntico, houve impacto negativo na QVRSB. Após três meses, foi detectada uma melhora na QVRSB, que progrediu ao longo do tempo.

Orthodontic treatment during pregnancy, lactation, and postmenopausal period: a questionnaire development

Abstract This study aimed to develop and validate a self-administered questionnaire in Brazilian Portuguese to verify the level of knowledge of orthodontists in the care of pregnant, lactating, and postmenopausal women, named "Considerations on Orthodontic Treatment during Pregnancy, Lactation, and Postmenopausal Periods." The development and validation of the questionnaire consisted of the following steps: a) item generation; b) item reduction; c) questionnaire design; and d) validity and reliability tests in a cross-sectional study with 258 orthodontists working in the field from different Brazilian states. A total of 60 orthodontists participated in test-retest over a mean period of 45 days. The preliminary questionnaire consisted of a total of 60 questions. After item reduction, 40 questions were selected for the final version of the questionnaire, with eight questions about pregnant women; six about lactating women; 18 about postmenopausal women, and eight about general knowledge in dentistry. Each item had three response options in the Likert scale format. Face and content validity analysis, reliability assessment through internal consistency (Cronbach's alpha and McDonald's omega), and test-retest reliability through the intraclass correlation coefficient (ICC) and Spearman's correlation coefficient were performed. Face and content validity indicated that the questionnaire was considered valid, objective, and easily understandable. The questionnaire had good internal consistency (Cronbach's alpha = 0.77; McDonald's omega = 0.78) and good test-retest reliability (ICC = 0.71; Spearman's correlation coefficient = 0.51). The questionnaire was considered valid and reliable to assess the level of knowledge of orthodontists in the care of pregnant, lactating, and postmenopausal women.

Orthodontics in the oral health care network of the Unified Health System (SUS)

Abstract This observational study aimed to describe and analyze data from two external evaluations of the National Program for Improving Access to and Quality of Dental Specialty Centers (PMAQ CEO), held in 2014 and 2018 in Brazil, which evaluated Dental Specialty Centers (CEO) using a national and census approach. We selected questions through a search in the microdata of the first and second evaluations. The groups were analyzed independently. To compare the groups, nonparametric tests were performed (Mann Whitney U). The formulated hypotheses were: there would be no differences between the data of these groups (h0) and there would be differences between the data of these groups (h1). For qualitative nominal variables, frequency distribution was verified and association tests were performed (chi-square test). The significance level for this study was set at 5%. We observed that orthodontic treatments were found in about 13% of the CEO. Regarding human resources, most professionals were specialists or had MSc or PhD degrees; were civil servants; had been hired by direct administration; or had been hired via public tender. Regarding the work process and inclusion of the CEO in the health care network, we observed a greater number of services that use single and electronic medical records, greater presence of services monitoring and analyzing goals, greater knowledge about monthly average of absenteeism (for 2018); and larger number of services with referrals from primary health care centers (for 2014). Expanding the view on orthodontics and including preventive, interceptive, and corrective treatments at different points in health care networks are essential strategies for achieving comprehensive care in universal health systems.

Cone-beam computed tomography study of root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology in high-angle Class Ⅱ open bite patients / 口腔疾病防治

Objective@#This study aimed to explore the root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology in patients with high-angle skeletal Class Ⅱ open bite, aiming to provide a reference for clinical treatment.@*. Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. CBCT images of eighty-one untreated patients (40 anterior open bite patients and 41 normal overbite patients) with high-angle skeletal Class Ⅱ malocclusion were selected before treatment. Dolphin software was used to study the root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology, and the differences between the two groups were analyzed.@*Results@#There was no statistical significance in the root length of maxillary lateral incisor and canine between the open bite group and the normal overbite group, significant differences were found in the root length of maxillary central incisor （11.12 ± 1.37） mm、mandibular central incisor（10.15 ± 1.09）mm, mandibular lateral incisor（11.27 ± 1.15）mm and mandibular canine（12.81 ± 1.48）mm between the open bite group and the normal overbite group（P<0.05）. On the other hand, the two groups were significantly different in crown-root morphology of the maxillary central incisor (1.10° ± 3.62° vs. 4.53° ± 2.30°, P<0.01) but not in the mandibular central incisor.@*Conclusion@#The root length of the maxillary central incisor, mandibular central incisor, mandibular lateral incisor, mandibular canine in high-angle Class Ⅱ open bite patients is shorter than that in high-angle Class Ⅱ normal overbite patients, and the long axis of the crown of the maxillary central incisor in high-angle Class Ⅱ open bite patients obviously deviates toward the labial side relative to the long axis of the root. The crown-root angle is smaller, which is beneficial to torque control or adduction movement of the anterior teeth in high-angle Class Ⅱ open bite patients.

Effect of miniscrew placement height on the distribution of biological forces produced by clear aligner for mandibular molar distalization / 口腔疾病防治

Objective@#To explore the effect of different miniscrew placement heights on the distribution of biological forces produced by clear aligner combined with intramaxillary traction for mandibular molar distalization, to identify the miniscrew location that is conducive to the protection of lower anterior tooth anchorage and to provide a reference that can be used when designing clinical treatments.@*Methods@#Mimics, GeomagicStudio 2017, SolidWorks 2016, and Ansys workbench were used to establish finite element analysis models and perform mechanical analysis under the following six working conditions: working condition 1 was the control group without miniscrews; working conditions 2 to 5 had miniscrew in the buccal bone cortex between the first and second molars of the lower jaw 10 mm, 7 mm, 4 mm, and 1 mm from the top of the alveolar crest, respectively; working condition 6 had the miniscrew in the center of the buccal tongue at the anterior edge of the ascending branch of the lower jaw 5 mm above the occlusal plane.@*Results@#On the sagittal axis, miniscrew anchorage caused distal displacement of all teeth. Compared to the control group, in the miniscrew group, the displacement of the anterior molars exceeded that of the second molars. On the vertical axis, the result in the control group was similar to backward bending; the results in the miniscrew groups resembled the effect of a lever, lowering the lateral incisors and canines and raising the central incisors and first premolars. On the coronal axis, the second premolars and the first molars showed lingual displacement in the control group, and only the premolars and first molars showed lingual displacementin the miniscrew groups. The canines were the teeth that were most strongly affected by the change in miniscrew placement height.@*Conclusion@#The higher the miniscrew position is, the stronger the protective effect on the anterior anchorage. According to the miniscrew placement height, the mandibular arch should be properly narrowed, the central incisors and first premolars should be lowered, and the lateral incisors and canines should be raised when designing clinical treatments.

Study on the role of nano antibacterial materials in orthodontics (a review)

Abstract Nanoparticles (NPs) are insoluble particles with a diameter of fewer than 100 nanometers. Two main methods have been utilized in orthodontic therapy to avoid microbial adherence or enamel demineralization. Certain NPs are included in orthodontic adhesives or acrylic resins (fluorohydroxyapatite, fluorapatite, hydroxyapatite, SiO2, TiO2, silver, nanofillers), and NPs (i.e., a thin layer of nitrogen-doped TiO2 on the bracket surfaces) are coated on the surfaces of orthodontic equipment. Although using NPs in orthodontics may open up modern facilities, prior research looked at antibacterial or physical characteristics for a limited period of time, ranging from one day to several weeks, and the limits of in vitro studies must be understood. The long-term effectiveness of nanotechnology-based orthodontic materials has not yet been conclusively confirmed and needs further study, as well as potential safety concerns (toxic effects) associated with NP size.

Resumo Nanopartículas (NPs) são partículas insolúveis com diâmetro inferior a 100 nanômetros. Dois métodos principais têm sido utilizados na terapia ortodôntica para evitar a aderência microbiana ou a desmineralização do esmalte: NPs são incluídas em adesivos ortodônticos ou resinas acrílicas (fluoro-hidroxiapatita, fluorapatita, hidroxiapatita, SiO2, TiO2, prata, nanopreenchimentos) e NPs são revestidas nas superfícies de equipamentos ortodônticos, ou seja, uma camada fina de TiO2 dopado com nitrogênio nas superfícies do braquete. Embora o uso de NPs em ortodontia possa tornar acessível modernos recursos, pesquisas anteriores analisaram as características antibacterianas ou físicas por um período limitado de tempo, variando de 24 horas a várias semanas, por isso devem ser compreendidos os limites dos estudos in vitro. A eficácia de longo prazo de materiais ortodônticos com base em nanotecnologia ainda não foi confirmada de forma conclusiva, o que exige mais estudos, bem como potenciais preocupações de segurança (efeitos tóxicos) associadas ao tamanho da NP.

Study on the role of nano antibacterial materials in orthodontics (a review) / Estudo sobre o papel dos materiais nanoantibacterianos na ortodontia

Nanoparticles (NPs) are insoluble particles with a diameter of fewer than 100 nanometers. Two main methods have been utilized in orthodontic therapy to avoid microbial adherence or enamel demineralization. Certain NPs are included in orthodontic adhesives or acrylic resins (fluorohydroxyapatite, fluorapatite, hydroxyapatite, SiO2, TiO2, silver, nanofillers), and NPs (i.e., a thin layer of nitrogen-doped TiO2 on the bracket surfaces) are coated on the surfaces of orthodontic equipment. Although using NPs in orthodontics may open up modern facilities, prior research looked at antibacterial or physical characteristics for a limited period of time, ranging from one day to several weeks, and the limits of in vitro studies must be understood. The long-term effectiveness of nanotechnology-based orthodontic materials has not yet been conclusively confirmed and needs further study, as well as potential safety concerns (toxic effects) associated with NP size.

Nanopartículas (NPs) são partículas insolúveis com diâmetro inferior a 100 nanômetros. Dois métodos principais têm sido utilizados na terapia ortodôntica para evitar a aderência microbiana ou a desmineralização do esmalte: NPs são incluídas em adesivos ortodônticos ou resinas acrílicas (fluoro-hidroxiapatita, fluorapatita, hidroxiapatita, SiO2, TiO2, prata, nanopreenchimentos) e NPs são revestidas nas superfícies de equipamentos ortodônticos, ou seja, uma camada fina de TiO2 dopado com nitrogênio nas superfícies do braquete. Embora o uso de NPs em ortodontia possa tornar acessível modernos recursos, pesquisas anteriores analisaram as características antibacterianas ou físicas por um período limitado de tempo, variando de 24 horas a várias semanas, por isso devem ser compreendidos os limites dos estudos in vitro. A eficácia de longo prazo de materiais ortodônticos com base em nanotecnologia ainda não foi confirmada de forma conclusiva, o que exige mais estudos, bem como potenciais preocupações de segurança (efeitos tóxicos) associadas ao tamanho da NP.

Effect of peracetic acid on orthodontic elastics: an in vitro experiment / Efeito do ácido peracético nos elásticos ortodônticos: um estudo in vitro

Objetivo: Este estudo teve como objetivo avaliar a elasticidade de elásticos ortodônticos após desinfecção e esterilização com ácido peracético 0,2%. Materiais e métodos: Neste estudo piloto in vitro, elásticos ortodônticos Morelli® e American Orthodontics™ nas cores cinza e cristal foram divididas em três grupos experimentais: Grupo 1, imerso em água destilada por 72 horas, Grupo 2, imerso em peracético 0,2% por 10 min (para desinfecção) e Grupo 3, imerso em ácido peracético 0,2% por 30 min (para esterilização). Após a imersão, os valores de resistência à tração dos elásticos foram analisados em uma máquina de ensaios universal (EMIC DL-1000) para avaliar a resistência, em Newtons, necessária para a ruptura dos mesmos. A normalidade dos dados foi avaliada pelo teste de Shapiro-Wilk e os dados dos diferentes grupos experimentais foram comparados pelo teste ANOVA. Resultados: Para ambas as marcas, não houve diferença estatisticamente significativa entre os grupos experimentais quanto à resistência à tração. Discussão: O estudo apresentou um método alternativo para a desinfecção e esterilização de materiais termossensíveis. Conclusão: Assim, podemos concluir que a desinfecção e esterilização dos elásticos ortodônticos com ácido peracético 0,2% não alterou seu módulo de elasticidade.

Aim: This study aimed to evaluate the elasticity of orthodontic elastics after disinfection and sterilization with 0.2% peracetic acid. Materials and methods: In this in vitro pilot study, Morelli® and American Orthodontics™ elastic bands in gray and crystal colors were divided into three experimental groups: Group 1, immersed in distilled water for 72 hours, Group 2, immersed in 0.2% peracetic acid for 10 min (for disinfection) and Group 3, immersed in 0.2% peracetic acid for 30 min (for sterilization). After immersion, the tensile strength values of the elastics were analyzed in a universal test machine (EMIC DL-1000) to evaluate the strength, in Newtons, necessary for their rupture. Normality of the data was assessed using the Shapiro-Wilk test, and data from the different experimental groups were compared using the ANOVA test. Results: For both brands, there was no statistically significant difference between the experimental groups regarding tensile strength. Discussion: This study presented an alternative method for the disinfection and sterilization of thermo-sensitive materials. Conclusion: Thus, it can be concluded that the sterilization of orthodontic elastics with 0.2% peracetic acid did not change their modulus of elasticity.

Aesthetic perception of black spaces between lower incisors by laypeople of different ethnicities and age groups

Objective: To evaluate the degree of perception among lay people of different age groups about black spaces between lower incisors. Methodology: digital changes were performed in a frontal photograph of a smiling 30 year-old patient, simulating different dimensions of black spaces. The images were printed on photographic paper and applied with a questionnaire in order to evaluate the attractiveness using as tool a visual analogue scale (VAS). The participants were divided into 6 groups, considering race (Caucasian and Negroid) and age (15-19 years, 35-44 years and 65-74 years old). The differences between the examiners were checked by the Mann-Whitney test and the significance level was 5% (α = 0.05) for all analyzes. Results: The photographs that did not have black spaces were better graded and the ones that had larger black spaces scored worse. The older age group and the Negroid race group graded better the photograph with the largest black spaces, compared to the younger age groups and the group of Caucasians. Conclusion: black spaces between lower incisors are esthetically unattractive and their perception decreases with aging, besides being less relevant to older and Negroid people.