Are there evidences of correlation between temporomandibular dysfunction and orthodontic treatment?

Aim: The aim of this study was verifying, through literature review, whether there are evidences of correlation between temporomandibular dysfunctions and the orthodontic treatment. Material and Methods: Papers published from 1981 to 2015 were excluded and 41 articles and 06 books composed this review. Results: It is known that temporomandibular dysfunctions is a general term that represents signals and symptoms involving masticatory muscles, the temporomandibular joint and associated structures, and it is the main cause of pain from non-dental origin in the orofacial region, including head, face and other structures. Its etiology is multifactorial involving a large number of direct and indirect causes. Among them, the occlusion was already considered one of the main etiological factors for temporomandibular dysfunction. From epidemiological studies, it is known that signals and symptoms of temporomandibular dysfunction occur in healthy people, they are common in children and adolescents and tend to increase with age, particularly after adolescence, from 13 to 45 years old. The hypothesis for causality between orthodontics and temporomandibular dysfunction has led to legal problems for dentists and orthodontists. For these reasons, the interest on the relation among occlusal factors, orthodontic treatments and temporomandibular dysfunction has growth and several studies were carried out. Conclusions: We conclude that until this moment, it is not possible affirm that the orthodontic treatment could prevent, cure or cause temporomandibular dysfunction.

The use of botulinum toxin as a way of treatment for gingival smile: case report

Gingival smile is defined as excessive gum exposition. Its etiology may be related to several factors, among them a maxillary vertical excess, superior dentoalveolar protrusion, changed passive extrusion and or eruption of anterior-superior teeth and hyperactivity of superior lip lift muscle. In cases in which the etiological factor is from muscle, the use of Botulinum toxin typo A (BTX-A) should be indicated. To highlight the benefits obtained with therapeutic use of this substance, the authors describe a clinical case of a female young patient, in which the Botox® was applied to correct gingival smile as a way to complement the orthodontic treatment. The applications were performed in two lateral points on the nose wing in a single session. The result was very satisfactory and there was no need additional dose. The authors concluded that BTX-A is a safe option and minimum invasive for treatment of gingival smile when provoked by muscle hypercontraction. Its side effects are rare with discrete discomfort during the application.

Uso de um distrator ósseo dentoimplantossuportado, feito a partir de tornos expansores convencionais, na reabilitação oral / Use of a tooth-implant supported bone distractor, made from standard orthodontic expansion-screws, in oral rehabilitation. Case report

A osseodistração é uma realidade clínica disponível já há algumas décadas para a resolução de deficiências ósseas extensas, em casos em que existam dentes ou implantes osseointegrados, porém mal posicionados. O objetivo deste artigo é apresentar um caso clínico na qual uma nova possibilidade de distração óssea, baseada em um distrator dentoimplantossuportado (feito com tornos expansores ortodônticos convencionais), foi utilizada em uma área onde havia necessidade extensa de recuperação estética e de tecido ósseo, aliada ao mau posicionamento dentário e de um implante previamente instalado na região. A técnica utilizada apresentou bons resultados clínicos, associado à sua simplicidade e baixo custo, contribuindo como solução clínica viável para ganho tecidual e otimização estética. Como conclusão tem-se que a técnica sugerida alcançou os resultados esperados, melhorando a posição do implante e o perfil de tecidos duro e mole, permitindo a finalização de sua reabilitação oral.

Osteodistraction is a clinical reality, available in the last decades for the resolution of large bone deficiencies, in cases that there are pre-existing, but misplaced implants and teeth. The aims of thearticle is to present a case report in which a new possibility for bone distraction, based on tooth-implant bone distractors, made from standard orthodontic expansion-screws, was used in an area where there was an extensive need of alveolar bone and aesthetical recovery, allied to teeth and dental implant misplacement. This technique presented good clinical results, associated to effective simplicity and low cost, becoming viable clinical solution for bone tissue augmentation and aesthetical optimization. In resume, it is possible to say that the suggested technique achieved its objectives, improving the hard and soft tissue profile, whilst allowing completion of oral rehabilitation.

Avaliação da alteração do plano oclusal em cirurgias ortognáticas combinadas com utilização de fixação interna rígida em pacientes com padrão facial de Classe II / Evaluation of occlusal plane alteration in Orthognathic Surgeries combined with rigid internal fixation in Class II skeletal facial standard patients

OBJETIVO: avaliar a estabilidade de cirurgias bimaxilares com fixação interna rígida, na qual promoveu-se uma rotação anti-horária da mandíbula e conseqüente redução do ângulo do plano oclusal.METODOLOGIA: foram estudados 15 pacientes com padrão facial de Classe II e deficiência mandibular. Os movimentos cirúrgicos foram avaliados por meio de medidas lineares e angulares realizadas no programa CefX, obtidas de telerradiografias cefalométricas em norma lateral em três diferentes tempos: (T0) pré-operatório, (T1) pós-operatório imediato e (T2) pós-operatório de no mínimo 6 meses.RESULTADOS E CONCLUSÕES: os resultados demonstraram que a cirurgia bimaxilar promove mudanças faciais significativas e, principalmente, que a rotação anti-horária da mandíbula com redução do ângulo do plano oclusal mostrou-se estatisticamente estável, sendo uma opção confiável em cirurgias de pacientes com padrão facial de Classe II com deficiência mandibular.