Effect of ibuprofen and low-intensity pulsed ultrasound on the reduction of pain after initial archwire placement: a double-blind randomized clinical trial / Efecto del ibuprofeno y el ultrasonido pulsado de baja intensidad en la reducción del dolor después de la colocación inicial del arco de ortodoncia: un ensayo clínico aleatorizado doble ciego

Objective: This study aimed to compare the effect of ibuprofen and low intensity pulsed ultrasound (LIPUS) on the reduction of pain after the placement of initial archwire in orthodontic patients. Material and Methods: This double-blind clinical trial study was carried out on 60 female candidates for fixed orthodontic treatment referring to the Orthodontic Department of School of Dentistry in Mashhad University of Medical Sciences, Mashhad, Iran, during 2015-2016. The subjects were divided into four groups of ibuprofen, LIPUS, placebo, and mock LIPUS. A questionnaire and a rectangular and flexible cubic silicone were given to each patient to record the severity of pain based on the visual analog scale at specified time points (i.e., 2 h, 6 h, at bedtime, 2nd, 3rd, and 7th days after archwire placement) when biting the silicone block with the anterior and posterior teeth and without biting at all. Repeated measures analysis of variance was used in order to compare the pain severity at different time points. Results: The comparison of pain severity at various time points showed that the highest and lowest mean scores of pain were reported at bedtime and seven days after the intervention (p<0.001). In each of the three conditions (i.e., biting the silicone block with the anterior and posterior teeth and without biting the teeth) at six time points (i.e., 2 h, 6 h, at bedtime, 2nd, 3rd, and 7th days following archwire placement), no significant difference was observed in the severity of pain (p>0.05). Conclusion: In conclusion, LIPUS (with a frequency of 1 MHz and an intensity of 100 mW) and ibuprofen have no significant effects on reduction of the pain severity at different time points and various conditions in orthodontic patients.

Objetivo: Este estudio tuvo como objetivo comparar el efecto del ibuprofeno y el ultrasonido pulsado de baja intensidad (LIPUS) en la reducción del dolor después de la colocación del arco inicial en pacientes de ortodoncia. Material y Métodos: Este estudio de ensayo clínico doble ciego se llevó a cabo en 60 candidatas a tratamiento de ortodoncia fija referidas al Departamento de Ortodoncia de la Facultad de Odontología de la Universidad de Ciencias Médicas de Mashhad, Mashhad, Irán, durante 2015-2016. Los sujetos se dividieron en cuatro grupos: ibuprofeno, LIPUS, placebo y LIPUS simulado. Se entregó un cuestionario y un bloque de silicona cúbica rectangular y flexible a cada paciente para registrar la intensidad del dolor según la escala analógica visual en puntos de tiempo específicos (es decir, 2 h, 6 h, hora de acostarse, 2do, 3er y 7mo día después de la colocación del arco) al morder el bloque de silicona con los dientes anteriores y posteriores, y sin morder en absoluto. Se utilizó el análisis de varianza de medidas repetidas para comparar la intensidad del dolor en diferentes momentos.Resultados: La comparación de la intensidad del dolor en varios puntos de tiempo mostró que las puntuaciones medias de dolor más altas y más bajas se informaron a la hora de acostarse y siete días después de la intervención (p<0,001). En cada una de las tres condiciones (es decir, al morder el bloque de silicona con los dientes anteriores y posteriores, y sin morder) en seis momentos (2 h, 6 h, antes de acostarse 2do, 3er y 7mo día después de la colocación del arco), no se observó diferencia significativa en la severidad del dolor (p>0.05).Conclusión: En conclusión, LIPUS (con una frecuencia de 1 MHz y una intensidad de 100 mW) y el ibuprofeno no tienen efectos significativos en la reducción de la severidad del dolor en diferentes puntos de tiempo y diversas condiciones en pacientes de ortodoncia.

Impact of the First Archwires Placement on the Everyday Activities of Orthodontics Patients / Impacto de la Instalación de los Primeros Arcos en las Actividades de Vida Diaria en Pacientes de Ortodoncia

ABSTRACT: Orthodontic treatment (OT) is essential for the aesthetic and functional rehabilitation of the chewing apparatus, however it may lead to certain complications which can have a negative impact on patients' everyday lives. The study included patients of the Dental Teaching Clinic of Universidad de La Frontera who were undergoing OT for the first time, with the placement of their first orthodontic arch. To analyse the impact of the placement of the first arches on everyday activities (EDA), patients completed a questionnaire with questions relating to their oral condition, including: functional limitation, physical impairment, psychological malaise, physical pain and oral hygiene. The impact on EDAs was classified as high, moderate or low. The chisquared test, Student's t-test and Spearman's coefficient were applied, using a significance threshold of 5 %. Statistical analysis used the SPSS software, v. 22.0. The variables were analysed by sex and age-band. Difficulty in brushing their teeth, eating and speaking were the limitations on EDAs most frequently reported by the patients. Females presented higher scores than males (p=0.003), showing that they suffer a greater negative impact on EDAs than do males. The majority of the patients presented a low impact on EDAs after the placement of their first orthodontic arches. Physical pain after installation, and difficulty in adapting to the orthodontic apparatus were factors determining a negative impact on EDAs, affecting sleep, speech, eating and oral hygiene of patients after starting OT.

RESUMEN: El tratamiento ortodóntico (TO) es esencial para la rehabilitación estética y funcional del aparato masticatorio, sin embargo puede determinar algunas complicaciones que pueden impactar negativamente en la vida diaria de los pacientes. Fueron incluidos pacientes de la Clínica Odontológica Docente Asistencial de la Universidad de La Frontera que realizaban tratamiento ortodóntico por primera vez, con instalación del primer arco ortodóntico. Para análisis del impacto de la instalación de los primeros arcos en las actividades de vida diaria (AVD), los pacientes llenaron un cuestionario con preguntas relacionadas a su condición oral, incluyendo: limitación funcional, incapacidad física, incapacidad psicológica, dolor físico e higiene oral. El impacto en las AVDs fueclasificado como alto, moderado y bajo. Para análisis estadístico se utilizó el software SPSS v. 22.0. Fueron aplicadas las pruebas de chi-cuadrado, t-student y Spearman's coefficient, considerándose umbral de significación de 5 %. Para análisis estadístico se utilizó el software SPSS v. 22.0. Las variables fueron analizadas según sexos y rangos etarios. Dificultad para cepillar los dientes, para comer y hablar fueron las limitaciones en las AVDs más frecuentemente reportadas por los pacientes. Las mujeres presentaron mayores puntajes en relación a los hombres (p=0,003), lo que demostró que presentan mayor impacto negativo en las AVDs en relación a los hombres. La mayoría de los pacientes presentaron bajo impacto en las AVDs tras la instalación de los primeros arcos de ortodoncia. El dolor físico tras instalación y la dificultad en la adaptación con el aparato ortodóntico fueron factores que determinaron impacto negativo en las AVDs, afectando el sueño, el habla, la alimentación y la higiene oral de los pacientes que iniciaron el TO.

Efectividad de la retención post ortodoncia en pacientes de 12-35 años relacionada con 2 tipos de retención fija. Revisión sistemática de la literatura / Post-orthodontic retention effectiveness of two types of fixed retainers in patients aged between 12 and 35: a systematic literature review

Identificar la efectividad de la retención post ortodoncia en pacientes de 12 a 35 años con dos tipos de retención fija, mediante una revisión sistemática de la literatura. Método: Se identificaron las publicaciones mediante búsqueda electrónica en las bases de datos: Cochrane, Pubmed, Science Direct, Isi Web Science, Scielo. Palabras claves: Tooth crowding, Posttreatment, Retainer, Maloclusión, Recurrence, Orthodontic stability, Relapse. Se analizaron por título, resumen y texto completo. Se seleccionaron aquellos que cumplían con los criterios de elegibilidad. Se evaluó la calidad metodológica de los artículos seleccionados, a través de la lista de chequeo Mincir. Se determino el nivel de evidencia y el grado de recomendación a través de la lista SIGN. Resultados: En la búsqueda electrónica inicial, se identificaron 6.632 artículos, de los cuales, posterior a los filtros, se seleccionaron 15 que cumplían con los criterios de inclusión. Se obtuvieron finalmente 4 artículos que cumplieron con los criterios de calidad y de inclusión. Conclusiones: No existe suficiente evidencia científica, en las publicaciones analizadas, que sustente cuál de los dos tipos de retenedores evaluados, presenta mayor efectividad en la retención postortodoncia

Objective: To identify the effectiveness of two types of fixed post-orthodontic retainers in patients aged between 12 and 35 through a systematic literature review. Method: A systematic literature search was performed using the followings electronic databases: Cochrane, Pubmed, Science Direct, Isi Web Science, Scielo. Keywords: Tooth crowding, Posttreatment, Retainer, Malocclusion, Recurrence, Orthodontic stability, Relapse. The articles were analyzed by title, abstract and full text. The ones that fulfilled the eligibility criteria were chosen. The methodological quality of the articles selected was evaluated using the MINCIR checklist. The articles were classified using the SIGN list, where the articles were evaluated according to study design. Results: In the initial electronic search, 6,632 articles were identified, 15 of which fulfilled the inclusion criteria. After being analyzed, only four articles were considered to include all the quality and inclusion criteria. Conclusions: There is not enough scientific evidence in the publications analyzed to determine which of the two types of evaluated retainers is the most effective in post-orthodontic retention

Efeitos dos fios de nivelamento de níquel-titânio e de aço inoxidável na posição dos incisivos inferiores / Effects of nickel-titanium and stainless steel leveling wires on the position of mandibular incisors

OBJETIVO: estudar os efeitos do nivelamento realizado com fios de NiTi termoativado e de aço inoxidável, avaliando-se as possíveis alterações na posição dos incisivos inferiores, em casos com extrações, correlacionando com o tempo de tratamento. MÉTODOS: a amostra foi composta de 36 indivíduos, de ambos os sexos, leucodermas brasileiros, com idade média inicial de 15 anos e 5 meses, portadores de más oclusões de Classes I e II, distribuídos em dois grupos. No Grupo 1 (n=17), o nivelamento foi realizado com a sequência 1, utilizando-se três fios - 0,016" e 0,019"x0,025" de NiTi termoativado, e 0,019"x0,025" de aço inoxidável. No Grupo 2 (n=19), foi testada a sequência 2, na qual foram utilizados apenas fios de aço inoxidável (0,014"; 0,016"; 0,018"; 0,020" e 0,019"x0,025" com torque passivo nos incisivos inferiores). Os dados foram coletados utilizando-se o método cefalométrico computadorizado e comparados pelo teste t de Student com o nível de significância de 5 por cento. RESULTADOS: no Grupo 1, os incisivos inferiores inclinaram-se para lingual, com movimento significativo apenas da coroa (1,6mm). No Grupo 2, os incisivos inferiores permaneceram estáveis. Não houve alteração vertical em nenhum dos grupos. CONCLUSÕES: a sequência 2 proporcionou um melhor controle dos incisivos inferiores, não alterando suas posições iniciais, enquanto a sequência 1 permitiu a expressão do torque da prescrição utilizada, levando a uma inclinação lingual desses dentes. O tempo de tratamento foi menor utilizando-se a sequência 1. As variações biomecânicas estudadas apresentaram vantagens e desvantagens que devem ser conhecidas e ponderadas pelo ortodontista no planejamento do caso.

OBJECTIVE: Investigate the effects of heat-activated NiTi and stainless steel wires to evaluate potential changes in the position of mandibular incisors in extraction cases as correlated with treatment length.METHOD: The sample consisted of 36 individuals of both genders, Brazilian Caucasians with mean initial age of 15 years and 5 months with Class I and Class II malocclusions, divided into two groups. In Group 1 (n=17) leveling was performed with Sequence 1, comprised of three different wire cross-sections: 0.016-in and 0.019 x 0.025-in heat-activated NiTi wires and 0.019 x 0.025-in stainless steel wires. In Group 2 (n=19) Sequence 2 was tested using only stainless steel wires (0.014-in, 0.016-in, 0.018-in, 0.020-in and 0.019 x 0,025-in) with passive torque in the mandibular incisors. Data were collected using computerized cephalometry and compared using Student's t-test with 5% significance level.RESULTS: In Group 1, mandibular incisors were inclined lingually although only the crowns showed significant movement (1.6 mm). In Group 2, mandibular incisors remained stable. No vertical changes were noted in either group.CONCLUSIONS: Sequence 2 yielded better mandibular incisor control with no changes in their initial positions, while Sequence 1 allowed torques in the bracket prescription to be expressed, leading to the lingual inclination of these teeth. Treatment length was shorter when Sequence 1 was used. The evaluated biomechanic variations presented advantages and disadvantages that should be known and considered by the orthodontist during treatment planning.