Avaliação da eficácia do acessório mamilo na remoção dos hábitos deletérios / Evaluation of the effectiveness of the nipple accessory in the removal of the deletery habits

Objetivo: avaliar a eficácia do acessório mamilo aplicado a aparelhos ortopédicos/ ortodônticos no tratamento de hábitos deletérios de sucção de chupeta, língua, lábio e dedo, e onicofagia em pacientes tratados nos últimos 20 anos com o aparelho. Métodos: Trata-se de um estudo clínico observacional, retrospectivo, no qual a amostra foi composta de prontuários de pacientes de ambos os gêneros, atendidos por profissionais habilitados pelo aparelho mamilo, que os utilizaram em crianças de 03 a 16 anos portadoras de hábitos deletérios. Os prontuários utilizados, correspondem a pacientes tratados entre os anos 2000 a 2020. Todas as análises foram realizadas no programa R, com nível de significância de 5%. Resultados: Foram analisados 142 prontuários, nos quais 122 foram incluídos, por estarem dentro dos critérios de inclusão propostos no estudo e 20 foram excluídos da pesquisa por apresentarem informações incompletas e/ou não preenchidas corretamente. O hábito com maior incidência foi o de sucção digital, em 71,3% dos pacientes, 91,8% dos pacientes deixaram o hábito, destacando que nos casos de sucção de chupeta e onicofagia, o sucesso na remoção do hábito foi de 100%, em ambos os casos. O tempo médio de uso do aparelho foi de 4,8 meses, variando de 0,6 a 14 meses. O tempo médio para a remoção do hábito após a instalação do aparelho foi de 1,6 meses, variando de 0 a 12 meses. Conclusão: O aparelho mamilo, mostra-se como uma alternativa de alta eficácia na remoção de hábitos deletérios de sução de chupeta, dedo, língua e onicofagia.(AU)

Objective: Evaluate the effectiveness of the nipple accessory applied to orthopedic/orthodontic appliances in the treatment of harmful pacifier, tongue, lip and finger sucking habits, and onychophagia in patients treated in the last 20 years with the device. Methods: This is an observational, retrospective clinical study, in which the sample consisted of medical records of patients of both genders, assisted by professionals qualified by the nipple device, who used them in children aged 03 to 16 years with deleterious habits. The medical records used correspond to patients treated between the years 2000 and 2020. All analyzes were performed in the R program, with a significance level of 5%. Results: 142 medical records were analyzed, in which 122 were included, as they were within the inclusion criteria proposed in the study and 20 were excluded from the research because they presented incomplete information and/or not filled in correctly. The habit with the highest incidence was digital sucking, in 71.3% of patients, 91.8% of patients quit the habit, noting that in cases of pacifier sucking and onychophagia, success in removing the habit was 100%, in both cases. The average time of use of the device was 4.8 months, ranging from 0.6 to 14 months. The mean time to remove the habit after installing the device was 1.6 months, ranging from 0 to 12 months. Conclusion: The nipple device is a highly efficient alternative for removing harmful habits of pacifier, finger, tongue and onychophagy sucking.(AU)

Intervención educativa en la Escuela Primaria «Paco Cuesta¼ / Educational intervention at "Paco Cuesta" Primary School

RESUMEN Se realizó un estudio de intervención educativa en 48 estudiantes de la Escuela Primaria «Paco Cuesta¼, ubicada en el área de salud «XX Aniversario¼ del municipio Santa Clara, Villa Clara, durante el curso escolar 2016 - 2017. Los objetivos de esta investigación fueron: identificar las necesidades de aprendizaje sobre hábitos bucales deformantes en escolares de cuarto grado, y evaluar, a corto plazo, los resultados obtenidos en la población objeto de estudio. Los resultados demostraron que los adolescentes modificaron positivamente la información que tenían sobre estas temáticas a partir de las instrucciones de los profesionales.

ABSTRACT An educational intervention study was carried out in 48 students belonging to "Paco Cuesta" Primary School which is located in the «XX Anniversary¼ health area from Santa Clara municipality, Villa Clara, during the 2016-2017 academic year. The objectives of this research were to identify the learning needs about deforming oral habits in fourth-grade school children, and to evaluate the results obtained, in the population under study, in the short term period. The results showed that the adolescents positively modified the information they had on these topics based on the instructions of the professionals.

Prevalence of malocclusion and non-physiological oral habits in primary school children from Ercilla, Chile / Prevalencia de maloclusión y hábitos bucales no fisiológicos en niños de primaria de Ercilla, Chile

Introduction: Dentomaxillary Anomalies (DMA) affect the growth and morphology of the stomatognathic system of individuals, representing a public health problem. Few studies have described its prevalence among vulnerable populations in Chile. The aim of the study was to explore the prevalence of DMA and its association to non-physiological habits (NFH) and sociodemographic characteristics among primary school children living in Ercilla, Chile. Material and Methods: A convenience sample of 327 primary school students from six schools in Ercilla, were assessed through an intraoral and extraoral evaluation. Overjet, overbite, molar relationship, presence of DMAs, and NFHs were measured. Descriptive statistics, analysis of association between DMAs and studied factors, and logistic regression models were done and odds ratio with 95% confidence intervals presented. Results: A total of 61.5% of students presented at least one DMA. Chi-square test showed no significant association between DMA prevalence and NHFs, however, after adjusting for sociodemographic factors, children with NFH were 1.69 (95%CI 1.02-2.78) times more likely to have DMAs. Gender and area of residence were not significantly associated with DMAs. Conclusion: In children from Ercilla, DMAs were associated with NFHs, however, sociodemographic characteristics did not have a significant role in the presence of DMA, suggesting that sociodemographic factors might not strongly influence orthodontic needs among children from this geographical area.

Introducción: Las anomalías dentomaxilares (ADM) afectan el crecimiento y la morfología del sistema estomatognático de los individuos, lo que representa un problema de salud pública. Pocos estudios han descrito su prevalencia en poblaciones vulnerables en Chile. El objetivo del estudio fue explorar la prevalencia de ADM y su asociación con hábitos no fisiológicos (HNF) y características sociodemográficas en niños de escuela primaria que viven en Ercilla, Chile. Material y Métodos:Se evaluó una muestra de conveniencia de 327 estudiantes de educación básica de seis escuelas de Ercilla mediante una evaluación intraoral y extraoral. Se midieron el resalte, la sobremordida, la relación molar, la presencia de DMA y HNF. Se realizó estadística descriptiva, análisis de asociación entre ADMs y los factores estudiados, y modelos de regresión logística y se presentaron odds ratio con intervalos de confianza del 95%. Resultados: El 61,5% de los alumnos presentó al menos una ADM. La prueba de chi-cuadrado no mostróuna asociación significativa entre la prevalencia de ADM y HNF, sin embargo, después de ajustar de acuerdo a factores sociodemográficos, los niños con HNF tenían 1,69 (IC del 95%: 1,02 a 2,78) veces más probabilidades de tener ADMs. El género y el área de residencia no se asociaron significativamente con las ADMs. Conclusión: En los niños de Ercilla, las DMA se asociaron con NFH, sin embargo, las características sociodemográficas no tuvieron un papel significativo en la presencia de DMA, lo que sugiere que los factores sociodemográficos podrían no influir fuertemente en las necesidades de ortodoncia entre los niños de esta área geográfica.

Prevalencia de lesiones bucales en tejido blando encontradas en la Clínica de Estomatología de la Facultad de Odontología de la Universidad de los Andes: periodo 2015-2018 / Prevalence of oral lesions in soft tissue found in the Clinic of Stomatology of the Faculty of Dentistry of the University of los Andes: 2015-2018 period

Introducción: La epidemiología sobre alteraciones en tejidos blandos bucales es limitada cuando se compara con caries, enfermedades periodontales y maloclusiones, por lo que su estudio representa un paso adelante en la odontología más allá de los dientes. Objetivo: Describir la prevalencia de las lesiones bucales en tejido blando encontradas en la Clínica de Estomatología de la Facultad de Odontología de la ULA, del 2015 al 2018, con la finalidad de proporcionar una fuente de datos actualizada, que oriente a una mejor prevención y oportuno diagnóstico. Material y métodos: Se realizó una investigación descriptiva, documental, retrospectiva y multivariable. Resultados: De 1,000 fichas clínicas estudiadas, las patologías más frecuentes fueron: lengua saburral (50.6%), queilitis (33.4%), traumatismo de la mucosa de los carrillos (27.6%), várices linguales (18.3%), anquiloglosia (13.7%) y agrandamiento de rugas palatinas (11.7%). La zona con mayor alteración fue la lengua (92.1%), mientras que el paladar fue la menos afectada (29%). De los hábitos predisponentes a la formación de lesiones, el mordisqueo de mucosa fue el más común (16.5%). En cuanto a los factores locales asociados, una higiene oral regular/ deficiente resultó el principal (53.8%). Conclusión: La educación del paciente sigue siendo considerada la clave para disminuir la aparición de patologías y su evolución a entidades más graves (AU)

Introduction: Epidemiological studies on soft tissue alterations in the mouth are limited when compared with caries, periodontal diseases and malocclusions, so their study represents a step forward in dentistry beyond the teeth. Objective: To describe the prevalence of soft tissue oral lesions found in the Stomatology Clinic of the ULA School of Dentistry, from 2015 to 2018, in order to provide an up-to-date data source, to guide better prevention and timely diagnosis. Material and methods: A descriptive and documentary, retrospective and multivariable research was carried out. The statistical package IBM SPSS Statistics v 23 was applied for the analysis. Results: 1,000 clinical records studied, the most frequent pathologies were: saburral tongue (50.6%), cheilitis (33.4%), traumatism of the cheek mucosa (27.6%), lingual varices (18.3%), ankyloglossia (13.7%) and enlargement of palatal rugas (11.7%). The tongue was the most affected (92.1%), while the palate was the least affected (29%). Of the predisposing habits to the formation of lesions, mucosal nipping was the most common (16.5%). Regarding the associated local factors, a regular / deficient oral hygiene was the main one (53.8%). Conclusion: Patient education is still considered the key to diminish not only the appearance of pathologies but their evolution to more serious entities (AU)

El quad-hélix, un aparato versátil / The quad-hélix, a versatile appliance

El quad-hélix (QH) es un aparato de expansión maxilar, fabricado con alambre de acero inoxidable soldado a bandas en molares, que dispone de espirales o hélices que aumentan la longitud de alambre del aparato, lo que lo hace muy elástico y aligera la magnitud de la fuerza sobre los dientes, es ampliamente usado tanto en dentición mixta como en permanente temprana, fácil de fabricar, higiénico y bien tolerado por los pacientes. Su principal acción es mover hacia vestibular los procesos dentoalveolares de la arcada maxilar, influyendo secundariamente en la expansión de la sutura palatina media en pacientes con dentición mixta o permanente temprana. El QH es muy práctico y tiene muchos usos y adaptaciones y se puede utilizar como auxiliar en el tratamiento de problemas de hábito de dedo o lengua, para abrir mordida, rotar y dar torque a molares permanentes o para mover sólo un diente en particular. En este artículo describimos una nueva aplicación del QH que consiste en la tracción, de dientes anteriores superiores permanentes retenidos, después del abordaje quirúrgico para localizarlos. También revisaremos las indicaciones, contraindicaciones, ventajas y desventajas del aparato QH soldado a bandas en molares así como su elaboración, variantes y forma de activación (AU)

The quad-helix (QH) is a maxillary expansion appliance, manufactured with stainless steel wire welded to bands in molars, which has spirals or helix to increase the length of wire of the device, which makes it very elastic and lightens the magnitude of the force on the teeth, is widely used both in mixed and in early permanent dentition, is easy to manufacture, hygienic and well tolerated by patients. Its major action is to move towards the dentoalveolar process of the maxillary arcade, secondarily influencing the expansion of the middle palatal suture in young patients with mixed or permanent early dentition. The QH is very practical and has many uses and adaptations as an aid in the treatment of problem of thumb sucking or tongue habit, to open bite, to rotate and torque permanent molars or to move only one particular tooth. In this article we describe a new application of the QH that consist of the traction or retained permanent upper teeth, after surgical approach to locate them. We will also review the indications, contraindications, advantages and disadvantages of the QH welded to molar bands, as well as its construction, variants and activation form (AU)

Maloclusiones dentarias y su relación con los hábitos bucales lesivos / Dental malocclusion and its relationship to harmful oral habits

RESUMEN Introducción: La ruptura del equilibrio de las fuerzas extrabucales e intrabucales debido a una función anómala, desencadena maloclusión. Estas funciones musculares anómalas se conocen como hábitos bucales lesivos. Objetivo: Actualizar conocimientos y analizar los factores relacionados con las maloclusiones dentarias como los hábitos bucales lesivos en niños, en función de la frecuencia y duración de la succión nutritiva y no nutritiva, respiración por la boca y el empuje lingual atípico. Métodos: se realizó una revisión bibliográfica en cuatro bases de datos digitales Pubmed, Lilacs, Ibecs y Cumed correspondiente a los últimos 5 años. Se usó tesauro para el idioma inglés malocclusion, habits, finger sucking, pacifiers, bottle feeding, tongue habit, mouth breathing y en español maloclusión, hábitos, succión del dedo, chupete, biberones, hábitos linguales, respiración por la boca. La búsqueda reveló 65 artículos, de estos solo 19 cumplieron los criterios de inclusión. Análisis e integración de la información: El 89,5 por ciento de los artículos pertenecen a estudios de hábitos de succión no nutritivos solo o en conjunto con otros hábitos; y el 10,5 por ciento realizan investigaciones en niños respiradores bucales. Teniendo en cuenta la duración y frecuencia de los hábitos solo el 26,31 por ciento de las pesquisas seleccionadas tomaron en cuenta estas variables. En hábitos de succión nutritivos presentaron resalte horizontal aumentado, mordida cruzada posterior y escalón distal. Existe una asociación entre períodos cortos de amamantamiento y prevalencia de hábitos de succión no nutritivos; presentan además de maloclusiones anteriormente citadas, mordida abierta anterior. En respiración por la boca citaron clase II, mandíbula corta y retruida y disminución del tercio inferior de la cara. Conclusiones: Numerosas investigaciones se han realizado para asociar la duración de los hábitos de succión nutritivos y no nutritivos con maloclusiones, sin considerar la frecuencia de estos, además existe una reducida información científica en las bases electrónicas exploradas en lo que refiere a estudios de respiración por la boca y empuje lingual atípico en los niños(AU)

ABSTRACT Introduction: Malocclusion is triggered by rupture of the balance between extraoral and intraoral forces as a result of an anomalous function. Such anomalous muscular functions are known as harmful oral habits. Objective: Update knowledge and analyze factors related to dental malocclusions, such as harmful oral habits in children, in terms of the frequency and duration of nutritive and non-nutritive sucking, mouth breathing and atypical tongue thrust. Methods: A bibliographic review was conducted of papers published in the last five years in the digital databases Pubmed, Lilacs, Ibecs and Cumed. The search terms used were malocclusion, habits, finger sucking, pacifiers, bottle feeding, tongue habit and mouth breathing in English, and maloclusión, hábitos, succión del dedo, chupete, biberones, hábitos linguales and respiración por la boca in Spanish. 65 papers were obtained, of which only 39 met the inclusion criteria. Data analysis and integration: 89.5 percent of the papers corresponded to studies about non-nutritive sucking habits alone or in combination with other habits, whereas 10.5 percent dealt with studies about mouth breathing children. Only 26.31 percent of the studies selected took into account the variables duration and frequency of the habits. Nutritive sucking habits were found to be associated with overjet, posterior crossbite and distal step. A relationship was also found between a short breastfeeding period and the prevalence of non-nutritive sucking habits, with the presence of anterior open bite alongside the aforementioned malocclusions. Mouth breathing was related to class II, small retrognathic jaw and a decreased lower third of the face. Conclusions: Numerous studies have been conducted to determine the relationship between malocclusions and the duration of nutritive and non-nutritive sucking habits, without considering the frequency of such habits. On the other hand, the electronic databases consulted contain few studies about mouth breathing and atypical tongue thrust in children(AU)

Detalles clínicos de la oclusión dental en niños de un círculo infantil / Clinical details of dental occlusion in children of a day-care center

Se efectuó un estudio descriptivo y transversal de 122 niños del Círculo Infantil Espiguita, pertenecientes al área de salud del Hospital Clinicoquirúrgico Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, desde febrero hasta marzo de 2017, con vistas a mostrar detalles clínicos de la oclusión dentaria en estos menores, según variables seleccionadas. A los afectados se les realizó el examen clínico bucal y facial; además, se confeccionó la historia clínica individual y se utilizó el porcentaje como medida de resumen. En la serie predominaron los niños de 4 años de edad, el sexo femenino y las maloclusiones; en tanto, la succión digital y la disfunción lingual fueron los hábitos fundamentales. Asimismo, se obtuvo una primacía de la mordida abierta como característica de la maloclusión

A descriptive and cross-sectional study of 122 children of Espiguita Day-Care Center belonging to the health area of Dr Juan Bruno Zayas Alfonso Teaching Clinical Surgical Hospital was carried out from February to March, 2017 in Santiago de Cuba, aimed at showing clinical details of dental occlusion in these children, according to selected variables. The oral and facial clinical examination was carried out to those affected minors; also, the individual medical record was made and the percentage as summary measure was used. In the series there was a prevalence of 4 years children, female sex and malocclusions; as long as, the digital suction and the lingual dysfunction were the fundamental habits. Also, a primacy of the open bite was obtained as characteristic of malocclusion

Association between tongue rolling and tongue folding in Osogbo, Southwestern Nigeria / Asociación entre la lengua enrollada y la lengua plegada en Osogbo, Suroeste de Nigeria

This study was carried out among 144 individuals (18 years) from the Yoruba tribe of Southwestern Nigeria in order to determine the association between tongue rolling and folding. Participants were examined for the ability to roll and/or fold their tongues. The incidence of tongue rollers and folders were 59.7 % and 79.2 % respectively. Tongue rolling was higher in females than male but the difference was not significant (X2= 1.039, df = 1, p= 0.308). Tongue folding was significantly higher in females than males (X2= 4.211, df= 1, p= 0.04). Of the 144 participants, 76 (52.8 %) were tongue rollers and folders, 10 (6.9 %) were rollers and non-folders, 38 (26.4 %) were non-rollers and folders and 20 (13.9 %) were non-rollers and non-folders. These classes did not vary significantly with sex (X2= 5.895, df= 3, p= 0.117) but there was a significant association between the ability to roll the tongue and the ability to fold the tongue (X2= 10.97, df= 1, p <0.001). This study shows that tongue rollers are associated with tongue folders.

Este estudio se realizó en 144 individuos (18 años) de la tribu Yoruba del suroeste de Nigeria con el fin de determinar la asociación entre la lengua enrollada y plegada. Los participantes fueron examinados por la capacidad de enrollar y/o doblar sus lenguas. La incidencia de enrollar y/o doblar las lenguas fueron de 59,7 % y 79,2 %, respectivamente. La capacidad de enrollar la lengua fue mayor en mujeres que en los hombres, pero la diferencia no fue significativa (X2= 1,039, df= 1, p= 0,308). El plegado o doblado de la lengua fue significativamente mayor en mujeres que hombres (X2= 4,211, df= 1, p= 0,04). De los 144 participantes, 76 (52,8 %) enrollaron y doblaron la lengua, 10 (6,9 %) enrollaron y no doblaron la lengua, 38 (26,4 %) no enrollaron y doblaron la lengua, y 20 (13,9 %) no enrollaron y ni doblaron la lengua. Estas clasificaciones no variaron significativamente con el sexo (X2= 5,895, df= 3, p= 0,117), sin embargo hubo una asociación significativa entre la capacidad de enrollar la lengua y la capacidad de doblar la lengua (X2= 10,97, df= 1, p<0,001). Este estudio muestra que la capacidad de enrollar la lengua está asociada con la capacidad de doblar la lengua.

Orthodontic treatment in a patient with unilateral open-bite and Becker muscular dystrophy. A 5-year follow-up

INTRODUCTION: Becker muscular dystrophy is an X-chromosomal linked anomaly characterized by progressive muscle wear and weakness. This case report shows the orthodontic treatment of a Becker muscular dystrophy patient with unilateral open bite. METHODS: To correct patient's malocclusion, general anesthesia and orthognathic surgery were not considered as an option. Conventional orthodontic treatment with intermaxillary elastics and muscular functional therapy were employed instead. RESULTS: After 36 months, open bite was corrected. The case remains stable after a 5-year post-treatment retention period. .

INTRODUÇÃO: a distrofia muscular de Becker é uma anomalia ligada ao cromossomo X, caracterizada por desgaste muscular progressivo e fraqueza. Este relato de caso mostra o tratamento ortodôntico de um paciente com distrofia muscular de Becker e mordida aberta unilateral. MÉTODOS: na correção de sua má oclusão, anestesia geral e cirurgia ortognática não foram consideradas como uma opção. Tratamento ortodôntico convencional com elásticos intermaxilares e terapia miofuncional foram empregados. RESULTADOS: após 36 meses, a mordida aberta foi corregida. O processo manteve-se estável após um período de cinco anos de retenção de pós-tratamento. .

Multidisciplinary Therapy of Extensive Oligodontia: A Case Report

Oligodontia is a rare congenital disorder consisting in the absence of six or more teeth. This case report describes a multidisciplinary treatment approach for a 12-year-old male with absence of 11 permanent teeth. Prior to any procedure, all primary teeth were scheduled for extraction due to poor crown-to-root ratio. The treatment plan comprised two phases: 1. orthodontic and speech therapy aimed at overbite and anterior open bite adjustment, as well as tongue position improvement; and 2. prosthetic treatment by insertion of removable temporary partial dentures. The multidisciplinary treatment involving orthodontics, speech and prosthetic therapies have reestablished the masticatory function and aesthetics, allowing the patient to achieve greater self-esteem and better social acceptance.

Resumo A oligodontia é uma doença rara, congênita, caracterizada pela ausência de seis ou mais dentes. Este relato de caso descreve uma abordagem terapêutica multidisciplinar de um adolescente de 12 anos de idade com ausência de 11 dentes permanentes. Antes de qualquer procedimento, todos os dentes decíduos foram extraídos devido à pobre relação coroa-raiz. O plano de tratamento foi constituído por duas fases: 1. terapia ortodôntica e fonoaudiológica com o objetivo de ajuste de sobre-mordida e mordida aberta anterior, bem como melhoria da posição da língua, e 2. tratamento reabilitador protético através da instalação de próteses parciais removíveis provisórias. A abordagem multidisciplinar envolvendo os tratamentos ortodônticos, fonoaudiológico e protético reestabeleceram a função mastigatória e a estética, melhorando a autoestima e aceitação social do paciente. .

Open bite: diagnosis, treatment and stability

Open bite has fascinated Orthodontics due to the difficulties regarding its treatment and maintenance of results. This anomaly has distinct characteristics that, in addition to the complexity of multiple etiological factors, have aesthetic and functional consequences. Within this etiological context, several types of mechanics have been used in open bite treatment, such as palatal crib, orthopedic forces, occlusal adjustment, orthodontic camouflage with or without extraction, orthodontic intervention using mini-implants or mini-plates, and even orthognathic surgery. An accurate diagnosis and etiological determination are always the best guides to establish the objectives and the ideal treatment plan for such a malocclusion. This report describes two cases of open bite. At the end of the treatment, both patients had their canines and molars in Class I occlusion, normal overjet and overbite, and stability during the posttreatment period.

A mordida aberta tem fascinado enormemente a Ortodontia devido à dificuldade de tratamento e manutenção da estabilidade. É uma anomalia com características distintas que, além da complexidade dos múltiplos fatores etiológicos traz consequências estéticas e funcionais. De acordo com a etiologia, muitas mecânicas têm sido utilizadas no tratamento da mordida aberta, entre elas, grades palatinas, forças ortopédicas, ajuste oclusal, terapia de camuflagem com ou sem exodontias, intervenção ortodôntica com auxilio de mini-implantes ou mini-placas até a cirurgia ortognática. Considerando que um diagnóstico apropriado e a determinação da etiologia sempre serão os melhores guias para conduzir os objetivos e o plano de tratamento ideal desta maloclusão, dois casos de mordida aberta foram apresentados. Ao final do tratamento ambos os casos apresentaram oclusão de Classe I de caninos e molares, trespasse horizontal (overjet) e trespasse vertical (overbite) normais e na avaliação pós-contenção, mostraram estabilidade.

Arco duplo helicoide palatino fixo: O arco indesejável para o hábito de sucção do polegar / Double helicoidal palatal arch. The undesirable arch for thumb sucking habit

A mordida aberta anterior é a má oclusão mais freqüente dentre as consequências do hábito de sucção do polegar. No presente relato de caso clínico, na fase de dentição mista com má oclusão Classe II divisão 1 subdivisão direita, mordida aberta anterior e palato profundo, preconizou-se um aparelho fixo com uma configuração diferenciada na região da curvatura anterior do palato constituída de duplo helicoide para impedir, de forma mecânica, o hábito de sucção do polegar da mão direita e interceptar a mordida aberta anterior. Após três meses de tratamento ocorreu a eliminação do hábito, correção da mordida aberta anterior e normalização do overjet. A estabilidade da conduta clínica empregada foi constatada após três anos de remoção do hábito de sucção.

Anterior open bite is the most frequent malocclusion among the consequences for thumb sucking habit. In this Angle Class II, 1 malocclusion, in mixed dentition and na open bite, it was used a fixed appliance with a differentiated configuration in the anterior curvature of the palate. This device consisted in a allow double helix to prevent sucking the thumb and the anterior open bite to close. After three months of treatment it was observed the correction of anterior open bite and normalization of overjet. The stability of treatment was found after three years of removing the sucking habit. The main reason was the elimination of the thumb sucking habit.

Prevalência de más-oclusões em crianças na fase de dentição decídua e mista e sua associação com hábitos bucais deletérios / Prevalence of malocclusion in children during the deciduous and mixed dentition and its association with oral habits

Objetivos: Verificar a prevalência das más-oclusões de Angle e hábitos bucais deletérios, em crianças na fase de dentição decídua e mista atendidas na Clínica Infantil do Curso de Graduação em Odontologia da Universidade Paulista – UNIP, na cidade de São Paulo. Material e Método: A amostra constituiu-se de 289 crianças, com idades entre 3 e 11 anos, que estavam em tratamento de Odontopediatria e Ortodontia. Foram descritas as afinidades entre todos os fatores estudados e as diferentes más-oclusões. Para análise descritiva realizou-se uma divisão quanto à faixa etária e sexo, submetendo os resultados a uma análise estatística de variância e correlação dos fatores avaliados. Resultados: As más-oclusões de Angle apresentaram-se em média: 40,8% Classe I, 45,3% Classe II e 13,8% Classe III, sem variação significante segundo a faixa etária e o sexo. A prevalência de hábitos como agentes etiológicos mostrou percentual médio para onicofagia, seguindo-se para sucção de chupeta e sucção digital. As alterações funcionais apresentadas foram diversas, demonstrando uma incidência à alta de respiração bucal, ausência de selamento labial, deglutição atípica e fonação alterada. Conclusões: A amostra estudada apresentou uma alta prevalência das más oclusões de Angle e elevada incidência de hábitos e alterações funcionais, mostrando que é de fundamental importância o diagnóstico precoce para atuação preventiva e interceptativa na Clínica Infantil.

Aim: This study aimed to verify the Angle’s malocclusions prevalence and deleterious habits in children with deciduous and mixing dentition that were in treatment at the Clinic of the Dental Graduation Course on the Paulista University - UNIP, São Paulo city. Material and Method: The sample consisted of 289 children, with ages between 3 and 11 years old. In order to fulfill the analysis descriptive a division had been done per age range and sex, submitting the results to a statistics variance analysis and correlation of the factors evaluated. Results: The Angle’s malocclusions had presented 40.8% on average Class I, 45.3% Class II and 13.8% Class III, without significant variation according to age and sex. The prevalence of habits as etiological agents showed the average percentage for nail biting, following by pacifier and digital sucking. The presented functional alterations had been diverse, showing a high incidence of mouth breathing, lack of lip closure, atypical deglutition and speech changes. Conclusions: The studied sample presented a high prevalence of Angle’s malocclusions and high incidence of habits and functional changes, showing that it is important the early diagnosis for preventive and interceptative performance in Pedodontics Clinic.

Protocolo de tratamento para mordida aberta dentária em dentição permanente / Treatment protocol for dental open bite in permanent dentition

A mordida aberta anterior apresenta-se com grande incidência em pacientes jovens, sendo de fácil solução quando interceptada precocemente. Essa má oclusão está relacionada a hábitos deletérios, como sucção de dedo e chupeta, sendo mantida posteriormente pela interposição lingual. Entretanto, a literatura é escassa em tratamento desta maloclusão em dentição permanente. Existem diferentes terapias ortodônticas que podem ser empregadas para correção da mordida aberta. O objetivo deste artigo é descrever uma forma de tratamento com o mínimo de efeitos colaterais e cooperação do paciente.

The anterior open bite presents a high incidence in young patients, it hás been easily resolved when intercepted early. This malocclusion is related to harmful habits such as thumb-sucking and pacifier, and maintained thereafter by the thong interposition. However, the literature is poor on treatment of this malocclusion in permanent dentition. There are different orthodontic therapies that can be used to open bite correction. The aim of this paper is to describe a form of treatment with minimal collateral effects and patient cooperation.

Deglución atípica y succión de dedos / Atypical swallowing and sucking toes

La deglución atípica corresponde a movimientos inadecuados de la lengua y/o otras estructuras que participan en el acto de deglutir. En general estas atipias ocurren por problemas de postura inadecuada de la cabeza, por alteraciones de torus, de la movilidad o la propiocepción de los órganos: lengua, labio mejilla y paladar blando. La deglución debe ser realizada con posición labial y lingual adecuada para no intervenir en el desarrollo óseo, en la dentición y en la oclusión. La succión digital se ha descrito como un hábito común en la infancia que se considera normal hasta la edad de los 3 a 4 años. Aunque la mayoría de los niños que comienzan a chuparse el pulgar interrumpen esta costumbre hacia los 2,5 a 3 años, en algunos casos este hábito permanece hasta edades entre los 6 y 12 años. Los riesgos asociados a la succión del pulgar dependen de la frecuencia, intensidad, duración y posición de la boca. La presencia de este hábito después de los 4años genera cambios en la tonicidad muscular de labio y bucinadores, retarda su maduración, dificulta la deglución normal y crea mecanismos nocivos que llevan a desarrollar una actividad muscular de compensación para lograr la deglución, todo lo cual también puede afectar otras acciones como la fonación y la respiración entre otras. Se parte de una breve exposición de la deglución normal y se analiza la atipia más frecuente, tipos y tratamientos de ambos hábitos. Se realizó una revisión exhaustiva de la literatura científica con los objetivos de describir las fases del mecanismo de la deglución normal, diferenciar la deglución infantil de la adulta, explicar los diferentes tipos de deglución, con el propósito de ofrecer una síntesis actualizada a la comunidad científica..

Influencia de las funciones y parafunciones en el crecimiento y desarrollo craneofacial / The influence of functions and parafunctions on the craniofacial growth and development

El trabajo en equipo multidisciplinario es muy importante y enriquecedor en la formación profesional. Sin embargo, existe ciertafalta de información y desconocimiento acerca de nuestra labor como profesionales de la salud. No solo tratamos la caries dental.Si bien es de enorme valor el control de dicha infección en nuestros pacientes, también lo es el diagnóstico y control delcrecimiento y desarrollo craneofacial.Es posible evitar muchas de las disgnacias, realizando un diagnóstico precoz correcto y tratamientos preventivos e interceptivosde las mismas.Es importante hacer un seguimiento detallado del crecimiento y desarrollo general de cada niño, y del Sistema Estomatognático(SE) en particular, prestando especial atención a las funciones vitales, ya que como afirmaba el Dr. Moss la función hace a la forma.Pi Suñer señalaba: un puro criterio morfológico será siempre un criterio cadavérico, un criterio biológico será vital.

Working in a multi-disciplinary team is very important and enriches one´s professional development.Nevertheless, there is a lack of information and knowledge about work as health professionals.We are not just cavity-fillers. If in fact it is very important to do basic dentistry for our patients, it is just as important to be goodat diagnosing and checking on proper growth and craniofacial development.It is possible to avoid some malocclusions through early diagnosis and preventive treatments.It´s important to do a detailed follow-up of the general growth and development of each child and especially the stomatognathic system. One must pay special attention to the vital sign functions as affirmed by Dr. Moss who said Form follows functions.Pi Suñer said, A pure morphological criteria will always be cadaverous criteria, a biological criteria will be alive.

Principales hábitos deformantes en escolares de primer grado del Seminternado 30 de Noviembre / Main deforming habits in first grade schoolchildren from 30 de Noviembre Day Boarding School

Se realizó una investigación descriptiva y transversal de 98 niños de primer grado del Seminternado 30 de Noviembre de Santiago de Cuba, atendidos en la propia escuela por odontólogos de la Clínica Estomatológica de Vista Alegre durante el 2007, para determinar su estado de salud bucal, así como los hábitos bucales deformantes presentes. Entre las principales alteraciones del complejo bucomaxilofacial sobresalieron: gingivitis, caries, deformidad dentofacial (vestibuloversión y mordida abierta anterior), así como la lengua protráctil como hábito deformante, asociada a la higiene bucal deficiente. Predominaron la dieta cariogénica y la placa dentobacteriana como factores de riesgo. Se recomendó elaborar y ejecutar un programa de actividades de educación para la salud, cuyas acciones estratégicas sean dirigidas a niños, padres, familiares y educadores.

A descriptive and cross-sectional study was carried out in 98 first grade schoolchildren from 30 de Noviembre Day Boarding School of Santiago de Cuba, who were attended at their own school by odontologists from the Dental Clinics of Vista Alegre during 2007 to determine their oral health state and deforming habits. Among the main disorders of the oral and maxillofacial complex were gingivitis, decay, dentofacial deformity (vestibuloversion and anterior open bite), as well as protractile tongue as a deforming habit associated with poor oral hygiene. Cariogenic diet and dentobacterial plaque predominated as risk factors. It was recommended to develop and implement a program of educational activities for health, strategic actions of which are addressed to children, parents, relatives and educators.

O sistema Trainer no contexto do tratamento de má-oclusão / The Trainer system in the context of treating malocclusions

A Ortopedia Funcional dos Maxilares (OFM), estuda o tratamento de má-oclusões através de estimular ou inibir a atividade do músculos masticatórios e/ou faciais, tambem como desenvolvimento dos maxillares, e através dessa ação, estimular modelagem dos maxilares que permitam um melhor alinhamento dos dentes. Assim, OFM produz um equilíbrio entre os músculos do sistema crânio-mandibular, seguido de uma melhora nas relações entre o maxilar superior e inferior, e como consequência disso, os dentes tendem a se posicionar melhor. É muito importante compreender a filosofia por trás de cada aparelho e o modus operandi de cada um dos aparelhos na OFM que estão disponíveis para tratar má-oclusões, porque assim o profissional poderá determinar o sucesso e as limitações que se podem esperar quando tratar com cada um deles. O presente documento tem como objetivo explicar o modus operandi dos Trainers: um aparelho funcional projetado para corrigir as forças erradas entregues pelos músculos da língua, bochechas e lábios.

Functional Maxillary Orthopedics (FMO) is the subject in dentistry studying the treatment of malocclusions by stimulating or inhibiting the activity of the masticatory and/or facial muscles, as well as jaws development, and through that action, to stimulate modeling and remodeling of the maxillaries permitting a better tooth alignment. Thus, FMO produces a balance between the muscles of the cranial-mandibular system, followed by improving the relationship between the upper lower maxillaries, an as a consequence of that, teeth tend to position better. It is very important to understand the modus operandi of each of the FMO appliances that are available to treat malocclusions, because that permits the health professional to understand the philosophy behind each appliance and what may be the success and limitations that can be expected when treating with each of them. The purpose of the present paper is to explain the modus operandi of the Trainers, a functional appliance designed to correct the wrong forces delivered by the muscles of the tongue, cheeks and lips.

Vertical interincisal trespass assessment in children with speech disorders

Through a transversal epidemiological study, conducted with 333 Brazilian children, males (157) and females (176), aged 3 to 6 years old, enrolled in a public preschool, this study aimed to evaluate the prevalence of the different types of vertical interincisal trespass (VIT) and the relationship between these occlusal aspects and anterior lisping and/or anterior tongue thrust in the articulation of the lingua-alveolar phonemes /t/, /d/, /n/ and /l/. All children involved were submitted to a VIT examination and to a speech evaluation. Statistical significance was analyzed through the Qui-square test, at a significance level of 0.05 (95 percent confidence limit). The quantitative analysis of the data demonstrated the following prevalences: 1 - the different types of VIT: 48.3 percent for normal overbite (NO), 22.5 percent for deep overbite (DO), 9.3 percent for edge to edge (ETE) and 19.8 percent for open bite (OB); 2 - interdental lisping in relation to the different types of VIT: 42 percent for NO, 12.5 percent for DO, 12.5 percent for ETE, 32.9 percent for OB; and 3 - children with anterior tongue thrust in the articulation of lingua-alveolar phonemes in relation to the different types of VIT: 42.1 percent for NO, 14 percent for DO, 10.5 percent for ETE, 33.3 percent for OB. The results demonstrated that there was a significant relationship between open bite and anterior lisping and/or anterior tongue thrust in the articulation of the lingua-alveolar phonemes /t/, /d/, /n/ and /l/; and that there was a significant relationship between deep overbite and the absence of anterior lisping and anterior tongue thrust in the articulation of the lingua-alveolar phonemes.