Bone response after immediate placement of implants in the anterior maxilla: a systematic review.

PURPOSE: The objective of this systematic review was to assess the three-dimensional changes in bone tissue after immediate installation of a single implant in a fresh extraction socket in the anterior maxilla. METHODS: After defining a strategy, an electronic search was carried out using the databases PubMed, Embase, LILACS, Web of Science, Cochrane, and Scopus. In addition, the gray literature was also researched using Google Scholar and ProQuest. Two reviewers independently screened for eligible studies, assessed the methodological quality, and extracted the data. The inclusion criteria were observational studies and experimental studies that assessed bone response after the immediate installation of a single implant in a fresh extraction socket, immediately loaded or not, in the region between the maxillary canines. Studies were included in any language, with no publication date restrictions and with a minimum of 6 months of follow-up after the surgical procedure. RESULTS: From a total of 3272 articles, only 12 studies met the inclusion criteria and were selected for the review. Bone remodeling after immediate installation of a dental implant was assessed using standardized periapical radiographs and cone beam computed tomography (CBCT). CONCLUSION: It can be concluded that bone remodeling occurs after tooth extraction and immediate implant installation.

Comparative Analysis of Cutting Efficiency and Surface Maintenance Between Different Types of Implant Drills: An In Vitro Study.

INTRODUCTION: This study evaluated cutting efficiency (CE) and linear wear of dental implant drills after 450 standardized osteotomies on bovine ribs. Diamond-like carbon-coated steel drills (SG), acid-treated steel drills (EG), and ceramic drills (ZG) were divided into 6 subgroups according to the number of uses. MATERIALS AND METHODS: A robot-controlled program performed systematic instrumentation, timing, axial loading, and managed feed rate. CE was recorded in a polyurethane resin blank and end wear (VBBmax) was analyzed under stereo microscopy. RESULTS: After osteotomies in beef ribs, CE for the Ø2.0-mm drill decreased 10.2% in SG and 10.9% in ZG; for the Ø3.0-mm drill, CE decreased 30.6% in SG, 8.5% in ZG, and improved in EG. The greatest wear occurred in Ø2.0-mm drills; ZG drills (Ø3.0 mm) exhibited only edge frittering, as confirmed on scanning electron microscopy. CONCLUSION: After 50 exposures to mechanical loads, steel and ceramic drills lost CE. Whereas cutting and thermal performance improved in experimental drills, the Ø2.0-mm drill exhibited the most signs of wear proportional to use. These findings suggest that, with the methodology employed, the life of these drills exceeds 50 osteotomies.

Abordagem multidisciplinar para o tratamento da reabsorção cervical externa: relato de caso / Multidisciplinary approach for the treatment of external cervical resorption: case report

Introdução: a reabsorção radicular é um processo patológico que resulta na perda de cemento, dentina e osso, sendo desencadeada por desequilíbrio entre osteoblastos e osteoclastos. O diagnóstico geralmente ocorre por meio de exame radiográfico e/ou tomográfico. Objetivo: relatar o tratamento de um caso de reabsorção cervical no dente #14 com abordagem multidisciplinar envolvendo Endodontia, Ortodontia, Periodontia e Prótese. Métodos: após realização de tomografia, verificou-se que a imagem correspondia a uma reabsorção cervical externa na raiz palatina, estendendo-se desde distal, seguindo para palatal e mesial. Após abertura e medicação intracanal, o endodontista optou por encaminhar a paciente para avaliação com ortodontista, sendo sugerida a realização de tracionamento ortodôntico, numa tentativa de expor a área da lesão. Para se atingir a posição final do dente, entre ativações de segunda e terceira ordens e ajustes oclusais, a etapa ortodôntica durou onze meses, incluindo três meses de contenção. Um mês antes de remover o aparelho ortodôntico e após um ano desde o início do tracionamento, realizou-se a obturação dos canais radiculares. Ainda com o dispositivo ortodôntico, foi realizada a cirurgia para correção do nível ósseo e gengival, que tende a acompanhar o dente, visualizando-se totalmente a área da reabsorção. Após um mês da cirurgia de aumento de coroa clínica, removeu-se o aparelho ortodôntico e realizou-se o tratamento protético com núcleo metálico fundido com liga de ouro e coroa em cerâmica com infraestrutura de zircônia. Conclusão: a partir de uma abordagem multidisciplinar, torna-se possível o tratamento de casos de reabsorções cervicais externas.

Fracture Strength of Standard and Small Diameter Prosthetic Abutments for Full-Arch Implant-Supported Restorations.

This study tested the fracture strength of prosthetic abutments with different sizes and combinations to support a 5-implant milled framework with distal extension. Prosthetic abutments with different dimensions (4.8-mm diameter mini conical abutment and 3.5-mm diameter microconical abutment) were screwed to 5 threaded implants. The following groups were divided (n = 3): G1 with 5 miniconical abutments (standard size), G2 with 5 microconical abutments (small sized), G3 with a combination of 3 small sized abutments and 2 standard sized abutments, and G4 with a combination of 2 small sized abutments and 3 standard sized abutments. Standardized titanium frameworks for full-arch fixed dental prosthesis were milled with equidistant holes for each of the 5 implants and abutments. A loading point was selected at 18 mm away from both distal implants. A universal testing system was used for the fracture strength tests and load was applied at a crosshead speed of 0.5 mm/min on the previously described loading points until component fracture. Mean fracture strength for each group was statistically compared (α = 0.05). Prosthetic screws were the only fractured components for all tested groups. Mean fracture strength was: G1, 1130.22 N; G2, 1031.36 N; G3, 757.9 N; and G4 792.03 N (P < .05). All prosthetic abutments and combinations that were tested provide adequate fracture strength for clinical use. However, the combination of standard and small diameter abutments leads to lower fracture strength compared with when only standard sized prosthetic abutments were used, irrespective of the abutment diameter (4.8- or 3.5-mm).

Thermal Variation During Osteotomy With Different Dental Implant Drills: A Standardized Study in Bovine Ribs.

INTRODUCTION: This study evaluated thermal variation (heat generation) by dental drills of similar geometries, made from different materials, during performance of 450 standardized osteotomies in bovine ribs to simulate implant site preparations. MATERIALS AND METHODS: Each of the 3 groups-steel with a diamond-like carbon coating (SG), experimentally surface-treated steel (EG), and aluminum-toughened zirconium ceramic (ZG)-included 3 drills, distributed across 6 subgroups. An implant motor provided torque, rotation, and irrigation for 50% of subgroups. RESULTS: In preparations drilled to 5 mm under irrigation, the number of osteotomies, material, and diameter did not influence thermal variation (ΔT); when drilling to 13 mm, the greatest ΔT occurred in EG (2.8°C). When drilling to 5 mm without irrigation, drill material influenced mean temperature; when drilling to 13 mm without irrigation, the greatest ΔT (5.5°C) occurred in EG. The highest temperature was observed in SG (79.6°C). CONCLUSION: After 50 uses, the greatest ΔT occurred in EG and the ∅3.0-mm drill exhibited the highest mean and peak temperatures. Temperatures were influenced by irrigation, number of uses, depth, drill diameter, geometry, and material; however, mean values were within physiological limits.

Assessing the effects of hydrogen peroxide bleaching agent on the shear bond strength of orthodontic brackets.

BACKGROUND: Tooth bleaching is, today, one of the most widespread cosmetic treatments in dental practice,  so it is important to determine whether it can interfere with orthodontic bonding or not. AIM: The aim of this study was to assess the in vitro effects of 35% hydrogen peroxide bleaching agent on the shear bond strength of orthodontic brackets. MATERIALS AND METHODS: Forty-five upper bicuspids were divided into three groups (n = 15). In the control Group (C), the brackets were bonded without previous bleaching treatment. Group 1 (G1) was treated with 35% hydrogen peroxide bleaching agent 24 h before bracket bonding. Group 2 was also bleached, and the brackets were bonded after 30 days. The shear bond strength of the brackets was measured using an EMIC machine, and the results were analyzed by ANOVA. RESULTS: There were no statistically significant differences between the three groups (P > 0.05), with Group C showing a mean bond strength of 9.72 ± 2.63 MPa, G1 of 8.09 ± 2.63 MPa, and G2 of 11.15 ± 4.42 MPa. CONCLUSION: It was possible to conclude that 35% hydrogen peroxide bleaching agent does not affect the shear strength of orthodontic brackets bonded 24 h and 30 days after bleaching.

Risk factors associated with the failure of miniscrews - A ten-year cross sectional study.

The aims of this study were to identify (1) patient-related factors (sex, age, craniofacial pattern and smoking habit), (2) miniscrews implants (MSI)-related factors (length and diameter) and (3) location-related factors [bone (maxilla or mandible) and area (buccal, lingual and alveolar ridge)] that may be associated with MSI loss of stability. A total of 1356 MSI were installed in 570 patients (423 females and 147 males) with mean age of 42.7 during a 10-year period and were clinically evaluated once a month until the end of the proposed movement. Length (5, 7, 9 and 11 mm) and diameter (1.3, 1.4 and 1.6 mm) of the MSI were selected according to insertion site. The evidence of clinical mobility during treatment or fracture during insertion was considered as failure. A total success rate of 89.1% was observed. There was no statistically significant difference in loss of stability when considering age, sex, craniofacial pattern or smoking habit. Considering diameter, there was no statistically significant difference (p = 0.645), but the shorter miniscrews (5 mm) showed higher failure rates (p < 0.001) than the longer ones. There were more loses (p < 0.001) in the mandible than in the maxilla, but the area (buccal, lingual or alveolar ridge) did not interfere in the results (p = 0,421). It can be concluded that MSIs are effective for skeletal anchorage in orthodontics. Patient-related factors, such as sex, age, smoking habit and craniofacial pattern, did not affect MSI success. However, the use of shorter MSIs (5 mm) was inversely proportional to failure probability, and loss of stability was greater in the mandible.

Risk factors associated with the failure of miniscrews - A ten-year cross sectional study

Abstract The aims of this study were to identify (1) patient-related factors (sex, age, craniofacial pattern and smoking habit), (2) miniscrews implants (MSI)-related factors (length and diameter) and (3) location-related factors [bone (maxilla or mandible) and area (buccal, lingual and alveolar ridge)] that may be associated with MSI loss of stability. A total of 1356 MSI were installed in 570 patients (423 females and 147 males) with mean age of 42.7 during a 10-year period and were clinically evaluated once a month until the end of the proposed movement. Length (5, 7, 9 and 11 mm) and diameter (1.3, 1.4 and 1.6 mm) of the MSI were selected according to insertion site. The evidence of clinical mobility during treatment or fracture during insertion was considered as failure. A total success rate of 89.1% was observed. There was no statistically significant difference in loss of stability when considering age, sex, craniofacial pattern or smoking habit. Considering diameter, there was no statistically significant difference (p = 0.645), but the shorter miniscrews (5 mm) showed higher failure rates (p < 0.001) than the longer ones. There were more loses (p < 0.001) in the mandible than in the maxilla, but the area (buccal, lingual or alveolar ridge) did not interfere in the results (p = 0,421). It can be concluded that MSIs are effective for skeletal anchorage in orthodontics. Patient-related factors, such as sex, age, smoking habit and craniofacial pattern, did not affect MSI success. However, the use of shorter MSIs (5 mm) was inversely proportional to failure probability, and loss of stability was greater in the mandible.

Effects of neuromuscular deprogramming on the head position.

OBJECTIVES: The aim of this study was to evaluate the effects of the neuromuscular deprogramming of the mandible on the craniocervical position. METHODS: Participants (n=65) were separated into two groups: 25 untreated controls (10 men and 15 women) and 40 patients (17 men and 23 women) and underwent neuromuscular deprogramming with upper occlusal splints for an average of 6 months and 7 days, before orthodontic treatment. Lateral cephalograms were obtained from each subject in the natural head position (NHP), before and after neuromuscular deprogramming. Craniocervical cephalometric analysis was performed to evaluate craniovertical (NSL/VER), craniocervical (OPT/NSL and CVT/NSL), and cervicohorizontal (OPT/HOR and CVT/HOR) angulation, and the angle of the cervical curvature (OPT/CVT). RESULTS: After neuromuscular deprogramming, significant changes in three angles--NSL/VER (P<0.001), OPT/NSL (P<0.001) and CVT/NSL (P<0.001)--were found between the two groups. For the cervical spine position, no significant changes were observed. CONCLUSION: The results indicate that neuromuscular deprogramming using occlusal splint causes significant extension of the head.

Implantes cerâmicos - evidências científicas para o seu uso / Ceramic implants - scientific evidence for its use

A cerâmica de zircônia (ZrO) vem sendo objeto de muitas pesquisas biomédicas pela excelente biocompatibilidade e estabilidade química. Nos últimos anos tem sido utilizada como uma opção aos implantes dentários metálicos, principalmente pelas qualidades estéticas e periointegração. O propósito desta revisão bibliográfica é destacar as características das cerâmicas Y-TZP (zircônia tetragonal policristalina estabilizada com ítria) e ATZ (zircônia tenacificada por alumina), citando algumas limitações do uso como materiais alternativos na Implantodontia, baseadas em evidências científicas. Muitas pesquisas in vitro e in vivo demonstraram que as cerâmicas Y-TZP apresentam vantagens estéticas e biológicas sobre outros biomateriais. Os valores de resistência à fratura são clinicamente aceitáveis, sendo mais elevados nos compósitos ATZ. Alguns testes de carga cíclica com implantes dentários ATZ mostraram resistência igual ou superior aos de titânio (Ti). Novos tratamentos de superfície na cerâmica estão abreviando o tempo de cura, possibilitando carga imediata. Os experimentos com animais confirmaram o bom potencial de osseointegração das cerâmicas, com quantidade de BIC equiparável ao Ti e com menor acúmulo de biofilme. Estudos de até 5 anos com implantes dentários Y-TZP de peça única em humanos apresentaram índices de sucesso de 84,4 a 100%, enquanto que a taxa de sobrevida em 7 anos com ATZ foi de 99%. Apesar dos bons resultados com implantes dentários Y-TZP e ATZ, os autores sugerem cautela nas indicações e mais estudos prospectivos de longo prazo.

Ceramic zirconia (Zr02) has been the subject of many biomedical researches due to its excellent biocompatibility and chemical stability. In recent years it has been used as an alternative to metallic dental implants, and mainly for its aesthetic periointegration qualities. The purpose of this literature review was to evaluate some of the characteristics of ceramic Y-TZP (tetragonal zirconia polycrystalline yttria stabilized) and ATZ (zirconia toughened alumina), pointing its limitations of use as alternative materials in Implantology. Many in vitro and in vivo studies have demonstrated that the ceramics Y-TZP exhibit aesthetic and biological advantages over other biomaterials. The values of fracture toughness are clinically acceptable, being higher in ATZ composites. Some cyclic loading tests with ATZ dental implants showed resistance equal or superior to titanium (Ti). New surface treatments for ceramics have shortened the cure time, allowing immediate loading. Animal experiments have confirmed the good potential for osseointegration of ceramic, with the amount of BIC comparable to Ti and less accumulation of biofilm. Studies up to 5 years with dental implants Y-TZP one-piece in humans have success rates between 84.4 and 100%, whereas the survival rate in 7 years with ATZ implants was 99%. Despite the good results with the ceramic Y-TZP and ATZ, the authors suggest caution in their indications and further long-term prospective studies are required.

Lower molar uprighting with miniscrew anchorage: direct and indirect anchorage.

Lower molar uprighting has been increasingly indicated in clinical orthodontics, mainly because of adult patients with rehabilitation needs. The aim of this study was to determine the success rate of miniscrew use for lower molar uprighting and to compare the use of direct and indirect anchorage. One hundred and eighty-one miniscrews were inserted in 102 rehabilitation patients, with a mean age of 42.24 years. In 71 patients, indirect anchorage was used (116 miniscrews); in the other 31 patients, direct anchorage was employed (65 miniscrews). The choice of direct or indirect anchorage was determined by the orthodontist according to the force system that would be used for the movement and the bone availability. The overall success rate for miniscrews was 90. 05%; 18 miniscrews failed, including 15 that were used as indirect anchorage and 3 that were used as direct anchorage. Considering the results of this study, it can be concluded that both direct and indirect anchorage can be successfully used for molar uprighting.

Relação entre DTM e tratamento ortodôntico na visão de clínicos gerais, especialistas em Ortodontia e especialistas em Disfunção Temporomandibular e Dor Orofacial / Relationship between TMD and orthodontic treatment in the opinion of dental general practitioners, specialists in Orthodontics and specialists in TMD and Orofacial Pain

Objetivo: o objetivo do presente estudo foi avaliar a visão de clínicos gerais (CG), especialistas em Ortodontia (EO) e especialistas em Disfunção Temporomandibular e Dor Orofacial (EDTM), por meio de questionário, quanto à inter-relação tratamento ortodôntico e DTM. Métodos: foi enviado questionário via correio eletrônico a 9.490 cirurgiões-dentistas de diferentes regiões do Brasil. Resultados: dos 132 profissionais que responderam à pesquisa, 75% relatou examinar, usualmente, seus pacientes quanto a sinais e sintomas de DTM previamente ao tratamento odontológico. A maioria dos profissionais (55%) afirmou acreditar que tratamento ortodôntico pode prevenir DTM; 68% dos EDTM não concordam com essa opinião. A maior parte (62%) associou tratamento ortodôntico à causa da DTM e não acredita que Ortodontia possa tratar a referida desordem (56%). A maioria dos CG (64%), no entanto, considera que se pode tratar DTM por meio de Ortodontia. Conclusão: a maioria dos profissionais acredita que tratamento ortodôntico pode prevenir DTM, mas que, ao mesmo tempo, não pode curar e pode ainda causar tal desordem. Foi encontrada diferença estatisticamente significativa em relação às respostas das três áreas de interesse (CG, EO e EDTM).

Estabilidade da posição natural da cabeça e da coluna cervical no médio prazo / Stability of natural head position and cervical spine over time

O objetivo do presente estudo foi avaliar a estabilidade (reprodutibilidade) da posição natural da cabeça (PNC) e da coluna cervical ao longo do tempo. Foram avaliados 15 indivíduos assintomáticos, com má-oclusões de Classe I e média de idade de 20 anos e dois meses. Foram realizadas em cada indivíduo duas terradiografias laterais na PNC, utilizando um espelho como referência externa. O intervalo médio entre as duas séries foi de seis meses e 15 dias. A reprodutibilidade da PNC foi testada por meio do ângulo SNIVER. Utilizou-se a fórmula de Dahlberg para o cálculo do erro do método, e o teste "t" pareado para determinar se ocorreram modificações significativas. Após seis meses, tanto a posição da coluna cervical quanto a da cabeça permaneceram estáveis, já que não foram observadas alterações significativas para nenhuma das variáveis. A reprodutibilidade (erro do método) da PNC foi de 1,12O.

The aim of the present study was to evaluate the stability (reproducibility) of natural head position (N HP) and of cervical spine over time. Fifteen asymptomatic individuals, it mean age of 20 years and two months, presenting Angle S Class I malocclusion, were evaluated. Two lateral radiographs in natural head position (NHP), using a mirror as external reference, were taken from each subject. The mean interval between the two series was six months and 15 days. The reproducibility of NHP was carried out by evaluating the SN/VER angle. Dahlberg’s formula was applied to determine the method error and the paired t test was used to determine whether any significant changes in NHP and cervical spine had occurred. After six months, no significant alterations were observed. Thus, both the cervical spine and the head position had remained stable The reproducibility (error method) of NHP was 1,12.

Efeitos da desprogramação neuromuscular da mandíbula, segundo a filosofia de Roth, sobre as posições da cabeça e da coluna cervical, em indivíduos assintomáticos com maloclusão de Classe I / The effect of mandibular neuromuscular deprogramming, according to Roth’s philosophy, on the positions of the head and the cervical column, in asymptomatic subjetcs with Class I malocclusion

O propósito do presente estudo foi determinar, radiograficamente, os efeitos da desprogramação neuromuscular, por meio do uso da placa miorrelaxante superior, na posição craniocervical. A desprogramação neuromuscular foi feita objetivando-se realizar o diagnóstico ortodôntico com a mandíbula em relação cêntrica (RC), de acordo com filosofia de Roth (1981). Foram avaliados 39 indivíduos assintomáticos, com maloclusões Classe I de Angle, separados em dois grupos, o controle, contendo 15 indivíduos, com média de idade de 26 anos, não submetidos a qualquer forma de tratamento, e o tratado, contendo 24 indivíduos, com média de idade de 23 anos e 10 meses, submetidos à desprogramação neuromuscular. De cada paciente, foram obtidas duas telerradiografias em norma lateral, na posição natural da cabeça (PNC). No grupo controle, o intervalo médio entre ambas foi 6 meses e 17 dias. No grupo tratado, a primeira telerradiografia foi realizada previamente, e a segunda, após a desprogramação neuromuscular. O tempo médio de uso da placa miorrelaxante foi de 6 meses e 7 dias. A análise cefalométrica craniocervical foi realizada avaliando-se as angulações craniovertical (SN/VER), craniocervical (OPT/SN e CVT/SN), cervicohorizontal (OPT/HOR e CVT/HOR) e o ângulo da curvatura cervical (OPT/CVT). Concluíu-se que houve extensão significativa da cabeça, tanto em relação à linha vertical verdadeira, demonstrada pelo aumento do ângulo SN/VER, quanto à coluna cervical, demonstrada pelo aumento do ângulo CVT/SN. A coluna cervical apresentou alteração significativa em sua inclinação, em relação à linha horizontal verdadeira, demonstrado pelo aumento do ângulo CVT/HOR. Não houve alteração significativa da curvatura cervical. Foram, ainda, observadas correlações significativas entre as alterações das variáveis SN/VER e OPT/HOR, SN/VER e CVT/HOR, SN/VER e CVT/SN, OPT/CVT e OPT/HOR, OPT/CVT e OPT/SN, OPT/HOR e CVT/HOR, OPT/HOR e OPT/SN, assim como OPT/SN e CVT/SN.

Correlação entre deslocamentos condilares e alteração da altura facial ântero-inferior / Correlation between condylar discrepancies and anterior inferior facial height modifications

Estudos prévios demonstraram alterações significativas dos deslocamentos condilares entre RC e MIH e da altura facial ântero-inferior, após a desprogramação neuromuscular da mandíbula com placa oclusal de efeito miorrelaxante. O propósito da presente pesquisa foi o de avaliar as possíveis correlações entre ambas alterações. Foram analisados 35 indivíduos assintomáticos, com média de idade de 20 anos e nove meses, sendo 20 com más-oclusões de Classe I e 15 com más-oclusões de Classe 11. Obtiveram-se, de cada indivíduo. duas telerradiografias laterais, sendo uma antes, e outra, após a desprogramação neuromuscular e mediu-se a AFAi, de acordo com McNamara19 (1984). Os deslocamentos condilares entre MIH inicial e RC pós-desprogramação foram medidos nos três planos do espaço (vertical: V, horizontal: H e transversal: T) de ambos os lados (direito: D e esquerdo: E), por meio do indicador de posição axial, a partir de modelos montados em articulador Panadent. Foram observadas correlações significativas ediretas, no nível de I%, entre as variáveis IPA-VD e AFAi, IPA-VE e AFAi e IPA-HD e AFAi. As correlações IPA-HEX AFAi e IPA-T X AFAi não foram significativas.

Previous studies demonstrated significant condylar shifting between the mandibular positions of centric relation( CR) and maximum intercuspation (MI), as well significant increase of anterior inferior facial height (AFH) after neuromuscular deprogramming, through splint therapy. The present research was designed to determine the possible correlation between these alterations. Thirty-five asymptomatic individuals, being 20 with Angle’s Class I malocclusion and 15 with Class II maloclusion. with a mean age of twenty year and nine months, were evaluated. Two lateral radiographs were taken from each subject, one before and the other one after the neuromuscular deprogramming. he analysis of AFH was performed according to McNamarai19 (1984). The condylar sifting were recorded in 3 planes of space (vertical: C:horizontal: H and transversal: T) of both sides (right: R and left: L), through the condylar position indicator (CPI) in mounted models in articulator (Panadent Corp. Grand Terrace, CA.). Significant and positive correlations (p<0,001) were observed between the AFH and the variables CPI- VR, CPI-VL and CPI-HR. however, the correlations AFH x CPIHL and AFH x CPI-T were no! significant.

Estudo da correlação entre a alteração do espaço aéreo orofaríngeo e as mudanças da posição natural da cabeça e da altura facial ânter-inferior em indivíduos assintomáticos, com maloclusões de classe II de angle, submetidos à desprogramação neuromuscular com placa oclusal / Study of the correlation between the alteration of the lower pharyngeal width and the changes in natural head position and in anterior inferior facial height in asymptomatic individuals, with angle's class II malocclusion, after neuromuscular deprogramming throug the use occlusal splint

Estudos prévios demonstraram alterações cefalométricas significativas no espaço aéreo orofaríngeo, na altura facial antero-inferior e na posição da cabeça após o uso de placa oclusal superior. O propósito da presente pesquisa foi avaliar as possíveis correlações entre estas alterações. Foram analisados 15 indivíduos assintomáticos, com média de idade de 17 anos e 4 meses e com maloclusões de classe II de Angle. Obtiveram-se, de cada indivíduo, duas telerradiografias laterais na posição natural da cabeça (PNC), sendo uma antes, e a outra, após a desprogramação neuromuscular. A análise da orofaringe(ORO) e da altura facial ântero-inferior (AFAi) foi feita de acordo com McNamara (1984). A posição da cabeça foi avaliada por meio dos ângulos craniovertical (SN/VER)n e craniocervical (CVT/SN). As correlções observadas foram: ORO e AFAi: -0,31 (p=0,257); ORO e SN/VER: 0,43 (p=0.104); ORO e CVT/SN: (p=0,915). Concluiu-se que não existiram correlações significativas entre as alterações do espaço aéreo orofaríngeo e as mudanças da posição natural da cabeça e da altura facial antero-inferior após desprogramação neuromuscular em pacientes com maloclusões de classe II.

Previous studies demonstrated significant cephalometrics in lower pharyngeal airway space, anterior inferior facial height and natural head position after the use of use upper oclusal splint. The present research was designed to determine the possible correlation between these alterations. Fifteen asymptomatic individuals, with a mean age of seventeen years and four months, presenting Angle’s Class II malocclusion, were evaluated. Two lateral radiographs in natural head position (NHP) were taken from each patient, one before and the other one after neuromuscular deprogramming. The analysis of lower pharyngeal airway space (LP) and the anterior inferior facial height (ANS-Me) was performed according to McNamara (1984). The NHP analysis was carried out by evaluating the craniovertical (SN/VER) and craniovertival (CVT/SN) angles. The correlations were: LP and ANS-Me: -0,31 (p=0,257); LP and SN/VER: ,43 (p=0.104); LP and CVT/SN: -0,03 (p=0,915). It was concluded that there were no significant correlations between the alteration of the lower pharyngeal width and the changes in natural head position and in anterior inferior facial height neuromuscular deprogramming in patients with Angle’s class II malocclusion.

Avaliaçäo cefalométrica radiográfica da posiçäo craniocervical antes e após a desprogramaçäo neuromuscular em pacientes com maloclusäo Classe II de Agle / Radiographic cephalometric evaluation of the cranio cervical position before and after neuromuscular deprogramming in patients with Angle's Classe II malocclusion

O propósito do presente estudo foi determinar, radiograficamente, o efeito da desprogramaçäo neuromuscular, por meio de placa miorrelaxante superior, na posiçäo craniocervical. A desprogramaçäo neuromuscular foi feita objetivando-se realizar o diagnóstico ortodôntico com a mandíbula em relaçäo cêntrica (RC). Foram avaliados 15 indivíduos assintomáticos, com maloclusöes de Classe II de Angle, entre 15 anos e 7 meses e 20 anos e 2 meses de idade, sendo 7 do sexo masculino e 8 do feminino. De cada paciente, foram obtidas duas telerradiografias em norma lateral, na posiçäo natural da cabeça (PNC), sendo a primeira previamente, e a segunda, após a desprogramaçäo neuromuscular. O tempo médio de uso da placa miorrelachante foi de 10 meses e 6 dias. A análise cefalométrica craniocervical foi realizada avaliando-se as angulaçöes craniovertical (SN/VER), craniocervical (OPT/SN e CVT/SN), cervicohorizontal (OPT/HOR e CVT/HOR) e o ângulo da curvatura cervical (OPT/CVT). Concluí-se que houve extensäo significativa da cabeça, tanto em relaçäo à linha vertical verdadeira, demonstrada pelo aumento do ângulo SN/VER, quanto à coluna cervical, demonstrada pelo aumento dos ângulos OPT/SN e CVT/SN. Já, a inclinaçäo da coluna cervical näo apresenta alteraçäo significativa em relaçäo à linha horizontal verdadeira. Também näo houve alteraçäo significativa da curvatura cervical