Aparelhos ortodônticos removíveis – passado, presente e futuro / Removable orthodontic appliances – past, present and future

Os aparelhos removíveis não constituem tema frequentemente abordado em debates ou artigos científicos atualmente, embora sejam amplamente utilizados no tratamento ortodôntico contemporâneo. De certa forma, este fato ocorre devido a uma tendência da Ortodontia em dedicar mais tempo e atenção às abordagens mecânicas que envolvam aparelhos fixos com bráquetes ou outros dispositivos mais “modernos”. Entretanto, atualmente movimentações ortodônticas tidas como mais dificultosas conseguem ser obtidas de modo satisfatório com o uso dos alinhadores, que constituem aparelhos ortodônticos removíveis sequenciais, confeccionados a partir de tecnologia computadorizada. Neste contexto, o presente artigo procura fazer uma revisão histórica sobre os aparelhos ortodônticos removíveis, buscando dados referentes desde o surgimento dos primeiros dispositivos, as evoluções sofridas pelos mesmos, bem como apresentar um caso clínico de disjunção maxilar com o uso de um aparelho removível, com sistema de retenção GCS, demonstrando sua eficácia na substituição dos grampos de retenção convencionais

Removable appliances are not an often topic of orthodontic discussion nowadays, although they are widely used in contemporary treatment. That occurs due to a tendency in Orthodontics according to which greater time and attention are given to mechanical approaches using fixed appliances with brackets or “modern” techniques. However, now even more troublesome orthodontic movement can be achieved with the use of aligners, which are sequential removable orthodontic appliances manufactured using computer technology. In this context, this article aims to make a historical review about the theme of removable appliances, seeking data since the appearance of the first devices, the enhancements, as well as presenting a case report of a rapid maxillary expansion realized with a removable appliance with a fixation system called GCS, showing its efficacy in replacing conventional orthodontic clasps.

Aparelho expansor GCS: aparelho expansor fixo removível / GCS expansion appliance: fixed-removable expander

Este artigo apresenta um novo sistema de fixação para aparelhos removíveis que dispensa a confecção de grampos, sendo especialmente indicado para pacientes que apresentem dentes com pouca ou nenhuma retenção. Esse sistema de fixação, chamado GCS, utiliza attachments, fabricados a partir de botões ortodônticos, que são colados aos dentes, proporcionando excelente retenção mecânica e permitindo que os aparelhos removíveis, nesse caso um expansor, possam ser ativados como se fossem aparelhos fixos cimentados ou colados aos dentes, com a vantagem adicional de poderem ser removidos para higienização e para eventuais consertos. Também é apresentado um aparelho de contenção GCS que se encaixa aos attachments, trava o aparelho em posição e dispensa o uso de grampos, e que pode ser utilizado em praticamente todos os dispositivos ortodônticos ativos ou de contenção, aliando alta eficiência retentiva com simplicidade de construção.

This study describes a new fixation system for removable appliances that does not require the fabrication of clasps and is specially recommended for patients whose teeth provide little or no retention. This fixation system, called GCS, uses attachments fabricated with orthodontic buttons bonded to the teeth. It provides excellent mechanical retention, and the removable appliances, in this case an expander, can be activated as if they were fixed appliances cemented or bonded to teeth. An additional advantage is that they may be removed for cleaning and repairs, if necessary. This study also describes a GCS retention appliance that fits into the attachments and fixes the appliance in a certain position, which precludes the use of clasps and may be adapted for practically all active or retentive orth odontic devices as it combines high retentive efficiency and fabrication simplicity.

Photoradiation and orthodontic movement: experimental study with canines.

OBJECTIVE: The aim of this study was to evaluate, through a double-blind study, the effect of gallinium-aluminium- arsenic (GaAlAs) laser irradiation on the speed of orthodontic movement in canine premolars. METHODS: Eighteen dogs were divided into two groups, and their third molars were extracted. An orthodontic device was placed between the first molar and the second premolar for stabilization purpose. Group I was irradiated with a dosage of 5.25 J/cm(2) on the right side, whereas the left side was used as the control group. Group II was submitted to the same procedure, but was irradiated with a dosage of 35.0 J/cm(2). Irradiations were done every 7 days, for a total of nine irradiations. The orthodontic space was measured every 21 days. RESULTS: The 5.25 J/cm(2) dosage accelerated orthodontic movement during the first observation period, from 0 to 21 days (p < 0.05), whereas the 35.0 J/cm(2) dosage retarded the orthodontic movement in the treated group when compared with the control group, during both the first and second observation periods, from 0 to 42 days (p < 0.05). CONCLUSION: The results suggets that photoradiation may accelerate orthodontic movement at a dosage of 5.25 J/cm(2), whereas a higher dosage, 35.0 J/cm(2), may retard it.