Prospective clinical study of transverse development with orthodontics with self-ligating brackets.

Orthodontics with low friction, low force, passive self-ligating brackets produces alveolar-dental remodeling, resulting in an increase in the transverse diameter of the dental arches, especially in the premolar sector. The aim of this study was to compare the modifications of the transverse diameter in the pre- and post-dental alignment cast models with orthodontics with passive self-ligating brackets in patients with moderate to severe dental discrepancy. The study included 28 patients of both sexes aged 16 to 48 years with dental discrepancies between -6 and -16 mm, treated with self-ligating Damon brackets and thermally activated Nickel- Titanium-Copper arches. With a digital pachymeter, Mitutoyo brand, five measurements were taken per dental arch: distance between canines (C), first premolars (1PM), second premolars (2 PM), first molars (1M) and second molars (2M), before and after orthodontic alignment. The variations were statistically evaluated by Student T Test for paired samples. Average distance between teeth varied with dental alignment in both jaws. The greatest increases in transverse diameter were recorded in the premolar areas. Minor though statistically significant variations also occurred in the 2M of the maxilla and in the C of the mandible In alignment with passive self-ligating brackets, there is an increase in the transverse diameter due to the development of the dental arches, mainly in the premolar sector of both jaws and also at the level of the canines in the mandible.

La ortodoncia con brackets autoligables pasivos, de baja fricción y baja fuerza, produce remodelación alvéolodentaria; con aumento del diámetro transversal de las arcadas, especialmente en el sector de los premolares. El objetivo de este trabajo fue comparar las modificaciones del diámetro transversal en los modelos de yeso pre y post alineación dentaria con ortodoncia con brackets autoligables pasivos en pacientes con discrepancia dentaria moderada a severa. El estudio incluyó 28 pacientes de ambos sexos de entre 16 y 48 años de edad con discrepancia dentaria entre -6 y -16mm, tratados con brackets autoligables sistema Damon y arcos termo activables de Níquel-Titanio-Cobre. Con un paquímetro digital marca Mitutoyo, se tomaron 5 medidas por arcada: distancia entre caninos (C), primeros y segundos premolares (1 PM y 2 PM) y primeros y segundos molares (1M y 2M); pre y post alineación ortodóncica. Las variaciones registradas fueron evaluadas estadísticamente mediante Student T Test para muestras apareadas. La distancia promedio entre dientes varió con la alineación dentaria en ambos maxilares. Los mayores aumentos del diámetro transversal se registraron en las zonas de los premolares. Se produjeron también variaciones menores, aunque estadísticamente significativas, en los 2M del maxilar superior y en los C del maxilar inferior. En la alineación con brackets autoligables pasivos, hay incremento del diámetro transversal por desarrollo de las arcadas, principalmente en el sector premolar de ambos maxilares y en el maxilar inferior también a nivel de los caninos.

Prospective clinical study of transverse development with orthodontics with self-ligating brackets / Estudio clínico prospectivo del desarrollo transversal con ortodoncia con brackets autoligables

ABSTRACT Orthodontics with low friction, low force, passive self-ligating brackets produces alveolar-dental remodeling, resulting in an increase in the transverse diameter of the dental arches, especially in the premolar sector. The aim of this study was to compare the modifications of the transverse diameter in the pre- and post-dental alignment cast models with orthodontics with passive self-ligating brackets in patients with moderate to severe dental discrepancy. The study included 28 patients of both sexes aged 16 to 48 years with dental discrepancies between -6 and -16 mm, treated with self-ligating Damon brackets and thermally activated Nickel- Titanium-Copper arches. With a digital pachymeter, Mitutoyo brand, five measurements were taken per dental arch: distance between canines (C), first premolars (1PM), second premolars (2 PM), first molars (1M) and second molars (2M), before and after orthodontic alignment. The variations were statistically evaluated by Student T Test for paired samples. Average distance between teeth varied with dental alignment in both jaws. The greatest increases in transverse diameter were recorded in the premolar areas. Minor though statistically significant variations also occurred in the 2M of the maxilla and in the C of the mandible In alignment with passive self-ligating brackets, there is an increase in the transverse diameter due to the development of the dental arches, mainly in the premolar sector of both jaws and also at the level of the canines in the mandible.

RESUMEN La ortodoncia con brackets autoligables pasivos, de baja fricción y baja fuerza, produce remodelación alvéolodentaria; con aumento del diámetro transversal de las arcadas, especialmente en el sector de los premolares. El objetivo de este trabajo fue comparar las modificaciones del diámetro transversal en los modelos de yeso pre y post alineación dentaria con ortodoncia con brackets autoligables pasivos en pacientes con discrepancia dentaria moderada a severa. El estudio incluyó 28 pacientes de ambos sexos de entre 16 y 48 años de edad con discrepancia dentaria entre -6 y -16mm, tratados con brackets autoligables sistema Damon y arcos termo activables de Níquel-Titanio-Cobre. Con un paquímetro digital marca Mitutoyo, se tomaron 5 medidas por arcada: distancia entre caninos (C), primeros y segundos premolares (1 PM y 2 PM) y primeros y segundos molares (1M y 2M); pre y post alineación ortodóncica. Las variaciones registradas fueron evaluadas estadísticamente mediante Student T Test para muestras apareadas. La distancia promedio entre dientes varió con la alineación dentaria en ambos maxilares. Los mayores aumentos del diámetro transversal se registraron en las zonas de los premolares. Se produjeron también variaciones menores, aunque estadísticamente significativas, en los 2M del maxilar superior y en los C del maxilar inferior. En la alineación con brackets autoligables pasivos, hay incremento del diámetro transversal por desarrollo de las arcadas, principalmente en el sector premolar de ambos maxilares y en el maxilar inferior también a nivel de los caninos.

Increased interpremolar development with self-ligating orthodontics. A prospective randomized clinical trial.

In compressed dental arches with mild to moderate crowding, space can be gained during the alignment phase to help improve tooth location. The aim of this study was to compare transverse measurements before and after the alignment stage in two groups: Group A treated with passive selfligating brackets, (Damon System) and Group B with conventional brackets (Roth philosophy). The change in transverse diameter between teeth was measured on dental casts taken before and after orthodontic alignment. Twenty four patients of both sexes aged 13 to 36 years, with moderate tooth crowding (4 to 6 mm), were treated. They all received treatment at the Department of Orthodontics, School of Dentistry, University of Buenos Aires. Patients were distributed randomly into two groups of 12. No extraction was performed until the end of the alignment. Dental casts were measured before and after alignment. The distance between upper first premolars increased more in Group B (p = 0.008), and the distance between canines was higher in Group B, with statistically significant difference (p < 0.01). Both systems enable tooth alignment by increasing transverse diameter of the arches in patients with mild to moderate crowding. The greatest transversal development occurs in the interpremolar area in both techniques and is significantly higher with selfligating orthodontics. Intercanine distance increases significantly with conventional orthodontics compared to selfligating orthodontics.

En las arcadas dentarias comprimidas, con apiñamiento dentario de leve a moderado, es posible obtener ganancia de espacio que favorezca la ubicación de las piezas en la fase de alineación por remodelación alvéolodentaria de las arcadas. El objetivo de este trabajo fue comparar las diferencias pre y post tratamiento en la etapa de alineación de los grupos A: brackets autoligables pasivos, (Sistema Damon) y grupo B: brackets convencionales (Filosofía de Roth). Se evaluaron las variaciones en el diámetro transversal, antes y después de alinear ortodón cicamente los dientes, utilizando modelos de estudio. Participaron 24 pacientes de ambos sexos, entre 13 y 36 años con apiñamiento dentario moderado (entre 4 y 6 mm) tratados en la Cátedra de Ortodoncia de la Facultad de Odontología, Universidad de Buenos Aires. Los pacientes fueron distribuidos al azar en dos grupos de 12 pacientes cada uno. No se realizaron exodoncias hasta finalizar la alineación. Se midieron los modelos pre y post alineación. La distancia entre primeros premolares superiores aumentó en el grupo A más que en el B (p=0.008) y entre caninos fue mayor en el grupo B, con diferencia estadísticamente significativa (p< 0,01). En pacientes con apiñamiento leve a moderado, la expansión con ambos sistemas permite la alineación dentaria por aumento del diámetro transversal de las arcadas fundamentalmente en el área premolar. El mayor desarrollo transversal se produce en el área premolar para ambas técnicas y es significativamente mayor con ortodoncia autoligable. En ortodoncia convencional, aumenta significativamente la distancia intercanina en comparación con la autoligable.

Method for evaluation of transverse dimension in self-ligating orthodontic treatment. A comparative study.

Knowledge of the best way to evaluate changes in transverse dimension produced by orthodontic treatment enables the estimation of potential space that may be generated and optimizes planning. The aim of this study was to compare two methods for measuring changes in transverse dimension following tooth alignment by passive self-ligating system: Method 1 (M1) considering palatal landmarks and Method 2 (M2) considering dental landmarks. Subjects were 12 patients of both sexes, aged 15 to 24 years old, with moderate crowding (Nance discrepancy -4 to -6 mm), who were treated with the Damon System at the Department of Orthodontics of the School of Dentistry, Buenos Aires University. Their pre- and posttreatment maxillary casts were analyzed (24 casts altogether). Five measurements were taken on each cast: intercanine width, first and second inter-premolar width and first and second inter-molar width, using the two measurement methods (M1 and M2). Both methods found average width to have increased, though this increase was smaller as measured by Ml than by M2, with statistically significant difference between values (p<0.05). Ml and M2 provided significantly different measurements for first and second inter-premolar and first intermolar distances (p< 0.05). The values obtained using Ml (palatal landmarks for teeth) present less variation and provide information on the changes in the dental arches without adding tooth tipping. Considering Ml, the greatest gain in transverse dimension occurred in first and second inter-premolar distance, there was a slight increase in inter-canine and first inter-molar distance, and a decrease in second inter-molar distance.

Conocer la mejor manera de evaluar los cambios en el diámetro transversal de las arcadas producidos con el tratamiento ortodóncico permite estimar el espacio que puede generarse y optimizar la planificación del mismo. El objetivo del trabajo fue comparar las modificaciones del diámetro transversal utilizando reparos palatinos (M1) y reparos dentarios, (M2) luego de la alineación dentaria con sistema autoligable pasivo. Se evaluaron los maxilares superiores de 12 pacientes de ambos sexos (24 modelos pre y post tratamiento en total) atendidos con Sistema Damon en la Cátedra de Ortodoncia de la FOUBA, de entre 15 y 24 años de edad con apiñamiento moderado (discrepancia de Nance entre -4 y -6 mm). Se tomaron 5 medidas por arcada: distancia entre caninos, primeros y segundos premolares y primeros y segundos molares de los modelos pre y post alineación por tratamiento ortodóncico, utilizando dos métodos de evaluación (M1 y M2). La variación en el diámetro transversal promedio aumentó en ambos métodos y fue menor utilizando M1 que M2, con diferencia estadísticamente significativa entre los valores (p< 0.05). En el análisis de la distancia entre piezas dentarias homólogas, comparando M1 y M2, se encontró diferencia estadísticamente significativa entre primeros, segundos premolares y primeros molares (p< 0,05). Las arcadas presentaron incremento del diámetro transversal que fue evidenciado por ambos métodos de medida. Los valores tomando reparos en palatino de las piezas dentarias presentan menos variación e informan sobre las modificaciones de las arcadas dentarias sin agregar las inclinaciones de las piezas. Considerando M1 la mayor ganancia de diámetro transversal se produce en primeros y segundos premolares, con aumento leve en caninos y primeros molares y disminución entre segundos molares.

Variations in the vestibular cortical bone of permanent canine teeth in orthodontic patients. a comparative study: linear tomography vs. cbct (3d accuitomo).

The aim of this study was to compare the results of measuring the height of the vestibular cortical bone of canine teeth by linear tomography (LT) and 3-D Accuitomo cone beam computed tomography (CBCT) before and after aligning dental arches by orthodontic treatment. LT and CBCT were performed before and after orthodontic alignment on 12 canines in three patients undergoing orthodontic treatment, and the height of the canine vestibular cortical bones measured in mm. Measurements were taken by double-blinded operators. The mean variation in height of the vestibular cortical bone with orthodontic treatment was - 0,33 mm} 0.233 standard error using CBCT and -0,08mm } 0.55 standard error using LT. Analysis of variance (ANOVA) was performed to compare the techniques, the patients and upper and lower canines. No significant difference was found for any of the cases. Using LT to evaluate vestibular crest cortical bone in canines is comparable in efficiency to using CBCT. Height in millimeters is less in LT because image resolution is lower and when it is very thin it is not appreciable by this method.

Gingival response in orthodontic patients: Comparative study between self-ligating and conventional brackets.

Orthodontic brackets contribute to the accumulation of bacterial plaque on tooth surfaces because they hinder oral hygiene. In contrast to conventional brackets, self-ligating brackets do not require additional parts to support the arches, thus improving dental hygiene. The aim of this study was to compare the gingival response in orthodontic patients wearing self-ligating or conventional brackets. A sample of 22 patients aged 16 to 30 years was divided into two groups: Group A, treated with selfligating brackets (Damon system) and Group B, treated with conventional brackets (Roth technique). The following were assessed during the treatment: Plaque Index (PI), Gingival Index (GI) and Probing Depth (PD), and sub-gingival samples were taken from teeth 14/24 for microbiological observation. No statistically significant difference was found between Groups A and B; p>0.05 (sign-ranked) or between PI, GI and PD at the different times (Friedman's Analysis of Variance), even though the indices were found to increase at 14 days, particularly for self-ligating brackets. The quantity and quality of microorganisms present were compatible with health on days 0, 28 and 56. As from day 14 there is a predominance of microbiota compatible with gingivitis in both groups. In the samples studied, orthodontic treatment increases bacterial plaque and inflammatory gingival response, but gingival-periodontal health can be maintained with adequate basic therapy. Self-ligating and conventional brackets produced similar gingival response.

Variations in the vestibular cortical bone of permanent canine teeth in orthodontic patients. a comparative study: linear tomography vs. cbct (3d accuitomo). / Variations in the vestibular cortical bone of permanent canine teeth in orthodontic patients. a comparative study: linear tomography vs. cbct (3d accuitomo).

The aim of this study was to compare the results of measuring the height of the vestibular cortical bone of canine teeth by linear tomography (LT) and 3-D Accuitomo cone beam computed tomography (CBCT) before and after aligning dental arches by orthodontic treatment. LT and CBCT were performed before and after orthodontic alignment on 12 canines in three patients undergoing orthodontic treatment, and the height of the canine vestibular cortical bones measured in mm. Measurements were taken by double-blinded operators. The mean variation in height of the vestibular cortical bone with orthodontic treatment was - 0,33 mmü} 0.233 standard error using CBCT and -0,08mm ü} 0.55 standard error using LT. Analysis of variance (ANOVA) was performed to compare the techniques, the patients and upper and lower canines. No significant difference was found for any of the cases. Using LT to evaluate vestibular crest cortical bone in canines is comparable in efficiency to using CBCT. Height in millimeters is less in LT because image resolution is lower and when it is very thin it is not appreciable by this method.

Gingival response in orthodontic patients: Comparative study between self-ligating and conventional brackets. / Gingival response in orthodontic patients: Comparative study between self-ligating and conventional brackets.

Orthodontic brackets contribute to the accumulation of bacterial plaque on tooth surfaces because they hinder oral hygiene. In contrast to conventional brackets, self-ligating brackets do not require additional parts to support the arches, thus improving dental hygiene. The aim of this study was to compare the gingival response in orthodontic patients wearing self-ligating or conventional brackets. A sample of 22 patients aged 16 to 30 years was divided into two groups: Group A, treated with selfligating brackets (Damon system) and Group B, treated with conventional brackets (Roth technique). The following were assessed during the treatment: Plaque Index (PI), Gingival Index (GI) and Probing Depth (PD), and sub-gingival samples were taken from teeth 14/24 for microbiological observation. No statistically significant difference was found between Groups A and B; p>0.05 (sign-ranked) or between PI, GI and PD at the different times (Friedmans Analysis of Variance), even though the indices were found to increase at 14 days, particularly for self-ligating brackets. The quantity and quality of microorganisms present were compatible with health on days 0, 28 and 56. As from day 14 there is a predominance of microbiota compatible with gingivitis in both groups. In the samples studied, orthodontic treatment increases bacterial plaque and inflammatory gingival response, but gingival-periodontal health can be maintained with adequate basic therapy. Self-ligating and conventional brackets produced similar gingival response.

Sistemas de individualización en el cementado de técnica lingual: posicionamiento de brackets en técnica lingual / Individualization systems in lingual technique cementation: brackets positioning in lingual technique

El factor más importante en ortodoncia lingual es la colocación precisa de los brackets. Para ello, las distintas técnicas de cementado, con sus respectivos sistemas de individualización/posicionamiento, pretenden optimizar la calidad y el tiempo de tratamiento, para cumplir con los objetivos. Los sistemas de posicionamiento/individualización, las técnicas de cementado indirectas o directas, pretenden brindar al clínico la información necesaria para seleccionar aquella que considere adecuada al plan de tratamiento de su paciente.

Importancia de la terapia básica pre-tratamiento ortodóncico / The importance of pre-orthodontic treatment basic therapy

Introducción: la capacidad de los microorganismos para formar y mantenerse en el biofilm tiene un alto impacto en las infecciones crónicas, pues el mismo protege y nutre a comunidades de microorganismos que pueden influir en el tratamiento ortodóncico, aumentando la incidencia de caries y enfermedad periodontal. Objetivo: comparar la condición periodontal inicial y la alcanzada luego de la terapia básica periodontal de los pacientes que concurren a la consulta para iniciar un tratamiento ortodóncico. Materiales y métodos: se evaluaron 10 pacientes entre 14 y 30 años que concurrieron al servicio de la Cátedra de Ortodoncia de la Facultad de Odontología de la UBA. Se tomaron el índice de placa de Silness y Loe y gingival de Loe y Silness, la profundidad de sondaje y hemorragia gingival al sondaje en todas las piezas dentarias presentes en la boca del paciente. De la zona de los primeros premolares superiores se eliminó la placa supragingival y se tomaron muestras subgingivales, las cuales fueron colocadas en solución fisiológica y medio de transporte VMGAIII. Simultáneamente se realizaron extendidos del materiales y se coloreó con la técnica de Gram y de Giemsa. Luego de que los pacientes recibieran enseñanza de técnicas de higiene bucal y/o terapia básica periodontal, se volvieron a registrar dichos índices. Resultados: el índice de placa inicial presentó una mediana de 2.5 y post terapia básica, una mediana de 1.0 con una diferencia estadísticamente significativa (p=0.005) según Wilcoxon Signed Rank Test. El indice gingival inicial presentó una mediana de 2.0 y post terapia básica fue de 1.0 con una diferencia estadísticamente significativa (p<0.005 Wilcoxon Signed Test). La profundidad de sondaje pretratamiento presentó una mediana de 3.0mm con sangrado al sondaje positivo y microbiota compatible con gingivitis y periodontitis leve. Luego de enseñanza de técnicas de higiene bucal la misma fue de 1 mm con sangrado al sondaje negativo.