Does mandibular advancement ortho-surgical procedure cause condyle changes? A case-series analysis.

INTRODUCTION: Mandibular advancement surgery corrects bone bases while establishing patients' functional and aesthetic rehabilitation. However, little is known about the results of this procedure in the structures that make up the stomatognathic system, as the condyles. OBJECTIVE: This study aimed to evaluate the structural and positional changes of mandibular condyles in ortho-surgical patients who underwent mandibular advancement surgery. MATERIAL AND METHODS: A prospective investigation was conducted with cone-beam computed tomography images. Using Dolphin Imaging® software, seven ortho-surgical patients with Angle Class II malocclusion and mandibular deficiency were evaluated. The images assessed were obtained at pre-surgical phase and after, at least, 1 year of the procedure. To study the structural and positional changes of condyles, linear and angular measurements were obtained, and the right and left sides of patients were compared. Descriptive statistical analysis was performed and, in order to verify possible significant differences, normality tests (Kolmogorov-Smirnov) were applied, followed by a paired t-test to define significance. RESULTS: For all measures evaluated in this study, no statistically significant differences were found. CONCLUSION: The ortho-surgical procedure performed did not change the structure and position of the condyles of patients who underwent surgical mandibular advancement. Right and left mandibular condyles behaved similarly, suggesting stability and condylar adaptation after surgery.

Tooth movement toward alveolar bone grafting with rhBMP-2 in a child with unilateral cleft lip and palate: Case report with long-term follow-up.

The secondary alveolar bone grafting procedure is typically recommended during the late mixed dentition phase, prior to the eruption of the permanent canine, in patients with cleft lip and palate. The anatomical and functional adaptations observed in the grafted area allow spontaneous migration and eruption of the adjacent maxillary canine. An alveolar bone graft can be performed using autogenous bone or recombinant human bone morphogenetic protein-2 (rhBMP-2). Employing rhBMP-2 in a collagen membrane eliminates the need for a donor site, thus reducing surgical morbidity. This paper aims to present a case involving complete orthodontic rehabilitation with a three-year follow-up of a male patient with a unilateral complete cleft lip and palate, posterior and anterior crossbite, where grafting was performed with rhBMP-2 at a single centre. Orthodontic intervention began at 8 years of age with rapid maxillary expansion, followed by facemask therapy. The alveolar bone grafting procedure was performed using rhBMP-2 in a collagen membrane, according to the surgical protocol developed by the Oslo team. Comprehensive orthodontic treatment started 15 months post bone grafting, during which the maxillary permanent lateral incisor distal to the alveolar cleft was successfully moved mesially into the grafted region. This intervention resulted in adequate occlusal and periodontal outcomes. The alveolar graft with rhBMP-2 produced adequate and stable alveolar bone formation, facilitating tooth eruption, orthodontic movement, and stability at the cleft site.

Successful treatment of dumping syndrome with diazoxide in an infant with hypoplastic left heart syndrome.

Summary: Dumping syndrome is a rare but potentially serious condition that causes inappropriate postprandial hyperinsulinemia leading to hypoglycemia in children following gastrointestinal surgeries. While dietary modifications are often the first line of treatment, severe cases may require pharmacological intervention to prevent severe hypoglycemia. We present a case of successful treatment of dumping syndrome with diazoxide. A 2-month-old infant with left hypoplastic heart syndrome who underwent single ventricle palliation pathway and developed feeding intolerance that required Nissen fundoplication. Postprandial hypoglycemia was detected following the procedure, with glucose level down to 12 mg/dL, and the diagnosis of dumping syndrome was established. The patient was successfully managed with diazoxide, which effectively resolved postprandial hypoglycemia without any major adverse events. The patient was eventfully weaned off the medication at the age of 5 months. This case highlights the potential role of diazoxide in the management of pediatric patients with postprandial hyperinsulinemic hypoglycemia secondary to dumping syndrome. Learning points: Dumping syndrome is a possible complication of gastrointestinal surgeries and should be suspected in children with abnormal glucose levels. Postprandial hyperglycemia should be monitored closely for significant subsequent hypoglycemia. Diazoxide might be considered as part of the treatment plan for dumping syndrome.

Reconsidering the role of nasolabial angle in premolar extraction decision-making: A case-series study.

OBJECTIVES: To evaluate the impact of changes in upper incisor inclination and position on the alteration of the nasolabial angle (NLA) in a series of cases involving the extraction of four first premolars. MATERIALS AND METHODS: The study included 41 patients who underwent orthodontic treatment with premolar extractions. The patients were divided into two groups based on their pretreatment NLA values: Group 1 (NLA ≤ 100°) and Group 2 (NLA > 100°). Measurements of NLA, U1.NA and U1-NA were obtained before and after treatment and U1-Ls pretreatment measure was registered. Statistical analyses were performed to compare the differences in NLA, U1.NA and U1-NA between the two groups and to evaluate the influence of these variables added to U1-Ls (T1) on NLA changes. RESULTS: The results showed that Group 1 exhibited significant changes in NLA, while Group 2 did not. However, both groups showed significant changes in U1.NA and U1-NA. In Group 1, 80% of the individuals presented an increase in NLA and 20% no changes. In Group 2, 10% presented a decrease, 57% no changes and 33% an increase in NLA values. Multiple linear regression analysis indicated that the group factor had a statistically significant influence on NLA variation. Additionally, in Group 2, a negative correlation was observed between changes in U1.NA and NLA. CONCLUSIONS: The findings suggest that individuals with higher pretreatment NLA values tend to maintain their NLA values even after the correction of upper incisor inclination.

Class II subdivision treatment and stability with asymmetric Herbst appliance: A case report.

Non-surgical treatment of Class II subdivision may involve complex mechanics or asymmetric tooth extraction in its resolution. This report demonstrates the result and the short-term stability of Class II subdivision treated with asymmetrically installed Herbst appliance followed by conventional fixed orthodontic appliance. The approach allowed the correction of the unilateral Class II molar relationship and increased overjet, as well as the deviation of dental midlines, with improvement in lip posture and facial profile. The results remained stable two years after treatment, confirming the treatment success.

Malocclusion or laterorhinia: Which one impacts aesthetic facial perception the most?

INTRODUCTION: This study aimed to evaluate the perception of facial attractiveness when nose and teeth, together or isolated, present different degrees of disharmony. The secondary objective was to compare the perception of laypersons with that of dentists. MATERIALS AND METHODS: This cross-sectional observational study included 112 individuals (58 laypersons and 54 dentists) that evaluated 6 manipulated images of the face of the same model, scoring their attractiveness using 10 cm Visual Analogue Scales (VAS), with least and most attractive at the left and right anchors, respectively. The images contained manipulations performed only on the nose (laterorhinia) and mouth (misaligned teeth), as follows: (1) standard photograph, with symmetrical nose + aligned teeth; (2) 2 mm nasal deviation + aligned teeth; (3) 4 mm nasal deviation + aligned teeth; (4) symmetrical nose + misaligned teeth; (5) 2 mm nasal deviation + misaligned teeth and (6) 4 mm nasal deviation + misaligned teeth. We used the repeated measures ANOVA test and Tukey's post-test for intra-group comparison of the images. The independent t-test was used for inter-group comparison of each image. RESULTS: In the laypersons' group, the highest grades were given to images with aligned teeth and the lowest to misaligned teeth (smallest mean difference = 2.88 cm). For this group, there was no statistically significant difference (P-values ranged from .988 to 1.000) between scores of the three images in which teeth were aligned (range of 7.70-7.78 cm). In the group of dentists, highest grades were given to images with aligned teeth and the lowest to misaligned teeth. Difference between images 3 and 4 was not statistically significant (P = .204). All other differences between any image of straight teeth and any image with misaligned teeth were significant and the smallest mean difference between the two groups of images was 1.87 (P = .039). However, in the images with aligned teeth, there was also a statistically significant difference with higher scores to the images with symmetrical nose in contrast with those with significant laterorhinia (mean difference = 1.03 cm). CONCLUSION: Teeth disharmonies had a more negative impact on the aesthetic perception of the face than did nose deviations, for both dentists and laypersons.

Redirection of palatally ectopic maxillary canines: Case report and proposition of an interceptive sequential guideline.

The eruptive deviation of the permanent maxillary canine must be identified early, at the beginning of the second transitional period of the mixed dentition. Acting at this moment is fundamental for its spontaneous redirection and eruption. The aim of the paper is to present a case where the extraction of the deciduous canines was the choice for redirecting the maxillary permanent canines with eruptive palatal deviation, as well as to suggest a sequence of procedures for diagnosis and choice of treatment. The success of deciduous canine extraction in redirecting the ectopic permanent canines is discussed in this case, as well as aspects that might lead to failure. Still, it highlights the importance of computed tomography for choosing conservative treatment or traction, including it in the sequential guideline for acting in these cases.

Does mandibular advancement ortho-surgical procedure cause condyle changes? A case-series analysis

ABSTRACT Introduction: Mandibular advancement surgery corrects bone bases while establishing patients' functional and aesthetic rehabilitation. However, little is known about the results of this procedure in the structures that make up the stomatognathic system, as the condyles. Objective: This study aimed to evaluate the structural and positional changes of mandibular condyles in ortho-surgical patients who underwent mandibular advancement surgery. Material and Methods: A prospective investigation was conducted with cone-beam computed tomography images. Using Dolphin Imaging® software, seven ortho-surgical patients with Angle Class II malocclusion and mandibular deficiency were evaluated. The images assessed were obtained at pre-surgical phase and after, at least, 1 year of the procedure. To study the structural and positional changes of condyles, linear and angular measurements were obtained, and the right and left sides of patients were compared. Descriptive statistical analysis was performed and, in order to verify possible significant differences, normality tests (Kolmogorov-Smirnov) were applied, followed by a paired t-test to define significance. Results: For all measures evaluated in this study, no statistically significant differences were found. Conclusion: The ortho-surgical procedure performed did not change the structure and position of the condyles of patients who underwent surgical mandibular advancement. Right and left mandibular condyles behaved similarly, suggesting stability and condylar adaptation after surgery.

RESUMO Introdução: A cirurgia de avanço mandibular corrige as bases ósseas e estabelece a reabilitação funcional e estética dos pacientes. Entretanto, pouco se sabe sobre os resultados desse procedimento nas estruturas que compõem o sistema estomatognático, como os côndilos. Objetivo: Este estudo teve como objetivo avaliar as alterações estruturais e posicionais dos côndilos mandibulares em pacientes ortodôntico-cirúrgicos submetidos à cirurgia de avanço mandibular. Material e Métodos: Foi realizada investigação prospectiva com imagens de tomografia computadorizada de feixe cônico. Utilizando o software Dolphin Imaging®, foram avaliados sete pacientes ortodôntico-cirúrgicos com má oclusão Classe II de Angle e deficiência mandibular. Foram avaliadas imagens da fase pré-cirúrgica e de, no mínimo, um ano após o procedimento. Para estudar as alterações estruturais e posicionais dos côndilos, foram obtidas medidas lineares e angulares e comparados os lados direito e esquerdo dos pacientes. Foi realizada análise estatística descritiva e, para verificar possíveis diferenças significativas, foram aplicados testes de normalidade (Kolmogorov-Smirnov), seguido de teste t pareado, para definição de significância. Resultados: Para nenhuma das medidas avaliadas nesse estudo foram encontradas diferenças estatisticamente significativas. Conclusão: O procedimento ortodôntico-cirúrgico realizado não alterou a estrutura e a posição dos côndilos dos pacientes submetidos à cirurgia de avanço mandibular. Os côndilos mandibulares direito e esquerdo comportaram-se de forma semelhante, sugerindo estabilidade e adaptação condilar após a cirurgia.

Pain perception and expectation related to interradicular mini-implants insertion: a systematic review and meta-analysis.

OBJECTIVES: The aim of this systematic review was to compare the expectation and perception of pain reported by patients before and after the installation of interradicular mini-implants. MATERIALS AND METHODS: Electronic search was performed in six databases. Inclusion criteria were randomized controlled trials (RCTs) or non-randomized controlled clinical trials (nRCTs); studies using mini-implants in the interradicular region; assessment of pain intensity by visual analogue or numerical scale. The risk of bias assessment was based on the Rob 2 tool and Robins-I. RESULTS: A total of 1566 articles were retrieved, and 21 met the eligibility criteria. Six were classified as high risk, one as critical and the other one as uncertain, according to the Robins-I tool. In articles evaluated by the Rob2 tool, ten were classified as serious risk and three as moderate risk. A meta-analysis was also performed. Weighted means were calculated among the studies using the random-effects model and forest plots were generated. Heterogeneity was assessed through the Q test and I2 statistics. It was observed, with moderate evidence, that on a scale of 0 to 10, the pain expectation (effect size 4.75) is higher than that effectively pain generated by the procedure (effect size 1.94). CONCLUSION: Pain expectation was greater than that actually generated by the procedure, being almost non-existent 7 days postoperatively. CLINICAL RELEVANCE: This study may help the clinician to reassure the patient regarding the sensations that could be experienced during and after the installation.

Pharyngeal airway subdivisions in 3-dimensional analysis: Differences between anterior and posterior anatomic boundaries.

INTRODUCTION: This study aimed to evaluate if there were differences between anterior and posterior anatomic boundaries used for the 3-dimensional determination of pharyngeal airway. METHODS: The sample included 150 cone-beam computed tomography scans from healthy patients divided according to (1) age: 6-11, 12-16, and ≥16 years; (2) sex: female and male; (3) anteroposterior skeletal pattern: Class I, II, and III; (4) vertical pattern: brachyfacial, mesofacial, and dolichofacial; and (5) craniocervical inclination (CCI): natural head posture, head flexion, and head extension. Anatomic regions were created to determine the correspondences between structures anteriorly and posteriorly to the pharyngeal airway. RESULTS: The location of the epiglottis, vallecula, hyoid, C2, and C3 were statistically different according to the CCI, and the location of vallecula, C3, and C4 were different according to sex. However, no statistically significant differences were observed between the frequencies of anterior and posterior anatomic region locations among age and different anteroposterior and vertical skeletal patterns. Posterior landmarks tend to be located below the anterior ones; consequently, the anatomic subregion they define will also be located below. CONCLUSIONS: Anterior and posterior structures and vertical and anteroposterior skeletal patterns may determine upper airway limits regardless of age. However, the studies must be paired according to sex, and CCI must be standardized.

Odontologia UFES em 10 anos perfil profissional e sociodemográfico dos egressos / Odontología UFES en 10 años: perfil profesional y sociodemográfico de los egresados / Dentistry UFES in 10 years: professional and sociodemographic profile of graduates

Desde a sua regulamentação profissional, a Odontologia passou por muitas mudanças até sua consolidação. O aumento indiscriminado e sem planejamento da oferta de cursos de Odontologia resultou em um crescimento exagerado do número de profissionais no mercado de trabalho, culminando no atual momento de saturação e de acelerada reorganização do curso. Tais mudanças não se limitaram ao desenvolvimento tecnológico e científico. Observou-se, também, alteração no perfil do estudante e do profissional de odontologia no decorrer deste percurso, portanto essa pesquisa tem o objetivo de conhecer o perfil da força de trabalho dos profissionais graduados e verificar a inserção regional do Curso de Odontologia da Universidade Federal do Espírito Santo (UFES). Este estudo quantitativo de natureza descritiva e exploratória analisou o perfil profissional e sociodemográfico de 533 egressos do Curso de Odontologia da UFES entre 2008 e 2018, a partir do banco de dados do Conselho Regional de Odontologia do Espírito Santo e do DATASUS. Como resultados observou-se uma maioria feminina (70%), comidade entre 25-40 anos, ativos na Odontologia (85,1%), atuando no estado no setor privado. A maioria é formada por clínicos gerais (65,2%), mas existe uma tendência à especialidade que, quando presente, concentra-se na Ortodontia, Endodontia, Prótese e Implantodontia. Os resultados confirmaram a importante inserção regional do Curso de Odontologia da UFES no desenvolvimento local. Entretanto, apesar das Diretrizes Curriculares Nacionais direcionarem para um perfil generalista, voltado para a coletividade, constata-se maior tendência ao mercado privado, possivelmente pelos honorários mais atrativos (AU).

Desde su regulación profesional, la Odontología ha sufrido muchos cambios hasta su consolidación. El aumento indiscriminado y no planificado de la oferta de carreras de Odontología resultó en un crecimiento exagerado del número de profesionales en el mercado de trabajo, culminando en el momento actual de saturación y reorganización acelerada de la carrera. Tales cambios no se limitaron al desarrollo tecnológico y científico. También se observó un cambio en el perfil del estudiante y del profesional de odontología durante este curso, por lo que esta investigación tiene como objetivo conocer el perfil de la fuerza de trabajo de los profesionales graduados y verificar la inserción regional del Curso de Odontología en la Universidad Federal de Espírito Santo (UFES). Este estudio cuantitativo, descriptivo y exploratorio analizó el perfil profesional y sociodemográfico de 533 egresados de la Carrera de Odontología de la UFES entre 2008 y 2018, a partir de la base de datos del Consejo Regional de Odontología de Espírito Santo y DATASUS. Como resultado, hubo una mayoría femenina (70%), con edad entre 25-40 años, activa en Odontología (85,1%), trabajando en el estado en el sector privado. La mayoría está formada por médicos generales (65,2%), pero existe una tendencia a la especialización que, cuando está presente, se centra en Ortodoncia, Endodoncia, Prótesis e Implantología. Los resultados confirmaron la importante inserción regional de la Carrera de Odontología de la UFES en el desarrollo local. Sin embargo, a pesar de que los Lineamientos Curriculares Nacionales apuntan hacia un perfil generalista, dirigido a la comunidad, existe una mayor tendencia hacia el mercado privado, posiblemente por las tarifas más atractivas (AU).

Since its professional regulation, Dentistry has undergone many changes until its consolidation. The indiscriminate and unplanned increase in the offer of Dentistry courses led to a marked growth in the number of professionals in the job market, culminating in the current moment of saturation and accelerated reorganization of the course. Such changes were not limited to technological and scientific development; changes were also observed in the profile of students and dental professionals during this course. Thus, this study investigated the profile of the workforce of graduated professionals and verified the regional insertion of the Dentistry Course at the Federal University of Espírito Santo (UFES). This quantitative, descriptive and exploratory study analyzed the professional and sociodemographic profile of 533 graduates of the Dentistry Course at UFES between 2008 and 2018, based on the database of the Regional Dental Council of Espírito Santo and DATASUS. As a result, there was majority of females (70%), aged between 25-40 years, active in Dentistry (85.1%), working in the state in the private sector. The majority is formed by general practitioners (65.2%), but there is a tendency to specialize which, when present, focuses on Orthodontics, Endodontics, Prosthodontics and Implantology. The results confirmed the important regional insertion of the UFESDentistry Course in local development. However, despite the National Curriculum Guidelines directing towards a generalist profile, aimed at the community, there is a greater tendency towards the private market, possibly due to the more attractive incomes (AU).

Evaluation of circular business model: Theory of Change approach.

The transition from linear to circular business models, in which companies match the financial return with positive socio-environmental impact, is increasing. From this perspective, investing in projects or organizations aligned with the principles of circularity can be characterized as impact investments. However, a challenge that emerges for these investments that is gaining increasing prominence in the academic and corporate environment is related to the development of an efficient evaluation model concerning its real impact on business. Based on the Theory of Change and in the context of circular business models, this paper aims at proposing an integrative tool to evaluate impact investments and applying it to a circular business of the home appliance segment. The articulation between the ToC and circular business models can support the structuring of an evaluation model on the production logic of the desired (economic, environmental, and social) impact. Results present that an integrative tool can provide a way for companies, institutions and investors to compare the impact investment opportunities related to Circular Business Model.

Influence of clinical and demographic factors on the oral health-related quality of life of patients with cleft lip and palate undergoing orthodontic treatment: a systematic review and meta-analysis.

OBJECTIVE: The purpose of this study was to evaluate the influence of orthodontic treatment on the oral health-related quality of life (OHRQoL) of patients with cleft lip and palate. SEARCH METHODS: Electronic searches were conducted in Pubmed, Scopus, Web of Science, Cochrane Library, VHL, and OpenGrey databases, completed in January 2021. SELECTION CRITERIA: Cross-sectional and longitudinal observational studies that presented an assessment of OHRQoL in cleft patients undergoing orthodontic treatment were included, according to PRISMA guidelines. Contacts via email were made with authors, to clarify inaccuracies or request additional data. DATA COLLECTION AND ANALYSIS: The entire process was accomplished by two authors, in case of disagreement, a third author mediated the discussion until there was a consensus. Risk assessment was performed by the Fowkes and Fulton qualifier, and the quality of evidence, assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. A meta-analysis was performed considering the domains combined into three large groups (physical, psychological, and social). The questionnaires were standardized as to the scores and their direction. RESULTS: A total of 3822 studies were retrieved. After excluding duplicates, the titles and abstracts of the remaining articles were analysed. Twenty-eight articles were read in full; 13 met the eligibility criteria; 12 articles showed sufficient methodological quality and 7 were included in the quantitative assessment. The included studies were published between 2011 and 2019. The samples comprised 19 to 183 patients of both sexes. GRADE showed low evidence when compared to the control group, sexes, age, and types of cleft and very low evidence among longitudinal articles. CONCLUSIONS: The OHRQoL is lower in orthodontic patients with cleft than in those without. The OHRQoL of patients with cleft undergoing orthodontic treatment is not influenced by gender or age group, considering children and adolescents, but it is influenced by the type of cleft. The OHRQoL of patients with CLP does not undergo significant changes during orthodontic treatment. LIMITATIONS: The variety of instruments for measuring OHRQoL rendered meta-analysis difficult. REGISTRATION: PROSPERO database number CRD42017054764.

Therapeutic effects of botulinum toxin type A in subjects with gummy smile: A longitudinal sEMG approach.

OBJECTIVE: To evaluate the response of the myoelectric activity of levator labii superioris (LLS), levator labii superioris alaeque nasi (LLSAN), and minor zygomatic (Zm) muscles in individuals with gummy smile, volunteers to botulinum toxin type A (BTX-A) application, with a follow-up of 6 months. MATERIALS AND METHODS: Thirteen individuals were submitted to clinical evaluation and photographic records to monitor the variations of the gingival display (GD) during posed smile. The recording of the surface electromyography (sEMG) signal of muscles studied was performed in three tasks: posed smile (PS), upper lip elevation (ULE) and nose wing elevation (NWE). The root-mean-square value, an amplitude sEMG signal parameter, was extracted from the sEMG signals. One and three-way ANOVA were applied, and the level of significance set at 5%. RESULTS: There were significant differences (P<0.05) in the sEMG signal activity from the control condition (before BTX-A application - T0) to the 8th week of follow up, which was accompanied by clinical evaluation for the gingival display (P<0.05). The peak of the reduction in sEMG signals occurred 2 weeks after T0 for all the studied tasks, with the exception of the left hemiface in the PS, which showed a peak of reduction 4 weeks after T0. CONCLUSIONS: BTX-A led to a decrease in the sEMG signal amplitude over 2 to 4 weeks after application in the muscles, although differently concerning each hemiface when recruited to perform other mouth tasks. During the PS, the recruitment level of the upper lip elevator muscles was compatible with the clinical response obtained in the follow-up period in this study, which corroborates the sEMG assessment to clinical data.

Clinical predictors of laryngotracheoesophageal clefts and tracheoesophageal fistulae in children with dysphagia.

Laryngotracheoesophageal clefts (LTECs) and tracheoesophageal fistulae (TEF) are important structural causes of aspiration requiring bronchoscopy for diagnosis. Determining which children are at greatest risk for LTEC and TEF would enable clinicians to be more selective in performing bronchoscopy. METHODS: Medical records of children aged 0-18 years who underwent flexible and rigid bronchoscopy for evaluation of dysphagia with aspiration were collected and analyzed to identify predictors of LTEC and TEF. RESULTS: Seventy-two children age 2 months to 9 years were identified. LTEC was identified in 19 (26%) and TEF was identified in 1 (1.3%). One-third of the cohort was born preterm (median gestational age 34 weeks). The proportion of LTEC in those born preterm was lower than that of those born full-term (12% vs. 34%, p = .03). There was no statistically significant difference in LTEC prevalence based on age, midline defects, laryngomalacia, tracheomalacia, history of TEF repair, silent aspiration, or viscosity of barium aspirated during videofluoroscopic swallowing studies. Bronchoalveolar lavage fluid cytology, lipid-laden macrophage proportions, and culture results were similar among those with and without LTEC. CONCLUSION: Children with dysphagia and tracheal aspiration born full-term are three times more likely to have LTEC than those born preterm. Dysphagia in children with a history of preterm birth is more likely to be functional as opposed to structural, however, LTEC was identified in approximately 10% of these children and must be considered. These results support the role of bronchoscopy in children with dysphagia with tracheal aspiration.

Tomographic analysis of midpalatal suture prior to rapid maxillary expansion.

INTRODUCTION: In Orthodontics and Facial Orthopedics, the timing of treatment onset may be critical and individual analysis should be applied to promote a favorable treatment planning. In this study, individual analysis of midpalatal suture (MS) and palatal measurements were performed in teenagers and young adult patients treated with rapid maxillary expansion (RME). DESCRIPTION: Twenty-six patients submitted to RME with a tooth-supported appliance (Hyrax) were evaluated. The inclusion criteria were: minimum age of 14 years, presenting all posterior teeth, diagnosed with transverse maxillary discrepancy, and with a clinical indication for maxillary expansion. The pretreatment CBCT scans of these patients were assessed to obtain the stages of MS maturation (MSM); density ratio (MSD); and palatal length, thickness (anterior, intermediate and posterior) and sagittal area. RESULTS: The maturation stages present were C, D or E; the density ranged from 0.6 to 1, and lower density (MSD < 0.75) and higher density (MSD ≥ 0.75) groups were determined. Individuals with higher MSD presented smaller sagittal area, compared to the lower density group. Individuals in D and E MSM stages presented smaller sagittal area and intermediate thickness, compared to stage C. CONCLUSIONS: Smaller palatal sagittal area was observed in the high MSD groups and in the stages D and E of MSM.

Chromatic analysis of orthodontic resin bonding agents exposed to different antiseptic mouthrinses.

OBJECTIVE: To assess the color of different orthodontic resin bonding agents exposed to three antiseptic mouthrinses for a prolonged time interval (10-year aging simulation). METHODS: 160 specimens were distributed into four groups, according to the orthodontic resin bond agent (Concise, Transbond XT, Transbond Plus Color Change, and Natural Ortho). Each group was exposed to different antiseptic mouthrinses: alcohol-based (Listerine®), alcohol-free (Oral-B®), chlorhexidine (Periogard®) and distilled water as the control. Specimens were submitted to two cycles of staining and artificial aging. Color was evaluated by means of a digital spectrophotometer at the beginning of the experiment and after every cycle. The system used to assess color changes was the CIE L*a*b*. Data was analyzed using the ANOVA and Tukey post-hoc test. RESULTS: After simulation of 10 years of aging, Transbond XT and Natural Ortho composites presented no statistically significant differences in ∆E when exposed to different mouthrinses. The Concise composite specimens exposed to alcohol-free mouthrinse presented a significant difference when compared with specimens from the same group exposed to other antiseptic mouthrinses. Transbond Plus Color Change specimens exposed to chlorhexidine mouthrinse and to alcohol-containing mouthrinse presented a significant difference when compared with the specimens from the group exposed to water and alcohol-free antiseptic. CONCLUSION: All orthodontic resin bonding agents tested presented clinically perceptible color changes when exposed to at least one of the mouthrinses, except for the Natural Ortho composite. The Concise composite exposed to the alcohol-free solution was the resin that presented the highest color change values.

Hyperextension of the head versus cervical vertebrae morphology in mouth and nasal breathers: a preliminary study

Objective: This study aimed to compare through cone-beam computed tomography (CBCT) the morphology of the cervical vertebrae atlas (C1) and axis (C2) in mouth breathers (MB) and nose breathers (NB), correlating them with the head and neck postures of the two groups. Materials and Methods: CBCT images of 36 subjects aged 11 to 22 years were evaluated using the InVivo Dental 5.1 (Anatomage, San Jose, California) software. The following measurements were used to assess C1 and C2 morphology: posterior height, anterior height, length, and volume. The craniocervical angle (NSL/OPT) was used to evaluate head posture concerning the neck. Results: The posterior height, length, and volume of C1 and C2 were lower in the MB group, but only the posterior size was significantly shorter than the NB group (C1, p=0.01 / C2, =0.05). Mouth breathers also showed a considerably higher craniocervical angle (p=0.04). Spearman test showed a significant positive correlation between C1 and C2 length and craniocervical angle (C1, =0.629, p=0.005 / C2, =0.665, p=0.003). Conclusion: The mouth breathers showed an increased craniocervical angle and decreased posterior height of the C1 vertebra concerning nasal breathers. The hyperextension of the head present is positively correlated with the length of the vertebra.

Objetivo: Este estudo teve como objetivo comparar por meio da tomografia computadorizada de feixe cônico (TCFC) a morfologia do atlas das vértebras cervicais (C1) e do eixo (C2) em respiradores orais (MB) e nasais (RN), correlacionando-os com a cabeça e posturas do pescoço dos dois grupos. Materiais e Métodos: Imagens de CBCT de 36 indivíduos com idades entre 11 e 22 anos foram avaliadas usando o software InVivo Dental 5.1 (Anatomage, San Jose, Califórnia). As seguintes medidas foram usadas para avaliar a morfologia de C1 e C2: altura posterior, altura anterior, comprimento e volume. O ângulo craniocervical (NSL/OPT) foi utilizado para avaliar a postura da cabeça em relação ao pescoço. Resultados: A altura posterior, comprimento e volume de C1 e C2 foram menores no grupo MB, mas apenas o tamanho posterior foi significativamente menor que o grupo RN (C1, p=0,01 / C2, =0,05). Os respiradores orais também apresentaram um ângulo craniocervical consideravelmente maior (p=0,04). O teste de Spearman mostrou correlação positiva significativa entre comprimento de C1 e C2 e ângulo craniocervical (C1, =0,629, p=0,005 / C2, =0,665, p=0,003). Conclusão: Os respiradores orais apresentaram aumento do ângulo craniocervical e diminuição da altura posterior da vértebra C1 em relação aos respiradores nasais. A hiperextensão da cabeça presente está positivamente correlacionada com o comprimento da vértebra.