Life cycle phases: Literature review and new classification proposal for application in healthcare.

INTRODUCTION: Although uncommon in dentistry, the concept of the life cycle holds great importance for dental professionals in identifying crucial intervention opportunities and determining the optimal timing for treatments and procedures. OBJECTIVE: To carry out a review of the literature on life cycle classifications and their distinct phases, evaluating their applicability in healthcare. METHODS: A literature review was performed, searching for articles in PubMed, SciELO, National Health Library (BvB), and Google Scholar databases, as well as relevant books. The keywords "life cycle," "life stages," "human development," "age groups," and "biological age" were used. Relevant articles were selected by analyzing their titles and abstracts, and read in full to confirm their inclusion in the research. RESULTS: Nine distinct life cycle classifications were found, each with unique criteria. CONCLUSION: Based on the comprehensive literature review, a novel classification was proposed (The 10-phase Life Cycle), which encompasses dental, growth, physiological aging, sociocultural, and behavioral characteristics, aiming to enhance communication among healthcare professionals, particularly those engaged in the growth, development, and aging processes of human beings.

Life cycle phases: Literature review and new classification proposal for application in healthcare

ABSTRACT Introduction: Although uncommon in dentistry, the concept of the life cycle holds great importance for dental professionals in identifying crucial intervention opportunities and determining the optimal timing for treatments and procedures. Objective: To carry out a review of the literature on life cycle classifications and their distinct phases, evaluating their applicability in healthcare. Methods: A literature review was performed, searching for articles in PubMed, SciELO, National Health Library (BvB), and Google Scholar databases, as well as relevant books. The keywords "life cycle," "life stages," "human development," "age groups," and "biological age" were used. Relevant articles were selected by analyzing their titles and abstracts, and read in full to confirm their inclusion in the research. Results: Nine distinct life cycle classifications were found, each with unique criteria. Conclusion: Based on the comprehensive literature review, a novel classification was proposed (The 10-phase Life Cycle), which encompasses dental, growth, physiological aging, sociocultural, and behavioral characteristics, aiming to enhance communication among healthcare professionals, particularly those engaged in the growth, development, and aging processes of human beings.

RESUMO Introdução: Embora incomum na Odontologia, o conceito de ciclo vital é de grande importância para ajudar os profissionais dessa área a identificar oportunidades cruciais para intervenções e para determinar o momento ideal para tratamentos e procedimentos. Objetivo: Realizar uma revisão da literatura sobre as classificações do ciclo vital e suas distintas fases, avaliando sua aplicabilidade na área da saúde. Métodos: Foi realizada uma revisão da literatura, buscando artigos nas bases de dados PubMed, SciELO, Biblioteca Nacional de Saúde (BvB) e Google Acadêmico; além de livros relevantes. Foram utilizadas as palavras-chave "ciclo vital", "estágios de vida", "desenvolvimento humano", "faixas etárias" e "idade biológica". Os artigos relevantes foram selecionados por meio da análise de seus títulos e resumos e lidos na íntegra para confirmar sua inclusão na pesquisa. Resultados: Nove classificações distintas de ciclo vital foram encontradas, cada uma com critérios únicos. Conclusão: Com base nessa revisão abrangente da literatura, é proposta uma nova classificação (o ciclo vital de 10 fases) que engloba características dentárias, de crescimento, envelhecimento fisiológico, socioculturais e comportamentais, com o objetivo de melhorar a comunicação entre os profissionais da área de saúde, particularmente aqueles envolvidos nos processos de crescimento, desenvolvimento e envelhecimento do ser humano.

External apical root resorption after orthodontic treatment: analysis in different chronological periods.

INTRODUCTION: External apical root resorption (EARR) is characterized by the definitive loss of tooth root structure, with a higher incidence in lateral and central maxillary incisors. OBJECTIVE: To identify, in different chronological periods, the incidence of EARR in the maxillary incisors (MI) of patients orthodontically treated with or without premolars extraction. METHODS: Periapical radiographs before and after orthodontic treatment of 1,304 MIs from 326 patients (205 women and 121 men) were evaluated for EARR, divided into five groups, according to the chronological period in which treatments were started: G90) from 1990 to 1994, G95) from 1995 to 1999, G00) from 2000 to 2004, G05) from 2005 to 2009, G10) from 2010 to 2015. The evaluation was performed in each group, in patients who underwent maxillary first premolars extraction and those who did not. For statistical analysis, Fisher's exact test was used, with a significance level of p < 0.05. The EARR was measured using the adapted Levander and Malmgren classification. RESULTS: Incidence of EARR was higher in MIs of patients treated with maxillary premolar extraction (p < 0.05) in two chronological periods (G00 and G10), also being influenced by orthodontic treatments with longer duration, and due to possible individual genetic factors. CONCLUSION: Even with the limitations of a retrospective study, the lack of a defined EARR pattern in the MIs at different chronological periods was larger in the experimental group, due to the sum of factors such as premolars extraction, prolonged orthodontic treatment, possible genetic characteristics, and root shape, without the influence of the sex and age.

External apical root resorption after orthodontic treatment: analysis in different chronological periods

ABSTRACT Introduction: External apical root resorption (EARR) is characterized by the definitive loss of tooth root structure, with a higher incidence in lateral and central maxillary incisors. Objective: To identify, in different chronological periods, the incidence of EARR in the maxillary incisors (MI) of patients orthodontically treated with or without premolars extraction. Methods: Periapical radiographs before and after orthodontic treatment of 1,304 MIs from 326 patients (205 women and 121 men) were evaluated for EARR, divided into five groups, according to the chronological period in which treatments were started: G90) from 1990 to 1994, G95) from 1995 to 1999, G00) from 2000 to 2004, G05) from 2005 to 2009, G10) from 2010 to 2015. The evaluation was performed in each group, in patients who underwent maxillary first premolars extraction and those who did not. For statistical analysis, Fisher's exact test was used, with a significance level of p < 0.05. The EARR was measured using the adapted Levander and Malmgren classification. Results: Incidence of EARR was higher in MIs of patients treated with maxillary premolar extraction (p < 0.05) in two chronological periods (G00 and G10), also being influenced by orthodontic treatments with longer duration, and due to possible individual genetic factors. Conclusion: Even with the limitations of a retrospective study, the lack of a defined EARR pattern in the MIs at different chronological periods was larger in the experimental group, due to the sum of factors such as premolars extraction, prolonged orthodontic treatment, possible genetic characteristics, and root shape, without the influence of the sex and age.

RESUMO Introdução: A reabsorção radicular apical externa (RRAE) é caracterizada pela perda definitiva da estrutura dentária na região radicular, com maior incidência em incisivos centrais e laterais superiores. Objetivo: Identificar, em diferentes períodos cronológicos, a incidência de RRAE em incisivos superiores (IS) de pacientes tratados ortodonticamente com e sem extração de pré-molares. Métodos: Por meio de radiografias periapicais antes e após o tratamento ortodôntico, 1.304 IS de 326 pacientes (205 mulheres e 121 homens) foram avaliados quanto à RRAE, divididos em cinco grupos, de acordo com o período cronológico em que os tratamentos foram iniciados: G90) de 1990 a 1994; G95) de 1995 a 1999; G00) de 2000 a 2004; G05) de 2005 a 2009; e G10) de 2010 a 2015. Em cada grupo, foi realizada avaliação nos pacientes submetidos à extração dos primeiros pré-molares superiores e nos que não foram. Para análise estatística, foi utilizado o teste exato de Fisher, com p< 0,05; a RRAE foi mensurada por meio da classificação de Levander e Malmgren modificada. Resultados: A incidência da RRAE foi maior em IS de pacientes tratados com extrações de pré-molares (p< 0,05) em dois períodos cronológicos (G00 e G10), além de ter sido influenciada por tratamentos ortodônticos de maior duração e por possíveis fatores genéticos individuais. Conclusão: Mesmo com as limitações de um estudo retrospectivo, a ausência de um padrão definido de RRAE nos IS nos diferentes períodos cronológicos foi maior no grupo experimental, devido à soma de fatores, como extração de pré-molares, tratamento ortodôntico prolongado, possíveis características genéticas e morfologia radicular, sem influência do sexo e da idade.

Como realizar a análise tridimensional das vias aéreas superiores em pacientes ortodônticos? / How to perform a three-dimensional analysis of the upper airways in orthodontic patients?

Resumo As vias aéreas superiores (VAS) são influenciadas pelo crescimento e desenvolvimento do complexo craniofacial e posição espacial dos ossos maxilares durante o tratamento ortodôntico pode estreitar ou aumentar a dimensão dos espaços faríngeos. A análise tridimensional do volume e área axial mínima dos respectivos sub-espaços é benéfica para o planejamento do caso, pois permite identificar possíveis barreiras físicas que comprometem a passagem de ar e o fluxo respiratório, além de ser um método auxiliar de diagnóstico para desordens relacionadas a essa função. A solicitação de tomografias computadorizadas de feixe cônico (TCFC) é necessária para a correta avaliação digital, com os devidos protocolos de aquisição e reconstrução dos exames de imagem, calibração da metodologia e padronização de análise das mesmas. O objetivo deste trabalho é desmitificar o passo a passo específico dessa análise no software Dolphin Imaging® e descrever os fatores técnicos e anatômicos para delimitação dos espaços correspondentes às VAS. Para ilustrar o protocolo foram utilizadas TCFC de paciente com má oclusão de Angle Classe II, 1a divisão antes da instalação (T1) de propulsor mandibular (aparelho fixo cimentado de Herbst com ancoragem dentária) e após 12 meses de tratamento (T2). A partir da mensuração dos espaços correspondentes às VAS, comparando os dois tempos de tratamento, foi possível analisar as alterações do espaço faríngeo após o uso de propulsor mandibular e evidenciar a importância da avaliação tridimensional da dimensão aérea para um planejamento ortodôntico individualizado. (AU)

Abstract The upper airways (UA) are influenced by the growth and development of the craniofacial complex and any alteration in the maxillary bones during orthodontic treatment can narrow or increase the size of the pharyngeal spaces. The three-dimensional analysis of the volume and the minimum axial area of the respective sub-spaces is beneficial for case planning as it allows the identification of possible physical barriers that compromise the air passage and the respiratory flow, besides being an auxiliary diagnostic method for disorders related to this function. The request for cone-beam computed tomography (CBCT) is necessary for the correct digital evaluation with the appropriate protocols for the acquisition and reconstruction of the image exams, calibration of the methodology, and standardization of their analysis. The objective of this work is to demystify the specific step-by-step analysis in the Dolphin Imaging® software and to describe the technical and anatomical factors for delimiting the spaces corresponding to the UA. To illustrate this protocol, CBCT of a patient with Angle Class II malocclusion, first division were analyzed before the installation (T1) of a mandibular thruster (fixed cemented Herbst appliance with dental anchorage) and after 12 months of treatment (T2). From the measurement of the spaces corresponding to VAS, comparing the two treatment times, it was possible to analyze the changes in the pharyngeal space after the use of mandibular thruster and to highlight the importance of the three-dimensional assessment of the air dimension for individualized orthodontic planning. (AU)