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.

Orthodontic Wires: A 12-Year Bibliometric Study.

Aims and Objectives: To perform a bibliometric study to identify and evaluate articles associated with "orthodontic wires" indexed in six databases (PubMed, Embase, Cochrane, Scopus, Lilacs, and Google Scholar) from 2010 to 2022. Materials and Methods: The search strategy in PubMed combined different medical subject heading terms with free-text words and was adjusted for each selected database. The retrieved documents were original English articles containing the keywords used in the search strategies related to orthodontic wires. Collected data consisted of journal name, nationality, field, JIF-2 and JIF-5, SJR, CiteScore, Q and H-index, and categorization of the study. Results: In total, 417 articles were retrieved from the initial search. After the exclusion criteria, 257 articles remained. The most common theme was mechanical properties, with basic studies as the main categorization. Conclusions: This bibliometric survey provides an overview of orthodontic wires publications that might help orthodontists to understand the tendency of the studies on this subject. The retrieved papers were published in 100 journals, including 15 orthodontic journals, mainly in the first and second quartiles. Europe and America were the continents with the highest number of papers. The United States was the country with the highest number of journals on the topic. AJODO presented the highest h-index among the retrieved orthodontic journals. Brazil represented the principal institutions of origin of the listed articles. There was a tendency to increase the number of publications on orthodontic wires over the years. These findings indicate that research on orthodontic wires is still contemporary and relevant.

Oral Health Impact Profile (OHIP)-14 telephone interview reliability to assess oral health-related quality of life (OHRQoL) in orthosurgical patients.

BACKGROUND: The influence of the Oral Health Impact Profile (OHIP)-14 administration method through telephone or face-to-face interviews in orthosurgical patients is unknown. The study aims to assess the reliability of the OHIP-14 questionnaire through its stability and internal consistency when applied through a telephone interview compared with a face-to-face interview. METHODS: A total of 21 orthosurgical patients were selected to compare the scores obtained in OHIP-14. The interview was carried out by telephone, and 2 weeks later, the patient was invited to attend a face-to-face interview. Stability was verified by Cohen's kappa coefficient with quadratic weighting for individual items and intraclass correlation coefficient for the total OHIP-14 score. Internal consistency was assessed by Cronbach's alpha coefficient for the total scale and its seven subscales. RESULTS: Items 5 and 6 showed reasonable agreement in the two modes of administration; 4 and 14 moderate; 1, 3, 7, 9, 11, and 13 substantial; and items 2, 8, 10, and 12 showed almost perfect agreement, according to the Cohen's kappa coefficient test. The instrument's internal consistency was better in the face-to-face interview (0.89) than it was in the telephone interview (0.85). For the evaluation of the seven OHIP-14 subscales, differences were found in functional limitations, psychological discomfort, and social disadvantage subscales. CONCLUSIONS: Although there were some differences in OHIP-14 subscales between the interview methods, the total score of the questionnaire showed good stability and internal consistency. The telephone method can be a reliable alternative for the application of the OHIP-14 questionnaire in orthosurgical patients.

Cartesian three-dimensional method to quantify displacements between cone beam computed tomography models.

INTRODUCTION: Research in Orthodontics and Oral Surgery has been relying on three-dimensional (3D) models to evaluate treatment results with displacement color map techniques, even though it has important limitations. OBJECTIVES: This study proposed a method of tracking translational movements of 3D objects to evaluate displacements in surfaces with no shape modification. METHODS: Cone Beam Computed Tomography (CBCT) data of ten patients were imported to the Dolphin software. A hypothetical virtual surgical plan (randomly defined) was developed in the software and afterwards verified using the proposed method. All the procedures were carried out by two evaluators, in two different time-points, with a 15-day interval. ITK-Snap software was used to generate high quality STL models. Centroid points were automatically generated and their coordinates were compared to confirm if they represented the known displacements simulated. The paired t-test and the Bland-Altman plots were used, as well as the intraclass correlation coefficient. RESULTS: Interexaminers and intra-examiner tests showed excellent reliability of the method, with mean displacement measurement error values under 0.1mm. The paired t-test did not show any statistically significant differences. CONCLUSION: The method showed excellent reliability to track the simulated translational displacements of bone segments.

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.

Tratamento compensatório da má oclusão de Classe III assimétrica com arcos multiloop: estabilidade após 10 anos de tratamento / Compensatory treatment of asymmetric Class III occlusion with multiloop archwires: stability after 10 years of treatment

Resumo Este relato de caso clínico apresenta o tratamento não cirúrgico de uma paciente de 17 anos e 4 meses de idade, com má oclusão de Classe III, subdivisão direita, assimetria facial, desvio do mento para a direita, perfil reto, mordida anterior de topo, com prognatismo mandibular e mordida cruzada posterior unilateral. Foi realizado um tratamento compensatório com arcos multiloop para nivelamento lateral e sagital do plano oclusal, uma vez que o tratamento ortodôntico-cirúrgico não foi aceito pela paciente devido aos custos e riscos envolvidos. Adequados trespasses vertical e horizontal foram alcançados, além da relação de Classe I, com uma melhora aceitável da assimetria facial que permaneceu estável após 10 anos do tratamento ortodôntico (AU)

Abstract This clinical case report presents the non-surgical treatment of a 17 years and 4 months old female patient, with right subdivision, Class III malocclusion, facial asymmetry, chin deviation to the right, straight profile, top anterior bite, with mandibular prognathism, and unilateral posterior crossbite. A compensatory treatment was performed with multiloop archwires for lateral and sagittal leveling of the occlusal plane, since the orthodontic-surgical treatment was not accepted by the patient due to the cost and risks involved. Adequate overjet and overjet were achieved, in addition to a Class I relationship, with an acceptable improvement in facial asymmetry that remained stable after 10 years of orthodontic treatment. (AU)

External root resorption evaluated by CBCT 3D models superimposition.

INTRODUCTION: The literature reports the association of external root resorption (ERR) with orthodontic movement. In cases of premolars extractions, orthodontic movement of anterior teeth is usually quite expressive, which are precisely the most susceptible teeth to suffer from ERR. OBJECTIVE: The aim of this study was to assess the root morphology of maxillary canines and incisors in patients submitted to four premolar extraction and orthodontic retraction of the anterior teeth, by means of 3D surface models superimposition and mapping. METHODS: The sample consisted of six adult patients, five female and one male, with a mean age of 23.5 ± 6.5 years, who underwent orthodontic treatment. All patients presented bimaxillary dental protrusion, with indication of maxillary and mandibular first premolar extractions, followed by the retraction of anterior teeth and space closure. Cone beam CT scans were performed before the beginning of the treatment (T0) and right after space closure (T1). 3D models were built at both times and superimposed to identify the root changes for the given period. RESULTS: All average differences were close to zero and, even when evaluating the extreme values, the observed changes were always smaller than the accuracy of the CBCT. CONCLUSION: A mild resorption trend was observed, although it was not clinically significant, with values lower than the tomography accuracy.

Correlation between cervical vertebrae maturation and midpalatal suture fusion in patients aged between 10 and 20 years: A cross-sectional and 3D study.

OBJECTIVE: This study aimed to correlate the cervical vertebrae maturation (CVM) stages with the bone fusion stages of the midpalatal suture (MPS). MATERIALS AND METHODS: The sample consisted of 351 cone-beam computed tomographies (CBCTs) of patients divided into two groups: 10-15 years old and 16-20 years old. Both CVM and MPS stages were correlated using Spearman's correlation analysis. To assess the diagnostic performance of the CVM stages in identifying the bone fusion stages of the MPS, the likelihood ratio (LHR) test was applied. RESULTS: In the whole sample, a low positive correlation was found between CVM and MPS bone fusion level (P<0.001; Rho=0.395). In the younger age group, the correlation was moderate in the male (P<0.001; Rho=0.616) and low in the female (P<0.001; Rho=0.394) patients. In the 16-20 years age group, there was no correlation between CVM and MPS fusion. A moderate increase in the probability of determining CS1 for stage A (38%) and CS2 for stage B (42.2%) of MPS ossification was found among the 10-15 year old female patients. CONCLUSION: A low and moderate positive correlation was found between CVM and MPS level of bone fusion in female and male patients respectively, but the diagnostic performance of the CVM stages in the identification of MPS bone fusion stages did not have a high correlation. Therefore, the CVM stages indicated no conclusive probability of determining the MPS bone fusion stage.

Do low-cost 3-dimensional printers produce suitable dental models?

INTRODUCTION: When choosing a 3-dimensional printer for dental models, the cost-benefit ratio should be evaluated. The purpose of this study was to evaluate the accuracy, precision, cost, and time taken to prepare and print using different low-cost techniques (2 digital light processing [DLP] and 1 fused filament fabrication [FFF] printer) compared with the reference proven to be clinically accepted (PolyJet). METHODS: For this purpose, the upper and lower virtual models of 5 patients were printed using: (1) DLP printer Moonray, (2) DLP printer Anycubic, (3) DLP printer Moonray with Anycubic resin, (4) Filament printer UpMini 2 (FFF), and (5) Polyjet printer Objet Eden500V. One of the virtual models was also printed 4 consecutive times on each printer to allow consistency assessment. Afterward, the 14 printed resin models were scanned, and their accuracy was evaluated by model superimposition using Geomagic Qualify software (3D Systems, Rock Hill, SC). A digital caliper was also used to obtain linear measurements. All measurements were carried out by a calibrated examiner. RESULTS: The results showed that all printers produced similar results, although Moonray with Anycubic resin showed loss of accuracy and Anycubic showed inconsistent vertical dimensions. The printing cost and time consumed from each pair of models were calculated for the overall printing process, analyzing which would have the best cost-benefit ratio. CONCLUSIONS: Polyjet printing was considered the fastest method but with the highest cost. FFF printing was the lowest printing and input cost but was considerably more time-consuming. There was a balance in both DLP printers, and they were considered the best cost-benefit ratio for small independent dental offices.

Cartesian three-dimensional method to quantify displacements between cone beam computed tomography models

ABSTRACT Introduction: Research in Orthodontics and Oral Surgery has been relying on three-dimensional (3D) models to evaluate treatment results with displacement color map techniques, even though it has important limitations. Objectives: This study proposed a method of tracking translational movements of 3D objects to evaluate displacements in surfaces with no shape modification. Methods: Cone Beam Computed Tomography (CBCT) data of ten patients were imported to the Dolphin software. A hypothetical virtual surgical plan (randomly defined) was developed in the software and afterwards verified using the proposed method. All the procedures were carried out by two evaluators, in two different time-points, with a 15-day interval. ITK-Snap software was used to generate high quality STL models. Centroid points were automatically generated and their coordinates were compared to confirm if they represented the known displacements simulated. The paired t-test and the Bland-Altman plots were used, as well as the intraclass correlation coefficient. Results: Interexaminers and intra-examiner tests showed excellent reliability of the method, with mean displacement measurement error values under 0.1mm. The paired t-test did not show any statistically significant differences. Conclusion: The method showed excellent reliability to track the simulated translational displacements of bone segments.

RESUMO Introdução: Grande parte das pesquisas em Ortodontia e Cirurgia Oral tem utilizado modelos tridimensionais e realizado avaliações por meio de mapa de cores de deslocamento, apesar das limitações existentes. Objetivo: O presente estudo teve como objetivo propor um método de rastreamento de movimentos translacionais de objetos 3D, para avaliar deslocamentos em superfícies sem modificação de forma. Métodos: Dez adultos que seriam submetidos à cirurgia ortognática tiveram suas tomografias computadorizadas de feixe cônico pré-cirúrgicas importadas para o software Dolphin. Um plano cirúrgico virtual hipotético com deslocamentos conhecidos foi desenvolvido e posteriormente verificado pelo método proposto. Todos os procedimentos foram realizados por dois avaliadores, em dois momentos diferentes, com intervalo de 15 dias. O software ITK-Snap foi usado para gerar modelos STL de alta qualidade dos ossos do paciente. Os pontos do centroide foram gerados automaticamente, e suas coordenadas foram comparadas, para confirmar se representavam os deslocamentos conhecidos simulados. Para análise estatística, foram usados teste t pareado, coeficiente de correlação intraclasse e os gráficos de Bland-Altman. Resultados: O teste inter e intraexaminadores mostrou boa confiabilidade do método, com valores médios abaixo de 0,1mm para os erros de medida de deslocamento. Conclusão: O método mostrou boa confiabilidade para avaliar o deslocamento de segmentos ósseos após cirurgia ortognática, devendo ser aplicado como uma ferramenta completa de avaliação verdadeiramente tridimensional.

External root resorption evaluated by CBCT 3D models superimposition

ABSTRACT Introduction: The literature reports the association of external root resorption (ERR) with orthodontic movement. In cases of premolars extractions, orthodontic movement of anterior teeth is usually quite expressive, which are precisely the most susceptible teeth to suffer from ERR. Objective: The aim of this study was to assess the root morphology of maxillary canines and incisors in patients submitted to four premolar extraction and orthodontic retraction of the anterior teeth, by means of 3D surface models superimposition and mapping. Methods: The sample consisted of six adult patients, five female and one male, with a mean age of 23.5 ± 6.5 years, who underwent orthodontic treatment. All patients presented bimaxillary dental protrusion, with indication of maxillary and mandibular first premolar extractions, followed by the retraction of anterior teeth and space closure. Cone beam CT scans were performed before the beginning of the treatment (T0) and right after space closure (T1). 3D models were built at both times and superimposed to identify the root changes for the given period. Results: All average differences were close to zero and, even when evaluating the extreme values, the observed changes were always smaller than the accuracy of the CBCT. Conclusion: A mild resorption trend was observed, although it was not clinically significant, with values lower than the tomography accuracy.

RESUMO Introdução: A literatura relata a associação de reabsorção radicular externa (RRE) com a movimentação ortodôntica. Nos casos de extrações de pré-molares, a movimentação ortodôntica costuma ser bastante expressiva nos dentes anteriores, que são justamente os dentes mais suscetíveis à RRE. Objetivo: O objetivo do presente estudo foi avaliar a morfologia radicular de caninos e incisivos superiores em pacientes submetidos à extração de quatro pré-molares e retração ortodôntica dos dentes anteriores, por meio da sobreposição e mapeamento de modelos 3D. Métodos: A amostra foi composta por seis pacientes adultos, cinco do sexo feminino e um do masculino, com média de idade de 23,5 ± 6,5 anos, submetidos a tratamento ortodôntico. Todos os pacientes apresentavam biprotrusão dentária, com indicação de extração dos primeiros pré-molares superior e inferior, seguida de retração dos dentes anteriores e fechamento do espaço. A tomografia computadorizada de feixe cônico (TCFC) foi realizada antes do início do tratamento (T0) e logo após o fechamento de espaços (T1). Modelos 3D foram construídos em ambos os momentos e sobrepostos para identificar as mudanças nas raízes dentárias no período determinado. Resultados: Todas as médias das diferenças foram próximas de zero e, mesmo avaliando os valores extremos, as mudanças observadas foram sempre menores que a sensibilidade da TCFC. Conclusão: Observou-se tendência de leve reabsorção, embora não clinicamente significativa, com valores inferiores à sensibilidade tomográfica.

Sexo ou gênero? Entendendo a nomenclatura correta em pesquisa / Sex or gender? Understanding the correct nomenclature use on research

Resumo A terminologia "Sexo" e "Gênero" possui importância na área científica, especificamente, na área da saúde. Ainda se observa o uso incorreto dos termos Sexo e Gênero, até mesmo como sinônimos. Esta revisão sistematizada da literatura tem a finalidade de abordar e discutir o uso dos termos "Sexo" e "Gênero" nas pesquisas científicas na área da saúde. As bases de dados Medline/Pubmed, Google Acadêmico, DOSS/EBSCO, BVS/BBO/LILACS foram consultadas em 2022. A estratégia de busca incluiu os termos MeSH: "Sexo, Sexualidade"; "Gênero, Análise de Gênero, Identidade de Gênero"; "Masculino, Homem"; e "Feminino, Mulher". O critério PECO foi articulado para identificar artigos que definiam os termos "Sexo" e "Gênero". Foram recuperados 933 artigos até 2022, sendo 15 incluídos na síntese qualitativa dos resultados nas áreas de Medicina, Odontologia, Psicologia, Sociologia, Enfermagem e Ciências Econômicas, entre 1993 e 2021. Observou-se uma tendência de utilizar "Sexo" ao contexto ortodoxo exclusivo às características sexuais decorrentes da biologia humana. Enquanto, "Gênero" correspondeu à personificação individual de como o participante da pesquisa gostaria de se declarar ao estudo. O uso do termo "Sexo" está associado à biologia humana (macho ou fêmea), ou seja, relacionado às características sexuais. O termo "Gênero¼ refere-se à autopercepção, ao papel social, comportamento e à identidade da pessoa. Dessa forma, estudos que envolvem caraterísticas biológicas (morfológicas, cronológicas, de crescimento e desenvolvimento físicos) deveriam considerar o "Sexo", enquanto estudos de outra natureza, deveriam considerar o "Gênero".(AU)

Abstract The terms "Sex" and "Gender" are important in the scientific area, specifically in the health area. It is still observed the incorrect use of the terms Sex and Gender, even as synonyms. This systematic literature review aims to address and discuss the use of the terms "Sex" and "Gender" in scientific research in the health area. Medline/Pubmed, Google Scholar, DOSS/EBSCO, BVS/BBO/LILACS databases were consulted in 2022. The search strategy included MeSH terms: "Sex, Sexuality"; "Gender, Gender Analysis, Gender Identity"; "Male, Man"; and "Female, Woman". The PECO criteria was articulated to identify articles that defined the terms "Sex" and "Gender". A total of 933 articles were retrieved in 2022, of which 15 were included in the qualitative synthesis of results in the areas of Medicine, Dentistry, Psychology, Sociology, Nursing, and Economic Sciences, between 1993 and 2021. There was a tendency to use "Sex" in the orthodox context exclusive to sexual characteristics arising from human biology. Meanwhile, "Gender" corresponded to the individual personification of how the research participant would like to declare himself /herself to the study. The use of the term "Sex" is associated to the human biology (male or female), that is, related to sexual characteristics. The term "Gender" refers to self-perception, social role, behavior, and to the person identity. Thus, studies involving biological factors (morphological, chronological, physical growth and development) should consider Sex, while studies of another nature should consider Gender (AU)

New highlights on effects of rapid palatal expansion on the skull base: a finite element analysis study.

OBJECTIVE: The objective of this study was to evaluate the effect of the rapid palatal expansion (RPE) on the pterygoid process (PP), spheno-occipital synchondrosis (SOS) and sella turcica (ST) in the skull of a patient with transversal maxillary collapse, and identify the distribution of mechanical stresses and displacement, by finite element analysis (FEA). METHODS: Cone-beam computed tomography (CBCT) was employed to examine the skull of a patient in this study. The patient was a 13-year-old boy, with Class II skeletal relationship due to transverse atresia and maxillary protrusion. The computer-aided design (CAD) geometry of skull was imported into the SimLab v. 13.1 software, to build the finite element mesh. For the simulation, a displacement of 1 mm, 3 mm and 5 mm in a transverse direction was defined at the midpalatal suture, thereby representing the RPE. For the analysis of results, maximum principal stress (MPS) and displacements were evaluated by identifying different nodes, which were represented by the points as per the areas of interest in the study. RESULTS: In MPS, the maximum tensile stress was found at point 2 (366.50 MPa) and point 3 (271.50 Mpa). The maximum compressive stress was found at point 8 (-5.84 Mpa). The higher displacements in the transversal plane and the lateral segment were located at point 1 (2.212 mm), point 2 (0.903 mm) and point 3 (0.238 mm). CONCLUSIONS: RPE has a direct effect on PP, SOS and ST in the Class II model skeletal relationship with a transversal maxillary collapse. PP supported a higher tensile stress and displacement.

Comparison between traditional and alternative biocompatible welding techniques used in orthodontic devices.

OBJECTIVE: To compare the mechanical strength of joints made by conventional soldering with those made by alternative, more biocompatible, methods (spot, tungsten inert gas [TIG] and laser welding), and to compare the microstructural morphology of wires welded with these techniques. DESIGN: In vitro, laboratory study. METHODS: Forty stainless-steel wire segments with 0.8-mm diameter were joined by silver soldering, spot, laser and TIG welding. Ten specimens were produced for each one. Tensile strength test was performed 24 h after welding on the Emic DL2000™ universal testing machine, using a load cell of 1000 N with a crosshead speed of 10 mm/min. RESULTS: The highest tensile strength mean values were obtained with silver soldering (532 N), next were laser (420 N), spot (301 N) and TIG (296 N) welding. Statistically significant differences were observed between the groups; the Dunn post-hoc test revealed differences between laser and spot welding (p=0.046), laser and TIG (p = 0.016), spot and silver (p <0.001), and silver and TIG (p <0.001). CONCLUSION: Laser welding strength is high, and comparable to silver welding. Spot and TIG techniques present comparable and significantly lower strengths. The four methods presented resistance values compatible with orthodontic use. The microstructural morphology is different for each technique. The association between the mechanical performance and the microstructure evaluation shows that laser presented the highest quality joint.

A reflection on the role of women in Science, Dentistry and Brazilian Orthodontics.

INTRODUCTION: This paper reviews the history of women scientists in the 'Western world', whilst highlighting the persistent socio-structural issues that have led to the hiding and masking of the participation of women in Science. Further, a reflection is made of the situation of Dentistry, specifically in the field of Orthodontics in Brazil. The difference between genders is discussed, with the intention to map the progress of women in management and leadership positions, in both the academic and professional fields. DESCRIPTION: In Brazil, within Dentistry and Orthodontics, despite being in a numerical majority, women are still underrepresented in the area of professional leadership. This is true for Research Groups and Research Productivity; an example being the relatively low authorship of publications in a Brazilian journal of Orthodontics. They are also underrepresented as lead presenters at professional meetings, whilst there are also few female Presidents of professional organizations and associations. CONCLUSION: Despite being in a numerical majority, it is also important that women act in a more co-ordinated and consistent manner to achieve greater representation in these areas. The necessary changes in the structure in order to achieve this are not only of women and for women, but they must also involve the whole of society so that leadership, rights and duties are equally distributed between the genders.

Evaluation of the suture ossification level according to age and sex in children, adolescents, and adults. A cross-sectional and observational 3D study.

OBJECTIVE: To determine the ossification level of the midpalatal suture (MPS) in children, adolescents and adults from a Peruvian sample; according to the method proposed by Angelieri et al. with cone-beam computed tomographies (CBCTs). MATERIAL AND METHODS: The sample consisted of 315 CBCTs of 168 females and 147 males. The total sample was divided into 3 groups according to age and sex: children (n=77), adolescents (n=113) and adults (n=125). The images were mainly assessed in the axial plane using the Real Scan 2.0 software. The different periods of ossification of the MPS at the level of the vertical half of the palate was defined according to the five stages of Angieleri method (from A to E). The Student t-Test, Chi-square test, Kruskal-Wallis test and Spearman's Rho test were applied. RESULTS: Chi2 test results showed that the stages of MPS ossification depended on the age of the patient by age ranges (P<0.005). Multiple comparison tests affirmed that male and female subjects in the children group had fewer ossification stages than the adolescent and adult groups (P<0.001). Meanwhile, there were no statistically significant differences between the two older age groups. Finally, there was a moderate positive correlation between the stages of ossification of the MPS and the age in the male group (Rho=0.511). CONCLUSIONS: The onset of MPS ossification was significantly related to subjects up to 12 years of age and more frequently in stages B and C in both sexes. There was no difference in MPS ossification in adolescents and adult subjects.

A reflection on the role of women in Science, Dentistry and Brazilian Orthodontics

ABSTRACT Introduction: This paper reviews the history of women scientists in the 'Western world', whilst highlighting the persistent socio-structural issues that have led to the hiding and masking of the participation of women in Science. Further, a reflection is made of the situation of Dentistry, specifically in the field of Orthodontics in Brazil. The difference between genders is discussed, with the intention to map the progress of women in management and leadership positions, in both the academic and professional fields. Description: In Brazil, within Dentistry and Orthodontics, despite being in a numerical majority, women are still underrepresented in the area of professional leadership. This is true for Research Groups and Research Productivity; an example being the relatively low authorship of publications in a Brazilian journal of Orthodontics. They are also underrepresented as lead presenters at professional meetings, whilst there are also few female Presidents of professional organizations and associations. Conclusion: Despite being in a numerical majority, it is also important that women act in a more co-ordinated and consistent manner to achieve greater representation in these areas. The necessary changes in the structure in order to achieve this are not only of women and for women, but they must also involve the whole of society so that leadership, rights and duties are equally distributed between the genders.

RESUMO Objetivo: Este estudo objetivou resgatar a história de mulheres cientistas nos principais períodos históricos do mundo ocidental, para realçar a questão socioestrutural persistente que "invisibiliza" e mascara a participação das mulheres na Ciência. A partir disso, realizou-se uma reflexão sobre a situação da Odontologia, especificamente na área de Ortodontia no Brasil, no que tange à diferença de gêneros, com a finalidade de mapear a atuação das mulheres nos cargos de gestão e liderança nos âmbitos acadêmico e profissional. Descrição: No Brasil, na área de Odontologia e Ortodontia, apesar de serem maioria numérica, as mulheres ainda são minoria na liderança de Grupos de Pesquisa, Produtividade em Pesquisa, na autoria de artigos em um periódico nacional da área de Ortodontia, palestrantes de congressos e na presidência de Associações de Classe. Conclusão: Apesar de apresentar maioria numérica, é importante que as mulheres atuem de maneira mais consistente. As mudanças necessárias na estrutura não são apenas da mulher e para a mulher, mas devem envolver toda a sociedade para que direitos e deveres sejam distribuídos de forma igualitária entre os sexos.

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)

Three-dimensional accuracy of virtual planning in orthognathic surgery.

INTRODUCTION: This study aimed to assess the accuracy of virtual surgical planning (VSP) performed by Dolphin Imaging software (version 11.9; Dolphin Imaging and Management Solutions, Chatsworth, Calif). METHODS: Ten people requiring bimaxillary surgery and genioplasty were followed up prospectively. All patients had preoperative cone-beam computed tomography, plaster models, and photographs allowing for VSP. Interocclusal intermediate surgical splints were produced using a 3-dimensional (3D) printer. Postoperative images were acquired 15 days after surgery using cone-beam computed tomography. ITK-Snap (version 3.6; Cognitica, Philadelphia, Pa) allowed the segmentation of reliable 3D models. Geomagic Qualify 2013 (3D Systems, Rock Hill, SC) and MeshValmet (version 3.0) were used to identify the differences between VSP and actual surgical results through the root mean square values and the 3D translational displacement (3-axes) of the 3D centroid of each model. RESULTS: Discrepancies between the VSP and the actual result were found at the mandible (P = 0.013) and the chin (P = 0.013) when considering the root mean square values. In addition, 3D centroid differences were found in the transverse and sagittal direction of the right ramus (P = 0.034 and P = 0.005, respectively) and the sagittal aspect of the left ramus (P = 0.025). Considering 2 mm as a threshold of clinical relevance, almost all the bone fragments (maxilla, proximal, and distal mandibular segments) were accurately corrected by surgery, although not in the chin. CONCLUSIONS: On the basis of the obtained values, it is possible to consider the Dolphin Imaging software as clinically acceptable for performing virtual orthognathic surgical planning.

Management of the Vertical Dimension in the Camouflage Treatment of an Adult Skeletal Class III Malocclusion.

Treating skeletal class III malocclusions is one of the biggest challenges in Orthodontics. Given the complexity of these cases, orthognathic surgery is often the best treatment option. However, many patients refuse this treatment due to its risks, morbidity, and costs involved. Alternatively, dental compensation can be planned for some of these skeletal problems. This case report presents a dentoalveolar compensation in the orthodontic treatment of a 20-year-old female patient with class III malocclusion, concave profile, anterior crossbite, mandibular prognathism, maxillary retrusion, and a vertical deficiency in the posterior region. Treatment planning involved a multiloop edgewise archwire (MEAW) associated with intermaxillary elastics with counterclockwise rotation of the occlusal plane in the posterior region of the maxilla aiming at obtaining an increased posterior vertical dimension. After 24 months of treatment, the severe anterior crossbite was corrected, and the skeletal class III relationship was camouflaged. At the end of the orthodontic treatment, it was possible to observe an improved facial profile, a nice smile, and a functional occlusion. The results remained stable at a three-year follow-up. The MEAW, associated with the use of elastics, seems to be an effective treatment option for class III camouflage with reduced posterior vertical dimension with no need for additional anchoring devices but requiring adequate bending of wires and patient compliance.