Assessment of awake bruxism and oral mucosa indentation in adolescents.

BACKGROUND: Oral mucosa indentations can be signs of awake bruxism (AB) in adults, but this association has not yet been verified in adolescents. OBJECTIVES: To evaluate the frequency of AB in adolescents and determine whether there is an association between AB and oral mucosa indentation. METHODS: This study enrolled 66 high school students, mean age of 16.9 (±0.54) years. Clinical inspection was performed to assess the presence or absence of tongue, cheek and lip mucosa indentation. AB was assessed by the Ecological Momentary Assessment method using the WhatsApp mobile app. Messages were sent 15 times a day, 7 days, between 8:00 AM and 7:00 PM at random times to choose one of the five oral behaviours: teeth contact, teeth clenching, teeth grinding, mandible bracing and relaxed jaw muscles. The non-parametric Mann-Whitney U-test for independent samples, Friedman test for paired samples, Friedman pairwise multiple comparisons non-parametric test, Pearson's chi-squared tests, and z-test of comparisons between two proportions were performed (p < .05). RESULTS: During the week the frequency of AB behaviours was 56.20%, teeth contact was the most frequent (37.68% ± 22.26%), significantly more frequent than other AB behaviours; there was a greater frequency of cheek indentation (27.27%) and no difference between genders in oral behaviours and indentations (p > .05). A higher frequency of AB behaviours was observed in individuals with a greater frequency of cheek indentation (p < .05). CONCLUSIONS: Teeth contact and cheek indentation were the most frequent conditions among adolescents and AB behaviours are associated with this indentation.

Abordagem interdisciplinar do tratamento em paciente adulto com múltiplas perdas dentárias / Interdisciplinary treatment approach in adult patient with multiple tooth loss

Este relato de caso ilustra o tratamento interdisciplinar realizado em uma paciente adulta de 43 anos de idade, Classe II esquelética, perfil convexo, maloclusão Classe I de Angle com múltiplas perdas dentárias e extrusão dos molares superiores do lado direito com redução do espaço protético para reabilitação. O tratamento ortodôntico foi realizado para preparar os espaços desdentados para reabilitação com implantes dentários e próteses. Durante o nivelamento dos arcos dentários, mini-implantes foram posicionados entre o primeiro e o segundo molar superior, no lado direito, nas corticais vestibular e palatina, respectivamente, para auxiliar na intrusão desses dentes, aumentando o espaço protético mandibular. Na fase de finalização, implantes osseointegrados foram colocados para a reabilitação dos dentes ausentes. Após três anos e quatro meses de tratamento, os objetivos foram atingidos e o aparelho ortodôntico foi removido. A mecânica com mini-implantes ortodônticos favoreceu a intrusão dos molares superiores e a reabilitação bem-sucedida do caso, devolvendo a estética, a função dentária e mantendo os resultados estáveis após um ano e cinco meses de acompanhamento (AU)

This case report illustrates an interdisciplinary treatment approach performed in an adult female patient, 43-year-old, skeletal Class II, convex profile, Angle Class I malocclusion with multiple tooth loss and maxillary molars extrusion on the right side with reduction of the prosthetic space for rehabilitation. Orthodontic treatment was conducted in order to prepare the edentulous spaces for rehabilitation with dental implants and prostheses. During leveling of dental arches, mini-implants were placed between the first and second maxillary molars on the right side, in the buccal and palatal corticals, respectively, to aid intrusion of these teeth, increasing the mandibular prosthetic space. In the finalization phase, osseointegrated implants were placed for the rehabilitation of the missing teeth. After three years and four months of treatment, the goals were achieved, and the orthodontic appliance was removed. Mechanics with orthodontic mini-implants favored maxillary molars intrusion and successful rehabilitation of the case, returning aesthetics, dental function and maintaining stable results after one year and five months of follow-up (AU)

When the Midline Diastema Is Not Characteristic of the "Ugly Duckling" Stage.

This case report presents the interceptive orthodontic treatment of a 9-year, 5-month-old boy with class I malocclusion, a 9.0-mm maxillary midline diastema, and deviation from the midline. The treatment goals were to decrease the magnitude of the diastema and to simulate the characteristics of the "ugly duckling" stage. Braces were placed on the first molars and the maxillary central incisors. The biomechanics of the anchors on the first molars elicited substantial mesial movement of the left central incisor to match the midline. A flat wire segment was bonded onto the palatal surface of the central incisors for retention.