Fatores associados à descolagem de bráquetes ortodônticos / Factors associated with orthodontic brackets debonding

A descolagem de bráquetes ortodônticos são frequentes na prática clínica. O conhecimento dos fatores associados à descolagem é relevante para maior efetividade clínica na movimentação dentária. Este estudo teve por objetivo avaliar a ocorrência de descolagem de bráquetes e fatores associados em pacientes que concluíram tratamento ortodôntico. Foram avaliados os prontuários de 205 pacientes de uma clínica privada tratados ortodonticamente por um único operador entre 2000 e 2013, nos quais foram utilizados o mesmo tipo de bráquete e sistema adesivo para a colagem. Para a análise univariada foram utilizadas tabelas de frequências e médias de tendência central e dispersão. Na análise bivariada foram utilizadas tabelas de dupla entrada e teste Qui-quadrado ou Exato de Fisher. Em 45,9% dos pacientes não ocorreu descolagem de bráquetes durante todo o tratamento ortodôntico. Dos 54,1% pacientes que descolaram bráquetes, 46,3% descolaram de um a cinco bráquetes. Houve associação entre a descolagem e o tempo de tratamento. O dente que apresentou maior frequência de descolagem de bráquete foi o pré-molar inferior (44,7%). Descolagens ocorreram em 54,1% dos pacientes ao longo de todo o tratamento ortodôntico e houve associação entre descolagem e tempo de tratamento. (AU)

Introduction: Orthodontic brackets debonding is common in clinical practice. The knowledge of the factors associated to bracket debonding is relevant for greater clinical effectiveness in tooth movement. Objective: This study aimed to evaluate the occurrence of brackets debonding and associated factors in patients who completed orthodontic treatment. Material and Methods: The records of 205 orthodontic patients from a private clinic treated by a single operator between 2000 and 2013 were analysed, the same type of bracket and adhesive system were used for the bonding. For univariate analysis, tables of frequency and average of central tendency and dispersion were used. In the bivariate analysis were used double-entry tables and Chi-square test or Fisher's exact test. Results: There was no bonding failure of brackets in 45.9% of the patients during the entire orthodontic treatment. Of the 54.1% patients with bonding failure, 46.3% occurred in one to five brackets. There was an association between debonding and treatment time. The tooth with the highest bracket debonding frequency was the lower premolar (44.7%). Conclusions: Orthodontic brackets bonding failure occurred in 54.1% of patients throughout the orthodontic treatment and was associated with treatment time. (AU)

Fístula oronasal após palatoplastia em pacientes fissurados / Oronasal fistula after palatoplasty in cleft patients

A fístula oronasal (FON) consiste na principal sequela pós-cirúrgica da palatoplastia podendo levar a problemas funcionais, como a fala hipernasal e regurgitação de alimentos pelo nariz. Essa condição compromete o resultado do tratamento da fissura labiopalatina, e seu reparo torna-se um desafio para a equipe multidisciplinar. Este trabalho relata três casos de pacientes com fissura lábio-palatina que apresentaram FON após palatoplastia. Nos casos, foram diagnosticadas FON tipo VII (alveolar na região labial), provocadas pela tensão muscular excessiva sobre a sutura após palatoplastia. O tratamento consistiu em uma cirurgia para fechamento da fístula através da técnica de retalho mucoperiosteal, realizada por um cirurgião bucomaxilofacial. É essencial um planejamento cirúrgico adequado a fim de promover o melhor prognóstico para o paciente, visando a uma melhor qualidade de vida... (AU)

The oronasal fistula (ONF) is the main postoperative sequel of palatoplasty and can leads to functional problems such as hypernasality of voice and regurgitation of food through the nose. This condition affects the outcome of treatment of cleft palate and is challenging for the multidisciplinary team. This paper reports three cases of patients with cleft lip and palate who presented ONF after palatoplasty. In these cases, type VII ONF (alveolar in the labial region) were diagnosed, and were caused by excessive muscle tension on the suture after palatoplasty. The treatment consisted of a surgery for closure of the fistula through the mucoperiosteal flap, which was carried out performed by a maxillofacial surgeon. It is essential an appropriate surgical planning in order to promote better prognosis for the patient aiming better quality of life... (AU)

Anomalias dentárias de número em pacientes ortodônticos / Dental anomalies of number in orthodontic patients

Introdução: A prevalência e a distribuição das anomalias dentárias de número variam de acordo com a população estudada. Objetivo: Determinar a prevalência de anomalias dentárias de número, verificando-se a frequência com relação a gênero, localização e dentes mais acometidos. Método: Foram avaliadas 1.054 radiografias panorâmicas de pacientes com idade entre 5 e 30 anos, realizadas no período de janeiro a março de 2010, em uma clínica particular de diagnóstico por imagem de Teresina-PI. Foram registrados dados relativos a gênero, idade, presença ou ausência de anomalia, dente acometido e localização. Foram realizados os testes estatísticos Qui-quadrado de Pearson e Teste Binominal, para duas proporções. Resultado: A hipodontia, com prevalência de 4,9%, foi encontrada com mais frequência na maxila, não apresentando diferença entre os lados e os gêneros. Os dentes mais ausentes foram: incisivos laterais superiores e segundo pré-molar inferior. Em relação à hiperdontia, com prevalência de 4,0%, não foram observadas diferenças entre gêneros, lados e maxilares. As regiões com maior presença de supranumerários foram: distal dos terceiros molares e entre pré-molares inferiores. Conclusão: Foi observada prevalência de hipodontia de 4,9%, sendo mais comum na maxila, e de hiperdontia de 4%, não apresentando diferença entre maxilares, lados e gêneros.

Introduction: The prevalence and distribution of dental anomalies of number vary according to the population studied. Objective: To determine the prevalence of dental anomalies of number by assessing the frequency of hypodontia and hyperdontia regarding gender, the region of the maxila or mandible and the most affected teeth. Method: The panoramic radiographs of 1054 patients, aged 5 to 30 years, from a private diagnostic imaging clinic were evaluated. Gender, age, presence or absence of abnormality, affected teeth and region were compared. Chi-square statistical tests and Pearson Test Binominal for two proportions were carried out. Result: The prevalence of hypodontia was 4.9% and it was more frequent in the maxilla. There were no significant differences between the left and right side of the maxila or genders. The most frequently missing teeth were the maxillary lateral incisors and mandibular second premolar. The prevalence of hyperdontia was 4.0%. There were no significant differences between genders, right or left side of the maxila or mandible. The regions most frequently affected were distal to the third molars and between mandibular premolars. Conclusion: The prevalence of hypodontia was 4.9% and it was more frequent in the maxilla. The prevalence of hyperdontia was 4%. No significant differences between genders and the maxillary or mandibular region were found.

Civil liability of dentists based on reports filed to the Regional Council of Dentistry

Civil liability is the obligation to repair the damage that one causes someone else. Dentists must respect legal precepts and comply with the Consumer Protection and Defense Code. In order to prevent legal action, it is important to communicate with the patients and/or their caregiver. Aim: The goal of this study was to assess the number of dentists living in the city of Teresina-PI and in some other capitals of the northeastern Brazil as well as the number of reports filed against dentists to the Regional Council of Dentistry (CRO) between 2002 and 2009. Methods: This was a cross-sectional descriptive study conducted in the city of Teresina, located in northeastern Brazil, with an estimated population of 802,537 inhabitants. In 2009, 1,938 dentists were registered at the CRO - Piauí, 1,239 of whom belonged to the city of Teresina. The number of reports filed against dentists is presented, using a comparative description of the data by dental specialty and states in northeastern Brazil. Results: Data collection showed that 70 complaints were registered. The majority were against orthodontists (N=16), regarding advertising (N=15) and regarding administrative, ethical or service violation (N=15, 11 of whom were dentists who worked in a nonregistered practice). Conclusions: The number of reports filed against dentists has decreased in Piauí, unlike other states. However, professionals must be aware about communication with the patient and archiving of dental charts and treatment-related documents or exams.