Clinical evaluation on the use of a new accessory device for Fox plane.

OBJECTIVE: Evaluate the assimilation capacity and ease of handling of the Fox plane accessory by dentistry students, through a questionnaire about the experience in using this device compared to the conventional one. Its intention is to minimize possible interpretation errors and challenges that the traditional method determines. METHODS: After approval by the Research Ethics Committee, registration at Sistema Nacional de Informações sobre Ética em Pesquisa/National Information System on Research Ethics (SISNEP) and signing of the free and informed consent form, 51 undergraduate students treating patients in need of complete dentures at Instituto de Ciência e Tecnologia/Institute of Science and Technology (ICT) Unesp in São José dos Campos completed a questionnaire to evaluate the technical ease of use and provider acceptance. The obtained data were submitted to statistical analysis, evaluating technical ease and acceptance by operators. RESULTS: The results were analyzed using descriptive and inferential statistics using the Jamovi 2.2.5 software. From the responses, the frequency was obtained for each question in the questionnaire, then the weighted mean was calculated, average rating and percentage. With the results of these analyses it was possible to measure the level of satisfaction of the participants in relation to the use of the device. CONCLUSION: It was concluded that most students have difficulty using the conventional Fox plane and that the accessory facilitated the process of determining the superior orientation plane, and its ease of use.

Comparison of mesiodistal angulations of premolars and molars in anterior open bite subjects with different sagittal malocclusions: A retrospective study.

INTRODUCTION: Mesiodistal angulation of premolars and molars can be altered by forces of open bite malocclusion. The aim of this study was to compare the mesiodistal angulations of the posterior teeth in class I, II, and III individuals with anterior open bite (AOB) versus individuals with harmonious occlusion. METHODS: This comparative cross-sectional study used 299 lateral head radiographs of individuals with permanent dentition. There were 4 groups (harmonious occlusion [n=89], Class I open bite [OB] [n=75], Class II OB [n=66], and Class III OB [n=69]). Premolar (1UPM, 2UPM) and molar (1UM, 2UM) angulations were measured relative to the occlusal plane and the palatal or mandibular plane by a trained and calibrated evaluator. ANOVA and Scheffe tests were used for statistical analyses (P<0.05). RESULTS: The mesial angulation of the upper premolars showed greater angulation of between approximately 2° and 5° in the OB groups compared to the harmonious occlusion group (P<0.05). Only in the Class II OB group did the first and second upper molars show distal angulation in relation to the palatal plane (1UM 81.85°±5.42°; 2UM 75.32±7.4°) (P<0.05). The Class III OB group presented the greatest distal angulations of the lower premolars and molars (between 3° to 5° of difference, P<0.05) in relation to those of the harmonious occlusion group. CONCLUSIONS: The upper first premolars in all the AOB groups and the lower second premolars in the Class II OB group had greater mesioangulation. Additionally, the upper molars of the Class II OB group and the lower molars of the Class III OB group showed distoangulation compared with the molars in the group with harmonious occlusion.

Surgical Control of the Pitch, Roll and Yaw in the Maxillary Arch: A Technical Note.

The adequate three-dimensional location of the maxilla is one of the main objectives in orthognathic surgery. We propose an instrument manufactured from a Fox Plane (FP) modified with red light in the shape of a cross and a bubble level, in which we perform an occlusal registration for the trans-surgical control of the three-dimensional position of the maxilla, By adding an occlusal registration to the FP, the occlusal plane is transferred and amplified to an extraoral reference. The red light in the shape of a cross allows us to assess the success of our movements more accurately.

Relationship between the occlusal plane and three different levels of ala-tragus line in a sample of sudanese adults / Relación entre el plano oclusal y tres niveles diferentes de la línea ala-trago en una muestra de adultos sudaneses

Aim: Correct orientation of the occlusal plane plays a vital role in achieving the perfect occlusal balance and function of complete dentures. This study aimed to evaluate the most reliable posterior reference point of the ala-tragus line (ATL) concerning occlusal plane (OP) in a sample of the dentate Sudanese population. Materials and Methods: A total of 150 subjects with healthy and well-aligned permanent teeth were randomly selected. Right lateral profile photographs were taken with subjects having a fox plane placed intra-orally, contacting the occlusal plane. Reference points corresponding to inferior, middle, and superior borders of the tragus and inferior border of the ala of the nose were marked on photographs. The angles between the lines were measured using the Auto-CAD software program, and the most parallel relationship was determined. Descriptive statistics in terms of means and standard deviations were presented. Independent t-test and one-way ANOVA tests were used to compare as appropriate. A p-value < 0.05 was considered significant. Results: The mean angle formed by the OP and ATL was 8.5±3.69º for the superior level, 4.68±3.13º for the middle line, and 2.89±2.57º for the inferior line. A significant difference was found between the means of the three angles (p< 0.001), while no significant difference (p> 0.05) was found between both genders regarding the measured angles. Conclusions: The line joining the inferior border of the ala of the nose with the inferior border of the tragus of the ear was the most reliable line in terms of parallelism to determine the occlusal plane orientation.

Antecedentes: La orientación correcta del plano oclusal juega un papel vital para lograr el equilibrio oclusal perfecto y la función de las prótesis completas. Este estudio tuvo como objetivo evaluar el punto de referencia posterior más confiable de la línea ala-trago (ATL) con respecto al plano oclusal (OP) en una muestra de la población dentada de Sudán. Materiales y Métodos: Se seleccionaron aleatoriamente un total de 150 sujetos con dientes permanentes sanos y bien alineados. Se tomaron fotografías de perfil lateral derecho de sujetos a los que se les colocó un plano de zorro intraoralmente, en contacto con el plano oclusal. En las fotografías se marcaron los puntos de referencia correspondientes a los bordes inferior, medio y superior del trago y al borde inferior del ala de la nariz. Los ángulos entre las líneas se midieron utilizando el programa de software Auto-CAD y se determinó la relación más paralela. Se presentaron estadísticas descriptivas en términos de medias y desviaciones estándar. Se utilizaron prueba-t independiente y prueba ANOVA unidireccional para las comparaciones, según correspondiera. Se consideró significativo un valor de p<0,05. Resultados: El ángulo medio formado por OP y ATL fue de 8,5±3,69º para el nivel superior, 4,68±3,13º para la línea media y 2,89±2,57º para la línea inferior. Se encontró una diferencia significativa entre las medias de los tres ángulos (p< 0,001), mientras que no se encontró diferencia significativa (p>0,05) entre ambos sexos con respecto a los ángulos medidos. Conclusión: La línea que une el borde inferior del ala de la nariz con el borde inferior del trago de la oreja fue la línea más confiable en términos de paralelismo para determinar la orientación del plano oclusal.

Impact of counterclockwise rotation of the occlusal plane on the mandibular advancement, pharynx morphology, and polysomnography results in maxillomandibular advancement surgery for the treatment of obstructive sleep apnea patients.

PURPOSE: Evaluate the impact of counterclockwise rotation of the occlusal plane (CCWROP) on pharynx morphology and polysomnography in maxillomandibular advancement (MMA) surgery to treat obstructive sleep apnea (OSA) patients. METHODS: Prospective clinical trial of patients with OSA treated by MMA. Computed tomography and polysomnography were performed pre- and postoperatively and the parameters were compared. The surgery classified the patients into two groups: with (R) and without (NR) CCWROP. RESULTS: The study sample comprised 38 individuals: R (n = 19) and NR (n = 19). An anterior mandible advancement of 0.71 mm was identified for each degree of CCWROP (p < 0.001). As for polysomnography, the apnea-hypopnea index was reduced by 80% and 62% in R and NR, showing final values of 6.8 and 13.0, respectively. The apnea index changed equally in both groups. Reduction of 68 and 26% in the hypopnea index was observed for R and NR, respectively, with no statistically significant difference. Total volume increased by 45% in R and 30% in NR. Retropalatal and retrolingual volumes increased by 49% and 4% in R and 43% and 15% in NR, respectively. The minimum axial area increased by 92% in the retropalatal region and 97% in the retrolingual region in R, whereas these increases were of 76% and 31% in NR, respectively. CONCLUSION: Anterior mandibular advancement of 0.71 mm for each degree of CCWROP is of great importance for surgical planning. As a result of this resource, individuals in R presented better results than those in NR in all parameters assessed, especially regarding the retrolingual region.

Comparison reproducibility between the facebow and a new technique based on a spirit level device.

Objective: This study aimed to introduce a spirit level device for mounting maxillary casts to compare the reproducibility between the facebow and this new technique.Methods: The maxillary casts of 10 participants were mounted in three different situations: 1) with the facebow; 2) with the spirit level device, the participant in seated position; and 3) with the spirit level device with participant in standing position. Each procedure was performed by three different evaluators. The values obtained were calculated using the Technical Error of Measurement (TEM) and the inter-evaluator Coefficient of Variation (CV).Results: The mean values obtained were 4.3 mm, 2.2 mm, and 2.6 mm for absolute TEM; 8.7%, 5.4%, and 6.4% for relative TEM; and 7.3%, 4.5%, and 5.6% for CV.Conclusion: These results show that the facebow is less reproducible compared to the new device, demonstrating that the new technique can be satisfactorily used in clinical practice.

Factores morfofuncionales de interés en prostodoncia que dependen de los biotipos craneofaciales / Morphofunctional factors of interest in prosthodontics depending on the craniofacial biotypes

El presente es un trabajo de investigación bibliográfica que busca establecer la posibilidad de utilizar las cefalometrías como elementos de diagnóstico pronóstico y elaboración de prótesis. Centra su objeto de estudio en encontrar y clasificar los factores morfológicos y funcionales que varían con los biotipos craneofaciales y que son de interés en la prostodoncia. La metodología empleada fue la revisión de la literatura histórica hasta la actualidad en la que se relacionan temas de prostodoncia a los biotipos craneofaciales. Si bien solo dos autores relacionaron la prostodoncia con los biotipos cráneo faciales, sí se encontraron varios temas de interés asociados directamente a la prostodoncia. Se clasificaron en temas de oclusión: Curva de Spee, plano de oclusión, movimientos mandibulares, dimensión vertical oclusiva y de especio libre interoclusal. Tema de maloclusiones. Tema de fuerza muscular. Tema variaciones morfológicas de procesos alveolares, corticales ósea y de la forma dentaría. Encontrándose para cada uno de ellos alguna correlación positiva con los distintos tipos faciales. De este estudio, se concluye que es necesario sistematizar el estudio de los conocimientos que puede aportar la cefalometría como una importante herramienta de diagnóstico al prostodoncista a partir de haberse encontrado variaciones muy importantes en los aspectos mencionados que hacen al interés de la rehabilitación prostodóncica (AU)

This Work is a bibliographic research that seeks to establish the use of cephalometries as elements of diagnosis prognostic and prosthesis elaboration. Its focus is to find and classify morphological and functional factors that vary with facial types which are of interest in prosthodontics. This was a review of the historical literature to date, in which prosthodontics are related to facial types. Although only two authors related prosthodontics to facial ypes, they did find several topics of interest directly associated with prosthodontics. They were classified into occlusion themes: Spee curve, occlusion plane, mandibular movements, occlusive vertical dimension and interocclusal free space. Malocclusion issue. Muscle strength theme. Morphological variations of alveolar processes, cortical bone and dental morphology. They found some positive correlation with the different facial types for each of them. From this study, it is concluded that it is necessary to systematize the study of cephalometries because they can provide to be an important diagnostic tool to the prosthodontist because there were found very important variations in the mentioned aspects that are of interest in prosthodontic rehabilitation (AU)

Análise bi e tridimensional das vias aéreas superiores em pacientes submetidos à cirurgia ortognática bimaxilar / Two- and three-dimensional analysis of the upper airways in patients undergoing bimaxillary orthognathic surgery

O propósito deste trabalho foi analisar as mudanças bi e tridimensionais na via área superior após procedimentos de cirurgia ortognática. Tomografias pré (T1) e pós-operatórias (T2) foram utilizadas, padronizando pontos craniométricos que serviram de referência para analisar mudanças lineares e volumétricas de diferentes áreas na via aérea superior. Vinte e dois pacientes foram incluídos no estudo, tendo sido submetidos a cirurgia bimaxilar com alteração do plano oclusal. Todos os casos foram planejados virtualmente, e o software Dolphin Imaging (versão 11.9) foi utilizado para análise das medidas lineares, bem como, o cálculo da área da via área superior total, e de suas 3 subdivisões e da região de maior constrição. A via aérea posterior e superior total, foi beneficiada com os movimentos de avanço das cirurgias bimaxilares. Houve correlação positiva entre o valor da constrição pré e pós e o valor total 3D da via aérea pré e pós. Observou-se diferença significativa quando se avalia a média Pré e Pós do seguimento de via aérea total (ST) bi e tridimensionalmente. Encontrou-se uma correlação positiva entre o giro anti-horário do plano oclusal e a ampliação da via aérea. Não foi possível determinar com precisão como cada ponto craniométrico individualmente influenciou e/ou contribui para as mudanças em cada segmento da via aérea analisada. Com bases nos dados da pesquisa a cirurgia ortognática bimaxilar demonstrou aumento das dimensões da via aérea superior, apresentando comportamentos diferentes a depender do segmento da via aérea superior avaliado, e da sua relação com os movimentos dos pontos craniométricos (AU).

The purpose of this work aimed to analyze the bi and three-dimensional changes in the upper airway after orthognathic surgery procedures. Pre (T1) and postoperative (T2) CT scans were used, standardizing craniometric points that served as a reference to analyze linear and volumetric changes in different areas in the upper airway. Twenty-two patients were included in the study, having undergone bimaxillary surgery with alteration of the occlusal plane. All cases were planned virtually, and the Dolphin Imaging software (version 11.9) was used to analyze the linear measurements, as well as the calculation of the area of the total upper area, and its 3 subdivisions and the region most significant. The posterior and upper total airways benefited from the advancing movements of bimaxillary surgeries. There was a positive correlation between the pre and post constriction value and the total 3D value of the pre and post airway. A significant difference was observed when evaluating the pre and post average of the total airway (ST) bi and three-dimensional follow-up. A positive correlation was found between the counterclockwise rotation of the occlusal plane airway's enlargement of the airway. It was not possible to accurately determine how each craniometric point individually influenced and / or contributed to the changes in each segment of the analyzed airway. Based on the research data, bimaxillary orthognathic surgery demonstrated an increase in the dimensions of the upper airway, showing different behaviors depending on the segment of the upper airway evaluated, and its relationship with the movements of the craniometric points (AU).

Clinical study on the posterior occlusal plane and morphology of temporomandibular joint / Estudio clínico sobre el plano oclusal posterior y la morfología de la articulación temporomandibular

The objective of the study was to investigate the morphological features of the temporomandibular joint in adult patients with posterior occlusal plane and different inclinations. Fifty five skeletal I occlusion patients with average were included, shooting CBCT in the intercuspal position, divided into 3 groups according to OPP-FH angle, and measurement of the temporomandibular joint morphology was calculated with cone beam computed tomography (CBCT) special software Invivo 5.0, Statistical analysis of three groups of data using SPSS23.0. The condyle usually locates in the middle of the fossa, the maximum axial area of the condyle (A) was statistically significant between the group 1 and the group 3. The internal and external diameter (MD) of the condyle was statistically significant between group 1 and group 3, and group 2 and group 3. The bilateral TMJ morphological features of the three groups were basically symmetrical. The position of the condyle in the fossa is mostly centered, and some of the posterior, the maximum axial area and the internal and external diameter of the condyle are different in three groups.

El objetivo de este estudio fue investigar las características morfológicas de la articulación temporomandibular (ATM) en pacientes adultos con plano oclusal posterior y diferentes inclinaciones. Se incluyeron 55 pacientes con oclusión esquelética tipo I, visualizados por tomografía computarizada de haz cónico (CBCT) en posición intercuspiana, y se dividieron en 3 grupos según el ángulo OPP-FH. La medición morfológica de la articulación temporomandibular se calculó con CBCT y mediante el software especial Invivo 5.0. El análisis estadístico de datos se realizó con el software SPSS 23.0. El cóndilo de la mandíbula generalmente se ubica en el centro de la fosa; el área axial máxima del cóndilo de la mandíbula (A) fue estadísticamente significativa entre los grupos 1 y 3. Los datos de los diámetros medial y lateral (DM) del cóndilo de la mandíbula fueron estadísticamente significativos entre los grupos 1 y 3 y los grupos 2 y 3. Las características morfológicas de la ATM de los tres grupos fueron básicamente simétricas. La posición del cóndilo de la mandíbula en la fosa fue principalmente centrada, y parte del área axial máxima, posterior y los diámetros medial y lateral del cóndilo de la mandíbula fueron diferentes en los tres grupos.

Comparação das medidas extraorais com as medidas intraorais na confecção da prótese total / Comparison of the extra-oral measurements with the intra-oral measurements in the manufacture of the total prosthesis

Introdução: o edentulismo é um problema bastante comum, e o conhecimento adequado da anatomia e da fisiologia da cavidade oral é essencial na recuperação e no equilíbrio neuromuscular do sistema estomatognático. O uso das linhas de referência juntamente com o plano oclusal orientam o posicionamento dos dentes artificias, que são utilizados para construção das próteses totais. Objetivo: comparar as medidas extraorais com as intraorais da largura dos dentes anteriores com as medidas das linhas de referências preconizadas na literatura para confecção de uma prótese total. Métodos: estudo do tipo observacional transversal, com amostra não probabilística, com 50 indivíduos de ambos os gêneros, no quais se realizou uma análise dentária e facial com auxílio de fotografias e um paquímetro digital. Resultados: foi observado que, na maioria dos indivíduos, não houve coincidência entre a largura dos dentes e as linhas de referência analisadas, que as mulheres apresentaram menor coincidência entre os dentes e a largura da asa do nariz, quando comparadas com os homens (8,3% e 91,7%, respectivamente), com p = 0,001. Conclusão: as linhas de referência não foram coincidentes com o tamanho dos dentes na maioria dos casos avaliados. (AU)

Introduction: edentulism is a fairly common problem, and adequate knowledge of the anatomy and physiology of the oral cavity is essential in the recovery and neuromuscular balance of the stomatognathic system. The use of reference lines together with the occlusal plane guide the positioning of the artificial teeth, which are used to construct the total dentures. Objective: to compare the extra-oral and intra-oral measurements of the width of the anterior teeth with the measurements of the reference lines recommended in the literature for making a total prosthesis. Methods: cross-sectional observational study with a non-probabilistic sample, with 50 individuals of both sexes, where a dental and facial analysis was carried out using photographs and a digital caliper. Results: it was observed that most of the individuals analyzed did not coincide between the width of the teeth and the reference lines, and that the analyzed women showed less coincidence between teeth and the width of the nose wing when compared with men (8.3% and 91.7%, respectively), with p = 0.001. Conclusion: the reference lines did not coincide with tooth size in most cases analysed. (AU)

Occlusal plane canting: a treatment alternative using skeletal anchorage

ABSTRACT A canted occlusal plane is the cause of unaesthetic smile, and also represents a challenge, due to the complex orthodontic procedures involved in its treatment. The skeletal anchorage allows successful treatment of this asymmetry in the majority of cases, with less dependency on the patient cooperation and reducing the necessity of orthognatic surgery. Given this condition, this article aims at discussing the main aspects related to the diagnosis of occlusal plane canting, treatment plan, and orthodontic mechanics using skeletal anchorage either by mini-implants or miniplates. In this context, five cases will be reported, showing the main details related to the orthodontic mechanics used to correct the occlusal plane, avoiding side effects and successfully reaching treatment objectives and long-term stability.

RESUMO O plano oclusal inclinado é causa de um sorriso esteticamente desagradável e representa um desafio, devido à complexidade dos procedimentos ortodônticos envolvidos no seu tratamento. A ancoragem esquelética permite a correção da inclinação do plano oclusal, na maior parte dos casos, sem a necessidade de cirurgia ortognática e com menor dependência da colaboração dos pacientes. Com base nisso, o objetivo desse artigo é discutir os principais aspectos relacionados ao diagnóstico, plano de tratamento e mecânica ortodôntica envolvida no tratamento do plano oclusal inclinado com mini-implantes ou miniplacas. Nesse contexto, cinco casos serão apresentados, demonstrando os principais detalhes relacionados à mecânica utilizada na correção do plano oclusal inclinado com a utilização de ancoragem esquelética.

Morphological characteristics of soft tissue profile of Angle's class II division i malocclusion before and after orthodontic treatment / Características morfológicas del perfil de tejido blando de la clase II de la división I de maloclusión de ángulo antes y después del tratamiento de ortodoncia

SUMMARY: By analysing cephalometrics before and after the treatment of Angle's class II division 1 malocclusion, soft tissue profile changes were observed, and to explore whether there was a correlation between the change of posterior occlusal plane (OP-P) and soft tissue profile. The study aimed to provide a theoretical reference in the clinical diagnosis and orthodontic treatment of early permanent dentition of Angle class II division 1 malocclusion patients. We randomly selected 20 cases of orthodontics in Shanxi Medical University orthodontics patients (aged 12-18 years) of the lateral cephalograms, Winceph 8.0 software was used to measure the posterior occlusal plane (OP-P), TUL-EP, TLL-EP, nasolabial angle, upper lip base thickness, upper lip tension, lower lip H line distance, chin soft tissue thickness and Z angle. And SPSS 22.0 software was used to analyze the correlation between OP-P and other measurement indexes. The change of posterior occlusal plane was positively related to the distance from upper lip to the esthetic plane, the distance from lower lip to the esthetic plane, the tension of the upper lip and distance from lower lip to H line, and the change of posterior occlusal plane was negatively related to nasolabial angle and Z angle. The change of posterior occlusal plane had no significant correlation with upper lip base thickness and soft tissue chin thickness. The change of posterior occlusal plane has an important guiding significance for orthodontic treatment,by focusing on the change of the posterior occlusal plane to achieve the purpose of changing the soft tissue profile.

RESUMEN: Se realizó un estudio cefalométrico antes y después del tratamiento de ortodoncia en pacientes portadores de maloclusión clase II división 1 de Angle. Se observaron cambios en el perfil de los tejidos blandos y se exploró si había una correlación entre el cambio del plano oclusal posterior (OP-P) y el perfil de los tejidos blandos. El objetivo de este estudio fue otorgar una referencia teórica en el diagnóstico clínico y el tratamiento de ortodoncia de los pacientes con dentición permanente temprana con maloclusión clase II división 1 de Angle. Seleccionamos al azar 20 casos cefalometrías de pacientes de ortodoncia de la Universidad Médica de Shanxi (entre 12 y18 años). Para ello, se utilizó el software Winceph 8.0 para medir el plano oclusal posterior (OP-P), TUL-EP, TLL-EP, ángulo nasolabial, grosor de la base del labio superior, tensión del labio superior, distancia entre líneas del labio inferior H, grosor del tejido blando del mentón y ángulo Z. Se utilizó el software SPSS 22.0 para analizar la correlación entre OP-P y otros índices. El cambio del plano oclusal posterior tuvo una correlación positiva con la distancia desde el labio superior al plano estético, la distancia desde el labio inferior hasta el plano estético, la tensión del labio superior y distancia del labio inferior a la línea H. El cambio del plano oclusal posterior tuvo una correlación negativa con el ángulo nasolabial y el ángulo Z. El cambio del plano oclusal posterior no tuvo una correlación significativa con el grosor de la base del labio superior y la barbilla de tejido blando. El cambio del plano oclusal posterior tiene un importante significado de orientación para el tratamiento de ortodoncia, de tal manera que al cambiar el plano oclusal posterior se podrá lograr el propósito de cambiar el perfil del tejido blando.

Tratamento ortodôntico mediante o controle do plano oclusal e da dimensão vertical com arcos gummetal / Orthodontic treatment through control of the occlusal plane and the vertical dimension with gummetal arches

O objetivo básico do tratamento de Ortodontia é restaurar a harmonia do esqueleto maxilo-facial através do controle da dimensão vertical e do plano oclusal. O método multi-bráquetes, amplamente usado na terapia ortodôntica, permite o controle tridimensional dos dentes. Durante muito tempo os ortodontistas não aproveitaram esse controle, concentrando-se apenas no movimento mesio-distal, uma vez que a principal técnica para alinhar e melhorar o perfil do paciente era movendo os caninos distalmente, permitindo em seguida a retração dos incisivos. Em 1967, Dr. Young Kim, em Boston, reconheceu a importância da verticalização do eixo dos dentes, do controle vertical e introduziu os "Multiloop Edgewise Arch Wire" (MEAW). Nos anos 80, Dr. Sadao Sato, no Japão, propôs novas ideias para esses arcos, usando-os para diferentes tipos de más oclusões, controlando a dimensão vertical e alterando a inclinação do plano oclusal com notável êxito. Apesar da eficiência biomecânica dos Arcos MEAW, eles demandam muito trabalho, pois são várias dobras complicadas e, para tanto, requerem uma formação específica da técnica. Outro inconveniente desses arcos é o seu volume na boca do paciente, o que dificulta a higiene e também é antiestético. Todos esses fatores têm dificultado a expansão da técnica MEAW, no entanto, foi encontrada uma maneira de mudar a reduzida constante elástica dos arcos MEAW, os quais são feitos com fio Elgilloy 0.16" x 0.22", utilizando um fio estruturado mais simples. Recentemente, foi introduzida no mercado uma nova liga chamada GUMMETAL. As características do GUMMETAL estão perfeitamente adequadas para superar todos os inconvenientes dos arcos MEAW, mencionados anteriormente.(AU)

The basic goal of orthodontic treatment is to restore the harmony of the maxillofacial skeleton by controlling the vertical dimension and the occlusal plane. The multi-bracket method, widely used in orthodontic therapy, allows three-dimensional control of teeth. For a long time, orthodontists did not take advantage of this control, concentrating only on the mesio-distal movement, since the main technique to align and improve the patient's profile was to move the canines distally, allowing the incisors to retract. In 1967, Dr. Young Kim, in Boston, recognized the importance of vertical axis of the teeth, the vertical control and introduced the Multiloop Edgewise Arch Wire (MEAW). In 1980, Dr. Sadao Sato, in Japan, proposed new ideas for these arches, using them for different types of malocclusions, controlling the vertical dimension and changing the inclination of occlusal plane with remarkable success. Despite the biomechanical efficiency of the MEAW arches, they require a lot of work, as they are several complicated folds and, for that, requires a specific technique training. Another drawback of these arches is the volume in the patient's mouth, which makes hygiene difficult and is also anti-aesthetic. All these factors have made it difficult to expand the MEAW technique, however, a way has been found to change the reduced elastic constant of the MEAW arches, which are made with Elgilloy .016x.022" wire, using a simpler structured wire. Recently, a new alloy called GUMMETAL was introduced in the market. The characteristics of GUMMETAL are perfectly suited to overcome all the drawbacks of the MEAW arches mentioned above.(AU)

Effects of Class II elastics in the treatment of Class II malocclusion / Alterações dentoalveolares e esqueléticas consequentes ao uso de elásticos para tratamento da má-oclusão de Classe II

Introduction: The objective of this study was to compare the effects of Class II malocclusion correction with Class II elastics with those produced by Class II malocclusion correction with extraoral headgear associated with multibracket appliances. Methods: A sample of 53 patients with Class II malocclusion was divided into two groups. The elastic group (EG) consisted of 26 patients who were treated with fixed appliances associated with Class II elastics. The control group (CG), consisted of 27 patients treated with fixed appliances and extraoral headgear. The groups were matched regarding initial age, treatment time, initial severity of Class II molar relationship and sex distribution. Pre- and posttreatment lateral cephalometric radiographs were evaluated. T tests were performed to compare the initial status and the treatment changes of the groups. Results: There was occlusal plane clockwise rotation in the EG. The maxillary incisors presented greater palatal tipping and retrusion and the mandibular incisor experienced smaller extrusion in the elastic than in the control group. Conclusion: Despite these small differences in treatment effects, they cannot be considered generally clinically unfavorable in every situation. (AU)

Introdução: O objetivo deste trabalho foi comparar as alterações resultantes do tratamento da má-oclusão de Classe II com o uso de elásticos intermaxilares de Classe II com as alterações resultantes do tratamento do mesmo tipo de má-oclusão com o uso do aparelho fixo associado ao aparelho extrabucal. Métodos: Uma amostra composta de 53 pacientes com má-oclusão de Classe II foi dividida em dois grupos. O Grupo Elástico (GE) foi composto por 26 pacientes tratados com aparelho fixo associado aos elásticos de Classe II. O Grupo Controle (GC) foi composto por 27 pacientes tratados com aparelho fixo associado ao aparelho extrabucal. Os grupos foram compatibilizados de acordo com a idade inicial, o tempo de tratamento, a severidade da má-oclusão de Classe II inicial e a distribuição por sexos. Telerradiografias laterais iniciais e finais do tratamento foram avaliadas. O teste t foi utilizado para comparar a condição inicial e as alterações do tratamento dos grupos. Resultados: Ocorreu uma rotação horária do plano oclusal no GE. Os incisivos superiores apresentaram uma maior inclinação palatina e maior retrusão, e os incisivos inferiores mostraram uma menor extrusão no GE que no GC. Conclusão: Apesar das pequenas diferenças nos efeitos dos tratamentos, eles não podem ser geralmente considerados como clinicamente desfavoráveis em todas as situações. (AU)

Estudio del Plano Oclusal de una Población Chilena según los Cefalogramas de Steiner, Ricketts y Delaire / Study of the Occlusal Plane in a Chilean Population Using the Cephalometric Analysis of Steiner, Ricketts and Delaire

El propósito de esta investigación fue comparar la ubicación del Plano Oclusal (PO) en una población eugnásica chilena mediante el análisis cefalométrico de Steiner, Ricketts y Delaire. Estudio transversal. Se analizaron 96 telerradiografías digitales de adultos jóvenes chilenos eugnásicos (47 hombres y 49 mujeres) entre 18 y 35 años. En las telerradiografías de determinó la ubicación del PO de acuerdo a los parámetros cefalométricos de Ricketts, Steiner y Delaire. Todos los trazados cefalométricos fueron realizados utilizando el software Adobe® Photoshop® CC, versión 14.2.1. Para las mediciones angulares correspondientes a los análisis de Steiner y Ricketts se utilizó el software Screen Protractor version 4.0© 2006. Para las mediciones milimétricas correspondientes al análisis de Delaire, se utilizó el software Screen Calipers versión 4.0© 2006. Al aplicar el análisis de Steiner en la muestra se obtuvo un promedio de 17,16° para el ángulo formado entre el plano Silla-Nasion y el PO (norma 14,5±3°). Al utilizar el análisis de Ricketts, el ángulo promedio formado por el plano de Frankfurt y el PO fue 6,98° (norma 7,5±2°) Según el análisis de Delaire, la distancia en milímetros desde el PO al punto medio entre las cúspides vestibulares del primer y segundo premolar inferior fue 1,76 mm (referencia teórica 0±1 mm). El promedio de la angulación del PO se encuentra dentro del rango de normalidad según la norma de Steiner y Ricketts y el promedio de la distancia medida en milímetros del PO al punto medio entre las cúspides vestibulares del primer y segundo premolar inferior difiere en 1,76 mm de la referencia teórica del análisis cefalométrico de Delaire. Se recomienda realizar nuevos estudios que permitan definir las normas cefalométricas apropiadas para la poblacion chilena, lo que podría mejorar tanto diagnóstico como planes de tratamiento en diversas áreas de la odontología.

The aim of this study was to compare the location of the occlusal plane (OP) in a eugnathic Chilean population using Steiner, Ricketts, and Delaire cephalometric analysis. A cross-sectional study was carried out and ninety-six digital cephalometric radiographs from 47 male and 49 female young adults between ages 18 and 35 were analyzed to determine the location of the OP according to Steiner, Ricketts and Delaire cephalometric parameters. Cephalometric tracings were obtained with Adobe® Photoshop® CC, version 14.2.1 for all three analysis. Screen Calipers version 4.0© 2006 software was used to measure the distance in millimeters from the OP to a midpoint between the first and second inferior premolars cusps for Delaire analysis. For Steiner and Ricketts angle measurements, software Screen Protractor version 4.0© 2006 was used. Mean and Standard Deviation Tests for Steiner analysis showed that the mean angle between Sella-Nasion plane and OP was 17.16° (cephalometric norm 14.5±3°). The mean angle between Frankfurt plane and OP was 6.98° (cephalometric norm 7.5±2°) for Ricketts analysis. In Delaire analysis, the distance in millimeters from the OP to a midpoint between the first and second inferior premolars cusps obtained was 1.76 mm, which differs from the theoretical reference (0±1 mm). The mean angle of the occlusal plane obtained is within the average standards for Steiner and Ricketts analysis. The mean distance in millimeters obtained from the OP to a midpoint between the first and second inferior premolars cusps in this study differs from the theoretical reference reported in Delaire analysis. Further studies are recommended to study more appropriate cephalometric norms for the Chilean population that would improve diagnosis and treatment plans in different areas of the dentistry field.

Paralelismo entre plano oclusal y plano de Camper / Parallelism between the occlusal plane and the Camper's line

Objetivo: El propósito de este estudio fue verificar la relación de paralelismo entre el plano oclusal y 3 definiciones de plano de Camper en una población eugnásica chilena. Material y métodos Estudio transversal. Se seleccionaron 60 adultos jóvenes chilenos eugnásicos (32 hombres y 28 mujeres) entre 18 y 35 años. Se utilizaron telerradiografías de perfil digitales y fotografías faciales laterales estandarizadas. Se superpuso la cefalometría en las fotografías laterales con el programa Quick-Ceph®. Los planos de Camper se trazaron desde 3 diferentes puntos de inicio en el tragus (superior, medio e inferior) hacia el punto más inferior del ala de la nariz. Se midieron los ángulos formados entre el plano oclusal y los 3 planos de Camper resultantes con el programa Screen Protractor®. Resultados El análisis ANOVA muestra diferencias significativas entre los 3 ángulos. El ángulo promedio entre el plano de Camper medio y el plano oclusal fue -0,63°. En hombres, el plano de Camper medio fue más paralelo al plano oclusal (1,11°) y en mujeres el plano de Camper superior fue el más paralelo con el plano oclusal (1,39°). Conclusión El paralelismo fue verificado para el plano de Camper medio en hombres y para el plano de Camper superior en mujeres.

Objective: The aim of this study was to verify the parallelism between the occlusal plane and three different Camper's line definitions in a Chilean eugnathic population. Material and methods Cross-sectional study was conducted on 60 Chilean eugnathic young adults (32 males and 28 females) between 18 and 35 years old. Lateral digital standardised cephalometric radiographs and facial photographs were used. The cephalometric analysis was superimposed over the lateral photographs with Quick-Ceph® software. The Camper's line was traced from three different starting points at the Tragus (upper, middle and lower) to the lowest point below the nostrils. The angles obtained between the occlusal plane and the resulting Camper's lines were measured with Screen Protractor® software. Results The ANOVA test showed significant differences for the obtained angles. The mean parallelism between the medium Camper's line and the occlusal plane was -0.63°. In males, the medium Camper's line was more parallel to the occlusal plane (1.11°), and for females, the upper Camper's line was the most parallel to the occlusal plane (1.39°). Conclusion The parallelism was verified for the medium Camper's line in males, and for the upper Camper's line in females.

El arco facial en la elaboración de las férulas oclusales tipo Míchigan / Face bows in the production of Michigan occlusal splints

Introducción: la férula oclusal tipo Míchigan (FOM) es un dispositivo usado frecuentemente para el manejo de pacientes con bruxismo. La literatura menciona el uso del arco facial para el montaje de modelos en el articulador semiajustable, sin embargo el beneficio de este en la elaboración de las FOM aún es controvertido. Por lo tanto el objetivo de esta investigación fue comparar el registro de número de puntos de contacto y el tiempo de ajuste entre las FOM elaboradas con y sin el uso del arco facial en pacientes con diagnóstico de bruxismo. Métodos: se elaboraron 90 férulas entregadas a 45 pacientes de la Clínica de Rehabilitación Benemérita Universidad Autónoma de Puebla (BUAP), previo diagnóstico de bruxismo. Las dos férulas elaboradas (una con modelos montados con arco facial y otra sin él), se compararon en el articulador y clínicamente. Se registró el número de puntos de contacto obtenidos en ambas férulas y el tiempo de ajuste requerido. Las comparaciones se hicieron con la prueba estadística de Wilcoxon y significancia menor a 0,05. Resultados: la media de puntos de contacto en boca de las férulas con el uso del arco fue superior (11,67) a la de sin uso del arco (11,58) sin diferencias significativas (p = 0,799). El tiempo de ajuste fue superior en las férulas elaboradas sin arco (51 s) que con arco (33 s), sin diferencias significativas (p = 0,332). Conclusión: no existen diferencias significativas con el uso del arco facial o sin él para la elaboración de las FOM en pacientes bruxómanos.

Introduction: Michigan occlusal splints (MOS) are frequently used for the management of patients with bruxism. The literature mentions the use of face bows for mounting models in semi-adjustable articulators, but its benefit in the production of MOS is still controversial. Therefore, the objective of this study was to compare the record of number of contact points and mounting time between MOS made with and without face bows in patients diagnosed with bruxism. Methods: a total of 90 splints were made and distributed among 45 patients diagnosed with bruxism at the Oral Rehabilitation Clinic of Benemérita Universidad Autónoma de Puebla (BUAP). The two splints (one made with a face bow mounted model and the other one without it) were compared at the articulator and clinically. The number of obtained contact points was recorded in both splints as well as the time needed for mounting. The comparisons were made with Wilcoxon statistical test and a significance level lower than 0.05. Results: the splints with face bows showed a greater average of contact points in the mouth (11.67) compared with the ones without face bows (11.58), with no significant difference (p = 0.799). Mounting time was higher in the splints made without face bows (51 s) compared with the ones with face bows (33 s), with no significant difference (p = 0.332). Conclusion: there are no significant differences in using face bows for developing MOS in bruxism patients.

Visualización del plano oclusal y guía anterior en desdentados parciales en la telerradiografía lateral: descripción de la técnica a través de casos clínicos / Occlusal plane and anterior guidance visualization in lateral cephalometric radiographs in partially edentulous patients: technique description through case reports

El uso de la telerradiografía lateral ha tomado gran importancia en Rehabilitación Oral ayudando al clínico en el diagnóstico y planificación del tratamiento a través de la identificación del biotipo facial del paciente, la inclinación del plano oclusal, la relación anteroposterior entre maxilar y mandíbula, inclinación de los ejes dentarios y como ayuda complementaria en casos de alteraciones de la Dimensión Vertical. El problema surge cuando estamos frente a pacientes desdentados que han perdido puntos de referencia cefalométricos necesarios para el análisis. El presente trabajo muestra una técnica para poder visualizar radiográficamente el plano oclusal y la guía anterior utilizando láminas de plomo.

The use of lateral cephalometric radiographs has become very important in Oral Rehabilitation, helping the clinician in the diagnosis and treatment planning through the identification of facial biotype, occlusal plane inclination, sagittal relationship between maxilla and mandible, inclination of the dental axes, and a valuable help in assessing alterations of the vertical dimension of occlusion. The problem arises when treating partially edentulous patients who have lost their cephalometric reference points necessary for the analysis. This paper shows a technique to visualize the occlusal plane and anterior guidance in partially edentulous patients who have lost these anatomical landmarks in a lateral cephalometric radiograph, using lead sheets.

Inclinación del plano oclusal en niños entre nueve y diez años de edad con asimetría postural: estudio en el plano frontal / Occlusal plane inclination in children between 9 and 10 years old with postural asymmetry: study on the frontal plane

Introducción: con el fin de establecer la relación entre el lado y sentido de la inclinación del plano oclusal en niños con asimetría postural de la unidad supraescapular, se hizo un estudio observacional en 34 sujetos de nueve y diez años de edad. Métodos: la asimetría postural y la inclinación del plano oclusal utilizando una platina de fox fueron medidas a través de un análisis fotográfico estandarizado por el software Kinovea 0.7.10 versión 2. Resultados: 18 sujetos de la muestra presentaron ángulo cervical medio occipital-cintura escapular menor (ACMOCEM) a la izquierda con un ángulo mínimo de 87,4°; 4 de ellos mostraron plano oclusal elevado (POE) en el mismo lado, con respecto al plano bipupilar; 11 de ellos lo mostraron elevado a la derecha y 3 de ellos no presentaron inclinación del plano oclusal. 16 sujetos de la muestra presentaron un ACMOCEM a la derecha con ángulo mínimo de 87,13°; 5 de ellos mostraron POE al mismo lado, 7 lo mostraron elevado a la izquierda y 4 no presentaron inclinación del plano oclusal. Los estadígrafos utilizados fueron media y desviación estándar. Conclusión: se concluyó que en niños sanos con asimetría postural existe tendencia a mostrar un plano oclusal más bajo del lado de la inclinación de cabeza supuestamente debido a factores de crecimiento dentoalveolar.

Introduction: with the purpose of establishing the relationship between side and direction of occlusal plane inclination in children with postural asymmetry of the suprascapular unit, an observational study was conducted in 34 subjects aged 9 to 10 years.Methods: both postural asymmetry and occlusal plane inclination using a fox plate were measured by means of photograph analysis standardized with the Kinovea 0.7.10 software version 2. Results: 18 subjects presented a minor occipital middle cervical-scapular waist angle (MOMCSWA) to the left, with a minimum angle of 87.4º; 4 of them presented elevated occlusal plane (EOP) in the same side in relation the bipupillary plane; in 11 patients this plane was elevated to the right, and 3 did not present occlusal plane inclination. 16 of the subjects presented (MOMCSWA) to the right with a minimum angle of 87.13º; 5 of them showed EOP to the same side, in 7 patients the plane was elevated to the left, and 4 did not present occlusal plane inclination. The variables used were average and standard deviation. Conclusion: this study allowed concluding that healthy kids with postural asymmetry present a tendency to have a lower occlusal plane to the side of head inclination, probably due to factors related do dentoalveolar growth.

Changes in occlusal plane through orthognathic surgery / Alteração do plano oclusal na cirurgia ortognática

INTRODUCTION: A conventional ortho-surgical treatment, although with good clinical results, does not often achieve the desired functional outcomes. Patients with dentofacial deformities, especially those with increased occlusal planes (OP), are also affected by muscle, joint and breathing functional disorders, as well as facial esthetic involvement. The surgical manipulation of the OP in orthognathic surgery is an alternative to overcome the limitations of conventional treatment. OBJECTIVE: To report the importance of assessing the occlusal plane during diagnosis, planning and ortho-surgical treatment of patients with facial skeletal deformities and its main advantages. CONCLUSION: Although both philosophies of ortho-surgical treatment (conventional and by surgical manipulation of the OP) have presented good results, the selective correction of the OP allows a full treatment of these patients, providing better esthetic and functional results.

INTRODUÇÃO: o tratamento ortocirúrgico convencional, embora apresente bons resultados clínicos, muitas vezes não alcança resultados funcionais desejáveis. Os pacientes com deformidades dentofaciais, principalmente os que possuem plano oclusal (PO) aumentado, são acometidos também por distúrbios funcionais musculares, articulares e respiratórios, além do comprometimento estético facial. A manipulação cirúrgica do PO na cirurgia ortognáticaé uma alternativa para suprir as limitações do tratamento convencional. OBJETIVO: relatar a importância da avaliação do plano oclusal nas fases de diagnóstico, planejamento e tratamento ortocirúrgico de pacientes com deformidades esqueléticas faciais, e suas principais vantagens. CONCLUSÃO: apesar de ambas as filosofias de tratamento ortocirúrgico (convencional e pela manipulação cirúrgica do PO) apresentarem bons resultados, a correção seletiva do PO permite um tratamento integral desses pacientes, propiciando melhores resultados estéticos e funcionais.