Orthodontic digital workflow: devices and clinical applications.

INTRODUCTION: The digital technology has contributed to improve and simplify diagnosis, treatment planning and execution in Orthodontics. Among CAD/CAM system (Computer-Aided Design / Computer-Aided Manufacturing) applications in Orthodontics, we highlight the installation and removal of fixed appliance, clear aligners, customized appliances, and retainers fabricated in digital environment. This approach has several advantages for practitioner and patient, as it enhances appliances precision, directly interferes in treatment time and predictability. Even with all the benefits arising from the digital workflow, few orthodontists have adopted this technique in their clinical practice, most due to high cost and lack of technical preparation for proper execution. OBJECTIVES: Thus, given the importance of digital technology to improve specialty performance and the still incipient incorporation of digital flow in Orthodontics, the purpose of this article is to describe the available resources and clinical applications of the CAD/CAM technology in Orthodontics.

Linear measurement accuracy of CBCT panoramic reconstructions: experimental study with dry human mandibles.

INTRODUCTION: Studies on software accuracy of reformatted panoramic computed tomography (CT) images are scarce. OBJECTIVES: The aim of this study was to evaluate the software accuracy of reformatted panoramic views from cone-beam computed tomography (CBCT). METHODS: Ten dry mandibles were scanned using CBCT with different voxel sizes. Following the reconstruction of panoramic views with three different software, horizontal and vertical linear measurements were performed using the electronic rules of each software. Measurements of the corresponding dry mandibles were taken with a digital caliper and defined as the gold standard. RESULTS: There were no statistically significant differences in linear distances among the dry mandibles and reformatted panoramic CT views. The relative error ranged from 1.3 to 8.0%, depending on the software and voxel size. CONCLUSIONS: The linear measurements on reformatted panoramic views are reliable.

Evaluation of the maxillomandibular positioning in subjects with sickle-cell disease through 2- and 3-dimensional cephalometric analyses: A retrospective study.

Sickle-cell disease (SCD), which involves morphological changes to the red blood cells, is the most common hemoglobinopathy worldwide. This conformational change in erythrocytes affects multiple organs and systems, including the hard and soft tissues of the stomatognathic system. The objective of this study was to provide a description of the maxillomandibular positioning of patients using computed tomography in a case series of 40 patients with SCD. To define the facial profile of patients, 2-dimensional (2D) and 3-dimensional (3D) McNamara and Steiner cephalometric tracings were performed. The results showed that there is a tendency to maxillary protrusion in 2D and 3D analyses. There was no statistical difference between the 2D and 3D evaluations; additionally, sex affected the maxillomandibular positioning of patients, but only in McNamara evaluations.

Evaluation of upper airways after bimaxillary orthognathic surgery in patients with skeletal Class III pattern using cone-beam computed tomography.

INTRODUCTION: It has been suggested that mandibular setback surgery, combined or not with maxillary advancement as a treatment alternative for patients with mandibular prognathism, can induce changes in upper airway space (UAS). Therefore, this study aimed to assess the response of the upper airway in the oropharynx region of patients with Class III skeletal pattern that underwent bimaxillary orthognathic surgery (maxillary advancement and mandibular setback) combined with mentoplasty. MATERIAL AND METHODS: The sample comprised 26 cone-beam computed tomography (CBCT) scans of 13 patients. The examination was taken before and after surgery. UAS volume, sagittal area, length and minimal axial area with its width, depth and location, were measured with the aid of Dolphin Imaging™ software version 11.5 Premium. Data were statistically treated by applying Shapiro-Wilk test and Student's paired t-test, considering as statistically significant the results of which p-value was lower than 0.05. RESULTS: No statistically significant differences were found in any measurements evaluated. CONCLUSIONS: No significant changes were observed in the oropharynx after bimaxillary orthognathic surgery and mentoplasty.

Evaluation of upper airways after bimaxillary orthognathic surgery in patients with skeletal Class III pattern using cone-beam computed tomography

Introduction: It has been suggested that mandibular setback surgery, combined or not with maxillary advancement as a treatment alternative for patients with mandibular prognathism, can induce changes in upper airway space (UAS). Therefore, this study aimed to assess the response of the upper airway in the oropharynx region of patients with Class III skeletal pattern that underwent bimaxillary orthognathic surgery (maxillary advancement and mandibular setback) combined with mentoplasty. Material and Methods: The sample comprised 26 cone-beam computed tomography (CBCT) scans of 13 patients. The examination was taken before and after surgery. UAS volume, sagittal area, length and minimal axial area with its width, depth and location, were measured with the aid of Dolphin ImagingTMsoftware version 11.5 Premium. Data were statistically treated by applying Shapiro-Wilk test and Student's paired t-test, considering as statistically significant the results of which p-value was lower than 0.05. Results: No statistically significant differences were found in any measurements evaluated. Conclusions: No significant changes were observed in the oropharynx after bimaxillary orthognathic surgery and mentoplasty.

Introdução: tem sido sugerido que a cirurgia de recuo mandibular - que é uma das alternativas de tratamento para pacientes com prognatismo mandibular -, associada ou não ao avanço maxilar, pode promover alterações no espaço das vias aéreas superiores. Por esse motivo, o presente estudo teve como objetivo avaliar o comportamento das vias aéreas superiores, na região da orofaringe, em pacientes com padrão esquelético de classe III submetidos à cirurgia ortognática bimaxilar (avanço maxilar e recuo mandibular) e mentoplastia. Métodos: a amostra foi composta por 26 tomografias computadorizadas de feixe cônico de 13 pacientes, tomadas antes e após o procedimento cirúrgico. Usando o programa Dolphin Imaging(r) versão 11.5 Premium, foram mensurados o volume do espaço orofaringeano; sua área (em um corte sagital); a mínima secção transversal dessa região, com sua largura, profundidade e localização; além de seu comprimento. Os dados obtidos foram tratados estatisticamente, tendo-se utilizado os testes Shapiro-Wilk e T-student pareado, considerando-se significativos os resultados com p < 0,05. Resultados: não foram encontradas diferenças estatisticamente significativas em qualquer uma das medidas avaliadas. Conclusão: não foram observadas modificações significativas na orofaringe após a realização da cirurgia ortognática bimaxilar e mentoplastia.