Comparison of smile attractiveness in cases with gummy smile treated with botulinum toxin and maxillary impaction surgery: A retrospective study.

This study aimed to compare the smile's attractiveness in patients submitted to the treatment of gummy smiles with botulinum toxin or maxillary impaction surgery. The retrospective sample comprised 26 patients divided into two groups: Group 1 (BTX): 13 patients (12 females and 1 male) with a mean age of 28.06 years (s.d. = 6.09) and mean gingival exposure during smile of 5.18 mm (s.d. = 1.51) treated with botulinum toxin; Group 2 (SURGICAL): 13 patients (9 females and 4 males) with a mean age of 30.59 years (s.d. = 5.72) and mean gingival exposure during smile of 5.21 mm (s.d. = 1.55) treated with orthognathic maxillary impaction surgery. The group of evaluators comprised 317 participants, divided into 143 orthodontists (85 females and 58 males) with a mean age of 41.40 (s.d. = 9.30); 62 dentists (47 female and 15 male) with a mean age of 35.44 (s.d. = 10.44), and 112 lay people (74 female and 38 male) with a mean age of 46, 91 (s.d. = 10.11) in a questionnaire on Google Forms. Without knowing the therapy used, the evaluators assigned scores to the photographs of the posed smile taken before (T1) and after (T2) treatment. Intergroup comparison of smile attractiveness was performed using the t-independent, one-way ANOVA, and Tukey tests. There was a significant improvement in smile attractiveness with treatment in both groups; however, the improvement was significantly better in the surgical group than in the BTX group. Orthodontists rated smile attractiveness significantly higher than dentists and laypersons for the final phase of the BTX and surgical groups. There was a significant improvement in the smile attractiveness with botulinum toxin application and orthodontic-surgical treatment. However, orthognathic surgery promoted a greater improvement in smile attractiveness than the application of botulinum toxin.

Assessment of patients' knowledge and preferences for the use of orthodontic aligners.

OBJECTIVE: To evaluate the knowledge and preference of patients treated at a Dental School in Jaraguá do Sul, Brazil, about using aligners and the reasons for choosing this device as a treatment option. DESIGN: A cross-sectional study. PARTICIPANTS: A total of 82 participants aged 18-45 years recruited at a screening clinic. METHODS: A questionnaire was completed in person using a tablet with digital forms. RESULTS: Almost half of the participants (49%) knew about aligners; 40% were aged 18-24 years, and 77% were female. When observing the images of the types of orthodontic appliances, the aligners had an acceptance rate of 80%. Among the reasons that led to the preference for choosing aligners, 68% cited aesthetics and 42% comfort. CONCLUSION: Recently, clear aligners have become a popular choice for orthodontic treatment, particularly among adults. Despite their popularity and effectiveness, many patients still need more information about aligner treatment. Over half of the respondents did not know what orthodontic aligners were. Younger participants had more knowledge about aligners than older participants. Patients still need more knowledge about the types of appliances available for orthodontic treatment. When presented with images of the kinds of devices available, almost 80% of participants showed greater satisfaction with aligners.

Correção da inclinação frontal do plano oclusal com utilização de mini-implantes / Correction of frontal inclination of the occlusal plane with the use of mini-implants

Resumo O objetivo deste trabalho é relatar o caso clínico de uma paciente de 21 anos, dolicofacial, classe II com impacção de incisivo lateral superior esquerdo e queixa de inclinação do plano oclusal em vista frontal do sorriso. O tratamento ortodôntico foi realizado com aparelho fixo da prescrição Roth e alinhamento e nivelamento com fios de NiTi. Ao chegar no fio retangular, um mini-implante interradicular foi instalado entre incisivo lateral e canino superior direito (dentes 12 e 13) como ancoragem para mecânica intrusiva nessa região. Ainda durante essa fase, foi realizada a extrusão do dente 23 para nivelamento da margem gengival em relação aos incisivos. Após 11 meses, a inclinação do plano oclusal em vista frontal sorrindo foi corrigida e iniciada a fase de finalização. Ao final do tratamento, foi realizada a reanatomização do dente 23 transformando-o em incisivo lateral, o que resultou em um sorriso estético e harmônico. Por meio desse caso clínico, conclui-se que a inclinação frontal do plano oclusal de origem dentoalveolar pode ser corrigida com a ajuda da ancoragem esquelética em casos onde haja boa exposição gengival na região anterior (AU)

Abstract The objective of this study is to report a clinical case of 21-year-old female, hyperdivergent Class II patient with impaction of the maxillary left lateral incisor and a complaint of inclination of the occlusal plane in a frontal view of the smile. Orthodontic treatment was performed with a Roth prescription fixed appliance and alignment and leveling with NiTi wires. Upon reaching the rectangular wire, an interradicular mini-implant was inserted between the maxillary right lateral incisor and the maxillary right canine (teeth 12 and 13) as an anchorage for intrusive mechanics in this region. Also, during this phase, the extrusion of tooth 23 was performed to level the gingival margin in relation to the incisors. After 11 months, the inclination of the occlusal plane in a smiling frontal view was corrected and the finishing phase began. At the end of the treatment, tooth 23 was re-anatomized, transforming it into a lateral incisor, which resulted in an aesthetic and harmonious smile. Through this clinical case, it is concluded that the frontal inclination of the occlusal plane of dentoalveolar origin can be corrected with the help of skeletal anchorage in cases where there is good gingival exposure in the anterior region. (AU)

Tratamento de uma má oclusão de Classe II com propulsor mandibular Forsus associado à tração de canino inferior impactado devido ao odontoma ­ relato de caso / Treatment of a Class II malocclusion with Forsus appliance associated with traction of an impacted mandibular canine due to odontoma ­ a case report

Resumo O objetivo deste caso clínico foi relatar o tratamento de uma paciente portadora de má oclusão de Classe II com aparelho de propulsão mandibular fixo Forsus associado à tração de canino inferior retido devido a um odontoma. Após exame clínico e radiográfico, foi detectada a retenção prolongada do canino inferior decíduo direito devido à presença desse odontoma. O exame clínico também mostrou que a paciente apresentava uma má oclusão de Classe II. Após a extração do dente decíduo e excisão do odontoma, foi colado um acessório no canino retido e instalado o aparelho fixo. Inicialmente, foi planejada a instalação de um APM devido ao seu baixo custo, no entanto, a paciente não se adaptou e foi instalado um Forsus. Ao final de 48 meses, o canino inferior direito alcançou o plano oclusal e a má oclusão de Classe II foi corrigida. Após 2 anos da finalização do tratamento, os resultados obtidos se mostraram estáveis. O objetivo foi avaliar os efeitos dentários e tecidos moles no tratamento da má oclusão de Classe II leve a moderada de uma paciente no final de crescimento puberal, analisando o antes e depois da face no desenvolvimento dentofacial e os efeitos do aparelho de protração. Concluiu-se que o propulsor mandibular associado ao aparelho fixo corrigiu a má oclusão de Classe II basicamente através da protrusão dentoalveolar do arco inferior. (AU)

Abstract The objective of this case report is to present the treatment of a patient with Class II malocclusion with a Forsus fixed appliance associated with the traction of an impacted mandibular canine due to an odontoma. After clinical and radiographic examination, prolonged right primary mandibular canine retention was detected. In addition, the mandibular canine was impacted due to the presence of this odontoma. Clinical analysis also showed that the patient had a Class II malocclusion. After the extraction of the primary canine and excision of the odontoma, an orthodontic accessory was bonded to the impacted canine, and the fixed appliance was placed. Initially, an APM (mandibular protractor appliance) was planned due to its low cost. However, the patient did not cooperate with its use, and a Forsus was placed. At the end of 48 months, the right mandibular canine reached the occlusal plane, and the Class II malocclusion was corrected. (AU)