Risk factors for anterior open bite: A case-control study.

BACKGROUND: Anterior open bite (AOB) is noteworthy because it is a complex dysplasia, and clinical studies on this malocclusion are usually epidemiological studies or experimental models with small samples and no control group, which renders the data on AOB incomplete and therefore inconclusive. The objective this study was to assess the risk factors involved in developing AOB. MATERIALS AND METHODS: A case-control study was provided with a total of 96 lateral cephalometric radiographs of male and female patients aged between 8 and 14 years were used, regardless of facial type. The dependent variable was the presence or absence of AOB, which divided the participants into case and control groups, respectively; these groups were matched for gender and age. The case and control groups data were analyzed by descriptive and inferential analysis by binary logistic regression using at the 5% significance level. RESULTS: The occurrence of AOB was associated with the presence of deleterious oral habits (P = 0.014; Chi-square test) and was approximately three times (odds ratio = 3.04) more likely to occur in participants with AOB. No significant association between the presence of mouth breathing and the occurrence of AOB was found (P = 0.151; Chi-square test). The odds associated with tongue interposition were 10.51 times higher than those of participants with no such deglutition. The odds associated with the dolichofacial pattern were 5.74 times those of participants with a nondolichofacial pattern. CONCLUSION: Tongue interposition and dolichocephalic facial pattern were risk factors for developing AOB.

Associação entre padrão de crescimento facial e dimensão de orofaringe / Association between facial growth pattern and oropharynx dimension

Este estudo objetivou investigar a associação entre estenose de naso e orofaringe com o padrão de desenvolvimento facial. Selecionou-se 96 telerradiografias laterais digitais, pré-tratamento ortodôntico, faixa etária de 8 a 14 anos. Para a determinação do padrão facial foram utilizados o índice Vert de Riketts e o quociente de Jarabak. Os dados foram analisados através do Statistical Package for Social Sciences 20 (SPSS). O teste qui-quadrado foi utilizado nos cruzamentos das variáveis naso e orofaringe com tipo facial. Para analisar a concordância intraexaminador, foi realizado o teste Kappa. Segundo a classificação de Ricketts, a maioria da amostra consiste em pacientes com padrão dolicofacial, enquanto que, segundo análise Jarabak, na mesma amostra, a predominância foi do padrão braquifacial. Ao analisar as condições das vias aéreas, observou-se uma relação significativa entre estenose de nasofaringe e o perfil dolicofacial, quando classificado por Jarabak. Usando a classificação de Ricketts, essa mesma associação não foi observada. Considerando-se a orofaringe, não foram encontradas associações estatisticamente significantes com o padrão facial. Houve divergência na classificação do padrão facial de crescimento quando comparadas as análises de Ricketts e Jarabak; ao analisar as dimensões das vias aéreas, associada ao padrão facial, observou-se uma relação significativa entre o estreitamento da nasofaringe e o perfil dolicocefálico, quando classificado por Jarabak. O mesmo não foi evidenciado ao utilizar-se a classificação de Ricketts. Considerando-se a orofaringe, não houve associação desta com nenhuma das classificações de padrão facial utilizadas neste trabalho de pesquisa. (AU)

This study aimed to investigate the association between naso stenosis and oropharynx with facial development pattern. We selected 96 lateral digital teleradiographs, pre-orthodontic treatment, age range from 8 to 14 years old. The Riketts Vert index and the Jarabak quotient were used to determine the facial pattern. Data were analyzed through the Statistical Package for Social Sciences 20 (SPSS). The chi-square test was used in the naso and oropharyngeal variables crossing with facial type. To analyze the intra-examiner agreement, the Kappa test was performed. According to Ricketts classification, the majority of the sample consists of patients with a dolichofacial pattern, whereas according to Jarabak, in the same sample, the predominance was brachyfacial. When analyzing the airway conditions, there was a significant relationship between nasopharyngeal stenosis and the dolichofacial profile, when classified by Jarabak. Using the Ricketts classification, the same association was not observed. Considering the oropharynx, no statistically significant associations were found with the facial pattern. There was divergence in the classification of facial growth pattern when comparing the Ricketts and Jarabak analyzes; when analyzing the airways dimensions, associated with facial pattern, a significant relationship was observed between nasopharyngeal narrowing and the dolichocephalic profile, when classified by Jarabak. The same was not evidenced using the Ricketts classification. Considering the oropharynx, there was no association of this with any of the facial pattern classifications used in this research study.(AU)

Facial Growth Changes Induced by Orthodontic Treatment in Patients With Unilateral Cleft Lip and Palate.

The aim of this study was to investigate the effect of orthodontic treatment on the maxillofacial growth of patients with unilateral cleft lip and palate. The Great Ormond Street, London and Oslo (GOSLON) yardstick was used for a longitudinal evaluation of 24 patients with cleft lip and palate treated at the Cleft Center of the Lauro Wanderley University Hospital, Paraiba State, northeastern Brazil. Dental casts were evaluated by 3 orthodontists and classified according to the GOSLON yardstick. The evaluation was performed at 2 different stages: T1 (before orthodontic treatment) and T2 (follow-up evaluation) after a 6-year mean follow-up interval. The Kappa test was used to evaluate intra- and interexaminer agreement, and paired t-test was used to compare the differences between T1 and T2, with a 99% confidence interval. The average intraexaminer Kappa was 0.979, ranging from 0.971 to 0.990. The interexaminer Kappa value was 0.926 at T1, ranging from 0.885 to 0.964, and 0.896 at T2, ranging from 0.696 to 1.0. The mean GOSLON yardstick found at T1 was 2.5 ±â€Š1.18 with 50% in G1 + G2, 29.18% in G3, and 20.82% in G4 + G5. At T2, the GOSLON average was 1.71 ±â€Š1.12, with 79.18% in G1 + G2, 12.5% in G3, and 8.32% in G4 + G5. A statistically significant difference was found between T1 and T2. The results suggest that orthodontic treatment improves facial growth in patients with unilateral cleft lip and palate.

Assessment of upper airways measurements in patients with mandibular skeletal Class II malocclusion.

OBJECTIVE: Mandibular Class II malocclusions seem to interfere in upper airways measurements. The aim of this study was to assess the upper airways measurements of patients with skeletal Class II malocclusion in order to investigate the association between these measurements and the position and length of the mandible as well as mandibular growth trend, comparing the Class II group with a Class I one. METHODS: A total of 80 lateral cephalograms from 80 individuals aged between 10 and 17 years old were assessed. Forty radiographs of Class I malocclusion individuals were matched by age with forty radiographs of individuals with mandibular Class II malocclusion. McNamara Jr., Ricketts, Downs and Jarabak's measurements were used for cephalometric evaluation. Data were submitted to descriptive and inferential statistical analysis by means of SPSS 20.0 statistical package. Student's t-test, Pearson correlation and intraclass correlation coefficient were used. A 95% confidence interval and 5% significance level were adopted to interpret the results. RESULTS: There were differences between groups. Oropharynx and nasopharynx sizes as well as mandibular position and length were found to be reduced in Class II individuals. There was a statistically significant positive correlation between the size of the oropharynx and Xi-Pm, Co-Gn and SNB measurements. In addition, the size of the nasopharynx was found to be correlated with Xi-Pm, Co-Gn, facial depth, SNB, facial axis and FMA. CONCLUSION: Individuals with mandibular Class II malocclusion were shown to have upper airways measurements diminished. There was a correlation between mandibular length and position and the size of oropharynx and nasopharynx.

Assessment of upper airways measurements in patients with mandibular skeletal Class II malocclusion

Objective: Mandibular Class II malocclusions seem to interfere in upper airways measurements. The aim of this study was to assess the upper airways measurements of patients with skeletal Class II malocclusion in order to investigate the association between these measurements and the position and length of the mandible as well as mandibular growth trend, comparing the Class II group with a Class I one.Methods:A total of 80 lateral cephalograms from 80 individuals aged between 10 and 17 years old were assessed. Forty radiographs of Class I malocclusion individuals were matched by age with forty radiographs of individuals with mandibular Class II malocclusion. McNamara Jr., Ricketts, Downs and Jarabak's measurements were used for cephalometric evaluation. Data were submitted to descriptive and inferential statistical analysis by means of SPSS 20.0 statistical package. Student's t-test, Pearson correlation and intraclass correlation coefficient were used. A 95% confidence interval and 5% significance level were adopted to interpret the results.Results:There were differences between groups. Oropharynx and nasopharynx sizes as well as mandibular position and length were found to be reduced in Class II individuals. There was a statistically significant positive correlation between the size of the oropharynx and Xi-Pm, Co-Gn and SNB measurements. In addition, the size of the nasopharynx was found to be correlated with Xi-Pm, Co-Gn, facial depth, SNB, facial axis and FMA.Conclusion: Individuals with mandibular Class II malocclusion were shown to have upper airways measurements diminished. There was a correlation between mandibular length and position and the size of oropharynx and nasopharynx.

Introdução: as más oclusões de Classe II mandibulares parecem interferir nas dimensões das vias aéreas superiores. Assim, o objetivo do presente estudo foi avaliar as vias aéreas superiores de pacientes com Classe II esquelética, verificando a associação entre essas dimensões e a posição mandibular, o comprimento mandibular e a tendência de crescimento, comparando-os com um grupo pareado de pacientes com Classe I.Métodos: foram avaliadas 80 telerradiografias de perfil de 80 pacientes com 10 a 17 anos de idade, sendo 40 com má oclusão de Classe I e 40 com Classe II mandibular, pareados por idade. Para a avaliação cefalométrica, foram utilizadas medidas de McNamara Jr, Ricketts, Downs e Jarabak. Os dados foram submetidos à análise estatística descritiva e inferencial, por meio dosoftware SPSS 20.0, utilizando-se os testest de Student, coeficiente de correlação de Pearson e coeficiente de correlação intraclasse. Para interpretação dos resultados, adotou-se um intervalo de confiança de 95% e nível de significância de 5%.Resultados: houve diferença entre os grupos, e as medidas da orofaringe e nasofaringe foram menores no grupo de Classe II, assim como as medidas de comprimento e posição mandibular. Houve correlação positiva estatisticamente significativa entre a orofaringe e as medidas Xi-Pm, Co-Gn e SNB; já a nasofaringe apresentou correlação com as medidas Xi-Pm, Co-Gn, profundidade facial, SNB, eixo facial e FMA.Conclusão: indivíduos portadores de Classe II mandibular apresentaram as medidas das vias aéreas superiores diminuídas. Observou-se uma correlação entre o comprimento mandibular e a posição mandibular e as dimensões da orofaringe e da nasofaringe.

A Ortodontia como pilar na reabilitação do paciente com fissura labiopalatina / Orthodontics as a pillar in rehabilitations with cleft palate

As fissuras labiopalatinas são as malformações congênitas mais frequentes na face do ser humano e compromete as estruturas em diversos níveis de complexidade. Em função disso, o seu tratamento envolve uma equipe multidisciplinar da qual a Ortodontia faz parte como um dos pilares. O objetivo do presente artigo é de esclarecer o papel da Ortodontia no processo reabilitador, descrevendo as más oclusões mais comuns associadas à cada tipo de fissura, bem como alguns protocolos de tratamento empregados.

Cleft lip and palate deformities are one of the most common birth defects and it may affect the structures at different levels of complexity. Thus, the treatment involves a multidisciplinary team and the orthodontist has an important function. The aim of this paper is to describe more commons malocclusions related to cleft and some treatments protocols.

Facial growth evaluation of complete unilateral cleft lip and palate operated patients: a cleft reference center in Paraíba, Brazil, using the "GOSLON" yardstick.

OBJECTIVES: To evaluate the surgical outcomes of patients with complete unilateral cleft lip and palate (CUCLP) operated on by a single surgeon of the cleft reference center of the Lauro Wanderley University Hospital at the Federal University of Paraiba. METHODS: Forty-four individuals' dental casts diagnosed with CUCLP, born between 1995 and 2002, mean age of 11 years, were evaluated by three calibrated orthodontic specialists and scored by the Great Ormond Street, London and Oslo (GOSLON) yardstick on two occasions. The scores were compared with those observed in other centers around the world. The Kappa test was applied to evaluate the intra- and inter-examiner agreement. Descriptive statistics was applied for the GOSLON yardsticks core. RESULTS: The mean GOSLON score was 2.75. For the GOSLON yardstick, 43.2 % of the sample presented scores 1 and 2, 31.8 % had score 3, and 25 % were with scores 4 and 5. There was very good intra- and inter-examiner Kappa agreement in the application of the GOSLON yardstick. CONCLUSIONS: The data suggest favorable outcomes, with 75 % of cases with no need of orthognathic surgery. The Kappa values confirmed the high reproducibility of the GOSLON yardstick.

Variáveis relacionadas ao crescimento dos arcos dentários de portadores de fissuras labiopalatinas transforame incisivo unilateral / Variables related to the growth of the dental arches in patients wit unilateral cleft lip and palate

O presente trabalho tem como objetivo avaliar a associação das variáveis relacionadas às fissuras labiopalatinas transforame incisivo unilateral (FTIU) que interferem no índice de crescimento dos arcos dentários. As variáveis analisadas foram a extensão da fissura, presença de bandeleta de Simonart e idade de realização das cirurgias de queiloplastia e palatoplastia. Foi avaliado o índice de Goslon de 44 modelos de gesso consecutivos, pré-tratamento ortodôntico de indivíduos portadores de FTIU tratados no serviço de fissuras labiopalatinas do Hospital Universitário Lauro Wanderley (HULW) - UFPB, operados pelo mesmo cirurgião. Os modelos foram categorizados por três examinadores, ortodontistas com experiência no tratamento de portadores de fissuras labiopalatinas, previamente calibrados (K=0,905). As variáveis foram cruzadas utilizando se o teste qui quadrado com intervalo de confiança de 5% (p<0,05). As variáveis que demonstraram associação com o índice de Goslon foram a presença de bandeleta de Simonart (p= 0,011) e extensão da fissura (p=0,035), além de haver uma forte associação entre a extensão da fissura e a presença da bandeleta de Simonart (p=0,003). As idades de realização da queiloplastia e da palatoplastia não demonstraram associação estatisticamente significante (p>0,05), concluindo-se que variáveis inerentes à própria fissura podem interferir no prognóstico do crescimento maxilar dos pacientes portadores de FTIU à longo prazo.

This study aims to evaluate the association of variables related to unilateral cleft lip and palate (UCLP) that interfere in the growth rate of the dental arches. The variables analyzed were the extent of the fissure, the presence of bandeleta Simonart, cheiloplasty day of age and palatoplasty. It was assessed in plaster models of 44 consecutive7, pre-orthodontic treatment of individuals with UCLP treated cleft lip and palate service in the University Hospital Lauro Wanderley (HULW) - UFPB, operated by the same surgeon.The models were evaluated by three examiners, orthodontist with experience in treating patients with cleft lip and palate (K=0,905). The variables were combined using the chi square confidence interval p<0.05. The variables that showed association with the index were the presence of Goslon bandeleta of Simonart (p = 0.011) and the extent of the fissure (p = 0.035), and there is a strong association between the extent of the fissure and the presence of bandeleta Simonart (p=0.003). The ages of achievement of cheiloplasty and palatoplasty showed no statistically significant association (p> 0.05). It was concluded that variables inherent in the cleft can interfere in the prognosis of maxillary growth in patients with long-term UCLP.