Influência de drogas anticonvulsivantes no tratamento ortodôntico / Influence of anticonvulsant drugs on orthodontic treatment

As drogas utilizadas para prevenção de convulsões podem impactar na movimentação dentária durante o tratamento ortodôntico. O objetivo deste estudo foi avaliar a influência de drogas anticonvulsivantes no tratamento ortodôntico. O desenho deste estudo é uma revisão narrativa da literatura onde uma busca eletrônica foi realizada sem restrição de idioma e data em três bases de dados (PubMed via MEDLINE, SCOPUS e BVS). Foram utilizados os seguintes termos para o PubMed e BVS: anticonvulsants drugs AND orthodontic movement e para o SCOPUS: anticonvulsants AND drugs AND orthodontic AND movement. Uma pesquisa complementar foi realizada nas referências bibliográficas dos estudos incluídos. Os artigos indicaram que o uso de medicação anticonvulsivante favorece o desenvolvimento de hiperplasias gengivais, xerostomia e alterações no metabolismo ósseo que modulam a taxa de movimentação ortodôntica. Dentro das limitações desta revisão, concluiu-se que não há contraindicações para tratamento ortodôntico em pacientes utilizando anticonvulsivantes, no entanto os ortodontistas devem estar cientes dos potenciais efeitos adversos advindos do uso desses medicamentos para que possam adotar medidas para mitigar esses riscos.

Drugs used to prevent seizures can have an impact on tooth movement during orthodontic treatment. This study aimed to evaluate the influence of anticonvulsant medications on orthodontic treatment. The design of this study is a narrative literature review in which an electronic search was carried out without language or date restriction in three databases (PubMed/MEDLINE, SCOPUS, and BVS). The following terms were used for PubMed and BVS: anticonvulsants drugs AND orthodontic movement and SCOPUS: anticonvulsants AND drugs AND orthodontic AND movement. A complementary search was carried out on the bibliographical references of the included studies. The articles indicated that using anticonvulsant medication favors the development of gingival hyperplasia, xerostomia, and alterations in bone metabolism that modulate the rate of orthodontic movement. Within the limitations of this review, it was concluded that there is no contraindication for orthodontic treatment in patients using anticonvulsants. However, orthodontists should be aware of the potential adverse effects arising from the use of these drugs so that they can adopt measures to minimize these risks.

Percentage of patients shifting to another treatment modality: An experience-guided decision.

OBJECTIVE: This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. MATERIAL AND METHODS: This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). RESULTS: Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. CONCLUSIONS: A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.

Molar distalization in orthodontics: a bibliometric analysis.

OBJECTIVES: The study endeavors to undertake a bibliometric analysis on molar distalization, with the objective of illuminating its evolutionary trajectory, current status, and prognosticating future research hotspots and trends. MATERIAL AND METHODS: A comprehensive exploration of the literature on molar distalization was carried out by conducting a search in the Web of Science (WOS) core database of the University of Hong Kong Electronic Library. The search for topic terms employed included "molar distalization," "molar distalisation," "move molar distally," "molar distal movement," and "molar backwards." The search results were subsequently subjected to meticulous analysis using CiteSpace software. This analysis encompassed various facets such as the citation count; the geographical distribution of the countries, institutions, and journals responsible for publishing the articles; the distribution of the authors; the utilization of keywords within the articles; and the analysis of references. RESULTS: A total of 516 articles were included in the analysis. The top 5 countries in terms of the number of published papers were the United States (USA), South Korea, Turkey, Italy, and Germany, and the top 5 institutions in terms of the number of published papers were Kyung Hee University, A.T. Still University of Health Sciences, Catholic University of Korea, Seoul St. Mary's Hospital, and Universidade de Sao Paulo. The top 5 authors in terms of the number of published papers were Park, Kook, Bayome, Janson, and Lee. There was little cooperation overall. The top 3 journals in terms of the most published related articles were all orthodontic-related journals. After molar distalization and anchorage, the most frequently used keywords were distalization, movement, and pendulum appliance. Kinzinger GSM is the most frequently cited author in references, and one of his articles also has the highest centrality score in references. CONCLUSIONS: As the tides of time shift and scholars display an ever-growing dedication to unraveling the intricacies of this therapeutic modality, the realm of molar distalization has undergone notable advancements in technology. Initially, the traditional appliance suffered from aesthetic drawbacks and discomfort. However, contemporary iterations of the appliance have transcended these limitations, boasting enhanced elegance and convenience while concurrently elevating their efficacy. Nevertheless, limitations of current appliances, including their durability and propensity for recurrence post-treatment, continue to necessitate further advancement. Hence, the ongoing scientific inquiry aims to delve deeper into refining treatment modalities and fabricating cutting-edge appliances within this realm. CLINICAL RELEVANCE: This study holds the potential to significantly enhance the ability of orthodontists to devise treatment protocols and offer state-of-the-art clinical recommendations, thereby empowering them to deliver advanced and refined orthodontic interventions.

Microbial contamination profile on esthetic elastomeric ligatures through the checkerboard DNA-DNA hybridization technique : A randomized split-mouth study.

OBJECTIVE: The aim of this study is to assess the microbial contamination of three different brands of esthetic elastomeric ligatures. MATERIALS AND METHODS: Different brands of esthetic ligatures (Unistick Pearl [American Orthodontics, Sheboygan, WI, USA], Power Sticks Pearl [Ortho Technology, Tampa, FL, USA], and Ease [Obscure, 3M Unitek, Monrovia, CA, USA]) were randomly assigned to permanent canines of 25 patients (aged 11-18 years) undergoing corrective orthodontic treatment. After 30 days, the ligatures were removed, processed, and the biofilm composition was analyzed by checkerboard DNA-DNA hybridization for 40 bacterial species. The microbiological data were analyzed using a nonparametric mixed model. RESULTS: The ligatures presented intense microbial contamination after 30 days, but no statistically significant differences were observed among the three groups (p > 0.05). The levels of the evaluated individual species and proportions of the microbial complexes showed no statistically significant differences among the ligature groups (p > 0.05). CONCLUSIONS: Esthetic elastomeric ligatures became multicolonized by several bacterial species after 30 days of exposure to the oral cavity. However, no relevant differences were observed among the biofilm composition formed on the different ligature brands.

Eficiência da prescrição de bráquetes ortodônticos no tratamento com diferentes sistemas de bráquetes - uma proposta clínica / Orthodontic bracket prescription efficiency in treatment with different bracket systems - a clinical proposal

Com a diversificação das prescrições existentes, a correta escolha de acordo com a necessidade individual de cada má oclusão pode ser importante para estabelecer maior controle biomecânico durante o tratamento ortodôntico. Este estudo teve como objetivo avaliar o tratamento ortodôntico com a versatilidade na associação de diferentes prescrições em um relato de caso clínico e determinar se existe alguma relação com a dimensão vertical, transversal e o perímetro de arco que podem contribuir com a estabilidade e longevidade do tratamento ortodôntico. A prescrição, quando corretamente indicada, tem impacto no controle do movimento dentário para estabelecer oclusão, estética e estabilidade adequadas. Concluiu-se que o surgimento de novas prescrições tende a favorecer ao máximo a abrangência de mais pacientes no tratamento ortodôntico (AU)

With the diversification of existing bracket prescriptions, the correct choice according to the individual needs of each malocclusion is essential to establish greater biomechanical control during orthodontic treatment. This study aimed to evaluate orthodontic treatment with the versatility in association of different prescriptions in a clinical case report and to determine whether there is any relationship with the vertical dimension, transverse dimension, and arch perimeter that can contribute to the stability and longevity of the orthodontic treatment. The prescription, when correctly indicated, has an impact on the control of tooth movement to establish proper occlusion, esthetics, and stability. It was concluded that the emergence of new prescriptions favors the maximum coverage of more patients in orthodontic treatment. (AU)

Efeito do armazenamento em longo prazo sobre as características mecânicas dos elásticos de látex e sintéticos / Effect of long-term storage on the mechanical characteristics of latex and synthetic elastics

Este estudo objetivou determinar o efeito do armazenamento em longo prazo nas características mecânicas dos elásticos intermaxilares e o período apropriado para substituição no uso clínico. 270 elásticos (135 látex e 135 sintéticos), 3/16" médio, foram submetidos a testes de tração uniaxial com estiramento de 200% até 600% dos seus diâmetros internos. Os elásticos foram divididos nos grupos "Como Recebidos" (CR, n = 15); armazenados em refrigerador por 3 anos (n = 60), e armazenados à temperatura ambiente por 3 anos (n = 60). Os grupos de elásticos armazenados foram subdivididos em 4 subgrupos (n = 15 cada): sem estiramento prévio (SEP); estiramento prévio simulando o ambiente intraoral por 24 horas (EP24h), 48 horas (EP48h) e 72 horas (EP72h). Quanto aos elásticos de látex, as forças expressadas pelo grupo SEP, independente da temperatura de armazenamento, permaneceram similares às forças do grupo CR. Elásticos armazenados em temperatura ambiente de SEP até EP72h perderam aproximadamente 25 gF (p = 0.001), enquanto os refrigerados perderam em média 10 gF (p = 0.05). Sobre os elásticos sintéticos, o grupo SEP, independente da temperatura de armazenamento, ganhou, em média, 50 gF (p = 0.001) em comparação ao grupo CR. Os armazenados em temperatura ambiente, desde SEP até EP72h, perderam em média 30 gF (p = 0.001), enquanto os refrigerados perderam aproximadamente 50 gF (p = 0.001). Concluiu-se que os elásticos ortodônticos armazenados em longo prazo em suas embalagens originais expressam forças maiores do que os elásticos novos, e ao usar clinicamente elásticos armazenados a longo prazo, as substituições podem ser feitas a cada 72 horas sem perda da eficiência mecânica (AU)

This paper aimed to determine the effect of long-term storage on latex and non-latex intermaxillary elastics, and the proper time between substitutions. 270 elastics (135 latex and 135 non-latex elastics), medium force and standard size of 3/16", underwent uniaxial tensile tests with increase from 200% to 600% of their inner diameter. Each type was divided into groups of as received elastics (AR - n = 15), 3 years stored under refrigeration (n=60), and e years stored at room temperature (n=60). The stored groups were divided into 4 subgroups (n = 15): no previous stretching (NPS), pre-stretched si mulating the intraoral environment during 24 hours (PS24h), 48 hours (PS48h), and 72 hours (PS72h). About the elastics of latex, the forces expressed by the NPS at room temperature remained equal to the AR, while the forces of the refrigerated NPS had increased ±70 gF on average (p = 0.001). PS24h to PS72h at room temperature showed loss of ±20 gF (p = 0.001) when compared to the NPS or to AR. Non-latex - NPS, regardless of the temperature of storage, increased forces ± 70gF (p = 0.001) when compared to the AR. Starting at PS24h to PS72h, it was seen an average loss of ± 40gF (p = 0.001) when compared to the NPS. All 3 years stored non-latex elastics forces increased ± 30gF (p = 0.01) when compared to the AR. It was concluded that orthodontic elastics long-term stored in their original packages shows higher average forces than new elastics, and the replacement, when using long-term stored could be every 72 hours (AU)

Utilização do Carriere® Motion 3DTM na correção da má oclusão de Classe II / Use of the Carriere® Motion 3DTM to correct Class II malocclusion

Uma opção de tratamento para a má oclusão de Classe II de Angle é a distalização dos molares superiores, que pode ser obtida através de diferentes estratégias. O Carriere® Motion 3DTM (CM3D) é uma alternativa recente para a correção desse tipo de má oclusão e vem alcançando resultados bastante satisfatórios, por meio da distalização em bloco do segmento posterior superior, com controle tridimensional do movimento dentário. Esse aparelho apresenta um design moderno e pode ser utilizado tanto nos casos de Classe II unilaterais como bilaterais. Este trabalho tem como objetivo apresentar o caso de um paciente de 14 anos, portador de uma má oclusão de Classe II divisão 2, que foi tratado com CM3D e ancoragem inferior com arco lingual de Nance. Inicialmente foi instalado o CM3D por quatro meses para correção sagital, seguido por aparelho fixo total superior e inferior para finalização do caso. Após 24 meses de tratamento, observou-se significante melhora no sorriso e no perfil do paciente. CM3D é uma opção eficaz, prática, estética e de fácil aplicação profissional e bem aceito pelo paciente para o tratamento da má oclusão de Classe II. (AU)

A treatment option for Class II Angle occlusion is the distalization of the upper molars, which can inform through different strategies. The Carriere® Motion 3DTM (CM3D) is a recent alternative for the correction of this type of malocclusion and it has been achieving satisfactory results, utilizing block distalization of the upper posterior segment, with three-dimensional control of tooth movement. This device has a modern design and can be used in both unilateral and bilateral Class II cases. This study aims to present a case of a 14-year-old patient with Class II division 2 malocclusion, who was treated with the CM3D and lower anchorage with Nances lingual arch. Initially, it was installed a CM3D for four months for sagittal correction, followed by a total upper and lower fixed device for finalizing the case. After 24 months of detected treatment, the the patients' smile and profile significantly improved. The CM3D is a useful, practical, aesthetic, and easy to apply professional and well accepted option for the treatment of Class II malocclusion.(AU)

Methodological Quality of Systematic Reviews Addressing Orthodontic Interventions: Methodological Study

ABSTRACT Objective: To assess the methodological quality and characteristics of systematic reviews (SRs) of interventional studies in orthodontics and assess how the certainty of the evidence is reported using the GRADE approach. Material and Methods: Six electronic databases were searched, followed by a hand search of the reference lists of eligible studies (PROSPERO #CRD42020180852). The required study design was randomized and nonrandomized studies of interventions published between January 2019 and May 2020. The Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool was used for the quality appraisal of the included SRs. Paired reviewers independently screened the studies, extracted data, and appraised the methodological quality. Results: The study included 46 SRs; 19.5% had moderate to high methodological quality, and the remaining had low to critically low methodological quality. Fifty-four percent of the reviews assessed the certainty of evidence using the GRADE approach, and 34.8% followed all GRADE criteria. Conclusion: Most reviews had a good judgment of the AMSTAR2 items, although some critical items contributed to decreased overall quality. Half of the reviews used the GRADE approach to assess the certainty of the evidence, and this approach should be included in future systematic reviews of interventions.

Remineralization of white spot lesions in orthodontic. is that possible? Literature review / Remineralização de lesões de mancha branca em Ortodontia. Isso é possível? Revisão de literatura

Aim: The aim of this literature review is to describe the latest treatment available in the solution of this problem through remineralization. Literature review: A literature review was carried out in various electronic databases such as PubMed, MEDLINE, EBSCO, LILACS, EMBASE, Cochrane Library; from 1989 to 2022. The Medical Subject Headings (MeSH) terms used in the literature search were in English: "tooth reminaralization", "dental white spot", "orthodontic. Discussion: White spot lesions after orthodontic appliances is an undesired effect seen in dentistry. There is a wide option of agents that offer remineralization by the process of depositing calcium and phosphate ions into crystal voids in demineralized enamel, producing net mineral gain and preventing early enamel lesions progression, including fluoride toothpastes, fluoride varnishes, fluoride mouth rinses, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). Conclusion: Fluoride-based prevention strategies are the agent with the strongest evidence for the treatment of WSL. The dental professional should offer this therapy in the earliest phase of the lesions so that it can be remineralized.

Objetivo: O objetivo desta revisão de literatura é descrever osmais recentestratamentos disponíveisna remineralizaçãode lesões de mancha branca.Revisão da literatura: Foi realizada uma revisão da literatura em várias bases de dados eletrônicas como PubMed, MEDLINE, EBSCO, LILACS, EMBASE, Cochrane Library; de 1989 a 2022. Os termos do Medical Subject Headings (MeSH) utilizados na busca da literatura foram em inglês: "tooth reminaralization", "dental white spot", "orthodontics".Discussão: A lesão de mancha branca após utilização de aparelhos ortodônticos é um efeito indesejado observado na odontologia. Existe uma ampla opção de agentes que oferecem remineralização pelo processo de deposição de íons cálcio e fosfato nos cristaisdo esmalte desmineralizado, produzindoganho mineral líquido e prevenindo a progressão precoce das lesões do esmalte, incluindo cremes dentais com flúor, vernizes com flúor, enxaguatórios bucaiscom flúor e caseína fosfopeptídeo-fosfato de cálcio amorfo (CPP-ACP).Conclusão: As estratégias de prevenção utilizandoflúor constituem osagentescom mais evidências para o tratamento da mancha branca. O dentista deve oferecer essa terapia na fase inicial das lesões para que haja remineralização.

Force decay and elongation of orthodontic elastomeric chains exposed to different beverages common in the diet: An in vitro study.

BACKGROUND: Elastomeric chains promote controlled movements and are widely used in orthodontics. OBJECTIVES: The aim of the study was to evaluate the force decay and elongation of orthodontic chains exposed to low-pH saliva (pH = 4) and different beverages common in the diet. MATERIAL AND METHODS: Force decay and elongation were determined in vitro at 6 time intervals over 21 days for 2 commercial elastomeric chains - Ormco (group A) and Borgatta (group B). The samples were immersed in artificial saliva (AS) at pH 4, Coca-Cola®, coffee, or beer for 15 min every day, or in AS (the control group). For the remaining time, the chains were placed into AS at 37°C. In addition, microscopic qualitative changes were recorded by means of scanning electron microscopy (SEM). RESULTS: The group B chains showed higher force decay and elongation at the end of the follow-up as compared to the group A chains. Exposure to beer had a greater impact on the force decay and elongation of the chains as compared to other liquids, but it was not statistically significant. The group A chains showed a more irregular surface than the group B chains, in particular, those exposed to coffee. CONCLUSIONS: Elastomeric chains suffer force decay and elongation as a function of time, mainly in the first 24 h. At the end of the follow-up, the group A chains exhibited less force decay in comparison with the group B chains. The qualitative observations showed that the chains in group A had a more irregular surface than the chains in group B.

Inflammatory parameters and color alterations of dental bleaching in patients wearing fixed orthodontic appliance: a randomized clinical trial.

BACKGROUND: Many orthodontic patients request dental bleaching during orthodontic treatment to achieve a faster aesthetic resolution, however, no attention has been paid to the inflammatory processes that can occur when both therapies are indicated together. So, this clinical trial evaluated the inflammatory parameters and color alterations associated with dental bleaching in patients wearing a fixed orthodontic appliance. METHODS: Thirty individuals aged between 18 and 40 years were equally and randomly allocated into three groups: FOA (fixed orthodontic appliance), BLE (dental bleaching), and FOA + BLE (fixed orthodontic appliance + dental bleaching). The orthodontic appliances and the bleaching procedures were performed in the maxillary premolars and molars. For dental bleaching a 35% hydrogen peroxide was used. The gingival crevicular fluid (GCF) and nitric oxide (NO-) levels were evaluated at different time-points. Color evaluation was performed using an Easyshade spectrophotometer at baseline (FOA, FOA + BLE, BLE), one month after (FOA + BLE) and 21 days after appliance removing (FOA + BLE and FOA groups), in each tooth bleached. The ANOVA and Tukey's tests, with a significance level of 5%, were used for statistical analysis. RESULTS: The GCF volume in the FOA + BLE and FOA groups significantly increased at the time points evaluated (p < 0.001); however, this did not occur in the BLE group (p > 0.05). On the other hand, NO- levels significantly decreased during dental bleaching with or without fixed orthodontic appliances (FOA + BLE and BLE groups; p < 0.05), while no significant changes were observed in the FOA group (p > 0.05). Significant changes in color were observed in the FOA + BLE and BLE groups compared to in the FOA group (p < 0.01). However, the presence of fixed orthodontic appliance (FOA + BLE) negatively affected the bleaching efficacy compared to BLE group (p < 0.01). CONCLUSIONS: Dental bleaching did not increase the inflammatory parameters in patients wearing fixed orthodontic appliance. However, in the presence of orthodontic appliances, the bleaching efficacy was lower than that of bleaching teeth without orthodontic appliances. TRIAL REGISTRATION: RBR-3sqsh8 (first trial registration: 09/07/2018).

Tratamento da classe III com disjunção maxilar e tração reversa da maxila: relato de caso clínico / Class III treatment weth maxillary disjunction and reverse maxillary traction: clinical case report

Objetivo: A má oclusão classe III de Angle se caracteriza por protrusão mandibular, retrusão maxilar ou pela combinação de ambas. Além de prejudicar a estética facial do paciente, essa má oclusão pode causar alterações funcionais e respiratórias. Uma das alternativas de tratamento para esses casos é o uso da máscara de Petit e do aparelho disjuntor de Hyrax. Este estudo tem como objetivo avaliar por meio da cefalometria ortodôntica se o tratamento com expansão maxilar em conjunto com a tração reversa da maxila diminuem os agravos estéticos e funcionais do paciente Classe III. Relato de caso: o relato de caso descrito no presente trabalho é sobre uma paciente que foi submetida a esse tratamento, sendo descrito por meio de análises cefalométricas, exames radiográficos, fotos intrabucais e achados clínicos. Considerações finais: A verificação dos resultados obtidos após o término do tratamento mostrou que a paciente teve uma boa adesão ao uso desses aparelhos e obteve resultados satisfatórios na sua função mastigatória, na sua oclusão e na sua estética facial e dentária.(AU)

Objective: Angle class III malocclusion is characterized by mandibular protrusion, maxillary retrusion or a combination of both. In addition to impairing the patient's facial aesthetics, this malocclusion can cause functional and respiratory changes. One of the treatment alternatives for these cases is the use of the Petit mask and the Hyrax breaker device. This study aims to evaluate, through orthodontic cephalometry, whether the treatment with maxillary expansion in conjunction with the reverse traction of the maxilla reduces the aesthetic and functional problems of Class III patients. Case report: the case report described in the present work is about a patient who underwent this treatment, being described through cephalometric analysis, radiographic examinations, intraoral photos and clinical findings. Final considerations: The verification of the results obtained after the end of the treatment showed that the patient had a good adherence to the use of these devices and obtained satisfactory results in her masticatory function, in her occlusion and in her facial and dental aesthetics.(AU)

Avaliação da eficácia do acessório mamilo na remoção dos hábitos deletérios / Evaluation of the effectiveness of the nipple accessory in the removal of the deletery habits

Objetivo: avaliar a eficácia do acessório mamilo aplicado a aparelhos ortopédicos/ ortodônticos no tratamento de hábitos deletérios de sucção de chupeta, língua, lábio e dedo, e onicofagia em pacientes tratados nos últimos 20 anos com o aparelho. Métodos: Trata-se de um estudo clínico observacional, retrospectivo, no qual a amostra foi composta de prontuários de pacientes de ambos os gêneros, atendidos por profissionais habilitados pelo aparelho mamilo, que os utilizaram em crianças de 03 a 16 anos portadoras de hábitos deletérios. Os prontuários utilizados, correspondem a pacientes tratados entre os anos 2000 a 2020. Todas as análises foram realizadas no programa R, com nível de significância de 5%. Resultados: Foram analisados 142 prontuários, nos quais 122 foram incluídos, por estarem dentro dos critérios de inclusão propostos no estudo e 20 foram excluídos da pesquisa por apresentarem informações incompletas e/ou não preenchidas corretamente. O hábito com maior incidência foi o de sucção digital, em 71,3% dos pacientes, 91,8% dos pacientes deixaram o hábito, destacando que nos casos de sucção de chupeta e onicofagia, o sucesso na remoção do hábito foi de 100%, em ambos os casos. O tempo médio de uso do aparelho foi de 4,8 meses, variando de 0,6 a 14 meses. O tempo médio para a remoção do hábito após a instalação do aparelho foi de 1,6 meses, variando de 0 a 12 meses. Conclusão: O aparelho mamilo, mostra-se como uma alternativa de alta eficácia na remoção de hábitos deletérios de sução de chupeta, dedo, língua e onicofagia.(AU)

Objective: Evaluate the effectiveness of the nipple accessory applied to orthopedic/orthodontic appliances in the treatment of harmful pacifier, tongue, lip and finger sucking habits, and onychophagia in patients treated in the last 20 years with the device. Methods: This is an observational, retrospective clinical study, in which the sample consisted of medical records of patients of both genders, assisted by professionals qualified by the nipple device, who used them in children aged 03 to 16 years with deleterious habits. The medical records used correspond to patients treated between the years 2000 and 2020. All analyzes were performed in the R program, with a significance level of 5%. Results: 142 medical records were analyzed, in which 122 were included, as they were within the inclusion criteria proposed in the study and 20 were excluded from the research because they presented incomplete information and/or not filled in correctly. The habit with the highest incidence was digital sucking, in 71.3% of patients, 91.8% of patients quit the habit, noting that in cases of pacifier sucking and onychophagia, success in removing the habit was 100%, in both cases. The average time of use of the device was 4.8 months, ranging from 0.6 to 14 months. The mean time to remove the habit after installing the device was 1.6 months, ranging from 0 to 12 months. Conclusion: The nipple device is a highly efficient alternative for removing harmful habits of pacifier, finger, tongue and onychophagy sucking.(AU)

Orthodontic treatment need, the types of brackets and the oral health-related quality of life.

BACKGROUND: Malocclusion can affect the oral health-related quality of life (OHRQoL). The influence of the orthodontic treatment need (OTN) and the type of brackets on OHRQOL is not clear. OBJECTIVES: The aim of the present study was to determine the relationships between OTN and the bracket type and OHRQoL during the first 6 months of orthodontic treatment (OT) in adult patients. MATERIAL AND METHODS: This cohort study was conducted at the Department of Orthodontics of a private university. A total of 216 patients aged ≥18 years participated in the study (106 patients with conventional brackets and 110 with self-ligating brackets). The OHRQoL was evaluated using the 14-item Oral Health Impact Profile (OHIP-14) at 5 time points - before OT (T0), and at 24/48 h (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after the installation of the orthodontic appliance. The OTN was evaluated with the dental aesthetic index (DAI) by 2 previously calibrated operators. For the statistical analysis, the χ2 test and the Mann-Whitney U test were used. Additionally, Poisson regression models were performed. RESULTS: The evidence of an association between OHRQoL and OTN was found only at T3 (p = 0.0095). No association was found between OHRQoL and the bracket type. However, in the regression models, OHRQoL was statistically significantly worse at T3 in the group with a greater OTN (IRR (incidence rate ratio) = 1.34; 95% CI (confidence interval): 1.21;1.48) and at T4 in the self-ligation group (IRR = 1.23; 95% CI: 1.12;1.36). CONCLUSIONS: The OHRQoL was affected in the same way at the beginning of OT, regardless of OTN and the bracket type used. However, a worse OHRQoL was observed at 3 months in subjects with greater OTN and at 6 months in patients with self-ligating brackets.

Effect of oral exposure on chemical, physical, mechanical, and morphologic properties of clear orthodontic aligners.

INTRODUCTION: The dental industry is heavily committed to developing more esthetic solutions for orthodontic treatments. Invisalign is a system of transparent orthodontic aligners introduced as an alternative to conventional orthodontic fittings with brackets and metal wires. This study aimed to assess the chemical, physical, mechanical and morphologic changes in these polymeric aligners after exposure to the oral environment. METHODS: Twenty-four Invisalign orthodontic aligners were equally divided into 2 groups: an in vivo aged group in which patients used aligners for 14 days and the reference group, unexposed to the oral environment. Different experimental techniques were used to study the chemical structure, the color changes and translucency, the density and subsequent volume of the aligners, mechanical properties, surface roughness, morphology and elemental composition. The data were subjected to several statistical analyses. RESULTS: Clear orthodontic aligners exhibit chemical stability but undergo a statistically significant optical change in color and translucency. There was a gradual increase in the water absorption rate and the dimensional variation of the polymer, indicating a strong correlation among these factors. The mechanical properties of the polymer showed a statistically significant decrease in its elastic modulus and hardness. There was a slight tendency toward increased surface roughness of the material, but no statistical differences were found between reference and aged groups. The surface morphology of the used aligners demonstrates microcracks, distortions and biofilm formation. CONCLUSION: Intraoral aging adversely affected the physical, mechanical, and morphologic properties of the Invisalign appliance.

Deflection of tandem archwire in a specific self-ligating metal bracket system: an in vitro study.

The aim of this study was to quantify the force exerted by tandem archwires in a specific system of passive self-ligating bracket. Forty-eight thermo-activated nickel-titanium orthodontic archwires were separated into four groups (n = 12): G1 - two .014" + .014" round archwires; G2 - two .014" + .016" round archwires; G3 - .014" x .025" rectangular archwire; and. G4 - .016" x .022" rectangular archwire. Brackets were fixed onto teeth 1.5 to 2.5 using a device that represented the upper teeth, maintaining an interbracket distance of 6.0 mm. The deflection tests were performed using the structure representative of tooth 1.1 as support on the Instron testing machine at a speed of 2.0 mm/min. The archwires were evaluated at deflections of 0.5 mm, 1.0 mm, and 1.5 mm. The data were analyzed by a generalized linear model, considering values at different deflections as repeated measurements in the same experimental unit (α = 0.5%). At 0.5 mm, higher forces were observed in G2 and G3, which did not differ significantly (p > 0.05). The lowest force was observed in G4 (p < 0.05). At 1.0 mm and 1.5 mm, the highest force was observed in G3, followed by G4 and G2 (p < 0.05). The lowest force was observed in G1 (p < 0.05). In general, tandem archwires (same or different calibers) in a specific passive self-ligating bracket exerted lower force when compared with rectangular archwires.

Virtually Guided Palate Lateral Wall, TAD-Supported Expansion in Craniofacial Skeletally Mature Adolescents and Young Adults.

Different temporary anchorage device (TAD)-assisted rapid palatal expanders may be used to treat malocclusions involving the transverse dimension and, in many instances, prevent more complex situations in the future. Each style of expander has advantages and disadvantages. The acrylic type of TAD-supported palate lateral wall expander is a reliable and cost-effective appliance for expansion treatment in adolescents and young adults (ie, aged 13 to 21). In comparison, other palatal expander designs are more suitable for older patients. One advantage of an acrylic TAD-supported palate lateral wall expander system is that it can be used for both orthopedic expansions (ie, nonsurgical TAD-supported only) and surgically assisted rapid palatal expansions (ie, with the aid of minimally invasive corticotomies) in patients who do not respond to nonsurgical expansion. This article presents general diagnostic considerations regarding maxillary transverse deficiencies, discusses the importance of palatal expansion in managing malocclusions, and describes protocols for nonsurgical and surgical management of transverse deficiencies with an acrylic TAD-supported virtually guided palate lateral wall expander.

Analgesia por láser de baja potencia en pacientes con tratamiento ortodóncico / Low power laser analgesia in patients with orthodontic treatment i: en

Introducción: El dolor es el síntoma más común luego de la primera activación de la aparatología ortodóncica. El tratamiento analgésico más utilizado es el paracetamol; sin embargo, su uso inhibe la actividad de la ciclooxigenasa y la síntesis de prostaglandinas, lo que puede afectar el mecanismo del movimiento dental y el remodelado óseo. Objetivo: Evaluar la efectividad del láser de baja potencia para el alivio del dolor en pacientes con tratamiento ortodóntico. Métodos: Se realizó un estudio cuasiexperimental de intervención terapéutica, desde enero hasta diciembre de 2020, en 40 pacientes atendidos en la consulta de ortodoncia del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, en quienes se aplicaría fuerza ortodóncica por primera vez. Estos fueron distribuidos de forma aleatoria en 2 grupos de 20 integrantes cada uno: el de estudio, tratado con láser de baja potencia, y el de control, que recibió medicación convencional (paracetamol). Para la validación estadística de la información se emplearon el porcentaje y la prueba de la t de Student para muestras independientes, con 95 % de confiabilidad. Resultados: Luego de tres sesiones terapéuticas, 90,0 % del grupo de estudio refirió no presentar dolor o sentirlo de forma leve, mientras que del grupo de control solo 10,0 % de los pacientes fue ubicado en cualquiera de las dos categorías anteriores. Existió diferencia significativa entre ambos grupos (p=0,00). Conclusiones: Se demostró que el láser, como terapia alternativa, fue más efectivo que el paracetamol.

Introduction: Pain is the most common symptom after the first activation of orthodontic appliance. The most widely used analgesic treatment is paracetamol; however, its use inhibits cyclooxygenase activity and prostaglandin synthesis, which can affect the mechanism of tooth movement and bone remodeling. Objective: To evaluate the effectiveness of low power laser for pain relief in patients with orthodontic treatment. Methods: A quasi-experimental study of therapeutic intervention was carried out, from January to December 2020, in 40 patients treated at the orthodontic clinic of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, in whom orthodontic force was applied for the first time. These were randomly distributed into 2 groups of 20 members each: the study group, treated with low-power laser, and the control group, that received conventional medication (paracetamol). For statistical validation of data, the percentage and the Student's t test for independent samples were used, with 95 % confidence interval. Results: After three therapeutic sessions, 90.0% of the study group reported not presenting pain or feeling it slightly, while only 10.0% of patients in control group were put in any of the two previous categories. There was a significant difference between both groups (p=0.00). Conclusions: Laser, as an alternative therapy, was shown to be more effective than paracetamol.