Assessment of temporomandibular disorder and occlusion in treated class III malocclusion patients

OBJECTIVE: The aims of this study were to compare the prevalence of temporomandibular disorders (TMD) in individuals submitted to either orthodontic or ortho-surgical Class III malocclusion treatment and to assess the influence of occlusal aspects on TMD severity. MATERIAL AND METHODS: The sample consisted of 50 individuals divided into two groups, according to the type of treatment (orthodontic or orthodontic with orthognathic surgery). The presence of signs and symptoms of TMD was evaluated by an anamnestic questionnaire and a clinical examination, including TMJ and muscle palpation, active mandibular range of motion, joint noises and occlusal examination. RESULTS: Based on the anamnestic questionnaire, 48% had no TMD, 42% had mild TMD and 10% had moderate TMD. The presence and severity of TMD did not show any relationship with the type of orthodontic treatment (p>;0.05). The chi-square test showed a positive association (

Cephalometric study in patients that displayed class II, division 1 malocclusion treated with Herbst and high pull headgear appliances

Realizou-se um estudo cefalométrico, em telerradiografias, objetivando-se determinar os efeitos no complexo craniofacial de pacientes com más oclusões de Classe II, divisão 1 submetidos ao tratamento com o aparelho de Herbst com cantiléver e ao tratamento com o aparelho Extrabucal de tração occipital. Para tanto, utilizou-se uma amostra composta por quatro grupos, sendo dois experimentais e dois controles. Os grupos experimentais originaram-se da Faculdade de Odontologia de Bauru - USP, sendo 25 pacientes tratados com o aparelho ortopédico funcional, com a idade inicial média de 12,01 anos e 25 pacientes tratados com o aparelho ortopédico mecânico, com a idade inicial média de 10,28 anos. Os grupos controles, pareados cronologicamente aos grupos experimentais, foram compostos por pacientes não tratados ortodonticamente, oriundos do arquivo de documentações denominado Burlington Growth Centre, localizado na Faculdade de Odontologia da Universidade de Toronto. Para cada componente dos quatro grupos, obtiveram-se as telerradiografias ao início (T1) e ao final (T2) do período de tratamento ou de observação, sendo traçadas manualmente e digitalizadas para um programa de cefalometria. A comparação estatística entre os grupos experimentais e seus respectivos grupos controles evidenciou que ambas as terapias corrigiram, a curto prazo, a má oclusão inicial, porém com mecanismos específicos de correção. Resumidamente, o aparelho de Herbst repercutiu em maiores alterações dentoalveolares, em decorrência da perda substancial de ancoragem dentária, mesializando os molares inferiores e vestibularizando os incisivos inferiores, enquanto que o aparelho Extrabucal apresentou um efeito ortopédico mais proeminente sobre o complexo craniofacial, alterando a tendência de deslocamento em sentido anterior da maxila. Ambas as terapias restringiram o desenvolvimento normal no sentido vertical dos dentes póstero-superiores, contribuindo decisivamente para a correção da relação molar de Classe II e manutenção do padrão de crescimento craniofacial dos pacientes. Este achado acorda com a literatura quanto à similaridade de ação desses dois mecanismos terapêuticos, porém discorda quanto ao efeito inibitório dos molares superiores no sentido sagital, ou mesmo de distalização, pelo aparelho de Herbst relatado em trabalhos anteriores.This study investigated the treatment effects on the craniofacial growth of Class II patients treated with Herbst and high-pull Headgear appliances. The sample was comprised of four groups, two experimental and two control groups. The experimental groups originated from Bauru Dental School, University of São Paulo. This consisted of 25 patients treated with the Herbst appliance, with an initial mean age of 12,01 years and 25 patients treated by the Headgear, with an initial mean age of 10,28 years. The control groups, matched by age with the experimental groups, were originated from the Burlington Growth Centre, located at the Faculty of Dentistry, University of Toronto. All patients were assessed at the beginning (T1) and at the end of the treatment or observation period (T2) and 33 cephalometric variables were established. The statistical comparison between each experimental group and the specific control group showed that both therapies, in short-term fashion, corrected the initial malocclusion. The dental changes (loss anchorage) were more pronounced with the Herbst appliance and a combination of factors (skeletal and dental changes) with the Headgear. However the effect in inhibiting the vertical development of the maxillary first molars, essential characteristic to correct the Class II molar relationship and to maintain the craniofacial growth pattern, were shown with both therapie

Five years evaluation of cephalometric measurements in patients that displayed over than 4 degrees and angle, treated by means of orthodontic appliances and the four first-premolars extraction

Este trabalho teve como objetivo avaliar cefalometricamente a estabilidade das medidas SNA, SNB, ANB, 1.NA, 1-NA, 1 .NB, 1 -NB, 1.ENP-ENA, IMPA e 1.1 a longo prazo, de pacientes tratados ortodonticamente com extrações dos quatro primeiros pré-molares e verificar, paralelamente a isto, se foram realizadas as compensações dentárias na mecânica ortodôntica e se estas foram preservadas cinco anos após o término do tratamento. Vinte e sete pacientes foram analisados no início (T1), no final (T2) e cinco anos após a finalização terapêutica (T3). No início do tratamento, a idade média era de 13 anos e 5 meses e todos os componentes apresentavam o ângulo ANB maior que 4º. Quatorze componentes apresentavam más oclusões Classe II, 1ª divisão de Angle, 12 componentes apresentavam más oclusões Classe I e 1, má oclusão Classe II, 2ª divisão. Os casos foram tratados com a técnica Edgewise. Nas três fases de estudo os cefalogramas laterais foram realizados manualmente, obtendo-se as oito grandezas angulares e as duas lineares. A análise estatística indutiva envolveu a análise de variância a um critério para identificar as alterações interfases no valor de cada variável estudada, e o teste de Tukey para indicar, especificamente, entre quais fases de estudo estaria ocorrendo diferenças estatisticamente significantes. Utilizou-se o coeficiente de correlação de Pearson, no afã de relacionar a medida cefal ométrica 1.1 com as demais medidas nas três fases de estudo. De acordo com os resultados obtidos, todas as medidas estudadas entre as fases inicial e final se alteraram significantemente refletindo a influência da mecânica ortodôntica sobre os movimentos dentários e entre as fases final e cinco anos após, todas as medidaspermaneceram estáveis. Obtiveram-se as compensações dentárias necessárias no final do tratamento ortodôntico e estas foram preservadas a longo prazoThe main objective of this study was to evaluate the long-term stability of the following cephalometric measurements: SNA, SNB, ANB, 1.NA, 1-NA, 1 .NB, 1 -NB, 1.ENP-ENA, IMPA, 1.1 . This analysis was carried out in orthodontically treated patients which had the four first pre-molars extracted. Alternatively, this study also determined the influence of the proposed treatment at the dento-basal arrangements by orthodontic mechanics and its preservation after five years of treatment completion. The sample of this study was comprised of twenty-seven patients that were assessed at the beginning (T1), at the end (T2) and five years later (T3). At the beginning of treatment the patients age averaged thirteen years and five months and all the subjects displayed an ANB angle over than 4 degrees. Among the studied sample, 14 subjects were classified as Angle Class II, Division 2 malocclusion, 12 subjects displayed Angle Class I, and 1 Angle Classe II, Division 2. All the subjects were orthodontically treated by means of edgewise appliances. During all the three phases of the study the radiological data were obtained through lateral cephalograms, which were performed manually, depicted eight angular and two linear measurements. The statistical analysis in which the data were processed included one way analysis of variance in order to identify the changes between the phases related to each studied measurement. As an adjunctive method, the Tukey test was conducted to indicate in which phases of the proposed study the statistically significant changes were occurring. The Pearson Product Moment Correlation was recorded to relate the 1.1 cephalometric measurements with all the remaining measurements obtained throughout the three phases of the study. According to the obtained results, all the studied measurements, between phases T1 and T2, significantly changed reflecting the influence of orthodontic mechanics on the dental movement. Between the T2 and T3 phases, all the measurements remained stable. By the end of the orthodontic treatment all the necessaries dental arrangements were performed and preserved in a long-term fashion

Cephalometric study in patients that displayed class II, division 1 malocclusion treated with Herbst and high pull headgear appliances

Realizou-se um estudo cefalométrico, em telerradiografias, objetivando-se determinar os efeitos no complexo craniofacial de pacientes com más oclusões de Classe II, divisão 1 submetidos ao tratamento com o aparelho de Herbst com cantiléver e ao tratamento com o aparelho Extrabucal de tração occipital. Para tanto, utilizou-se uma amostra composta por quatro grupos, sendo dois experimentais e dois controles. Os grupos experimentais originaram-se da Faculdade de Odontologia de Bauru - USP, sendo 25 pacientes tratados com o aparelho ortopédico funcional, com a idade inicial média de 12,01 anos e 25 pacientes tratados com o aparelho ortopédico mecânico, com a idade inicial média de 10,28 anos. Os grupos controles, pareados cronologicamente aos grupos experimentais, foram compostos por pacientes não tratados ortodonticamente, oriundos do arquivo de documentações denominado Burlington Growth Centre, localizado na Faculdade de Odontologia da Universidade de Toronto. Para cada componente dos quatro grupos, obtiveram-se as telerradiografias ao início (T1) e ao final (T2) do período de tratamento ou de observação, sendo traçadas manualmente e digitalizadas para um programa de cefalometria. A comparação estatística entre os grupos experimentais e seus respectivos grupos controles evidenciou que ambas as terapias corrigiram, a curto prazo, a má oclusão inicial, porém com mecanismos específicos de correção. Resumidamente, o aparelho de Herbst repercutiu em maiores alterações dentoalveolares, em decorrência da perda substancial de ancoragem dentária, mesializando os molares inferiores e vestibularizando os incisivos inferiores, enquanto que o aparelho Extrabucal apresentou um efeito ortopédico mais proeminente sobre o complexo craniofacial, alterando a tendência de deslocamento em sentido anterior da maxila. Ambas as terapias restringiram o desenvolvimento normal no sentido vertical dos dentes póstero-superiores, contribuindo decisivamente para a correção da relação molar de Classe II e manutenção do padrão de crescimento craniofacial dos pacientes. Este achado acorda com a literatura quanto à similaridade de ação desses dois mecanismos terapêuticos, porém discorda quanto ao efeito inibitório dos molares superiores no sentido sagital, ou mesmo de distalização, pelo aparelho de Herbst relatado em trabalhos anteriores.This study investigated the treatment effects on the craniofacial growth of Class II patients treated with Herbst and high-pull Headgear appliances. The sample was comprised of four groups, two experimental and two control groups. The experimental groups originated from Bauru Dental School, University of São Paulo. This consisted of 25 patients treated with the Herbst appliance, with an initial mean age of 12,01 years and 25 patients treated by the Headgear, with an initial mean age of 10,28 years. The control groups, matched by age with the experimental groups, were originated from the Burlington Growth Centre, located at the Faculty of Dentistry, University of Toronto. All patients were assessed at the beginning (T1) and at the end of the treatment or observation period (T2) and 33 cephalometric variables were established. The statistical comparison between each experimental group and the specific control group showed that both therapies, in short-term fashion, corrected the initial malocclusion. The dental changes (loss anchorage) were more pronounced with the Herbst appliance and a combination of factors (skeletal and dental changes) with the Headgear. However the effect in inhibiting the vertical development of the maxillary first molars, essential characteristic to correct the Class II molar relationship and to maintain the craniofacial growth pattern, were shown with both therapie

Five years evaluation of cephalometric measurements in patients that displayed over than 4 degrees and angle, treated by means of orthodontic appliances and the four first-premolars extraction

Este trabalho teve como objetivo avaliar cefalometricamente a estabilidade das medidas SNA, SNB, ANB, 1.NA, 1-NA, 1 .NB, 1 -NB, 1.ENP-ENA, IMPA e 1.1 a longo prazo, de pacientes tratados ortodonticamente com extrações dos quatro primeiros pré-molares e verificar, paralelamente a isto, se foram realizadas as compensações dentárias na mecânica ortodôntica e se estas foram preservadas cinco anos após o término do tratamento. Vinte e sete pacientes foram analisados no início (T1), no final (T2) e cinco anos após a finalização terapêutica (T3). No início do tratamento, a idade média era de 13 anos e 5 meses e todos os componentes apresentavam o ângulo ANB maior que 4º. Quatorze componentes apresentavam más oclusões Classe II, 1ª divisão de Angle, 12 componentes apresentavam más oclusões Classe I e 1, má oclusão Classe II, 2ª divisão. Os casos foram tratados com a técnica Edgewise. Nas três fases de estudo os cefalogramas laterais foram realizados manualmente, obtendo-se as oito grandezas angulares e as duas lineares. A análise estatística indutiva envolveu a análise de variância a um critério para identificar as alterações interfases no valor de cada variável estudada, e o teste de Tukey para indicar, especificamente, entre quais fases de estudo estaria ocorrendo diferenças estatisticamente significantes. Utilizou-se o coeficiente de correlação de Pearson, no afã de relacionar a medida cefal ométrica 1.1 com as demais medidas nas três fases de estudo. De acordo com os resultados obtidos, todas as medidas estudadas entre as fases inicial e final se alteraram significantemente refletindo a influência da mecânica ortodôntica sobre os movimentos dentários e entre as fases final e cinco anos após, todas as medidaspermaneceram estáveis. Obtiveram-se as compensações dentárias necessárias no final do tratamento ortodôntico e estas foram preservadas a longo prazoThe main objective of this study was to evaluate the long-term stability of the following cephalometric measurements: SNA, SNB, ANB, 1.NA, 1-NA, 1 .NB, 1 -NB, 1.ENP-ENA, IMPA, 1.1 . This analysis was carried out in orthodontically treated patients which had the four first pre-molars extracted. Alternatively, this study also determined the influence of the proposed treatment at the dento-basal arrangements by orthodontic mechanics and its preservation after five years of treatment completion. The sample of this study was comprised of twenty-seven patients that were assessed at the beginning (T1), at the end (T2) and five years later (T3). At the beginning of treatment the patients age averaged thirteen years and five months and all the subjects displayed an ANB angle over than 4 degrees. Among the studied sample, 14 subjects were classified as Angle Class II, Division 2 malocclusion, 12 subjects displayed Angle Class I, and 1 Angle Classe II, Division 2. All the subjects were orthodontically treated by means of edgewise appliances. During all the three phases of the study the radiological data were obtained through lateral cephalograms, which were performed manually, depicted eight angular and two linear measurements. The statistical analysis in which the data were processed included one way analysis of variance in order to identify the changes between the phases related to each studied measurement. As an adjunctive method, the Tukey test was conducted to indicate in which phases of the proposed study the statistically significant changes were occurring. The Pearson Product Moment Correlation was recorded to relate the 1.1 cephalometric measurements with all the remaining measurements obtained throughout the three phases of the study. According to the obtained results, all the studied measurements, between phases T1 and T2, significantly changed reflecting the influence of orthodontic mechanics on the dental movement. Between the T2 and T3 phases, all the measurements remained stable. By the end of the orthodontic treatment all the necessaries dental arrangements were performed and preserved in a long-term fashion

Orthodontics 42 Karyna Martins do Valle-Corotti (a) Orthodontics

Association of infantile bruxism and the terminal relationships of the primary second molars Abstract: The aim of this study was to analyze the association between infantile bruxism and the terminal relationships of the primary second molars. A total of 937 pre-school children (both genders), aged from 2 to 6 years, from municipal schools in São Paulo were evaluated. In this study, a questionnaire considering the bruxism habit and the presence of headaches and/or restless sleep was answered by the parents/guardians. A clinical exam of occlusion in the anteroposterior direction (vertical plane -VP, mesial step -MS and distal step -DS) was performed by the examiners in the school environment. Student's t test, Fisher's test and a logistic regression test were applied for the statistical analysis at a significance level of 5%. The prevalence of the bruxism habit was 29.3% among the total sample. Because there was no significant difference between the sides evaluated, the left side was taken as the standard. Among those children with bruxism, 25.7% presented a mesial step terminal relationship at the primary second molars, 29.1% had DS, and 30.2% had VP. Regarding the association of the parafunctional habit with the type of terminal relationship, no significant results were found. Children who slept restlessly or suffered from headaches were verified to show a higher chance of expressing the habit (OR = 2.4 and 1.6, respectively). The prevalence of bruxism in the studied sample was 29.3%, and its association with the primary second molars' terminal relationship was not statistically significant

Bruxism in children and transverse plane of occlusion: Is there a relationship or not?

OBJECTIVE: To assess the occurrence of bruxism in deciduous dentition and a potential association between the habit and the presence or absence of posterior crossbite. METHODS: A total of 940 patient files were assessed. They were gathered from the archives of University of São Paulo City - UNICID; however, 67 patient files were dismissed for not meeting the inclusion criteria. Therefore, 873 children, males and females, comprised the study sample. They were aged between 2-6 years old and came from six different public primary schools from the east of the city of São Paulo. Data were collected through questionnaires answered by parents/guardians and by clinical examinations carried out in the school environment in order to obtain the occlusal characteristics in the transverse direction. First, a descriptive statistical analysis of all variables was performed (age, sex, race, posterior crossbite, bruxism, headache and restless sleep); then, the samples were tested by means of chi-square test with significance level set at 0.05%. A logistic regression model was applied to identify the presence of bruxism. RESULTS: The prevalence of this parafunctional habit was of 28.8%, with 84.5% of patients showing no posterior crossbite. Regarding the association of bruxism with crossbite, significant results were not found. Children with restless sleep have 2.1 times more chances of developing bruxism, whereas children with headache have 1.5 more chances. CONCLUSION: Transverse plane of occlusion was not associated with the habit of bruxism