Evaluation of maxillary canine and molar movement during the first phase of extraction space closure: a multilevel analysis

ABSTRACT Objective: This study was designed to analyze and compare the cusp and apex movements of the maxillary canines and first molars during canine retraction in the first step of extraction space closure, and to evaluate if these teeth follow a curvilinear (acceleration and/or deceleration) movement rate. Material and Methods: Twenty-five patients (23.3 ± 5.1 years of age) were enrolled. The retraction of the maxillary canines was accomplished using nickel-titanium closed coil springs (100gf) on 0.020-in stainless steel archwire. Oblique cephalograms were traced and superimposed on the anatomic best fit of the maxilla (before the retraction [T0], and after one month [T1], three [T3], five [T5] and seven [T7] months). Statistics was based in a normally distributed data. Multilevel procedures were used to derive polynomials for each of the measurements. Student’s t-test and one-way repeated measures ANOVA were conducted. The level of significance of 5% was adopted. Results: Canine cusps and apexes did not follow a quadratic curve regarding horizontal movement (neither accelerate nor decelerate). Canine and molar cusps showed more horizontal movement than apexes (4.80 mm vs. 2.78 mm, and 2.64 mm vs. 2.17 mm, respectively). Conclusions: Canine did not accelerate or decelerate overtime horizontally; the cusps and apexes of the canines and molars showed more horizontal movement and larger rate at the beginning of canine retraction, followed by significantly smaller and constant movement rate after the first month

Estudo cefalométrico com implantes metálicos das alterações esqueléticas, a longo prazo, após o uso do bionator de Balters

O propósito deste estudo foi avaliar as alterações esqueléticas que ocorreram pela terapia com aparelho ortopédico bionator de Balters e aquelas que ocorreram após o tratamento. A amostra consistiu de 13 pacientes, 9 do gênero masculino e 4 do gênero feminino, com má oclusão de classe II, idade média de 9,34 anos ao início do tratamento, incisivos superiores e inferiores erupcionados ou em erupção, mordida profunda, ausência de perdas dentárias e ausência de apinhamento e/ou mordida cruzada posterior. Em todos eles foram inseridos implantes metálicos na maxila e na mandíbula. Os pacientes foram tratados com o aparelho bionator de Balters por 1,87 anos, em média, e acompanhados longitudinalmente por 6 anos, em média. Sobreposições cefalométricas, com auxílio dos implantes metálicos, foram realizadas para avaliação da intensidade e direção da remodelação e rotação da maxila e da mandíbula. A comparação com a literatura mostrou que os efeitos esqueléticos mais evidentes do aparelho foram a mudança de direção do crescimento condilar, a mudança da rotação total da maxila, a inibição da rotação total anti-horária mandibular e o aumento do crescimento transversal dos maxilares. Após a terapia com o bionator houve uma tendência de redirecionamento do crescimento condilar ao padrão original e manutenção do padrão da rotação total maxilar pela presença dos aparelhos fixos e uso de elásticos classe II. Concluiu-se que o tratamento da má oclusão de classe II com o bionator de Balters, nesta idade, produziu alterações esqueléticas em ambos os maxilares que voltaram a apresentar um padrão original de crescimento no período de avaliação subsequente.The purpose of this study was to evaluate the skeletal changes that occur after treatment with Balters` bionator appliance and those that occur after the treatment. The sample included 13 patients, 9 males and 4 females, with Class II malocclusion, mean age of 9.34 years at the beginning of the treatment, erupted upper and lower incisors, absence of dental loss, crowding and posterior crossbite. Each patient had metallic implants placed in the maxilla and the mandible before treatment. The patients were treated with Balters appliance for approximately 1.87 years, and were followed for approximately 5.68 years. Cephalometrics superpositions, using metallic implants as references, were performed to evaluated intensity and direction of the remodeling and rotation of the maxilla and the mandible. The comparison with literature showed that the more evident skeletal effects of the appliance had been the change in direction of condylar growth, the change in the total rotation of the maxilla, the inhibition of the total counterclockwise rotation mandibular and the increase of the transversal growth of maxilla and mandible. After therapy with bionator, was observed a tendency of change in direction of condylar growth to the original standard and maintenance of the standard in total rotation of the maxilla, due the presence of fixed appliances and use of Class II intermaxillary elastics. It can be concluded that the treatment of Class II malocclusion with Balters` bionator appliance, in this age, produced skeletal changes in both maxillaries that they had come back to present a normal standard of growth in the follow-up evaluation period.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Estudo clínico do tempo de fechamento de espaço e do movimento dentário durante a retratação de caninos entre dois tipos de braquetes

O desenvolvimento tecnológico na fabricação de braquete trouxe consigo a ideia de que a tecnologia empregada no aparelho pode representar aumento na velocidade de movimentação dentária. O propósito deste estudo foi avaliar a taxa de movimentação mensal de caninos e a perda de ancoragem ocorrida durante o movimento de retração de caninos por deslizamento entre dois tipos de braquetes diferentes, um autoligado e outro convencionalmente ligado, bem como diferenças entre os arcos superior e inferior. A amostra consistiu de 25 pacientes biprotusos, portadores de má oclusão de classe I com necessidade de extração de quatro primeiros pré-molares para realização do tratamento ortodôntico, com apinhamento no arco superior e inferior menores que 4mm, idade variando entre 18 anos até 34 anos e sem ausências dentárias sendo facultativa a presença dos terceiros molares. Em todos eles foram colados dois braquetes autoligados, um no canino superior e outro no canino inferior de maneira randomizada e num sistema split-mouth. Os demais dentes receberam braquetes convencionais e tubos nos molares. Os primeiros pré-molares foram extraídos após o alinhamento e nivelamentos dos arcos e 7 a 15 dias após deu-se início à retração dos caninos. Telerradiografias laterais de 45º foram realizadas antes do início da retração e após a completa retração de cada canino. A superposição dos traçados cefalométricos iniciais e após a retração permitiu o cálculo da perda de ancoragem ocorrida e a quantidade de retração para cada canino. A divisão da quantidade de retração pelo tempo decorrido permitiu o cálculo da taxa de movimentação mensal dos caninos. Os resultados demonstraram que não existe diferença na taxa de movimentação mensal dos caninos e nem na perda de ancoragem entre os dois tipos de braquetes...The technological development in bracket manufacturing brought with it the belief that enhanced technology might translate as faster in tooth movement. The aim of this study was to evaluate the monthly rate of canine movement as well as the rate of anchorage loss during the retraction of canines by sliding mechanics with two different types of brackets: self-ligated and conventional and also, as well as differences between upper and lower arches. The sample comprised 25 biprotusive class I patients with need of four bicuspid extractions for orthodontic treatment, with upper and lower crowding less than 4 mm, age between 18 and 34 years old and no missing teeth except for the third molars. In all of them selfligated brackets were randomly bonded on the upper and lower canines in a split mouth design. The remaining teeth were bonded and banded with conventional brackets. First bicuspids were extracted after leveling and alignment and after 7 to 15 days canine retraction was initiated. Forty-five degree radiographic were taken before retraction and after complete canine retaraction. Cephalometrics tracings before and after canine retraction allowed the measurement of the resultant anchorage loss and the amount of canine retraction. By dividing the amount of canine retraction by it allowed the calculation of the canine movement monthly rate. The results showed that there is no difference between the rate of canine monthly movement and loss of anchorage between the two types of bracket. When arches were compared, upper canines were found to move faster than the lower ones and no difference was found on anchorage loss. It was concluded that canine retraction by sliding mechanics with either brackets occur at the same rate as well as the loss of anchorage of the molars. Upper... (Complete abstract click electronic access below)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Longitudinal study on skeletal changes during and after bionator therapy using metallic implants

Aim: To demonstrate the magnitude and direction of skeletal changes in the maxilla and mandible during and after the use of bionator, as well as their rotations. Methods: Partial superimposition on the maxilla and mandible on the metallic implants and total superimposition on the cranial base were performed at three periods, T1 before bionator therapy, T2 after bionator therapy, and T3 5.68 years after T2. Results: There was total clockwise maxillary rotation and counterclockwise mandibular rotation, in the North American technique, throughout the study period, as well as extensive remodeling on the condylar region, especially in vertical direction and on the gonial region in horizontal direction. Conclusions: The total maxillary rotation seemed to be significantly affected by therapy than the mandible. There was a clear change in the direction of condylar remodeling compared to the period of bionator therapy and posterior bionator therapy. Considering the entire study period, it was observed that intra-matrix rotation of the maxilla and mandible masked their total rotation, causing minimum changes in the matrix rotation

Paresthesia during orthodontic treatment: case report and review.

Paresthesia of the lower lip is uncommon during orthodontic treatment. In the present case, paresthesia occurred during orthodontic leveling of an extruded mandibular left second molar. It was decided to remove this tooth from the appliance and allow it to relapse. A reanatomization was then performed by grinding. The causes and treatment options of this rare disorder are reviewed and discussed. The main cause of paresthesia during orthodontic treatment may be associated with contact between the dental roots and inferior alveolar nerve, which may be well observed on tomography scans. Treatment usually involves tooth movement in the opposite direction of the cause of the disorder

Longitudinal study on skeletal changes during and after bionator therapy using metallic implants

Aim : To demonstrate the magnitude and direction of skeletal changes in the maxilla and mandible during and after the use of bionator, as well as their rotations. Methods: Partial superimposition on the maxilla and mandible on the metallic implants and total superimposition on the cranial base were performed at three periods, T1 before bionator therapy, T2 after bionator therapy, and T3 5.68 years after T2. Results: There was total clockwise maxillary rotation and counterclockwise mandibular rotation, in the North American technique, throughout the study period, as well as extensive remodeling on the condylar region, especially in vertical direction and on the gonial region in horizontal direction. Conclusions : The total maxillary rotation seemed to be significantly affected by therapy than the mandible. There was a clear change in the direction of condylar remodeling compared to the period of bionator therapy and posterior bionator therapy. Considering the entire study period, it was observed that intra-matrix rotation of the maxilla and mandible masked their total rotation, causing minimum changes in the matrix rotation

Dental assistant's awareness of their professional limits in orthodontic treatment

INTRODUCTION: nowadays the odontological market demands treatments with a distinguished quality and the proper use of dental assistants represents an important tool to increase productivity in dental offices. In order to do so, those professionals must be technically capable and involved with the job, following their tasks based on ethics and legal requirements of dental professions. AIM: to identify the assistant team technical profile, analyzing their awareness concerning their legal prerogatives in orthodontic treatment. METHODS: the present paper was developed upon a questionnaire that was answered by all dental assistants legally registered in the Goiás State Dental Board (CRO-GO) and applied in the cities of Goiânia and Aparecida de Goiânia/GO - Brazil. The research was conducted from May to June, 2003. RESULTS AND CONCLUSIONS: it was verified that several procedures that were not legally defined as assistant team tasks were being performed by those professionals. This results shows that Dentistry's professional laws have been either ignored or not followed.INTRODUÇÃO: numa época em que o mercado odontológico exige que os serviços prestados possuam qualidade diferenciada, a utilização adequada de profissionais auxiliares constitui uma ferramenta importantíssima para se obter aumento de produtividade no consultório. Para tanto, a correta utilização dessa ferramenta exige que a equipe auxiliar seja tecnicamente capacitada e envolvida num ambiente onde as funções delegadas estejam fundamentadas nos preceitos éticos e nas bases legais que regem a profissão. OBJETIVO: identificação do perfil técnico da equipe auxiliar, analisando-se a percepção destes profissionais quanto ao seu papel nas atividades pertinentes à clínica ortodôntica, com base na legislação vigente. METODOLOGIA: o presente levantamento foi desenvolvido com base num questionário aplicado a todos os profissionais que auxiliam diretamente os ortodontistas regularmente inscritos no CRO-GO, que atendem nas cidades de Goiânia e Aparecida de Goiânia (GO), no período de maio a julho de 2003. RESULTADOS E CONCLUSÕES: verificou-se que diversos procedimentos não estabelecidos nas normas que regem a delegação de funções em Odontologia estão sendo executados pela equipe auxiliar, demonstrando que o conteúdo dessa legislação está sendo ignorado ou descumprido.343

Utilização de auxiliares odontológicos em Ortodontia: implicações éticas e legais

INTRODUÇÃO: o mercado de trabalho tem se mostrado saturado de profissionais atuando nos grandes centros urbanos e, por este motivo, as estratégias de produtividade são imprescindíveis. A delegação de funções aos auxiliares odontológicos tem se tornado vital e corriqueira para aqueles que exercem a Ortodontia. OBJETIVO: conhecer o perfil do cirurgião-dentista especialista nesta área e as funções delegadas por ele à equipe auxiliar. METODOLOGIA: foi aplicado um questionário a todos os especialistas em Ortodontia e Ortopedia Facial inscritos no Conselho Regional de Odontologia de Goiás, com atividade em Goiânia e Aparecida de Goiânia. RESULTADOS E CONCLUSÃO: os resultados demonstraram que os ortodontistas, de um modo geral, aproveitam bem a mão-de-obra auxiliar chegando até a ultrapassar os limites ético-legais.INTRODUCTION: the work market has been shown to be saturated with professionals working at large urban centers and, for this reason, productive strategies are indispensable. The delegation of functions to dental assistants is becoming vital and quite common for those that work with Orthodontics. AIM: to evaluate the profile of the orthodontists and the workload delegated by them to the dental assistant team. METHODS: a questionnaire was given to all specialists in Orthodontics and Dentofacial Orthopedics registered at the Regional Council of Dentistry of Goiás, with practices in Goiânia and Aparecida de Goiânia. RESULTS and CONCLUSIONS: the results demonstrated that orthodontists, in general, take advantage of the work labor of the dental assistants even surpassing the ethical-legal limits