Múltiplas anomalias dentárias associadas: caso clínico

Certain human dental anomalies frequently occur together, supporting the accumulated evidence of the shared genetic control of dental developmental disturbances. The present study reports a rare and interesting case of a 12-year-old girl with an association of multiple dental abnormalities, including agenesis, tooth malposition and delayed development. The etiology and treatment planning are discussed with reference to the literature. The clinical implications of genetically controlled patterns of dental anomalies are important in the establishment of early diagnosis and appropriate orthodontic intervention.Certas anomalias dentárias humanas freqüentemente ocorrem concomitantemente, contribuindo para validar as evidências do controle genético nos distúrbios de desenvolvimento. O presente estudo relata um caso raro e interessante de uma jovem de 12 anos de idade, com associação de anormalidades dentárias múltiplas, incluindo agenesia, ectopia e atraso no desenvolvimento dentário. A etiologia e tratamento planejados são discutidos com referência à literatura. As implicações clínicas do padrão de anomalias dentárias geneticamente controladas são importantes no estabelecimento do diagnóstico precoce e de adequada intervenção ortodôntica

Rapid and slow palatal expansion in bilateral complete cleft lip and palate cone beam CT evaluation: preliminary results

Introduction: The upper dental arch of patients with complete bilateral cleft lip and palate commonly presents constricted due to the absence of the sutures and the lip and palate surgeries performed at an early age. Objective: The objective of this paper is to evaluate and compare the effects of maxillary expansion between two different appliances: Haas / Hyrax and quad-helix, in patients with bilateral complete cleft lip and palate, using cone-beam computed tomography (CT). Material and methods The study sample will consist of 30 patients with bilateral complete cleft lip and palate with maxilla constriction and that had received primary surgeries in childhood. Patients will be divided into two study groups, treated with Haas or Hyrax expanders (Group I = 30) and quadhelix expanders (Group II = 30). For preliminary results there were 23 patients (Group I = 13 and Group II = 10).The CT examination was performed immediately pre-expansion and six months after the expansion, when the appliance was removed. The following dimensions were performed: the maxillary transverse dimensions, the inclination of the posterior teeth, the buccal bone plates thickness and the buccal and lingual bone crest in the molar anchorage in both phases of the study. Changes interphases were evaluated using the Student \"t\" test (p <0,05). Comparison of baseline characteristics of each study group, as well as the intergroup comparison of the effect of the expansion were conducted by independent t test (p <0,05). Preliminary results: To date, no significant difference between groups was found

Are torque values of preadjusted brackets precise?

OBJECTIVE: The aim of the present study was to verify the torque precision of metallic brackets with MBT prescription using the canine brackets as the representative sample of six commercial brands. MATERIAL AND METHODS: Twenty maxillary and 20 mandibular canine brackets of one of the following commercial brands were selected: 3M Unitek, Abzil, American Orthodontics, TP Orthodontics, Morelli and Ortho Organizers. The torque angle, established by reference points and lines, was measured by an operator using an optical microscope coupled to a computer. The values were compared to those established by the MBT prescription. RESULTS: The results showed that for the maxillary canine brackets, only the Morelli torque (-3.33º) presented statistically significant difference from the proposed values (-7º). For the mandibular canines, American Orthodontics (-6.34º) and Ortho Organizers (-6.25º) presented statistically significant differences from the standards (-6º). Comparing the brands, Morelli presented statistically significant differences in comparison with all the other brands for maxillary canine brackets. For the mandibular canine brackets, there was no statistically significant difference between the brands. CONCLUSIONS: There are significant variations in torque values of some of the brackets assessed, which would clinically compromise the buccolingual positioning of the tooth at the end of orthodontic treatment

Cone-Beam Computed Tomography and Radiographs in Dentistry: Aspects Related to Radiation Dose

Introduction. The aim of this study was to discuss the radiation doses associated with plain radiographs, cone-beam computed tomography (CBCT), and conventional computed tomography (CT) in dentistry, with a special focus on orthodontics. Methods. A systematic search for articles was realized by MEDLINE from 1997–March 2011. Results. Twenty-seven articles met the established criteria. The data of these papers were grouped in a table and discussed. Conclusions. Increases in kV, mA, exposure time, and field of view (FOV) increase the radiation dose. The dose for CT is greater than other modalities. When the full-mouth series (FMX) is performed with round collimation, the orthodontic radiographs transmit higher dose than most of the large FOV CBCT, but it can be reduced if used rectangular collimation, showing lower effective dose than large FOV CBCT. Despite the image quality, the CBCT does not replace the FMX. In addition to the radiation dose, image quality and diagnostic needs should be strongly taken into account

Breastfeeding and non-nutritive sucking patterns related to the prevalence of anterior open bite in primary dentition

OBJECTIVE: Nutritional, immunological and psychological benefts of exclusive breastfeeding for the frst 6 months of life are unequivocally recognized. However, mothers should also be aware of the importance of breastfeeding for promoting adequate oral development. This study evaluated the association between breastfeeding and non-nutritive sucking patterns and the prevalence of anterior open bite in primary dentition. MATERIAL AND METHODS: Infant feeding and non-nutritive sucking were investigated in a 3-6 year-old sample of 1,377 children, from São Paulo city, Brazil. Children were grouped according to breastfeeding duration: G1 - non-breastfed, G2 - shorter than 6 months, G3 - interruption between 6 and 12 months, and G4 - longer than 12 months. Three calibrated dentists performed clinical examinations and classifed overbite into 3 categories: normal, anterior open bite and deep bite. Chi-square tests (p<0.05) with odds ratio (OR) calculation were used for intergroup comparisons. The impact of breastfeeding and non-nutritive sucking on the prevalence of anterior open bite was analyzed using binary logistic regression. RESULTS: The prevalence estimates of anterior open bite were: 31.9% (G1), 26.1% (G2), 22.1% (G3), and 6.2% (G4). G1 would have signifcantly more chances of having anterior open bite compared with G4; in the total sample (OR=7.1) and in the subgroup without history of non-nutritive sucking (OR=9.3). Prolonging breastfeeding for 12 months was associated with a 3.7 times lower chance of having anterior open bite. In each year of persistence with non-nutritive sucking habits, the chance of developing this malocclusion increased in 2.38 times. CONCLUSIONS: Breastfeeding and non-nutritive sucking durations demonstrated opposite effects on the prediction of anterior open bite. Non-breastfed children presented signifcantly greater chances of having anterior open bite compared with those who were breastfed for periods longer than 12 months, demonstrating the benefcial infuence of breastfeeding on dental occlusion

DEMOCRATIZAÇÃO DO ACESSO À ORTODONTIA INFANTIL

No Brasil, não há atendimento na saúde pública direcionado à prevenção das más oclusões, ou seja, na especialidade de Ortopedia e Ortodontia Preventiva. O objeto deste texto é apresentar um ato de regulação legal que determina o atendimento e exame clínico das más oclusões nas escolas públicas brasileiras para, posteriormente, as crianças serem atendidas na rede pública de saúde. A partir desta ideia foi desenvolvido um Projeto de Lei que estabelece que as crianças de 6 a 12 anos terão direito a cuidados ortodônticos preventivos na rede pública, protocolado pela Deputada Federal Celina Leão na Câmara dos Deputados, em Brasília, no dia 18 de abril de 2019

Comparison between 3D volumetric rendering and multiplanar slices on the reliability of linear measurements on CBCT images: an in vitro study

OBJECTIVE: The purpose of this study was to determine the accuracy and reliability of two methods of measurements of linear distances (multiplanar 2D and tridimensional reconstruction 3D) obtained from cone-beam computed tomography (CBCT) with different voxel sizes. MATERIAL AND METHODS: Ten dry human mandibles were scanned at voxel sizes of 0.2 and 0.4 mm. Craniometric anatomical landmarks were identified twice by two independent operators on the multiplanar reconstructed and on volume rendering images that were generated by the software Dolphin®. Subsequently, physical measurements were performed using a digital caliper. Analysis of variance (ANOVA), intraclass correlation coefficient (ICC) and Bland-Altman were used for evaluating accuracy and reliability (

Prevalence of long face pattern in brazilian individuals of different ethnic backgrounds

Conclusions: Black individuals had greater prevalence of long face pattern, followed by Brown, White and Yellow individuals. The prevalence of long face pattern was 14.06% in which 13.39% and 0.68% belonged to moderate and severe subtypes, respectively.Objective: The long face pattern is a facial deformity with increased anterior total facial height due to vertical excess of the lower facial third. Individuals with long face may present different degrees of severity in vertical excess, as well as malocclusions that are difficult to manage. The categorization of vertical excess is useful to determine the treatment prognosis. This survey assessed the distribution of ethnically different individuals with vertical excess according to three levels of severity and determined the prevalence of long face pattern. Material and Methods: The survey was comprised of 5,020 individuals of Brazilian ethnicity (2,480 females and 2,540 males) enrolled in middle schools in Bauru-SP, Brazil. The criterion for inclusion of individuals with vertically impaired facial relationships was based on lip incompetence, evaluated under natural light, in standing natural head position with the lips at rest. Once identified, the individuals were classified into three subtypes according to the severity: mild, moderate, and severe. Then the pooled sample was distributed according to ethnical background as White (Caucasoid), Black (African descent), Brown (mixed descent), Yellow (Asian descent) and Brazilian Indian (Brazilian native descent). The Chi-square (χ2 ) test was used (p<0.05) to compare the frequency ratios of individuals with vertically impaired facial relationships in the total sample and among different ethnicities, according to the three levels of severity. Results: The severe subtype was rare, except in Black individuals (7.32%), who also presented the highest relative frequency (45.53%) of moderate subtype, followed by Brown individuals (43.40%). In the mild subtype, Yellow (68.08%) and White individuals (62.21%) showed similar and higher relative frequency values.\ud Conclusions: Black individuals had greater prevalence of long face pattern, followed by Brown, White and Yellow individuals. The prevalence of long face pattern was 14.06% in which 13.39% and 0.68% belonged to moderate and severe subtypes, respectively

Evaluation of the intercanine distance in newborns with cleft lip and palate using 3D digital casts

OBJECTIVE: The purpose of this present study was to compare, by means of 3D digital casts, the anterior transverse dimension of the dental arch of newborns with and without cleft lip and palate. MATERIAL AND METHODS: The sample was composed of ninety-four children aged from 3 to 9 months divided into three study groups: Group I - children without craniofacial deformities (control group); Group II - children with unilateral cleft lip and palate; Group III - children with bilateral cleft lip and palate. Impressions were executed before lip and palate repair in patients with clefts. Dental casts were digitized using a 3D scanner linked to a computer. Measurements of the intercanine distance were measured on the digital casts. Intergroup comparisons were performed using ANOVA (

Bone-anchored maxillary protraction therapy in patients with unilateral complete cleft lip and palate: 3-dimensional assessment of maxillary effects

The aim of this study was to 3-dimensionally assess the treatment outcomes of bone-anchored maxillary protraction (BAMP) in patients with unilateral cleft lip and palate