Clinical evaluation of dental alignment and leveling with three different

INTRODUCTION: A wide variety of orthodontic wires made of different alloys is available to be used in orthodontic practice and may produce different clinical responses during tooth movement. OBJECTIVE: This research evaluated the alignment and leveling of lower dental arches after the use of three types of orthodontic wires. METHODS: A sample of 36 patients was randomly divided into 3 groups: stainless steel, multistranded steel and superelastic nickel-titanium, according to the first leveling arches used. In order to observe differences in tooth position and axial inclination of the lower incisors, all patients had lateral cephalometric radiographs taken before the insertion of the first arches and 2 months later. The irregularity index and the curve of Spee were measured, compared between groups and considered influential on the proclination of incisors during the initial phase of alignment and leveling. The Reflex microscope was used to measure the irregularity index, whereas the ANOVA analysis of variance was used to verify differences between groups with regard to the degree of dental alignment and leveling. RESULTS: There were significant differences between groups only at T2 for the irregularity index. CONCLUSION: The NiTi and multistranded steel wires showed greater aligning capacity when compared with stainless steel wires.INTRODUÇÃO: uma grande variedade de fios ortodônticos, compostos por diferentes ligas, está disponível para utilização ortodôntica, podendo gerar respostas clínicas diversas, durante a movimentação dentária. OBJETIVO: este trabalho visa a avaliar o alinhamento e nivelamento das arcadas dentárias inferiores, após a utilização de três tipos de fios ortodônticos. MÉTODOS: uma amostra de 36 pacientes foi aleatoriamente dividida em três grupos, de acordo com os primeiros arcos utilizados para o alinhamento e nivelamento: aço inoxidável convencional, aço multifilamentado e de níquel-titânio superelástico. Para se avaliar as diferenças relacionadas ao posicionamento dentário e inclinação axial dos incisivos inferiores, foram obtidas radiografias cefalométricas de perfil, de todos os pacientes, em duas fases do tratamento: antes da inserção dos primeiros arcos e dois meses após a inserção dos mesmos. O índice de irregularidade dentária (IID) e a profundidade inicial de curva de Spee, fatores influentes sobre a projeção de incisivos durante a fase inicial de alinhamento e nivelamento, foram avaliados e comparados intra- e intergrupos. Para a medição do IID, foi utilizado o Reflex Microscope, possibilitando a mensuração do grau de alinhamento e nivelamento dentário em terceira dimensão. A análise de variância (ANOVA) foi utilizada para se avaliar as diferenças intergrupos em relação ao grau de alinhamento e nivelamento dentário. RESULTADOS: diferenças estatisticamente significativas intergrupos somente foram encontradas em T2, em relação ao índice de irregularidade dentária, já que os fios de NiTi e aço multifilamentado apresentaram maior capacidade de alinhamento do que os fios de aço inoxidável convencionais

Prototype of a new tip developed to be coupled to dental light-curing units for optimizing bonding of orthodontic brackets and accessories

OBJECTIVE: development of a new device to be coupled to light-curing units for bonding orthodontic brackets and accessories, and test its efficacy in an in vitro mechanical trial. The inner surface of the device is mirrored and is based on physical concepts of light refraction and reflection. The main advantage of such device is the reduced clinical time needed for bonding and the low possibility of contamination during the process. METHODS: One hundred and twenty specimens were used for testing the shear bond strength of brackets bonded with the device. The Adhesive Remnant Index (ARI) was also determined. The sample was divided into 2 groups. In group 1 a halogen light-curing unit was used while in group 2 a led light-curing unit was used. Each group was then subdivided. In subgroups H1 and L1, a conventional light guide rod was used while in subgroups H2 and L2 bonding was performed with the mirrored device coupled to the tip of the guide light rod. RESULTS: The values obtained for the shear bond strength and the ARI in the subgroups were compared. Results showed that there was no statistically significant difference for the shear strength (p > 0.05) and the ARI (p > 0.05) between the subgroups. CONCLUSION: The tests of mechanical trials and the ARI analysis showed that the new device fulfilled the requirements for bonding orthodontic accessories, and that the time for bonding was reduced to half, being necessary only one light exposure.OBJETIVO: desenvolver uma nova ponteira para ser acoplada aos aparelhos fotopolimerizadores utilizados para colagem de braquetes e acessórios ortodônticos, e testar sua da efetividade em ensaio mecânico in vitro. A ponteira é espelhada na superfície interna e baseia-se em conceitos físicos de refração e reflexão de luz. Apresenta como principal vantagem o menor tempo clínico durante o procedimento de colagem, reduzindo a possibilidade de contaminação durante o processo. MÉTODOS: por meio de ensaio de resistência ao cisalhamento e determinação do índice remanescente de adesivo (IRA), testou-se a ponteira desenvolvida em 120 corpos de prova. A amostra foi dividia em dois grupos. No grupo 1, foi utilizado aparelho fotopolimerizador de fonte de luz halógena e, no grupo 2, fonte de LED. Cada grupo foi subdividido. Nos subgrupos H1 e L1, utilizou-se a ponteira convencional. Nos subgrupos H2 e L2 a colagem foi feita utilizando a ponteira desenvolvida para a polimerização do material de colagem. RESULTADOS: os valores dos testes de cisalhamento e IRA para os subgrupos foram comparados entre si. Os resultados mostraram que não houve diferença estatisticamente significativa para o ensaio de resistência ao cisalhamento (p > 0,05) nem para o IRA (p > 0,05) entre os subgrupos. CONCLUSÃO: os testes de ensaio mecânico, assim como a análise do IRA, mostraram que a nova ponteira desenvolvida cumpriu os requisitos necessários à colagem dos acessórios ortodônticos, e que o tempo de colagem foi reduzido pela metade, sendo necessária uma só incidência

Surgical-orthodontic Treatment of Skeletal Class III Malocclusion and Concomitant Open Bite: A Case Report

Surgical-orthodontic treatment for the correction of skeletal Class III malocclusion and concomitant open bite is challenging due to the probability of postsurgical relapse. The present case (19 year-old male) describes successful surgical-orthodontic treatment for the correction of Class III malocclusion with anterior and posterior open bite. Treatment consisted of the use of an Edgewise fixed appliance (0.022” × 0.028”) and bimaxillary orthognathic surgery. Treatment resulted in bilateral Class I molar and canine relationships, normal overjet and overbite, the correction of anterior and posterior open bite, alignment of the midlines, leveling of the curve of Spee, satisfactory facial harmony, and passive lip seal. The correct diagnosis as well as the proper indication and execution of orthodontic and surgical treatments enabled the achievement of satisfactory functional and facial results and smile esthetics

Mechanical properties of NiTi and CuNiTi shape-memory wires used in orthodontic treatment. Part 1: stress-strain tests

OBJECTIVE: This research aimed to compare, through traction tests, eight types of superelastic and heat-activated NiTi archwires, by six trade companies (GAC, TP, Ormco, Masel, Morelli and Unitek) to those with addition of copper (CuNiTi 27ºC and 35ºC, Ormco). METHODS: The tests were performed in an EMIC mechanical testing machine, model DL10000, capacity of 10 tons, at the Military Institute of Engineering (IME). RESULTS: The results showed that, generally, heat-activated NiTi archwires presented slighter deactivation loadings in relation to superelastic. Among the archwires that presented deactivation loadings biologically more adequate are the heat-activated by GAC and by Unitek. Among the superelastic NiTi, the CuNiTi 27ºC by Ormco were the ones that presented slighter deactivation loadings, being statistically (ANOVA) similar, to the ones presented by the heat-activated NiTi archwires by Unitek. When compared the CuNiTi 27ºC and 35ºC archwires, it was observed that the 27ºC presented deactivation forces of, nearly, ⅓ of the presented by the 35ºC. CONCLUSION: It was concluded that the CuNiTi 35ºC archwires presented deactivation loadings biologically less favorable in relation to the other heat-activated NiTi archwires, associated to lower percentage of deformation, on the constant baselines of deactivation, showing less adequate mechanical behavior, under traction, in relation to the other archwires

Shear bond resistance and enamel surface comparison after the bonding and debonding of ceramic and metallic brackets

OBJECTIVE: To evaluate, in vitro, the shear bond strength presented by three brands of polycrystalline ceramic brackets and one brand of metallic bracket; verify the adhesive remnant index (ARI) after the tests, and analyze, through scanning electron microscopy (SEM) the enamel surface topography after debonding, detecting the release of mineral particles. METHODS: Sixty bovine lower incisors were used. Three ceramic brackets (Allure(r), InVu(r), and Clarity(r)) and one metallic bracket (Geneus(r)) were bonded with Transbond XT(r). Kruskal-Wallis's test (significance level set at 5%) was applied to the results of share bond and ARI. Mann Whitney's test was performed to compare the pairs of brackets in relation to their ARI. Brown-Forsythe's test (significance level set at 5%) was applied to the results of enamel chemical composition. Comparisons between groups were made with Games-Howell's and the Post-hoc tests. RESULTS: No statistically significant difference was observed in relation to the shear bond strength loads. Clarity(r) brackets were the most affected in relation to the surface topography and to the release of mineral particles of enamel (calcium ions). CONCLUSION: With regard to the ARI, there was a prevalence of score 4 (40.4%). As for enamel surface topography, the Geneus(r) bracket was the only one which did not show superficial tissue loss. The InVu(r) and Clarity(r) ones showed cohesive fractures in 33.3% and the Allure(r) in 50%, the latter being the one that presented most fractures during removal

Mechanical properties of NiTi and CuNiTi wires used in orthodontic treatment. Part 2: Microscopic surface appraisal and metallurgical characteristics

OBJECTIVE: This research aimed at comparing the qualitative chemical compositions and the surface morphology of fracture regions of eight types of Nickel (Ni) Titanium (Ti) conventional wires, superelastic and heat-activated (GAC, TP, Ormco, Masel, Morelli and Unitek), to the wires with addition of copper (CuNiTi 27oC and 35oC, Ormco) after traction test. METHODS: The analyses were performed in a scanning electronic microscope (JEOL, model JSM-5800 LV) with EDS system of microanalysis (energy dispersive spectroscopy). RESULTS : The results showed that NiTi wires presented Ni and Ti as the main elements of the alloy with minimum differences in their composition. The CuNiTi wires, however, presented Ni and Ti with a significant percentage of copper (Cu). As for surface morphology, the wires that presented the lowest wire-surface roughness were the superelastic ones by Masel and Morelli, while those that presented the greatest wire-surface roughness were the CuNiTi 27oC and 35oC ones by Ormco, due to presence of microcavity formed as a result of pulling out some particles, possibly of NiTi. 4 The fracture surfaces presented characteristics of ductile fracture, with presence of microcavities. The superelastic wires by GAC and the CuNiTi 27oC and the heat-activated ones by Unitek presented the smallest microcavities and the lowest wire-surface roughness with regard to fracture, while the CuNiTi 35oC wires presented inadequate wire-surface roughness in the fracture region. CONCLUSION: CuNiTi 35oC wires did not present better morphologic characteristics in comparison to the other wires with regard to surfaces and fracture region

Evaluation of the friction force generated by monocristalyne and policristalyne ceramic brackets in sliding mechanics

OBJECTIVE: To evaluate and compare "in vitro" the maximum friction force generated by three types of esthetic brackets, two types of polycrystalline conventional ceramic brackets (20/40 and InVu) and one type of sapphire monocrystalline bracket (Radiance) in dry and artificial saliva wet settings. Also, to evaluate the influence exerted by artificial saliva on the friction forces of those brackets. METHODS: Tests were performed in dry and artificial saliva wet setting (Oral Balance) by using an EMIC DL 10000 testing machine, simulating a 2 mm slide of 0.019 x 0.025-in rectangular stainless steel wires over the pre-angulated and pre-torqued (right superior canine, Roth prescription, slot 0.022 x 0.030-in) brackets (n = 18 for each bracket). In order to compare groups in dry and wet settings, the ANOVA was used. For comparisons related to the dry versus wet setting, the student t test was used for each group. RESULTS: The results showed that in the absence of saliva the Radiance monocrystalline brackets showed the highest friction coefficients, followed by the 20/40 and the InVu polycrystalline brackets. In tests with artificial saliva, the Radiance and the 20/40 brackets had statistically similar friction coefficients and both were greater than that presented by the InVu brackets. The artificial saliva did not change the maximum friction force of the Radiance brackets, but, for the others (20/40 and InVu), an increase of friction was observed in its presence. CONCLUSION: The InVu brackets showed, in the absence and in the presence of saliva, the lowest friction coefficient.<br>OBJETIVO: avaliar e comparar in vitro as cargas máximas de atrito geradas por três tipos de braquetes estéticos, sendo dois deles cerâmicos policristalinos convencionais (20/40 e InVu) e um monocristalino de safira (Radiance), em ambientes seco e umedecido por saliva artificial. Também avaliar a influência exercida pela saliva artificial sobre as cargas de atrito dos referidos braquetes. MÉTODOS: os ensaios foram realizados em ambiente seco e em ambiente umedecido com saliva artificial em gel (Oral Balance), utilizando uma máquina de ensaios mecânicos (EMIC, modelo DL10000), simulando um deslizamento de 2mm de fios retangulares 0,019" x 0,025" de aço sobre os braquetes (n = 18, para cada braquete), pré-angulados e pré-torqueados (canino superior direito prescrição Roth, slot 0,022" x 0,030"). Para comparação entre os braquetes, em ambiente seco ou umedecido, utilizou-se a análise de variância; e para a comparação dos braquetes em ambiente seco e umedecido, utilizou-se o teste t para amostras independentes. RESULTADOS: os resultados obtidos indicaram que, na ausência de saliva, os braquetes monocristalinos Radiance demonstraram o maior coeficiente de atrito, seguidos pelos braquetes policristalinos 20/40 e InVu. Nos ensaios realizados em ambiente umedecido, os braquetes Radiance e 20/40 apresentaram coeficientes de atrito estatisticamente semelhantes, e superiores ao apresentado pelos braquetes InVu. A saliva artificial não promoveu alterações na força máxima de atrito para os braquetes Radiance; todavia, para os demais (20/40 e InVu), promoveu aumento significativo nos coeficientes de atrito. CONCLUSÃO: os braquetes InVu apresentaram, tanto nos ensaios realizados na ausência, quanto na presença de saliva, os menores coeficientes de atrito, entre os braquetes ensaiados