Effect of orthodontic treatment on tooth autotransplantation : systematic review of controlled clinical trials

This systematic review was focused on evaluating tooth autotransplantation, considering its impacts on the teeth, bone, soft tissues, and aesthetics in orthodontic patients. A bibliographic search was conducted without limitations on year of publication or language in the databases of PubMed, Web of Science, Scopus, Medline Complete, Cochrane, Clinical Trials, and Trials Central. For triage of articles, indications, surgical planning, orthodontic movement, risk factors for treatment, and long-term follow-ups were considered. For outcomes, the results with reference to teeth, alveolar bone, periodontal tissues, and esthetic satisfaction were considered. Risk of bias was evaluated using the methodological index for nonrandomized studies-MINORS. The results showed 10 controlled clinical trials, and no randomized clinical trials were found. The selected studies included 715 patients and 934 autotransplanted teeth among which there were premolars, molars, and anterior teeth evaluated in the long term, indicating that orthodontics associated with autotransplantation indicated a result that was generally clinically acceptable. The quality of the set of evidence was considered medium due to the presence of different methodological problems, risk of bias, and significant heterogeneity in the evaluated studies. There was a sufficient body of evidence that justified autotransplantation in patients who needed orthodontic movement. In teeth, there was an increase in root resorption influenced by orthodontics, but without impacting on the general clinical result in the long term. Bone and periodontal tissue do not appear to be affected by orthodontics. The patient’s aesthetic satisfaction was not considered in the studies

Long-term stability of maxillary anterior alignment in non-extraction cases

OBJETIVO: o presente estudo avaliou, por meio de uma an?lise retrospectiva, a estabilidade p?s-tratamento do alinhamento dos incisivos anterossuperiores de pacientes submetidos ao tratamento ortod?ntico sem extra??es. M?TODOS: a amostra foi constitu?da de 23 pacientes (13 do sexo feminino e 10 do sexo masculino), com idade inicial de 13,36 ? 1,81 anos. Mediu-se nos modelos de estudo das fases inicial (T1), final (T2) e p?s-tratamento (T3) de aproximadamente de 5 anos, a irregularidade dos incisivos superiores, as dist?ncias intercaninos e entre os primeiros e segundos pr?-molares, a dist?ncia intermolares, o comprimento e o per?metro da arcada superior. Ap?s a obten??o dos dados, realizou-se a an?lise estat?stica. Para a an?lise das altera??es ao longo dos tr?s tempos estudados, utilizou-se a an?lise de vari?ncia (ANOVA) a um crit?rio de sele??o e, em caso de resultado significativo, o teste de Tukey. Para verificar a presen?a de correla??o entre a recidiva do apinhamento anterossuperior e a recidiva das vari?veis dist?ncias intercaninos, interpr?-molares, intermolares, comprimento e per?metro da arcada, utilizou-se o teste de correla??o de Pearson. RESULTADOS: os resultados n?o evidenciaram altera??es dimensionais significativas ao final do tratamento; entretanto, durante o per?odo de p?s-tratamento, foram observadas altera??es significativas em rela??o ? quantidade de irregularidade dos incisivos superiores. CONCLUS?O: concluiu-se que houve recidiva estatisticamente significativa (+1,52mm) na irregularidade anterossuperior durante o per?odo de p?s-tratamento. Entretanto, nenhuma das vari?veis aferidas nos modelos p?de ser clinicamente associada ? recidiva anterossuperior.Funda??o de Amparo ? Pesquisa do Estado de Minas Gerais (FAPEMIG)Empresa de Pesquisa Agropecu?ria de Minas Gerais (EPAMIG)Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq)Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES)OBJECTIVE: The purpose of this retrospective study was to evaluate long-term stability of maxillary incisors alignment in cases submitted to non-extraction orthodontic treatment. METHODS: The sample comprised 23 patients (13 female; 10 male) at a mean initial age of 13.36 years (SD = 1.81 years), treated with fixed appliances. Dental cast measurements were obtained at three different time points (T1 - pretreatment, T2 - posttreatment and T3 - long-term posttreatment). Variables assessed in maxillary arch were Little Irregularity Index, intercanine, interpremolar and intermolar widths, arch length and perimeter. The statistical analysis was performed by one-way ANOVA and Tukey tests when necessary. Pearson' correlation coefficients were used to investigate possible associations between the evaluated variables. RESULTS: There was no significant change in most arch dimension measurements during and after treatment, however, during the long-term posttreatment period, it was observed a significant maxillary incisors crowding relapse. CONCLUSION: The maxillary incisors irregularity increased significantly (1.52 mm) during long-term posttreatment. None of the studied clinical factors demonstrated to be predictive of the maxillary crowding relapse

Comparative study of the maturation and eruption of permanent teeth in subjects with vertical and horizontal growth patterns

O objetivo desse estudo foi comparar a maturação e idade média de erupção dos dentes permanentes, em jovens leucodermas com padrões de crescimento vertical e horizontal. Para tanto, foram selecionadas telerradiografias em norma lateral de 111 jovens, a fim de classificá-los quanto ao tipo de padrão de crescimento facial. Uma vez realizada esta classificação, foram selecionados os 30 jovens que apresentaram o maior predomínio do vetor de crescimento vertical (15 do gênero masculino e 15 do feminino) e os 30 jovens que apresentaram o maior predomínio do vetor de crescimento horizontal (15 do gênero masculino e 15 do feminino), constituindo assim, os grupos Vertical e Horizontal, respectivamente. Selecionou-se as radiografias panorâmicas desses 60 jovens, todas obtidas aos 8 anos de idade (a idade média do Grupo Vertical foi 8,5067 e do Grupo Horizontal 8,4800), para avaliar a maturação dos dentes permanentes, expressa em idade dentária, pelo método proposto por DEMIRJIAN; GOLDSTEIN; TANNER (1973). Da amostra total de 111 jovens, previamente classificados de acordo com o padrão de crescimento facial, selecionou-se 533 pares de modelo de gesso de 97 jovens, na faixa etária dos 5 aos 13 anos de idade, para a avaliação da idade média de erupção dos dentes permanentes. Esses modelos de gesso foram distribuídos em dois grupos (Vertical e Horizontal). A idade média de erupção dos dentes permanentes foi obtida pelo método de Karber. As comparações entre os grupos foram realizadas por meio do teste t independente. Os resultados demonstraram que houve diferença estatisticamente significante entre a idade dentária dos grupos Vertical e Horizontal. O Grupo Vertical apresentou uma idade dentária mais avançada quando comparado ao Grupo Horizontal. Em relação à idade média de erupção, dos 28 dentes permanentes considerados (exceção dos terceiros molares), apenas os pré-molares superiores do lado esquerdo apresentaram diferença estatisticamente significante entre os grupos Vertical e Horizontal. Assim, pode-se esperar que jovens com padrão de crescimento vertical apresentem uma maturação dentária mais precoce do que aqueles com padrão de crescimento horizontal.The objective of this study was to compare the maturation stage and mean age of eruption of permanent teeth in Caucasian individuals with vertical and horizontal growth patterns. For that purpose, lateral cephalograms of 111 young subjects were selected in order to classify the individuals according to the facial growth pattern. The 30 subjects presenting the strongest predominance of vertical growth (15 males and 15 females), as well as the 30 presenting the strongest predominance of horizontal growth (15 males and 15 females) were selected, which comprised the vertical and horizontal groups, respectively. Panoramic radiographs of all individuals, obtained at 8 years of age (mean age 8.5067 years for the vertical group and 8.4800 for the horizontal group), were employed to evaluate the maturation of the permanent teeth, expressed by the dental age, according to the method of DEMIRJIAN; GOLDSTEIN; TANNER (1973). From the total sample of 111 young subjects, previously scored as to the facial growth pattern, 533 pairs of dental casts of 97 individuals ranging from 5 to 13 years of age were selected for evaluation of the mean age of eruption of the permanent teeth. These casts were assigned to two groups (vertical and horizontal). The mean age of eruption of the permanent teeth was calculated through Karbers method. Comparisons between groups were accomplished by means of independent t tests. Results demonstrated a statistically significant difference between the dental age of the vertical and horizontal groups, with the vertical group presenting a more advanced dental age than the horizontal. Regarding the mean age of eruption, among the 28 permanent teeth observed (excluding the third molars) only the left maxillary premolars demonstrated a statistically significant difference between the vertical and horizontal groups. Therefore, young subjects with vertical growth pattern should be expected to present earlier dental maturation than horizontal grower

Comparative study of the treatment effects of Class II division 1 malocclusion with the appliances Jasper Jumper and Bionator, associated with fixed appliances

O objetivo deste estudo foi comparar os efeitos do tratamento da má oclusão de Classe II, 1ª divisão por meio dos aparelhos Jasper Jumper e Bionator, associados ao aparelho ortodôntico fixo. Para tanto, utilizou-se uma amostra de 77 jovens, divididos em três grupos: Grupo Experimental 1, constituído por 25 pacientes com idade inicial média de 12,72 anos, tratados por meio do aparelho Jasper Jumper associado ao aparelho ortodôntico fixo, por um período médio de 2,15 anos; Grupo Experimental 2, contendo 30 pacientes com idade inicial média de 11,31 anos, tratados por meio do aparelho Bionator e aparelho ortodôntico fixo, e o tempo médio de tratamento foi de 3,92 anos; Grupo Controle, composto por 22 jovens, com idade inicial média de 12,67 anos, e observados por um período médio de 2,13 anos. Avaliou-se as telerradiografias em norma lateral iniciais e finais dos indivíduos dos três grupos estudados. As variáveis cefalométricas dentoesqueléticas foram comparadas entre os grupos por meio da Análise de Variância, nas fases inicial e final. As alterações de todas as variáveis cefalométricas no grupo tratado por meio do Bionator foram anualizadas e, posteriormente, comparadas às alterações das variáveis dos demais grupos. Observou-se que ambos os tratamentos apresentaram um efeito restritivo na maxila e não alteraram o desenvolvimento mandibular. O tratamento com o Jasper Jumper ocasionou a rotação horária da mandíbula, o aumento da altura facial ântero-inferior, e menor rotação anti-horária do plano oclusal funcional em relação ao grupo tratado pelo Bionator. Os incisivos superiores foram retruídos nos grupos experimentais e extruídos no grupo do Jasper Jumper, que também apresentou uma distalização dos molares superiores. Os incisivos inferiores protruíram e vestibularizaram no grupo tratado por meio do Bionator e apresentaram uma tendência de protrusão e limitação do desenvolvimento vertical nos pacientes tratados com o Jasper Jumper. Os molares inferiores foram extruídos em ambos os grupos experimentais e mesializados no grupo tratado pelo Jasper Jumper. Ambos os aparelhos melhoraram significantemente o trespasse horizontal, vertical e a relação molar.This study compared the treatment effects of Class II division 1 malocclusion with the appliances Jasper Jumper and Bionator, associated with fixed appliances. The study sample was composed of 77 young individuals, divided into three groups: Study Group 1, comprising 25 patients with initial mean age of 12.72 years, treated with the Jasper Jumper appliance associated with fixed appliances for a mean period of 2.15 years; Study Group 2, composed of 30 patients with initial mean age of 11.31 years, treated with the Bionator and fixed appliances, with a mean treatment time of 3.92 years; and the Control Group, including 22 young individuals, with initial mean age of 12.67 years and followed for a mean period of 2.13 years. The initial and final lateral cephalograms of individuals in the three groups were evaluated. The cephalometric dentoskeletal variables were compared among groups at the initial and final periods by analysis of variance. The changes of all cephalometric variables in the Bionator group were annualized and compared to the changes observed for the other groups. It was observed that both treatments presented a restrictive effect on the maxilla and did not change the mandibular development. Treatment with the Jasper Jumper appliance produced clockwise mandibular rotation, increase in lower anterior facial height, and smaller counterclockwise rotation of the functional occlusal plane compared to treatment with Bionator. The maxillary incisors were retruded in the study groups and extruded in the Jasper Jumper group, which also exhibited distalization of maxillary molars. The mandibular incisors presented protrusion and buccal tipping in the group treated with the Bionator appliance and a tendency to protrusion and relative intrusion in individuals treated with the Jasper Jumper appliance. The mandibular molars exhibited extrusion in both study groups and mesial movement in the Jasper Jumper group. Both appliances allowed significant improvement of overjet, overbite and molar relationship

Efficiency of 1-phase and 2-phase treatment protocols in Class II, division 1 malocclusions

OBJETIVO: o objetivo deste estudo retrospectivo foi comparar os resultados oclusais e a eficiência dos protocolos de tratamento em uma e duas fases da má oclusão de Classe II, divisão 1. A eficiência do tratamento foi definida como um melhor resultado oclusal em um menor tempo de tratamento. MÉTODOS: uma amostra de 139 pacientes com má oclusão de Classe II, divisão 1, foi dividida em dois grupos, de acordo com o protocolo de tratamento instituído para a correção da má oclusão: grupo 1 - constituído por 78 pacientes tratados com o protocolo de tratamento em uma fase, com idades médias inicial e final de 12,51 (± 1,28) e 14,68 (± 1,49) anos, respectivamente; e grupo 2 - constituído por 61 pacientes tratados com o protocolo de tratamento em duas fases, com idades médias inicial e final de 11,21 (± 1,21) e 14,70 (± 1,55) anos, respectivamente. Telerradiografias em norma lateral foram obtidas ao início do tratamento, para avaliar a compatibilidade cefalométrica dos grupos. Os resultados oclusais foram avaliados nos modelos de gesso dos pacientes nas fases inicial e final utilizando o índice IPT (Índice de Prioridade de Tratamento). Aplicou-se o teste do qui-quadrado para avaliar a compatibilidade dos grupos quanto à severidade da relação ântero-posterior dos arcos dentários e à distribuição por gêneros. As variáveis diretamente relacionadas aos resultados oclusais foram comparadas por meio do teste t independente. Finalmente, uma análise de regressão linear múltipla foi realizada, a fim de verificar a influência de diversas variáveis no tempo de tratamento. RESULTADOS: verificou-se que resultados oclusais semelhantes são obtidos com os protocolos de tratamento em uma e duas fases. No entanto, o tempo de tratamento foi significantemente menor no grupo tratado em uma fase. CONCLUSÃO: baseado nos resultados desse trabalho pode-se concluir que o tratamento da má oclusão de Classe II, divisão 1, é mais eficiente quando realizado com o protocolo de tratamento em uma fase.AIM: The purpose of this study was to compare the occlusal outcomes and the efficiency of 1-phase and 2-phase treatment protocols in Class II, division 1 malocclusions. Treatment efficiency was defined as a better dentoalveolar result in a shorter treatment time. METHODS: Class II, division 1 subjects (n = 139) were divided into two groups in agreement with the treatment protocol adopted for Class II correction. Group 1 comprised 78 patients treated with 1-phase treatment protocol (single-stage group) at initial and final mean ages of 12.51 (± 1.28) and 14.68 (± 1.49) years. Group 2 comprised 61 patients treated with 2-phase treatment protocol (two-stage group) at initial and final mean ages of 11.21 (± 1.21) and 14.70 (± 1.55) years. Lateral cephalometric radiographs were taken at the pretreatment stage to evaluate morphological differences among treatment groups. Evaluations were performed on the initial and final study models of the patients using treatment priority index (TPI). Chi-square tests were used to compare the two groups regarding initial molar Class and gender distribution. Variables regarding occlusal results were compared using independent t-tests. Finally, a multiple linear regression analysis was completed, with total treatment time as the dependent variable to identify clinical factors that predict treatment length for patients with Class II malocclusions. RESULTS: Results demonstrated that similar occlusal outcomes are obtained between 1-phase and 2-phase treatment protocols, but the duration of treatment was significantly smaller in the 1-phase treatment protocol group. CONCLUSION: Based on the results of this investigation, it can be concluded that treatment of Class II, division 1 malocclusions is more efficient with the 1-phase treatment protocol

Occlusal outcomes and efficiency of 1-and 2-phase protocols in the treatment of Class II Division 1 malocclusion

Introduction: The purpose of this study was to compare the occlusal outcomes and the efficiency of 1-phase and 2-phase treatment protocols in Class II Division 1 malocclusions. Treatment efficiency was defined as a change in the occlusal characteristics in a shorter treatment time. Methods: Class II Division 1 subjects ( n = 139) were divided into 2 groups according to the treatment protocol for Class II correction. Group 1 comprised 78 patients treated with a 1-phase treatment protocol at initial and final mean ages of 12.51 and 14.68 years. Group 2 comprised 61 patients treated with a 2-phase treatment protocol at initial and final mean ages of 11.21 and 14.70 years. Lateral cephalometric radiographs were taken at the pretreatment stage to evaluate morphological differences in the groups. The initial and final study models of the patients were evaluated by using the peer assessment rating index. Chi-square tests were used to test for differences between the 2 groups for categorical variables. Variables regarding occlusal results were compared by using independent t tests. A linear regression analysis was completed, with total treatment time as the dependent variable, to identify clinical factors that predict treatment length for patients with Class II malocclusions. Results: Similar occlusal outcomes were obtained between the 1-phase and the 2-phase treatment protocols, but the duration of treatment was significantly shorter in the 1-phase treatment protocol group. Conclusions: Treatment of Class II Division 1 malocclusions is more efficient with the 1-phase than the 2-phase treatment protocol

The orthodontic treatment in older patients

OBJETIVO: este artigo tem como objetivo abordar as características do tratamento ortodôntico associado a uma atuação odontogeriátrica, pois devido a um aumento da expectativa de vida, um maior número de pacientes idosos tem procurado tratamento odontológico para uma reabilitação estética e/ou funcional. METODOLOGIA: através de uma avaliação de dados presentes na literatura são abordados fatores como enfermidades sistêmicas, uso de medicamentos, condição da saúde bucal, quantidade de osso alveolar, motivação do paciente e estabilidade oclusal após a terapia ortodôntica. Para exemplificar o tratamento ortodôntico no paciente idoso são apresentados dois casos clínicos. CONCLUSÕES: o tratamento ortodôntico representa uma intervenção viável na atuação odontogeriátrica, desde que realizado com forças suaves, considerando as limitações de cada caso e respeitando as características inerentes a esta atuação.OBJECTIVE: to approach the characteristics of the orthodontic treatment in aged patients, because the increase of life expectancy resulted in a bigger number of these kind of patients looking for orthodontic treatment. METHODS: an evaluation of the literature show a series of factors as: systemic disease, medicine utilization, condition of the buccal health, amount of alveolar bone, patients’ motivations and occlusal stability after the orthodontic therapy. To demonstrate the orthodontic treatment in the aged patient two clinical cases are presented. CONCLUSIONS: the orthodontic treatment represents a viable intervention in the aged patients, since that carried through with soft forces, considering the limitations of each case and respecting the inherent characteristics to these patients

Influence of fixed appliances on two-phase orthopedic-orthodontic treatment

e purpose of this retrospective study was to investigate the effects of phase 2 with fixed appliances, after phase 1 Bionator treatment of Class II division 1 malocclusion, as compared to a matching control group. Methods: The experimental group consisted of 20 patients who were evaluated after orthodontic treatment with fixed appliances subsequently to functional therapy with the Bionator in phase 1. A control group consisting of 20 Class II, division 1 individuals. Results: During phase 1 there was significant forward growth restriction in the maxillary complex, improvement of the maxillomandibular relationship and decrease in facial convexity. There was also significant reduction of the maxillary incisor proclination and protrusion, protrusion of the mandibular incisors, and vertical development of the mandibular molars. The overjet was significantly reduced and the molar relationship was significantly improved. Treatment during phase 2, with fixed appliances, resulted in significant maxillary forward growth restriction and facial convexity reduction. Conclusion: Major Class II skeletal and dentoalveolar anteroposterior correction was obtained during phase 1, with the Bionator. Phase 2, with fixed appliances only produced a significant maxillary forward growth restriction and facial convexity reduction, without any significant dentoalveolar change

Digital smile design as a tool in the planning of porcelain laminate veneers restoration

ABSTRACT Digital smile design is an important tool for esthetic planning in dentistry as it facilitates ease of communication between professionals and patients. This clinical report has the objective of describing a clinical procedure involving digital smile design for the placement of porcelain laminate veneer restorations. The digital smile design included dental and facial analyzes. The smile curve was drawn and a dental ruler was used to delimitate the spaces between each tooth. An approximate simulation of the smile was generated using Adobe Photoshop software. For esthetic and functional evaluation of the digital plan was created a diagnostic waxing and mock-up. The laminate veneers were made with feldspathic porcelain. Digital smile design was essential for successful planning because it enabled better patient contact with the end result. This case demonstrates the importance of this tool in esthetic dentistry

Influence of heat treatment on the mechanical properties of CrNi stainless steel orthodontic wires

ABSTRACT Introduction: The heat treatment of stainless steel wires is a routine clinical procedure adopted by many dentists in order to relieve the stress caused after performing bends in the archwire. Objective: This study aimed to evaluate the influence of heat treatment of stainless steel archwires with a rectangular section of 0.016 x 0.022’-in. Methods: For analysis of the dimensional stability, the anterior and posterior dimensions of forty 0.016 x 0.022-in stainless steel orthodontic archwires without heat treatment and 30 days after heat treatment were evaluated. For analysis of the mechanical properties, 12 stainless steel wire segments with the same rectangular section without heat treatment and 30 days after heat treatment were tested through tensile strength and strain tests. To evaluate if there were differences between the anterior and posterior dimensions, the results were analyzed by the Student’s t-test. To compare the tensile strength and strain between the groups, the ANOVA test was used. The level of significance adopted was 95% (p< 0.05). Results: The heat treatment did not stop the expansion of archwires 30 days after their preparation, and there was no statistical difference in the tensile strength and strain tests with and without heat treatment. Conclusion: From the findings of this study, it can be conclude that the mechanical behavior of heat-treated stainless steel archwires is similar to that of archwires not subjected to heat treatment