Indicación de las distintas técnicas de expansión rápida del paladar quirúrgicamente asistida y comparativa de la estabilidad

La edad del paciente ha sido considerada por la mayoría de autores un parámetro esencial en la elección entre expansión ortopédica y expansión rápida del paladar quirúrgicamente asistida (SARPE) para tratar las discrepancias transversales maxilomandibulares. La mayoría de los autores coinciden en que la edad límite para realizar disyunción ortopédica sin necesidad de intervención quirúrgica son los 15 años de edad. Por lo que la opción terapéutica de elección para la corrección de discrepancias transversales depende principalmente de la madurez esqueletal del paciente y de la magnitud de la discrepancia transversal. Según Silverstein et al. las discrepancias transversales maxilomandibulares menores de 5 mm requieren expansión ortodóncica u ortopédica para su correción, sin embargo discrepancias transversales mayores a 5 mm en pacientes con madurez esqueletal requieren de SARPE

Estudio craneométrico y electromiográfico del síndrome de clase II

Fac. de MedicinaTRUEProQuestpu

Efficacy and predictability of maxillary and mandibular expansion with the Invisalign® system

The purpose of this study is to evaluate the efficacy and predictability of upper and lower orthodontic expansion with the Invisalign® system. From a sample of 167 patients; 64 upper and 51 lower arches were randomly selected from patients who had been

Obstructive Sleep Apnea Syndrome (OSAS). Review of the literature

Obstructive sleep apnea and hypopnea syndrome is characterized by repeated airway collapse during sleep. The literature describes multiple causes of the disease. The main cause is a reduction of the expansion forces of the pharyngeal dilator muscles, as in situations of genioglossal muscle dysfunction, and discoordination between the inspiratory activity of the muscle and respiratory effort, which play an important role in progression of the disease. Other described causes are soft tissue disorders, such as macroglossia or tonsillar hypertrophy, and skeletal structural alterations such as micrognathia and retrognathia. The syndrome is also more frequent in obese people, where the accumulation of fat in the neck region produces narrowing of th pharyngeal airway, thereby diminishing the passage of air. This review focuses on the pathogenesis, epidemiology, main features and diagnosis of the disease, and on its main forms of treatment

Bone- and dentoalveolar-anchored dentofacial orthopedics for Class III malocclusion: New approaches, similar objectives? A systematic review

Objectives: To analyze the scientific literature and compare in the results of conventional orthopedic appliances with those obtained from recent bone-anchored orthopedics for Class III malocclusion. Materials and Methods: The literature was systematically reviewed using PubMed/Medline, Scopus, and Scirus databases up to January 2012. Articles were selected by two different researchers (kappa index  =  0.83), based on established inclusion/exclusion criteria. Methodologic quality was classified as high, medium, or low quality. Results: The search strategy identified 1020 titles. Thirty studies were selected after applying the criteria (high quality  =  9, medium quality  =  21). Protraction rates differed within a range of one- to twofold between bone-anchored and dentoalveolar therapies (P < .001). All studies noted the effect of clockwise rotation on the mandible and an increase in inferior-anterior and total facial height; this was more obvious in dentoalveolar therapy than in bone-anchored orthopedics (P < .001). Conclusions: Dental parameters like overjet increased significantly with both sets of groups, ranging from 1.7 to 7.9 mm with dentoalveolar therapy and from 2.7 to 7.6 mm with bone-anchored orthopedics

Obstructive sleep apnea syndrome (OSAS): review of the literature

Obstructive sleep apnea and hypopnea syndrome is characterized by repeated airway collapse during sleep. The literature describes multiple causes of the disease. The main cause is a reduction of the expansion forces of the pharyngeal dilator muscles, as in situations of genioglossal muscle dysfunction, and discoordination between the inspiratory activity of the muscle and respiratory effort, which play an important role in progression of the disease. Other described causes are soft tissue disorders, such as macroglossia or tonsillar hypertrophy, and skeletal structural alterations such as micrognathia and retrognathia. The syndrome is also more frequent in obese people, where the accumulation of fat in the neck region produces narrowing of the pharyngeal airway, thereby diminishing the passage of air. This review focuses on the pathogenesis, epidemiology, main features and diagnosis of the disease, and on its main forms of treatment

Association between condylar asymmetry and temporo-mandibular disorders using 3D-CT

Objectives: Using reconstructed three-dimensional computed tomography (3D-CT) models, the purpose of this study was to analyze and compare mandibular condyle morphology in patients with and without temporomandibular disorder (TMD). Study Design: Thirty-two patients were divided into two groups: the first comprised those with TMD (n=18), and the second those who did not have TMD (n=14). A CT of each patient was obtained and reconstructed as a 3D model. The 64 resulting 3D condylar models were evaluated for possible TMD-associated length, width and height asymmetries of the condylar process. Descriptive statistics were used to assess the results and student?s t tests applied to compare the two groups. Results: Statistically significant (p<0.05) vertical, mediolateral and sagittal asymmetries of the condylar process were observed between TMD and non-TMD groups. TMD patients showed less condylar height (p<0.05) in comparison with their asymptomatic counterparts. Conclusions: Using 3D-CT, it was shown that condylar width, height and length asymmetries were a common feature of TM

Diagnostic of craniofacial asymmetry : literature review

Facial asymmetry is a common feature in many syndromes, and requires surgery as the only valid treatment option. Routine diagnostic methods (frontal RX, panoramic RX and submentovertex RX) have serious limitations mainly due to the transfer from a three dimensional image to a two dimensional plane. The feasibility of such methods is poorly supported due to inherent projection errors (image magnification, cranial rotation) and identification errors (image quality, precision and reproducibility). The use of computer tomographies represents a substantial improvement in the sense of skeletal and soft tissue structures? reproduction precision. The interpretation of this new data source makes evident the necessity of new analysis tools for extraction, manipulation and synthesization of the whole diagnostic and therapeutical potential based on more solid studies in this field

Study of mandibular growth in patients treated with Fränkel ?s functional regulator (1b)

Objectives: The purpose of this study was to assess mandibular growth in patients with Class II division 1 malocclusions when treated with Fränkel ?s functional regulator 1b. Study Design: The treatment group was made up of 43 patients that were divided into two groups: prepubescent (n:28), and pubescent (n:15). The control group included 40 patients who did not receive any kind of treatment and were likewise divided into a prepubescent group (n:19), and a pubescent group (n:21). A computerized cephalometric study was carried out and superimpositions were done in order to assess the antero-posterior, vertical and rotational movements of the mandible. A two-way ANOVA with interaction was done to compare the changes between the control group and the treatment group, while the Student t for independent samples was used to compare each age group. Results: The Gnathion and Gonion points showed significant differences in the whole sample (p0.05). Conclusion: The results show that the FR produces vertical orthopedic growth in the mandible but not horizontal growth compared to non-treated Class II-type I malocclusion patients. No rotational changes were found in the mandible, but we did record mandibular growth along the inclination of the facial axi

Effects on the maxilla and cranial base caused by cervical headgear : a longitudinal study

Objectives: The aim of this study is to test the possible orthopedic effects of cervical headgear on the cranial base and maxilla. Study design: a sample consisting of 79 subjects with skeletal class II malocclusion was divided into two groups. The experimental group was made up of 41 patients all treated with cervical headgear. The control group included a total of 38 non-treated patients. Each one of these groups was then subdivided according to age into one of three groups: prepubescent, pubescent or post-pubescent. Cephalometric parameters were compared in both groups in order to measure the cranial base angle and the vertical and sagittal position of the maxilla. Additionally, cephalometric superimpositions taken at the beginning and end of the study were compared. Results: results revealed significant differences in the cranial base angle and in the SNA angle (p<0.05). However, no differences were observed in the variables that measure the maxillomandibular relationship. While no changes were noted in the palatal plane slope, a flattening of the cranial base was found caused by the cervical headgear, in addition to a retrusion of point A that does not mean there was a reduction in the maxillomandibular relationship. Conclusions: cervical headgear treatment induces cephalometric flattening of the cranial base and a decrease of the SNA angl