Diagnóstico Cefalométrico em Relação Cêntrica. Uma Questão Académica?

A controvérsia gerada em torno da influência da posição condilar no diagnóstico e no planeamento do tratamento ortodônticos, foi o motivo deste estudo. Alguns autores defendem peremptoriamente o recurso às montagens em articulador, com a finalidade da realização do estudo ortodôntico em relação cêntrica. Para eles, o estudo só será adequado se for esta a posição mandibular considerada. O problema colocado gira em torno do significado estatístico do diagnóstico cefalométrico em relação cêntrica e, portanto, do interesse clínico prático, de tal atitude. Tentámos pois, avaliar o significado deste procedimento, que se poderá traduzir numa alteração diagnóstica e, por consequência, no plano de tratamento a instituir em determinados casos. Nesse sentido, estudaram-se os deslizamentos cêntricos de uma amostra de 104 pacientes, sucessivamente recebidos na primeira consulta de ortodontia. Seleccionaram-se os casos apresentando valores de deslizamento cêntrico maiores ou iguais a 1,8 mm. Compararam-se então as medidas obtidas nos traçados cefalométricos das radiografias em incidência de perfil em intercuspidação máxima e após o procedimento da conversão do traçado à relação cêntrica. A comparação analítica das médias dos valores obtidos, em cada um dos dois tipos de análise, permitiu comprovar a existência de significado estatístico em 11 dos 12 factores seleccionados para a avaliação. Em nove deles, verificou-se haver elevado significado estatístico. Parece confirmar-se portanto o inegável interesse de recorrer a esta atitude, nos casos que apresentam um deslizamento cêntrico maior ou igual a 1,8 mm. Estes casos surgiram em quase um terço da amostra considerada (30,8 %), o que parece ser uma frequência significativa. Como não se podem associar sinais clínicos premonitórios à existência de deslizamento cêntrico significativo, conclui-se que as montagens em articulador e o estudo do deslizamento cêntrico deve fazer parte integrante do estudo ortodôntico. Os resultados do estudo sugerem que, para proceder a um diagnóstico ortodôntico preciso, se deve considerar a posição da mandíbula em relação cêntrica, em vez da posição tradicionalmente aceite de oclusão cêntrica, que se associa à intercuspidação máxima.The controversy created around the influence of the condylar position on the diagnosis and planning of the orthodontical treatment was the reason for this study. Some authors highly defend the usage of articulator montage to perform the orthodontical study in centric relation. Accordingly to them, the study will not be considered valid if this is not the used technique. The formulated problem turns around the statistical meaning of the cefalometric diagnosis in centric relation and, as a consequence, on the practical clinical interest of such attitude. So, we tried to evaluate the meaning of this procedure, which can turn into a change on the diagnosis and planning of the treatment to implement in a certain number of cases.That way, centric slides were studied from a sample of 104 patients, who were received on first orthodontic consultation. The cases presenting values of centric slide equal or bigger than 1.8 mm were selected and, on a later phase, the measures obtained on the cefalometric trace of the radiographs taken in a profile incidence in maximum intercuspation were compared after converting the trace to centric relation. The comparison of the analytical average resulting from the achieved values, for each of the two types of analysis, aimed to certify the existence of a statistical meaning in 11 of 12 of the factors selected for evaluation. In nine of them was possible to detect a high statistical meaning. So, the extreme importance in adopting such attitude towards the cases presenting a centric slide equal or bigger than 1.8 mm seems to be confirmed. These cases were spotted in almost one third of the considered sample (30.8%), which looks like a significant frequency. Once we can not associate premonitory clinical signs to the existence of a significant centric slide, it can be concluded that the articulator mounting and the centric slide study should be a part of the orthodontical study.The results obtained from this study suggest that, in order to carry out a precise orthodontical diagnosis, the mandible position in centric relation should be considered instead of the traditionally accepted position of centric occlusion, associated to maximum intercuspation

IL-1 polymorphisms may predict unsuccessful dental implants?

AimThe aim of this study was to analyse the possible association between no success of dental implants and two polymorphisms, IL1A (-889) and IL1B (+3953), in a Caucasian Portuguese population, and a possible relationship with other potential risk variables associated with a peri-implant disease.Material and Methods155 unrelated Caucasian individuals, were divided into 2 groups: 100 with successful dental implant rehabilitations and 55 with unsuccessful ones. To identify the polymorphisms, in positions -889 of IL1A gene and +3953 of IL1B gene, was performed an oral mucosa scraping of the patients and the DNA obtained from epithelial cells. The data were analysed in the SPSS Statistics 17.0® and the statistic analysis included the independence test of the chi-square, the exact test of Fisher and techniques of analysis of binary logistic regression.ResultsThe estimated prevalence of polymorphisms of IL1A and IL1B gene, determined by the TGP (CGC Genetics, Portugal) results, in the Caucasian Portuguese population was of 33.5%.Success of rehabilitation with dental implants was more associated to a negative TGP result, whereas failure was found to be related to a positive result.Tobacco and alcohol consumption showed no statistically significant association with success or no success of the dental implants.ConclusionThe success of the dental implants was more associated with the presence of the allele 2 of the IL1A gene and the allele 2 of the IL1B gene.Tobacco and alcohol consumption showed no association with success or no success of the rehabilitation with dental implants

O caminho para a sustentabilidade em medicina dentária será a reutilização de mangas de esterilização viável?

Objectives: To answer the question: Can sterilized pouches be used a second time while maintaining their sterility conditions? Methods: This investigation tested paper/plastic sterilization pouches divided into three groups: experimental group twice-used pouches; negative control group once-used pouches; and positive control group environmentally contaminated pouches. In the experimental group, pouches were opened, a gauze dressing was placed into them, and they were sterilized again, representing the reuse of the pouches (second sterilization cycle). After the sterilization cycle, samples were stored for 1 day (T0), 7 days (T1), 31 days (T2), and 153 days (T3). Positive control group pouches were opened and exposed to contamination in the storage environment. After the specified storage period, the experimental and negative control groups pouches were opened, and the gauze dressings were removed aseptically. All gauze dressings of all groups, including the positive control group, were incubated in Petri dishes with nutrient agar at 37°C for 3 days. After incubation, the Petri dishes were inspected, and the microbial contamination was assessed and classified as present or absent. Results: The experimental groups Petri dishes showed no sign of contamination. The same happened to the negative control group. The positive control groups Petri dishes presented microbial contamination. The same results were obtained for all incubation times. Conclusions: This study showed that sterilization pouches could be used a second time while maintaining sterility and integrity conditions, even for extended periods (153 days 5 months of storage).(undefined)info:eu-repo/semantics/publishedVersio

The relation between mandibular symphysis and the Angle class in orthodontic treatment

OBJECTIVES: Facial perception depends on the different components of the face. The chin is a striking anatomical structure in the individual’s identity and mandibular symphysis (MS) shape influences the adjacent soft tissue, determining facial harmony. In lateral cephalometry, the MS corresponds to the image of the mandibular body in its anterior curvature. It shape, inclination and thickness provide valuable information for orthodontic diagnosis and prognosis. Since facial features are associated with malocclusions, the present investigation aims to relate the height, thickness and inclination of the MS using Angle’s Class. METHODS: 495 lateral incidence cephalograms of an orthodontic population were analyzed using a previously developed and tested software. The sample was randomly selected and the height, thickness and inclination of the MS were measured. The values were statistically analyzed (p ≤ 0.05). RESULTS: The distribution according to Angle’s Class was 48.9% for Class I, 34.7% for Class II Division 1, 7.4% for Class II Division 2 and 8.9% for Class III. The MS height did not’t show significant differences between the three dental classes. The MS thickness was significantly increased in Class II Division 2 and Class I subjects (p = 0,037). The MS inclination was significantly less in Class III subjects when compared to Class I and Class II Division 1 (p ≤ 0.001). CONCLUSIONS: The MS presented variations, which may be associated with a natural compensation against malocclusion, influencing the position of the teeth and their relationship with the other dento-craniofacial structures and with consequences on the facial harmony

Retrospective evaluation of therapeutic outcomes of functional appliances combined with headgear

Functional appliances were developed to correct mainly Class II malocclusions in growing children but the influence of those appliances on craniofacial growth is still controversial, even when used in combinations with headgear. The aim of this retrospective study was to investigate skeletal, dental and tegumental cephalometric modifications induced by Teuscher activator. This study was accomplished in a mixed dentition sample of Class II malocclusions subjects with mandibular retrognatism. This appliance was effective in treating growing patients with mandibular deficiency: the correction of Class II malocclusions was an arrangement of skeletal and dentoalveolar changes and leaded to the improvement of soft tissue facial profile