Resumo Os objetivos do presente estudo foram comparar e avaliar a estabilidade do tratamento precoce da mordida aberta anterior (MAA) com diferentes dispositivos. A amostra inicial foi composta por 99 pacientes randomizados em quatro grupos experimentais: BS - esporões colados; CC - mentoneira; FPC - grade palatina fixa; RPC - grade palatina removível. Análise cefalométrica foi realizada para avaliar os dados do período inicial (T1), final do tratamento (T2) e 2 anos após tratamento (T3), sendo a variável overbite o desfecho principal. Em T3, após perdas de seguimento, haviam 63 indivíduos, sendo BS (n=15; overbite 0.19 mm; 11.54 anos; 10 Feminino (F)/5 Masculino (M)); CC (n=11; overbite -0.19 mm; 11.41 anos; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 anos; 15 F/6 M) e; RPC (n=16; overbite 0.73 mm; 11.67 anos; 6 F/10 M). Comparações das alterações nas variáveis dentoesqueléticas e abandono de hábitos bucais deletérios durante o tempo de acompanhamento foram estatisticamente analisados com p<.05. Medidas esqueléticas lineares mandibulares e componentes verticais aumentaram gradualmente com a idade, principalmente com o surto de crescimento puberal e estabelecimento da dentição permanente no pós-tratamento. O overbite foi significantemente melhorado durante o tratamento, permanecendo estável com alterações positivas. A extrusão dos incisivos impactou na correção da MAA e estabilidade nos 4 grupos, que registraram uma melhora de 1.15 mm no pós-tratamento (T3-T2). Com suas limitações, todos dispositivos experimentais foram efetivos e mostraram resultados estáveis no tratamento precoce da MAA, sendo que a FPC apresentou a maior correção da MAA e o menor índice de desistência.

Abstract This 2-year-follow up study compared and evaluated the stability of early anterior open bite (AOB) treatment based on different appliances. Children from 7 to 10 years with Angle Class I, AOB larger than 1.0 mm and fully erupted maxillary and mandibular permanent central incisors were eligible. The initial sample was 99 patients distributed, by simple randomization, into four groups: BS (bonded spurs), CC (chincup), FPC (fixed palatal crib) and RPC (removable palatal crib). Cephalometric analysis was performed at baseline (T1), final (T2) and 2-year post-treatment (T3) by taking the overbite measurements as the main outcome. Blinding was possible to cephalometric analysis. At T3, with dropouts, there were 63 individuals, being BS (n=15; overbite 0.19 mm; 11.54 years; 10 female (F)/5 male (M)); CC (n=11; overbite -0.19 mm; 11.41 years; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 years; 15 F/6 M) and; RPC (n=16; overbite 0.73 mm; 11.67 years; 6 F/10 M). Changes in dentoskeletal variables and breaking deleterious oral habits during the follow up were statically analyzed with p<.05. Mandibular skeletal linear measurements and vertical dental components have gradually increased with age, manly at pubertal growth spurt and at the establishment of permanent dentition after treatment. Incisor teeth extrusion had impact on AOB correction and stability in 4 groups, which recorded a 1.15 mm-improvement of overbite after treatment (T3-T2). The experimental appliances were effective with stable results, being FPC the device recorded the highest AOB correction and the lowest patient withdrawal rate.

Abstract The object of this study was to compare the clinical complications of 4 different appliances used in the early treatment of anterior open bite (AOB), and to test the null hypothesis that there is no difference in the number of complications among the appliances. Records from 99 Class I malocclusion patients with AOB treated using bonded spurs, BS, n = 25; chin cup, CC, n = 25; fixed palatal crib, FPC, n = 25; and removable palatal crib, RPC, n = 24) were examined. The total number and frequency of clinical complications that occurred over 12 months were described and compared by using chi-square and Kruskal-Wallis tests (Dunn’s post-test) (α = 5%, CI = 95%). The incidence of clinical complications was 66.7%, comprising: breakage, bond failure, maladjustment, allergy, soft-tissue lesion, loss of removable appliance and abandonment. Eighteen patients gave up treatment; this occurred more frequently in the groups with removable appliances. Regarding the total number of complications per patient, Group BS exhibited a significantly higher number than the other groups (p < 0.0001). A low frequency of complications (1 to 3) was found in the groups, except for Group BS, in which 8% of the patients presented moderate frequency (4 to 6). In terms of appliance types (fixed or removable), there was no difference in the incidence of complications (p > 0.094). The null hypothesis was rejected, since the BS group exhibited the highest total number and frequency of complications. There was no difference between fixed and removable appliances in terms of incidence of clinical complications, although more patients using removable appliances abandoned their treatment.

RESUMO Objetivo: o presente estudo in vitro avaliou, por meio da técnica de fotoelasticidade, os efeitos produzidos pelo Arco de Intrusão de Connecticut (CIA) com dobra de 90o na face distal dos tubos molares e usando um aparelho 4 x 2 nas regiões anterior e posterior da arcada dentária superior. Métodos: foram confeccionados cinco modelos, aos quais foram correlacionadas duas situações clínicas diferentes: 1) uso do arco de intrusão sem dobra distal, mas com barra transpalatina para ancoragem (G1); 2) uso do arco de intrusão com dobra distal e barra transpalatina para ancoragem (G2). Avaliou-se as tensões geradas nos terços apical e médio das raízes dos dentes anterossuperiores e primeiros molares superiores. Resultados: considerando-se um valor de referência de 1,0 MPa = 100%, foi realizada uma análise descritiva qualitativa, a qual demonstrou uniformidade entre os valores de tensão na região apical dos dentes anteriores nos dois grupos (G1 e G2). Na região posterior dos modelos com arcos com dobra distal (G2), a tensão foi mantida em 100%. Já nos modelos do G1 (arco sem dobra distal), foram observadas variações na face mesial dos primeiros molares, com um aumento de 20% na tensão gerada. A região apical não sofreu qualquer alteração, ao passo que, na região distal dos molares, houve uma diminuição de 20% na tensão. Conclusão: os resultados laboratoriais revelaram diferenças, entre os grupos 1 e 2, para a tensão gerada na região dos molares, indicando que houve uma tendência de mesialização da raiz dos primeiros molares quando não foi realizada a dobra na extremidade distal do CIA.

ABSTRACT Objective: The present in vitro study evaluated, by means of the photoelastic technique, the effects generated by the Connecticut Intrusion Arch (CIA), with a 90o bend on the distal surface of molar tubes and using the 4 x 2 appliance on the anterior and posterior regions of the upper dental arch. Methods: Five models were manufactured, in which two different clinical situations were correlated: 1) use of intrusion arch not cinched back and transpalatal bar for anchorage (Group 1); 2) use of intrusion arch cinched back and transpalatal bar for anchorage (Group 2). Stress generated in the apical and middle regions of tooth roots of maxillary anterior teeth and maxillary first molars was evaluated. Results: Taking a reference value of 1.0 MPa = 100%, qualitative descriptive analysis was performed, which showed uniformity between stress values in the apical region of anterior teeth of both groups (G1 and G2). In the posterior region, for models with the arch cinched back (G2), stress remained within 100%. As for G1 models (with the arch not cinched back), variations in the mesial surface of first molars were observed, with an increase of 20% in the generated stress. The apical region did not undergo any changes, while in the distal region of molars there was a decrease of 20% in stress. Conclusion: Laboratory results revealed differences in stress between Groups 1 and 2 in the molar region, thereby indicating that there was a tendency towards mesial root tipping of first molars when the distal end of the CIA was not cinched back.

Objetivo: avaliar a estabilidade da inclinação mesiodistal dos molares superiores cinco anos após o tratamento realizado com o aparelho Pendulum seguido de aparelho ortodôntico fixo. As mudanças na angulação foram comparadas com uma amostra não tratada. Métodos: a amostra consistiu de 20 pacientes (14 do sexo feminino e 6 do masculino) com má oclusão de Classe II, divisão 1 tratados por meio da distalização dos molares com o aparelho Pendulum seguido de ancoragem extrabucal cervical e aparelho fixo. A inclinação dos molares superiores foi avaliada por meio de radiografias panorâmicas. A média da idade ao início do tratamento foi de 14,3 ± 1,6 anos; ao final do tratamento, de 18,6 ± 1,8 anos e, no longo tempo pós-tratamento, de 23,8 ± 2,0 anos. Para comparação, foi usado um grupo controle com 16 indivíduos não tratados e com oclusão normal, apresentando idades entre 12 e 17 anos. Os dados foram analisados estatisticamente pelo teste t independente e ANOVA, seguido do teste de Tukey. Resultados: os primeiros molares superiores apresentaram diferenças estatisticamente significativas entre T1 (94,5o) e T2 (98,8o), bem como entre T2 e T3 (94,7o). Os segundos molares superiores não apresentaram alterações estatisticamente significativas no seu posicionamento durante os períodos avaliados, T1 (107,5o), T2 (109,3o) e T3 (106,9o). Conclusões: apesar de os primeiros molares superiores apresentarem inclinação distal da coroa imediatamente após o tratamento, aproximadamente cinco anos depois suas raízes tendem a ocupar posições próximas às do início do tratamento.

Objective: To evaluate the stability of mesiodistal inclination of maxillary molars produced by a pendulum appliance, five years after completion of orthodontic treatment. Angulation changes were compared to an untreated sample. Methods: The sample consisted of 20 patients (14 females and 6 males) with Class II, Division 1 malocclusion that was treated through molar distalization with a pendulum appliance followed by cervical headgear and full fixed appliances. Maxillary molar inclination was evaluated through panoramic radiograph. The mean age at pretreatment was 14.3 ± 1.6 years, whereas at immediate post-treatment it was 18.6 ± 1.8 years, and at long-term post-treatment it was 23.8 ± 2.0 years. A control group of 16 untreated individuals with untreated normocclusion ranging in age from 12 to 17 years old were used as comparison group. Data were statistically analyzed with independent t-tests and ANOVA test followed by Tukey post-hoc tests. Results: Statistically significant differences were found between T1 (94.50) and T2 (98.80) as well as between T2 and T3 (94.70) for maxillary first molars. Maxillary second molars did not show any statistically significant positional changes during the evaluated time periods T1 (107.50), T2 (109.30) and T3 (106.90). Conclusion: Although maxillary first molars underwent distal crown inclination immediately after treatment, approximately five years thereafter their roots tended to upright close to the pretreatment positions.

The facial growth of Class III malocclusion worsens with age, in this case, the early orthopedic treatment, providing facial balance, modifying the maxillofacial growth and development. A 7.6-year old boy presented with Class III malocclusion associated with anterior crossbite; the mandible was shifted to the right and the maxilla had a transversal deficiency. Rapid maxillary expansion followed by facemask therapy was performed, to correct the anteroposterior relationship and improve the facial profile. The patient was followed for a 15-year period, after completion of the treatment, and stability was observed. Growing patients should be monitored following their treatment, so as to prevent malocclusion relapse.

Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and the teeth, including the presentation of malocclusion and the effect on the occlusion must be considered. The objective of this study was to describe the etiology, prevalence and alternative treatment modalities for dental agenesis and to present a clinical case of agenesis of the maxillary lateral incisors treated by the closure of excessive spaces and canine re-anatomization. A clinical case is presented to illustrate the interdisciplinary approach between orthodontics and restorative dentistry for improved esthetic results. In this report, the treatment of a girl with a Class II malocclusion of molars and canines with missing maxillary lateral incisors and convex facial profile is shown. Treatment was successfully achieved and included the space closure of the areas corresponding to the missing upper lateral incisors, through movement of the canines and the posterior teeth to mesial by fixed appliances as well as the canines transformation in the maxillary lateral incisors. This is a 14-year follow-up case report involving orthodontics and restorative dentistry in which pretreatment, posttreatment, and long-term follow-up records for the patient are presented.

OBJETIVO: as características cefalométricas dentárias variam consideravelmente entre as diferentes raças. No Brasil, em virtude da grande miscigenação populacional, é necessário conhecer, também, as variações apresentadas pelas misturas dessas raças. Por essa razão, o objetivo desse estudo foi identificar o padrão das variáveis dentárias de jovens mestiços nipo-brasileiros com oclusão normal e compará-los com amostras semelhantes de leucodermas e de xantodermas. MÉTODOS: foram utilizadas 40 telerradiografias de jovens leucodermas, 32 de nipo-brasileiros e 33 de xantodermas. As rês amostras apresentavam indivíduos com oclusão normal e face bem balanceada. Foram realizadas análises estatísticas de variância a um critério (ANOVA) e a de covariância (ANCOVA). Basicamente, as variáveis cefalométricas usadas seguiram as preconizadas por Steiner, Tweed e McNamara Jr. RESULTADOS: encontrou-se diferença estatística (p < 0,05) entre as raças em cinco das variáveis estudadas. Essas diferenças indicaram menor ângulo interincisivos e menor sobremordida para a amostra nipo-brasileira, com relação à amostra leucoderma, mas com valores semelhantes aos da amostra xantoderma. CONCLUSÃO: os valores dentários encontrados para os jovens nipo-brasileiros foram, em geral, mais similares àqueles da amostra de xantoderma.

INTRODUCTION: The objective of this study was to identify the patterns of dental variables of adolescent Japanese-Brazilian descents with normal occlusion, and also to compare them with a similar Caucasian and Mongoloid sample. METHODS: Lateral cephalometric radiographs were used to compare the groups: Caucasian (n = 40), Japanese-Brazilian (n = 32) and Mongoloid (n = 33). The statistical tests used were one-way ANOVA and ANCOVA. The cephalometric measurements used followed the analyses of Steiner, Tweed and McNamara Jr. RESULTS: Statistical differences (P < 0.05) indicated a smaller interincisal angle and overbite for the Japanese-Brazilian sample, when compared to the Caucasian sample, although with similar values to the Mongoloid group. CONCLUSION: The dental patterns found for the Japanese-Brazilian descents were, in general, more similar to those of the Mongoloid sample.

OBJETIVO: comparar a resistência ao atrito entre braquetes autoligáveis e braquetes convencionais, variando o tipo de fio. MÉTODOS: foram usados braquetes incisivos Abzil Kirium Capelozza e Easy Clip. Uma ligadura elastomérica ou um fio ligável de 0,010" foi usado para ligação do fio no braquete Abzil. Três tipos de ligas de fio ortodôntico foram avaliadas: fio de NiTi de 0,016"; fio de NiTi de 0,016" x 0,022"; e fio de aço de 0,019" x 0,025". Dez observações foram feitas para cada combinação "braquete-fio-inclinação". Os braquetes foram montados em um aparelho especial, posicionados a 90° em relação ao fio, e testados em duas inclinações. O teste de atrito foi realizado na máquina universal de ensaios, a 5mm/min e com 10mm de deslocamento. As médias (em MPa) foram submetidas aos testes ANOVA e de Tukey, a 5% de significância. As superfícies dos fios e dos braquetes foram observadas no MEV. RESULTADOS: o braquete com amarrilhos metálicos (16,48 ± 8,31MPa) apresentou médias mais altas que o braquete com ligaduras elastoméricas (4,29 ± 2,16MPa) e o braquete autoligável (1,66 ± 1,57) (p < 0,05), os quais também diferiram entre si (p < 0,05). Quanto ao tipo do fio, o fio de aço de 0,019" x 0,025" (5,67 ± 3,97MPa) apresentou médias mais baixas (p < 0,05) que os fios de NiTi de 0,016" (8,26 ± 10,92MPa) e de 0,016" x 0,022" (8,51 ± 7,95), os quais não diferiram entre si (p > 0,05). Nenhuma diferença estatística (p > 0,05) foi encontrada entre inclinações de zero (7,76 ± 8,46) e cinco (7,19 ± 7,93) graus. Concluão: o atrito foi influenciado pelo tipo de braquete e sistemas de ligaduras. Diferentes aspectos morfológicos foram observados para os braquetes e fios estudados.

OBJECTIVE: To compare the frictional resistance between self-ligating and conventional brackets tied to different types of wire. MATERIAL AND METHODS : Abzil Kirium Capelozza (Pattern I) and Easy Clip (Roth prescription) incisor brackets were used. An elastomeric ligature or a ligating wire 0.10-in was used to ligate the wire to the Abzil bracket. Three types of orthodontic archwire alloys were assessed: 0.016-in NiTi wire, 0.016 x 0.021-in NiTi wire and 0.019 x 0.025-in steel wire. Ten observations were carried out for each bracket-archwire angulation combination. Brackets were mounted in a special appliance, positioned at 90 degrees in relation to the wire and tested in two angulations. Frictional test was performed in a Universal Testing Machine at 5 mm/min and 10 mm of displacement. The means (MPa) were submitted to ANOVA and Tukey's test set at 5% of significance. The surfaces of wires and brackets were observed at SEM. RESULTS: Steel-tied brackets (16.48 ± 8.31) showed higher means of frictional resistance than elastomeric-tied brackets (4.29 ± 2.16 ) and self-ligating brackets (1.66 ± 1.57) (P < 0.05), which also differed from each other (P < 0.05). As for the type of wire, 0.019 x 0.025-in steel wire (5.67 ± 3.97) showed lower means (P < 0.05) than 0.16-in NiTi wire (8.26 ± 10.92) and 0.016 x 0.021-in NiTi wire (8.51 ± 7.95), which did not differ from each other (P > 0.05). No statistical differences (P > 0.05) were found between zero (7.76 ± 8.46) and five-degree (7.19 ± 7.93) angulations. CONCLUSIONS: Friction was influenced not only by the type of bracket, but also by the ligating systems. Different morphological aspects were observed for the brackets and wires studied

OBJETIVO: a proposta desse estudo foi comparar, cefalometricamente, os efeitos esqueléticos e dentoalveolares no tratamento da má oclusão de Classe II com os distalizadores Pendulum e Jones jig, seguidos de aparelho fixo corretivo, e compará-los ao grupo controle. MÉTODOS: a amostra foi dividida em três grupos. Grupo 1: 18 pacientes tratados com o Pendulum; grupo 2: 25 pacientes tratados com o Jones jig; e grupo 3: 19 jovens com má oclusão de Classe II não tratada. Empregou-se o teste qui-quadrado para avaliar a distribuição da severidade e do sexo. Os grupos 1 e 2 foram comparados ao controle pela ANOVA a um critério; também empregou-se o teste de Tukey com o intuito de diferenciar as alterações do tratamento daquelas ocorridas pelo crescimento craniofacial. RESULTADOS: não foram observadas alterações significativas entre os três grupos quanto aos componentes da maxila, mandíbula, relação maxilomandibular, padrão cefálico e tegumentar. Verificou-se uma vestibularização significativamente maior dos incisivos inferiores nos grupos experimentais e maior angulação mesial dos segundos molares superiores no grupo 2 (Jones jig). Nos grupos experimentais, a relação dentária e os trespasses horizontal e vertical foram corrigidos. CONCLUSÃO: pode-se afirmar que os distalizadores alcançaram seus objetivos de correção da Classe II.

OBJECTIVE: The purpose of this study was to cephalometrically compare the skeletal and dentoalveolar effects in the treatment of Class II malocclusion with Pendulum and Jones jig appliances, followed by fixed corrective orthodontics, and to compare such effects to a control group. METHODS: The sample was divided into three groups. Group 1: 18 patients treated with Pendulum, Group 2: 25 patients treated with Jones jig, and Group 3: 19 young subjects with untreated Class II malocclusions and initial mean age of 12.88 years. The chi-square test was applied to assess severity and gender distribution. Groups 1 and 2 were compared to the control group by means of the one-way ANOVA and Tukey tests in order to differentiate treatment changes from those occurred by craniofacial growth. RESULTS: There were no significant changes among the three groups with regard to the components of the maxilla and the mandible, maxillomandibular relationship, cephalometric and tegumental pattern. Buccal tipping of mandibular incisors was significantly greater in the experimental groups and increased mesial angulation of the maxillary second molars was found in the Jones jig group. In the experimental groups, dental relationship, overbite and overjet were corrected. CONCLUSION: It can be stated that the distalization achieved its purpose of correcting the Class II.

Resumo A má oclusão de Classe III esquelética, com sua imprevisibilidade e natureza potencialmente desfavoráveis, caracteriza um padrão de crescimento com duvidoso prognóstico à mecânica ortodôntica, ainda que esta seja realizada precocemente. Durante muito tempo, a Classe III foi considerada sinônimo de prognatismo mandibular, independente das estruturas esqueléticas comprometidas. O crescimento mandibular, determinado essencialmente por fatores genéticos, dificilmente seria controlado pela intervenção ortodôntica precoce. Assim, optava-se por aguardar o crescimento e então realizar a intervenção ortodôntica associada à cirurgia ortognática. A constatação de envolvimento da maxila como etiologia primária na má oclusão de Classe III foi decisiva para a mudança da terapêutica. O crescimento maxilar, de origem intramembranoso, responderia melhor ao tratamento por meio do controle e direcionamento do crescimento, contribuindo para o sucesso da intervenção precoce. Em muitos casos, excelentes resultados são obtidos com a expansão rápida e protração da maxila. O presente trabalho objetiva descrever e discutir o tratamento de uma paciente com má oclusão de Classe III, cujo plano de tratamento consistiu de duas fases: interceptora, realizada com aparelhos ortopédicos mecânicos e corretiva, com aparelho ortodôntico fixo. Os resultados deste caso clínico demonstraram que a má oclusão de Classe III deve ser interceptada o mais precoce possível, com vistas a redirecionar o crescimento. Esta abordagem deve acontecer, especialmente, quando a maxila é o fator etiológico primário ou quando fatores dentários e/ou funcionais estiverem envolvidos na determinação desta má oclusão. O diagnóstico, o plano de tratamento e o prognóstico dependem da idade do paciente, do potencial de crescimento e da severidade da má oclusão. A intervenção precoce, a indicação de aparelhos adequados e a colaboração do paciente constituem fatores determinantes para a obtenção do sucesso desejado.

Skeletal Class III malocclusion, with its unpredictable and unfavorable nature, has been characterized by a growth pattern with doubtful prognosis regarding orthodontic mechanics, even when performed early. For a long time, Class III malocclusion was regarded as a synonym of mandibular prognathism, regardless of the affected skeletal structures. Mandibular growth, essentially determined by genetic factors, could barely be controlled by early orthodontic interventions. Therefore, the treatment choice was to wait for the patient to grow, and then make an orthodontic intervention associated with an orthognathic surgery. Maxillary involvement in the etiology of Class III malocclusion was conclusive to change orthodontic therapeutics. Maxillary intramembranous growth has a better response to orthopedic treatment, based on growth control and redirection, thus contributing for early intervention success. In several cases, excellent results have been achieved with rapid maxillary expansion and protraction. The aim of this study was to describe and discuss the treatment of a patient with Class III malocclusion, whose treatment planning comprised two phases: interceptive (mechanical orthopedic appliances) and comprehensive (fixed orthodontic appliance). The results of this case showed that Class III malocclusion should be intercepted as early as possible to permit growth redirection, mainly when the maxilla is the primary etiologic factor or dental and/or functional factors are involved. Diagnosis, treatment planning and prognosis depend on patient age, growth potential and severity of malocclusion. Early intervention, adequate indication of appliances, and patient compliance are key factors for good outcomes.

Objective: The aim of this study was to compare the reliability of three different methods of cephalometric analysis. Material and Methods: Conventional pretreatment lateral cephalograms and cone beam computed tomography (CBCT) scans from 50 subjects from a radiological clinic were selected in order to test the three methods: manual tracings (MT), digitized lateral cephalograms (DLC), and lateral cephalograms from CBCT (LC-CBCT). The lateral cephalograms were manually analyzed through the Dolphin Imaging 11.0™ software. Twenty measurements were performed under the same conditions, and retraced after a 30-day period. Paired t tests and the Dahlberg formula were used to evaluate the intra-examiner errors. The Pearson's correlation coefficient and one-way analysis of variance (ANOVA) tests were used to compare the differences between the methods. Results: Intra-examiner reliability occurred for all methods for most of the measurements. Only six measurements were different between the methods and an agreement was observed in the analyses among the 3 methods. Conclusions: The results demonstrated that all evaluated methodologies are reliable and valid for scientific research, however, the method used in the lateral cephalograms from the CBCT proved the most reliable.

OBJETIVO: avaliar cefalometricamente a estabilidade das alterações dentoesqueléticas e tegumentares, no protocolo de tratamento com o aparelho removível com grade palatina associado à mentoneira, em jovens portadores de mordida aberta anterior tratados por 12 meses, comparando-os com um grupo de jovens portadores de má oclusão semelhante que não foram submetidos ao tratamento ortodôntico. MÉTODOS: avaliou-se um total de 76 telerradiografias em norma lateral de 38 jovens. Dois grupos compuseram a amostra: o Grupo 1 (Controle), composto por 19 jovens (idade média de 9,10 anos) que não receberam qualquer tratamento para a correção de sua má oclusão; e o Grupo 2 (Tratado), composto por 19 jovens (idade média de 9,78 anos) que receberam o protocolo de tratamento durante 12 meses. Verificou-se a estabilidade do tratamento da má oclusão durante aproximadamente 15 meses após a remoção dos aparelhos. Os dados obtidos nas medidas cefalométricas (diferenças das médias das alterações) para os dois grupos foram computados pelo teste t de Student não pareado. RESULTADOS: os resultados mostraram que os componentes esquelético e tegumentar não apresentaram alterações significativas. O overbite, overjet e o posicionamento dos dentes superiores mantiveram-se estáveis. Os incisivos inferiores vestibularizaram e protruíram no Grupo Tratado, enquanto o Grupo Controle apresentou maior extrusão desses dentes. Os molares inferiores também extruíram mais significativamente no Grupo controle. CONCLUSÃO: pode-se concluir que o protocolo de tratamento da mordida aberta anterior utilizando aparelho removível com grade palatina associado à mentoneira mostrou estabilidade de aproximadamente 95%, ressaltando a grande importância desse tratamento na dentição mista.

OBJECTIVE: The aim of this prospective study was to cephalometrically analyze the stability of dentoalveolar and skeletal changes produced by a removable appliance with palatal crib associated to high-pull chincup in individuals with anterior open bite treated for 12 months, and compare them to individuals with similar malocclusion and age, not submitted to orthodontic treatment, also followed for the same period. METHODS: Nineteen children with a mean age of 9.78 years old treated for 12 months with a removable appliance with palatal crib associated with chincup therapy were evaluated after 15 months (post-treatment period) and compared with a control group of 19 subjects with mean age of 9.10 years with the same malocclusion that was followed-up for the same period. Seventy-six lateral cephalograms were evaluated at T1 (after correction) and T2 (follow-up) and cephalometric variables were analyzed by statistical tests. RESULTS: The results did not show significant skeletal, soft tissue or maxillary dentoalveolar changes. Overall, treatment effects on the experimental group were maintained at T2 evaluation with an increase of 0.56 mm in overbite. Overjet and maxillary incisors/molars position (vertical and sagittal) remained essentially unchanged during the study period. Only mandibular incisors showed significant changes (labial inclination and protrusion) compared to control group. CONCLUSIONS: Thus, it can be concluded that the early open bite treatment with a removable appliance and palatal crib associated with high-pull chincup therapy provided stability of 95%.

OBJECTIVE: The aim of this prospective study was to compare the dentoalveolar effects produced by two types of palatal crib, removable (Rpc+C) and fixed (Fpc+C), combined with chincup in growing patients with anterior open bite. MATERIAL AND METHODS: each group comprised 30 patients, in the mixed dentition phase, with similar cephalometric characteristics and skeletal ages. Group 1 (Rpc+C) presented initial mean age of 8.3 years and mean anterior open bite of 4.0 mm. Group 2 (Fpc+C) presented initial mean age of 8.54 years and mean anterior open bite of 4.3 mm. The evaluation period comprised 12 months between initial (T1) and second lateral radiograph (T2). The T2-T1 changes were compared cephalometrically in the 2 groups using the non-paired t-test. RESULTS: Vertical changes in the posterior dentoalveolar region were similar between the groups (about 1 mm) and no significant differences were found in molar mesialization. The Fpc+C group had in average 1.6 mm more improvement of the overbite as a result of greater maxillary incisor extrusion (1.3 mm). Patients in this group also presented less lingual tipping of maxillary incisors and more mandibular incisors uprighting. CONCLUSIONS: The Fpc+C combination was more efficient in the correction of the negative overbite mainly due to greater extrusion of the maxillary incisors. However, the Rpc+C appliance promoted better upper and lower incisor inclination, resulting in a more adequate overjet.

OBJETIVO: avaliar as alterações do perfil facial decorrentes do tratamento ortodôntico com extrações de dois primeiros pré-molares superiores, sob a óptica de ortodontistas, cirurgiões-dentistas e leigos. MÉTODOS: foram traçados os perfis faciais das telerradiografias pré- e pós-tratamento de 70 pacientes com má oclusão de Classe II, divisão 1, e foi montado um álbum com as silhuetas dos 70 pacientes, de forma aleatória, sendo dois perfis em cada folha do mesmo paciente. A seguir, 30 ortodontistas, 30 cirurgiões-dentistas e 30 leigos escolheram o perfil facial mais estético (A ou B), e a quantidade de alteração que percebiam entre os dois perfis pré- e pós-tratamento, de acordo com a escala visual analógica (EVA). RESULTADOS: os resultados revelaram que 83 examinadores preferiram o perfil pós-tratamento, sendo que somente três cirurgiões-dentistas e quatro leigos escolheram com maior frequência os perfis pré-tratamento. Assim, os ortodontistas escolheram mais frequentemente os perfis pós-tratamento, seguidos pelos cirurgiões-dentistas, sem diferença estatisticamente significativa entre cirurgiões-dentistas e leigos. Houve diferença estatisticamente significativa intragrupos na preferência do perfil pré- e pós-tratamento. Além disso, os três grupos de avaliadores indicaram que os perfis pré- e pós-tratamento não diferiram substancialmente. CONCLUSÕES: o tratamento da má oclusão de Classe II, divisão 1, com extração de dois primeiros pré-molares produziu um efeito positivo na estética do perfil facial.

OBJECTIVE: Evaluate the facial profile changes of orthodontic treatment with extraction of two upper first premolars, from the perspective of orthodontists, dentists and lay people. METHODS: Facial profiles of radiographs taken before and after treatment of 70 patients with Class II, division 1 malocclusion were traced. The silhouettes of the 70 patients were randomly assembled in an album with, being two profiles on each sheet of the same patient. Then, 30 orthodontists, 30 dentists and 30 lay people chose the more esthetic facial profile (A or B), and the amount of change they perceived between the two profiles before and after treatment, according to a visual analog scale (VAS). RESULTS: The results revealed that 83 examiners preferred the post-treatment profiles, and only three dentists and four lay people chose the profiles pre-treatment more frequently. Thus, the orthodontists often chose the profiles after treatment, followed by dentists, with no statistically significant differences found between dentists and lay people. There were significant differences within groups in the preference of pre- and post-treatment profile. Furthermore, the three groups of evaluators indicated that pre and post-treatment profiles did not differ substantially. CONCLUSIONS: The treatment of Class II, division 1 malocclusion with extraction of two first premolars has a positive effect on facial profile esthetics.

This paper reports a case treated by a serial extraction program at the mixed dentition stage followed by a corrective orthodontic treatment, with a long-term follow-up period. Twenty years after the interceptive treatment, a harmonious face was observed along with treatment stability in the anterior posterior direction, deep overbite (which has been mentioned as a disadvantage of the serial extraction program), and a small relapse of anterior tooth crowding. All these conditions have been regarded as normal occurrences for most orthodontic treatments with a long-term follow-up period. This case report demonstrated that the establishment of a serial extraction protocol determined relevant esthetic changes that afforded an improvement of the patient's self-esteem, with a positive social impact. Furthermore, the low cost of this protocol permits the use of this therapy with underprivileged populations. It is important to emphasize that an early correction of tooth crowding by this protocol does not guarantee stability, but small relapses do not invalidate its accomplishment.