Abstract Background Genetic polymorphisms have been shown to influence several physiological traits, including dental and craniofacial characteristics. Understanding the clinical relevance of genetic polymorphisms in dental practice is crucial to personalize treatment plans and improve treatment outcomes. Objective to evaluate the association between dental age and genetic polymorphisms in genes encoding estrogen receptors alpha and beta (ESR1 and ESR2, respectively) in a sample of Brazilian children. Methodology This retrospective cross-sectional study was performed with children undergoing orthodontic treatment. Patients with syndromes, congenital anomalies, craniofacial deformities, under hormonal or systemic treatment, and with a previous history of facial trauma were excluded. Panoramic radiographs were used to assess dental age according to the Demirjian, Goldstein, and Tanner method. A delta [dental age-chronological age (DA-CA)] was obtained, which shows whether the patient tends to have a normal, delayed (negative values), or advanced (positive values) dental age. DNA isolated from buccal cells was used to genotype four genetic polymorphisms: rs9340799 (A>G) and rs2234693 (C>T), located in ESR1; and rs1256049 (C>T) and rs4986938 (C>T), located in ESR2. A statistical analysis was performed and values of p<0.05 indicated statistical difference. Results A total of 79 patients were included, 44 (55.70%) girls and 35 (44.30%) boys. The Demirjian, Goldstein, and Tanner method, in general, overestimated patients’ age by 0.75 years. There was no difference in the delta of dental age between the sexes (p>0.05). Genetic polymorphisms in ESR1 and ESR2 were not associated with dental age (p>0.05). Conclusion The studied genetic polymorphisms in ESR1 and ESR2 were not associated with dental age in Brazilian children.

Resumo Considerando que a fumaça de cigarro é um problema de saúde pública que está crescendo entre os adolescentes, o objetivo deste estudo foi investigar o impacto da fumaça de cigarro na sinalização osteogênica e osteoclastogênica da sutura palatina mediana de ratos. Foram utilizados ratos Wistar machos expostos (n=30) e não expostos à fumaça de cigarro (n=30). A exposição à fumaça de cigarro foi realizada duas vezes ao dia por 3 minutos, com um intervalo de 12 horas entre as exposições. Os animais foram mortos após o período experimental de 3, 7, 14 e 21 dias. Os tecidos coletados foram analisados em microscópico de luz e pelo RT-PCR em tempo real foi realizado para investigar a expressão gênica. s dados obtidos foram comparados usando o testes de Kruskal Wallis e Dunn (⍺ = 5%). Morfoligicamente, não houve mudança significativa na sutura palatina mediana nos ratos expostos ou não à fumaça de cigarro durante os tempo de 3, 7, 14 e 21 dias (p> 0.05). Por outro lado, a sinalização osteogênica esta aumentada nos animais expostos à fumaça e foi caracterizado por um aumento da produção de RANKL aos 3 e 14 dias (p <0.05), sem mudança na síntese da produção de RANK e osteoprotegerina (p> 0.05). Curiosamente, nos animais expostos, também foi observado um aumento precoce da síntese de osteocalcina, sialoproteína óssea e de osteopontina aos 3 dias de exposição, o que não foi mantido ao longo do tempo. A fumaça de cigarro modula a sinalização osteogênica e osteoclastogênica na sutura palatina mediana de ratos jovens, apesar de não tenha sido evidenciado alterações morfológicas.

Abstract Considering that smoking is a public health problem that has been growing among adolescents, the aim of this study was to investigate the impact of cigarette smoke on osteogenic and osteoclastogenic signaling in middle palatal suture of rats. Male Wistar rats exposed (n = 30) or not to cigarette smoke (n = 30) were used. Exposure to smoke was carried out for two daily periods of 3 minutes each, with an interval of 12 hours between exposures. After the experimental periods of 3, 7, 14 and 21 days, the animals were euthanized. The collected tissues were analyzed using light microscopy and real-time RT-PCR was performed to investigate gene expression. The data obtained were compared using the Kruskal Wallis and Dunn tests (⍺ = 5%). Morphologically, there were no significant changes in the middle palatal suture of rats exposed or not to cigarette smoke during 3, 7, 14 and 21 days (p> 0.05). On the other hand, osteoclastogenic signaling was increased in animals exposed to smoke and was characterized by a higher production of RANKL at 3 and 14 days (p <0.05), with no change in the synthesis of RANK and osteoprotegerin (p> 0.05). Interestingly, in the exposed animals, an early increase in the synthesis of osteocalcin, bone sialoprotein and osteopontin was also identified at 3 days of exposure (p <0.05), not sustained over time (p> 0.05). Cigarette smoke modulates osteogenic and osteoclastogenic signaling in the middle palatal suture of young rats, although morphological changes have not been evidenced.

Resumo Fator de crescimento endothelial (VEGF) e fator de crescimento de fibroblasto (FGF-2) tem a capacidade de aumentar a proliferação e permeabilidade vascular. O objetivo deste estudo foi quantificar a liberação dos dois fatores de crescimento (VEGF e FGF-2) após expansão rápida da maxilla (ERM). Trinta animais foram divididos aleatoriamente em dois grupos. Grupo Controle (5 ratos - sutura intacta) e grupos Experimentais (25 ratos submetidos a ERM) que foram avaliados em períodos diferentes de tratamento. Cinco animais foram eutanaziados em diferentes períodos de avaliação aos 0, 2, 3, 5 e 7 dias após ERM. RT-PCR foi usado para avaliar a expressão gênica dos fatores de crescimento liberados nos diferentes períodos de estudo. Os dados foram submetidos à análise estatística usando ANOVA seguido do pós-teste de Tukey com nível de significância de a=0.05. RT-PCR mostrou que os RNAm de VEGF e FGF-2 estavam expressos na sutura palatina mediana intacta. Os RNAm de VEGF e FGF-2 foram estimulados nos períodos iniciais (24h) após ERM (p<0.001 e p<0.01, respectivamente). Os nívies moleculares de VEGF nunca retornaram aos valores originais, e a expressão de FGF-2 reduziu até o dia 5 (p<0.001) e de repente aumentou até o dia 7, retornando aos níveis originais. ERM aumentou a secreção de VEGF, mas diminuiu a secreção de FGF-2 quando comparado ao tecido intacto. Os resultados mostraram que estes fatores de crescimento são liberados e regulados na sutura palatina mediana após ERM e podem ser de importante contribuição para o entendimento da resposta reparadora geral do tecido da sutura durante o processo de remodelação óssea.

Abstract Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (FGF-2) have the ability to increase vascular proliferation and permeability. The aim of this study was to quantify the release of two diffusible angiogenic growth factors (VEGF and FGF-2) after rapid maxillary expansion (RME). Thirty animals were randomly assigned to two groups. Control group (5 rats - intact suture) and Experimental groups (25 rats with RME) which were evaluated in different periods of treatment. Five animals were euthanized in different periods of healing at 0, 1, 2, 3, 5 and 7 days after RME. RT-PCR was used to evaluate the gene expression of angiogenic growth factors released on different periods of study. Data were submitted to statistical analysis using ANOVA followed by Tukey test and significance was assumed at a=0.05. RT-PCR showed that mRNAs of VEGF and FGF-2 were expressed in intact palatal suture tissue. mRNAs of VEGF and FGF-2 was upregulated in early periods (24 h) after RME (p<0.001 and p<0.01, respectively). The molecular levels of VEGF never returned to its original baseline values, and FGF-2 expression decreased up to day 5 (p<0.001) and suddenly increased at day 7, returning to its original level. RME increased VEGF secretion, but decreased FGF-2 secretion when compared to intact tissue. The results showed that these angiogenic growth factors are released and regulated in the palatal suture tissue after RME and could make an important contribution to the knowledge of overall reparative response of the suture tissue during the bone remodeling process.

Resumo O objetivo deste estudo foi investigar os efeitos da terapia a laser de baixo nível (LLLT) e a fumaça de cigarro na sinalização da osteoclastogênese do alvéolo após extração dentária, em ratos. Sessenta ratos Wistar machos foram distribuídos aleatoriamente em quatro grupos com 15 animais cada: Grupo de controle (com extração do molar superior direito (EM), Experimental I (EM e LLLT), Experimental II (EM e fumaça de cigarro) e Grupo Experimental III (EM, LLLT e fumaça de cigarro). A eutanásia foi realizada aos 3, 7 e 14 dias após a extração. O qRT-PCR foi utilizado para avaliar a expressão de Tnfrsf11a (RANK), Tnfsf11 (RANKL) e Tnfrsf11b (OPG). Os dados foram submetidos à análise estatística usando two-way ANOVA seguido do teste de Bonferroni (α=0,05). Houve um aumento na expressão dos genes RANK, RANKL e OPG ao longo do tempo de cicatrização no grupo Exp I em comparação com o grupo controle. O grupo Exp II mostrou uma expressão diminuída de todos os genes ao longo do tempo, enquanto a expressão dos genes do grupo Exp III foi superior aos valores observados em Exp II, mas inferiores aos valores do grupo Controle e Exp I ao longo do tempo. Os resultados deste estudo concluíram que o LLLT tem um efeito positivo, enquanto a fumaça de cigarro possui efeito prejudicial na expressão gênica de RANK, RANKL e OPG no processo de remodelação óssea.

Abstract The objective of this study was to investigate the effects of low-level laser therapy (LLLT) and cigarette smoke on alveolar socket osteoclastogenesis signaling after tooth extraction, in rats. Sixty male Wistar rats were randomly assigned to four groups with 15 animals each: Control Group (with right maxillary molar extraction - ME), Experimental I (with ME and LLLT), Experimental II (with ME and cigarette smoke) and Experimental III group (with ME, LLLT and cigarette smoke). Euthanasia was performed at 3, 7 and 14 days postoperative. qRT-PCR was used to evaluate expression of Tnfrsf11a (RANK), Tnfsf11 (Rankl) and Tnfrsf11b (OPG). Data were submitted to statistical analysis using two-way ANOVA followed by Bonferroni test (α=0.05). There was an upregulation of RANK, RANKL and OPG genes over all the time of healing in Exp I group compared to control group. Exp II group showed a decreased expression of all genes over time, whereas Exp III genes expression were higher than Exp II values but lower than Control and Exp I values over time. The results of this study concluded that the LLLT had a positive effect, whereas cigarette smoke had a negative effect on RANK, RANKL and OPG gene expression in bone remodeling process.

RESUMO A transposição é considerada uma das anomalias dentárias mais difíceis de se administrar clinicamente. Vários fatores devem ser considerados para que a melhor decisão seja tomada. Neste artigo, o objetivo foi discutir as modalidades de tratamento da transposição dentária, suas vantagens e desvantagens, e apresentar um caso clínico de transposição entre canino e incisivo lateral na hemiarcada superior direita. A opção terapêutica de escolha foi a extração de um dos dentes transpostos, tendo-se a necessidade de uma abordagem multidisciplinar com a participação da Ortodontia, Dentística e Periodontia, a fim de que adequados resultados estéticos e funcionais fossem alcançados.

ABSTRACT Tooth transposition is one of the most difficult dental anomalies to treat in the dental clinic. Several factors must be taken into account with a view of making the best decision. The aim of this study was to discuss treatment modalities for tooth transposition, their advantages and disadvantages. Additionally, it aims at presenting a clinical case of transposition between canine and lateral incisor in the upper quadrant on the right side. The treatment of choice was extraction of one transposed tooth. A multidisciplinary approach involving Orthodontics, Cosmetic Dentistry, and Periodontology was necessary to allow proper esthetic and functional outcomes to be achieved.

Resumo O objetivo deste estudo foi avaliar a sinalização osteoclastogenese na sutura palatina após a expansão rápida da maxila (ERM) em ratos. Um total de 30 ratos Wistar machos foram divididos aleatoriamente em dois grupos com 15 animais cada: controle (C) e grupo ERM. ERM foi realizada através da inserção de um anel de metal circular de 1,5 mm de espessura entre os incisivos superiores. Os animais foram sacrificados aos 3, 7 e 10 dias após a RME. qRT-PCR foi utilizado para avaliar a expressão de Tnfsf11 (RANKL), Tnfrsf11a (RANK) e TNFRSF11b (OPG). Os dados foram submetidos à análise de variância de duas vias, seguido pelo teste de Tukey (a=0,05). Houve uma regulação positiva de genes RANK e RANKL aos 7 e 10 dias e uma regulação positiva do gene OPG aos 3 e 7 dias de tratamento. Curiosamente, foi observado um aumento na expressão de todos os genes ao longo do tempo nos grupos ERM e C. O RANKL/OPG mostrou um aumento na sinalização favorecendo a reabsorção óssea no ERM em comparação com o C nos períodos de 3 e 7 dias. Foi observada uma sinalização contra a reabsorção óssea, assim como, uma regulação favorável da expressão do gene OPG no grupo ERM, comparado ao grupo C aos 10 dias. Os resultados deste estudo permitem concluir que o sistema RANK, RANK-L e OPG participa de remodelação óssea após a ERM.

Abstract The aim of this study was to evaluate osteoclastogenesis signaling in midpalatal suture after rapid maxillary expansion (RME) in rats. Thirty male Wistar rats were randomly assigned to two groups with 15 animals each: control (C) and RME group. RME was performed by inserting a 1.5-mm-thick circular metal ring between the maxillary incisors. The animals were euthanized at 3, 7 and 10 days after RME. qRT-PCR was used to evaluate expression of Tnfsf11 (RANKL), Tnfrsf11a (RANK) and Tnfrsf11b (OPG). Data were submitted to statistical analysis using two-way ANOVA followed by Tukey test (a=0.05). There was an upregulation of RANK and RANKL genes at 7 and 10 days and an upregulation of the OPG gene at 3 and 7 days of healing. Interestingly, an increased in expression of all genes was observed over time in both RME and C groups. The RANKL/OPG ratio showed an increased signaling favoring bone resorption on RME compared to C at 3 and 7 days. Signaling against bone resorption was observed, as well as an upregulation of OPG gene expression in RME group, compared to C group at 10 days. The results of this study concluded that the RANK, RANK-L and OPG system participates in bone remodeling after RME.

Abstract This study aimed to perform a systematic review and meta-analysis to evaluate the effectiveness of chlorhexidine varnish on the reduction of caries incidence during fixed orthodontic treatment. The literature searches involved The Cochrane Library, Medline, Scopus, OpenSigle databases and manual searches. The search on OpenSigle did not produce any additional articles. Clinical studies conducted in patients with orthodontic fixed appliances that used professional application of chlorhexidine varnish were included. The effect-size was calculated and a meta-analysis was performed. From 182 abstracts, a total of six articles fulfilled the inclusion criteria. After reading the full articles, one was excluded because of lack of a control group. Three articles were used for continuous data analysis, and two articles were used for the dichotomous data analysis. The pooled meta-analysis with continuous data demonstrated chlorhexidine varnish effectiveness on caries reduction (p = 0.003), with a mean difference and confidence interval of −1.49 [−2.47, −0.51]. On the basis of the pooled meta-analysis of continuous data, we were able to conclude that professional application of chlorhexidine varnish is effective in caries incidence reduction during fixed orthodontic treatment.

INTRODUCTION: Rapid maxillary expansion (RME) for the treatment of maxillary deficiency and posterior crossbite may induce changes in the vertical dimension. Expanders with occlusal splints have been developed to minimize unwanted vertical effects. OBJECTIVE: This preliminary study used cephalometri radiographs to evaluate the vertical effects of RME using a Hyrax appliance in children with maxillary deficiency. METHOD: Twenty-six patients (11 boys; mean age = 8 years and 5 months) with maxillary deficiency and posterior crossbite were treated using a Hyrax appliance with an acrylic occlusal splint. Radiographs and cephalometric studies were performed before the beginning of the treatment (T1) and after RME active time (T2), at a mean interval of 7 months. Results were compared with normative values. RESULTS AND CONCLUSIONS: At the end of treatment, there were no statistically significant changes, and measurements were similar to the normative values. Data showed that there were no significant effects on vertical growth, which suggests that appliances with occlusal splints may be used to correct transverse deficiencies regardless of the patient's growth pattern.

INTRODUÇÃO: os aparelhos expansores maxilares com cobertura oclusal têm sido sugeridos para controlar o aumento na dimensão vertical da face após a expansão rápida da maxila, porém ainda não há um consenso na literatura sobre seus reais efeitos. OBJETIVO: o objetivo deste trabalho foi avaliar as alterações cefalométricas verticais e anteroposteriores associadas à expansão da maxila realizada com o aparelho expansor com cobertura oclusal. MÉTODOS: a amostra foi composta por 25 crianças, de ambos os gêneros, com idades entre 6 e 10 anos, portadoras de mordida cruzada posterior esquelética. Após a expansão maxilar, o próprio aparelho expansor foi utilizado como contenção fixa. Foram analisadas telerradiografias em norma lateral tomadas antes do início do tratamento e após a remoção do aparelho expansor. CONCLUSÃO: com base nos resultados, pôde-se concluir que o uso do aparelho expansor com cobertura oclusal não alterou significativamente as medidas cefalométricas verticais e anteroposteriores das crianças.

INTRODUCTION: Bonded rapid maxillary expansion appliances have been suggested to control increases in the vertical dimension of the face after rapid maxillary expansion but there is still no consensus in the literature concerning its actual effectiveness. OBJECTIVE: The purpose of this study was to evaluate the vertical and anteroposterior cephalometric changes associated with maxillary expansion performed using bonded rapid maxillary expansion appliances. METHODS: The sample consisted of 25 children of both genders, aged between 6 and 10 years old, with skeletal posterior crossbite. After maxillary expansion, the expansion appliance itself was used for fixed retention. Were analyzed lateral teleradiographs taken prior to treatment onset and after removal of the expansion appliance. CONCLUSION: Based on the results, it can be concluded that the use of bonded rapid maxillary expansion appliance did not significantly alter the children's vertical and anteroposterior cephalometric measurements.

Este estudo avaliou alterações pulpares em molares de ratos movimentados com amplitude de força de 0,4 N. Vinte e cinco ratos machos adultos Wistar (Rattus norvegicus, albinus) foram aleatoriamente alocados em 5 grupos (n=5), sendo 1 grupo controle não submetido à aplicação de força, e 4 grupos teste submetidos a 6, 12, 24 e 72 h de aplicação de força. Os grupos teste receberam uma mola fechada tipo coil spring de níquel-titânio com 5 mm de comprimento, fixada do primeiro molar superior direito até os incisos superiores do animal. A mola tipo coil spring foi utilizada para mesialização do primeiro molar. Após o período específico de movimentação de cada grupo experimental, os animais foram sacrificados e as peças contendo o dente movimentado e o seu tecido pulpar foram processadas e coradas com hematoxilina e eosina para análise histológica em microscopia de luz. Os resultados mostraram alteração da camada de odontoblastos com hipertrofia dessas células, principalmente na região mesial da polpa coronária; edema no tecido conjuntivo pulpar, evidenciado na região central da polpa; alteração vascular, com acúmulo de eritrócitos e leucócitos dentro da luz dos vasos, principalmente na raiz mesial do dente movimentado. Essas alterações foram menos evidentes no período de 72 h. Dessa forma, conclui-se que o movimento dentário provoca alterações pulpares teciduais compatíveis com processo inflamatório, as quais são reversíveis se a agressão não ultrapassar o limite de tolerância do tecido.

This study evaluated pulp changes in molars of rats submitted to tooth movement by application of a 0.4 N force. Twenty-five adult male Wistar rats (Rattus norvegicus, albinus) were randomly assigned to 5 groups (n=5), being one control group not submitted to force application, and four study groups of 6, 12, 24 and 72 h of force application. The study groups received a 5-mm long nickel-titanium closed coil spring, placed from the right maxillary first molar to the maxillary incisors of each animal. The coil spring was used for mesial inclination of the first molar. After the specific period of tooth movement of each study group, the animals were sacrificed and specimens containing the teeth submitted to movement were processed and stained with hematoxylin and eosin for histological analysis under light microscopy. The results demonstrated alteration of the odontoblastic layer, with hypertrophy of odontoblasts especially at the mesial area of the coronal pulp, edema of the pulp connective tissue in the central area of the pulp, and vascular alteration with accumulation of erythrocytes and leukocytes inside the vessels, especially at the mesial root of the moved teeth. These changes were less remarkable for the 72-h period. Thus, it may be concluded that tooth movement yielded pulpal tissue alterations compatible with an inflammatory process, which are reversible if the aggression is not more intense than the physiological limit of tissue tolerance.

O propósito deste estudo foi comparar o padrão dentário de pacientes com maloclusão de mordida aberta anterior com indivíduos que apresentavam sobremordida normal usando radiografias cefalométrica lateral, panorâmica e modelos de estudos ortodônticos. Os achados mostraram que não houve diferença estatisticamente significante na inclinação do plano oclusal (SN.PlO) e na posição dos incisivos superiores e inferiores (1-NA, 1-NB) entre ambos os grupos dos indivíduos, mas os ângulos de inclinação dos incisivos superiores e inferiores (1.1, 1.NA e 1.NB) diferiram estatisticamente entre pacientes com mordida aberta anterior dos indivíduos que apresentavam sobremordida normal, o que sugere que a mordida aberta anterior poderia ser de origem dentária.

The purpose of this study was to compare the dental pattern of patients with anterior open bite malocclusion to that of individuals with normal overbite by utilization of lateral cephalograms, panoramic radiographs and study casts. The findings showed that there was no significant difference in the inclination of the occlusal plane (SN.PlO) and position of the maxillary and mandibular incisors (1-NA, 1-NB) between both groups of individuals; but the angles of inclination of the maxillary and mandibular incisors (1.1, 1.NA and 1.NB) differed statistically between patients with anterior open bite of the individuals that presented normal overbite, which suggests that the anterior open bite may be of dental origin.

O objetivo deste trabalho foi realizar uma revisão de literatura em relação ao tratamento da má oclusão esquelética de Classe II com a utilização do splint maxilar removível associado à tração alta, realçando sua influência no crescimento ósseo e seus benefícios. Através do relato do caso clínico será mostrada a confecção e os efeitos do aparelho de Thurow quando utilizado no período da dentadura mista, para a correção da Classe II esquelética

The aim of this study was to review the literature concerning the treatment of Class II malocclusion with removable maxillary splint associated to the high traction, enhancing its influence in the bony growth and its benefits. This clinical case will show the fabrication and the effects of Thurow's appliance, when it's used in the mixed dentition for the correction skeletal class II malocclusion.

The aim of this research was to verify, in vitro, the effect of various porcelain surface treatments on the shear strength of orthodontic brackets bonded to porcelain and the mode of fracture after debonding. Eighty-eight samples of metallic supported feldspathic porcelain were randomly divided into four groups according to their surface preparation as follows: the porcelain was maintained intact (GI), roughened with a diamond bur (GII), etched with 10% hydrofluoric acid (GIII), or sandblasted with aluminum oxide (GIV). The specimens were treated with silane (Scothprime) and brackets were bonded with Concise. Each sample was subjected to a shear load at a crosshead speed of 1 mm/min and a recording was made at the point of failure. Bond strengths, adequate to withstand the application of orthodontic forces, were achieved in all groups. The Kruskal-Wallis statistical test showed no significant differences in bond strength between the groups (p>0.05). However, many more porcelain fractures occurred on deglazed porcelain. This study indicates that with the appropriate material selection, the silane/composite procedure alone may be adequate for bonding.