Abstract Oral cleft surgical repairs are performed using different techniques worldwide. Objective To evaluate and compare the development of the dental arches of children with unilateral cleft lip and palate before and after the primary surgeries performed with different techniques at the first months and six years of life. Methodology This is a retrospective longitudinal study. The sample comprised 56 dental casts divided int the following groups: Group 1 (G1) – cheiloplasty (Millard technique) at three months and one-step palatoplasty (von Langenbeck technique) at 12 months; and Group 2 (G2) – cheiloplasty (Millard technique) and two-step palatoplasty: anterior hard palate closure (Hans Pichler technique) at three months and posterior soft palate closure (Sommerlad technique) at 12 months. The digitized dental casts were evaluated at three months – pre-surgical (T1) and six years of life– post-surgical (T2). The following linear measurements were analyzed: intercanine (C–C’), intertuberosity (T–T’) distances; anterior dental arch (I–CC’), anterior intersegment (I–C’), and total arch (I–TT’) lengths. The palate area was also measured. Parametric and non-parametric tests were applied (p<0.05). Results In G1, the intragroup comparison showed statistically significant smaller I–CC’ and I–C’ at T2 (p=0.001 and p<0.001, respectively), while T–T’, I–TT’, and area comparisons were significantly greater (p<0.001, p=0.002, and p<0.001, respectively). In G2, the intragroup comparison exhibited statistically significant smaller C–C’ and I–C’ at T2 (p=0.004, for both), whereas T–T’, I–TT’ and area comparisons were significantly greater (p<0.001, p=0.004, and p<0.001, respectively). At T2, the intergroup analysis revealed that G1 had a statistically significant smaller I–CC’ (p=0.014). The analysis of the intergroup differences (∆=T2–T1) showed that G1 had a statistically smaller I–CC’ (p=0.043). Conclusion The two-step palatoplasty showed a more favorable prognosis for the maxillary growth than one-step palatoplasty in children with oral clefts.

Aim to evaluate the surgical effects of two rehabilitation protocols on dental arch occlusion of 5-year-old children with or without cleft lip and palate. Methods this is a retrospective longitudinal study the sample comprised 45 digitized dental casts divided into followed groups: Group 1 (G1) – children who underwent to cheiloplasty (Millard technique) at 3 months and to one-stage palatoplasty (von Langenbeck technique) at 12 months; Group 2 (G2) – children who underwent to cheiloplasty (Millard technique) and two-stage palatoplasty (Hans Pichler technique for hard palate closure) at 3 months and at 12 months to soft palate closure (Sommerlad technique); and Group 3 (G3) – children without craniofacial anomalies. Linear measurements, area, and occlusion were evaluated by stereophotogrammetry software. Shapiro-Wilk test was used to verify normality. ANOVA followed by posthoc Tukey test and Kruskal-Wallis followed by posthoc Dunn tests were used to compared groups. Results For the measures intercanine distance (C-C’), anterior length of dental arch (I-CC’), and total length of the dental arch (I–MM’), there were statistical differences between G1x G3 and G2xG3, the mean was smaller for G1 and G2. No statistically significant differences occurred in the intermolar distance and in the dental arch area among groups. The occlusion analysis revealed significant difference in the comparison of the three groups (p=0.0004). Conclusion The surgical effects of two rehabilitation protocols affected the occlusion and the development of the anterior region of the maxilla of children with oral clefts when compared to children without oral clefts.

Abstract This study aimed at monitoring the maxillary growth of children with cleft lip/palate in the first two years of life, and to evaluate the effects of primary surgeries on dental arch dimensions. The sample consisted of the three-dimensional digital models of 25 subjects with unilateral complete cleft lip and palate (UCLP) and 29 subjects with isolated cleft palate (CP). Maxillary arch dimensions were measured at 3 months (before lip repair), 1 year (before palate repair), and at 2 years of age. Student’s ttest was used for comparison between the groups. Repeated measures ANOVA followed by Tukey’s test was used to compare different treatment phases in the UCLP group. Paired ttest was used to compare different treatment phases in the CP group. P<0.05 was considered statistically significant. Decreased intercanine distance and anterior arch length were observed after lip repair in UCLP. After palate repair, maxillary dimensions increased significantly, except for the intercanine distance in UCLP and the intertuberosity distance in both groups. At the time of palate repair and at two years of age, the maxillary dimensions were very similar in both groups. It can be concluded that the maxillary arches of children with UCLP and CP changed as a result of primary surgery.

RESUMO Objetivo: o objetivo do presente estudo foi comparar a eficiência de dois protocolos de intrusão de molares superiores com dois e três mini-implantes. Métodos: foram selecionados 25 primeiros molares superiores extruídos por perda de seus antagonistas, de pacientes adultos. A amostra foi dividida em dois grupos, de acordo com o protocolo de intrusão, com dois ou três mini-implantes: o Grupo 1 consistiu de 15 molares que sofreram intrusão com dois mini-implantes; o Grupo 2 foi constituído por 10 molares intruídos por três mini-implantes. As alterações com o tratamento foram analisadas em telerradiografias em norma lateral ao início e ao final da intrusão dos molares superiores. Resultados: os resultados mostraram que não houve diferença na eficiência dos dois protocolos de intrusão. Concluiu-se que molares superiores extruídos podem ser intruídos, com eficiência semelhante, por meio de dois ou três mini-implantes.

ABSTRACT Objective: The aim of this study was to compare the efficiency of two protocols for maxillary molar intrusion with two or three mini-implants. Methods: Twenty five maxillary first molars extruded for loss of their antagonists in adult subjects were selected. The sample was divided into two groups, according to the intrusion protocol with two or three mini-implants. Group 1 consisted of 15 molars that were intruded by two mini-implants. Group 2 consisted of 10 molars intruded by three mini-implants. Changes with treatment were analyzed in lateral cephalograms at the beginning and at the end of intrusion of maxillary molars. Results: Results showed that there was no difference in efficiency for the two intrusion protocols. It was concluded that extruded maxillary molars can be intruded with two or three mini-implants with similar efficiency.

Resumo Objetivo: o objetivo deste estudo foi comparar a expressão do torque em braquetes autoligáveis ativos e passivos e nos convencionais. Métodos: no total, 300 segmentos de fio de aço inoxidável 0,019" x 0,025" foram usados. Seis diferentes marcas de braquetes foram analisadas (Damon 3MX, Portia, In-Ovation R, Bioquick, Roth SLI, Roth Max). Os momentos de torque foram medidos em 120, 240, 360 e 480, utilizando-se um dispositivo de torção de fio associado a uma máquina de ensaios universal. Os dados obtidos foram comparados pela análise de variância, seguida de teste de Tukey para comparações múltiplas. A análise de regressão foi realizada pelo método dos mínimos quadrados, para gerar uma equação matemática da curva ótima de cada marca de braquete. Resultados: foram observadas diferenças estatisticamente significativas na expressão do torque entre todas as marcas de braquetes avaliadas e em todas as torções testadas (p < 0,05). Encontrou-se que o Bioquick apresentou a menor expressão do torque em todas as torções testadas; em contraste, o braquete Damon 3MX apresentou a maior expressão do torque até a torção de 360. Conclusões: o sistema de ligação entre fio e braquete (autoligável ativo ou passivo, ou convencional com ligadura elástica) parece não interferir na expressão final do torque, a qual é dependente da interação entre o fio e o braquete escolhido para ser utilizado na mecânica ortodôntica.

Abstract Objective: The aim of this study was to compare torque expression in active and passive self-ligating and conventional brackets. Methods: A total of 300 segments of stainless steel wire 0.019 x 0.025-in and six different brands of brackets (Damon 3MX, Portia, In-Ovation R, Bioquick, Roth SLI and Roth Max) were used. Torque moments were measured at 12°, 24°, 36° and 48°, using a wire torsion device associated with a universal testing machine. The data obtained were compared by analysis of variance followed by Tukey test for multiple comparisons. Regression analysis was performed by the least-squares method to generate the mathematical equation of the optimal curve for each brand of bracket. Results: Statistically significant differences were observed in the expression of torque among all evaluated bracket brands in all evaluated torsions (p < 0.05). It was found that Bioquick presented the lowest torque expression in all tested torsions; in contrast, Damon 3MX bracket presented the highest torque expression up to 36° torsion. Conclusions: The connection system between wire/bracket (active, passive self-ligating or conventional with elastic ligature) seems not to interfere in the final torque expression, the latter being probably dependent on the interaction between the wire and the bracket chosen for orthodontic mechanics.

A displasia ectodérmica é uma doença congênita rara, que afeta várias estruturas de origem ectodérmica. As principais características na cavidade oral são hipodontia, má formação dentária e subdesenvolvimento do rebordo alveolar. Devido às falhas de retenção das próteses convencionais, novas alternativas de tratamento são necessárias. Este relato de caso descreve o tratamento de reabilitação oral em uma menina de 9 anos de idade com displasia ectodérmica. O tratamento foi realizado com próteses dentárias convencionais sobre mini-implantes. Os mini-implantes promoveram a retenção da prótese. A paciente relatou uma boa adaptação das próteses e satisfação com o tratamento. O aumento da autoestima melhorou as atividades de socialização da criança. Neste estudo de caso, o uso de prótese com mini-implantes foi satisfatória para a retenção da prótese. No entanto, estudos clínicos longitudinais são necessários para testar os mini-implantes como uma alternativa para a reabilitação oral de crianças com displasia ectodérmica.

Ectodermal dysplasia is a rare congenital disease that affects several structures of ectodermal origin. The most commonly related oral characteristics are hypodontia, malformed teeth and underdeveloped alveolar ridges. New alternative treatments are needed due to the failure of the conventional prosthesis retention. This case report outlines the oral rehabilitation treatment of a 9-year-old girl with ectodermal dysplasia. The treatment was performed with conventional prosthesis upon mini-implants. The mini-implants provided prosthetic retention. The patient reported a good adaptation of the dental prosthesis and satisfaction with the treatment. The increased self-esteem improved the socialization skills of the girl. In this case report, use of prosthesis with mini-implants was satisfactory for prosthetic retention. However, clinical studies with long-term follow-up are needed to test the mini-implants as an alternative for oral rehabilitation of children with ectodermal dysplasia.

This study aimed to assess and compare the overall and anterior ratios of tooth size discrepancies in all Angle malocclusion groups. The following null hypothesis (H0) was tested: no difference between tooth size discrepancies (overall and anterior) would be observed among Angle malocclusion groups. The sample comprised of 711 pre-orthodontic treatment study casts of Brazilian patients with a mean age of 17.42 years selected from private practices in Brazil. The casts were divided into 3 groups according to the type of malocclusion: Class I (n = 321), Class II (n = 324), and Class III patients (n = 66). The measurement of the greatest mesiodistal width of the teeth was performed using a centesimal precision digital caliper directly on the study casts, from the distal surface of the left first molar to the distal surface of the right first molar. The overall and anterior ratios between the maxillary and mandibular teeth were evaluated using Bolton’s method. The following statistical tests were applied: chi-square, independent t-test, and one-way ANOVA. Results showed that all Angle malocclusions groups exhibited a ratio compatible with those recommended by Bolton. With respect to the overall and anterior ratios among the malocclusion groups, no statistically significant differences were found. The null hypothesis was accepted because the results showed no differences in the overall and anterior ratios of tooth size discrepancies among different Angle malocclusion groups.

Objectives: The shape memory resulting from the superelasticity and thermoelastic effect is the main characteristic of thermally activated NiTi archwires and is closely related to the transition temperature range (TTR). The aim of this study was to evaluate the TTR of thermally activated NiTi archwires commercially available. Material and Methods: Seven different brands of 0.019"x0.025" thermally activated nickel-titanium archwires were tested as received by differential scanning calorimetry (DSC) over the temperature range from -100°C to 150°C at 10°C/min. Results: All thermally activated NiTi archwires analyzed presented stage transformation during thermal scanning with final austenitic temperature (Af) ranging from 20.39°C to 45.42°C. Three brands of NiTi archwires presented Af close to the room temperature and, this way, do not present properties of shape memory and pseudoelasticity that are desirable in clinical applications. Conclusions: The thermally activated NiTi archwires present great variability in the TTR and the elastic parameters of each NiTi archwire should be provided by the manufacturers, to allow achievement of the best clinical performance possible.

OBJETIVO: avaliar os efeitos dentoesqueléticos do tratamento da má oclusão de Classe II com o aparelho Twin Block comparado a um grupo controle. MÉTODOS: o grupo experimental foi composto por 20 pacientes com idade inicial média de 11,76 anos e que foram tratados por um período de 1,13 anos. O grupo controle foi composto por 25 indivíduos com idade inicial média de 11,39 anos e que foram acompanhados por um período de 1,07 anos. Telerradiografias em norma lateral foram obtidas ao início e final do tratamento para avaliar as alterações decorrentes do tratamento. A comparação intergrupos foi realizada por meio do teste qui-quadrado e do teste t independente. RESULTADOS: o aparelho Twin Block não apresentou alterações significativas no componente maxilar. O componente mandibular revelou um aumento estatisticamente significativo do crescimento efetivo da mandíbula (Co-Gn) e uma melhora significativa da relação existente entre as bases ósseas. Os componentes dentoalveolar superior e inferior apresentaram um significativo componente de inclinação dos dentes anteriores em ambas as arcadas. Os incisivos superiores foram inclinados para lingual e retruídos, ao passo que os incisivos inferiores foram inclinados para vestibular e protruídos. CONCLUSÕES: o aparelho Twin Block apresenta grande efetividade na correção da má oclusão de Classe II esquelética em pacientes em fase de crescimento. A maior parte das alterações ocorridas é de natureza dentoalveolar, com um grande componente de inclinação dentária associado a um significativo efeito esquelético na mandíbula.

OBJECTIVE: The aim of this study was to assess the dentoskeletal effects of Class II malocclusion treatment performed with the Twin Block appliance. METHODS: The experimental group comprised 20 individuals with initial mean age of 11.76 years and was treated for a period of 1.13 years. The control group comprised 25 individuals with initial mean age of 11.39 years and a follow-up period of 1.07 years. Lateral cephalograms were taken at treatment onset and completion to assess treatment outcomes. Intergroup comparison was performed by means of the chi-square and independent t tests. RESULTS: The Twin Block appliance did not show significant effects on the maxillary component. The mandibular component showed a statistically significant increase in the effective mandibular length (Co-Gn) and significant improvement in the maxillomandibular relationship. The maxillary and mandibular dentoalveolar components presented a significant inclination of anterior teeth in both arches. The maxillary incisors were lingually tipped and retruded, while the mandibular incisors were labially tipped and protruded. CONCLUSIONS: The Twin Block appliance has great effectiveness for correction of skeletal Class II malocclusion in individuals with growth potential. Most changes are of dentoalveolar nature with a large component of tooth inclination associated with a significant skeletal effect on the mandible.

OBJETIVO: avaliar os efeitos dentoesqueléticos do tratamento da má oclusão de Classe II com o aparelho de Herbst em pacientes que se encontravam na fase pós-pico de crescimento. MÉTODOS: a amostra consistiu de 16 pacientes com má oclusão de Classe II com medianas das idades inicial e final de 14,04 (amplitude 11,50 - 35,66) e 17,14 anos (amplitude 13,68 - 38,64), respectivamente, que foram tratados por um período médio de 2,52 anos. Telerradiografias em norma lateral foram obtidas ao início e final do tratamento para avaliar as alterações decorrentes do tratamento. Os modelos de gesso iniciais foram utilizados para avaliar o trespasse horizontal e a severidade da relação anteroposterior existente entre os molares ao início do tratamento. As alterações cefalométricas entre as fases inicial e final foram comparadas pelo teste não-paramétrico de Wilcoxon. RESULTADOS: os resultados mostraram que o aparelho de Herbst não promoveu alterações significativas no componente maxilar, o comprimento efetivo da mandíbula aumentou significativamente, sem promover uma melhoria da relação maxilomandibular. As alterações dos componentes dentoalveolares superiores e inferiores mostraram que os incisivos superiores apresentaram uma retrusão e inclinação lingual, ao passo que os incisivos inferiores evidenciaram um aumento na protrusão e inclinação para vestibular. As relações dentárias apresentaram uma melhora significativa com o tratamento. CONCLUSÃO: com base nos resultados desse trabalho, concluiu-se que os efeitos da terapia com o aparelho de Herbst em pacientes na fase pós-pico de crescimento são de natureza predominantemente dentoalveolar.

OBJECTIVE: The objective of this study was to evaluate dentoskeletal effects in the treatment of Class II malocclusion performed with the Herbst appliance in patients at post-peak stage of growth. METHODS: The sample consisted of 16 patients with Class II malocclusion and average initial and final ages of 14.04 (ranging from 11.50 to 35.66) and 17.14 (ranging from 13.68 to 38.64) years, respectively, who were treated for an mean time of 2.52 years. Lateral cephalograms were obtained at treatment onset (T1) and completion (T2) to evaluate the effects of therapy. Initial dental casts were also used to evaluate the overjet and the anteroposterior severity of molar relationship at treatment onset. The cephalometric changes between initial and final stages were compared by means of the non-parametric Wilcoxon test. RESULTS: The results showed that the Herbst appliance did not promote significant changes in the maxillary component and the effective length of the mandible significantly increased without improving the maxillomandibular relationship. Changes in the maxillary and mandibular dentoalveolar components revealed that the maxillary incisors exhibited retrusion and lingual tipping, while the mandibular incisors presented increased protrusion and buccal tipping. The dental relationships exhibited significant improvements with the treatment. CONCLUSION: Based on the present results, it was concluded that the effects of treatment performed with the Herbst appliance in patients at post-peak stage of growth are predominantly of dentoalveolar nature.