Kinesio taping use to reduce pain and edema after third molar extraction surgery: A randomized controlled split-mouth study

OBJECTIVE

Evaluating Kinesio Taping (KT) use to reduce pain and edema in individuals subjected to surgical extraction of impacted mandibular third molars.

MATERIALS AND METHODS

Thirteen individuals (5 men and 8 women, mean age: 23.25 years) were subjected to mutual extraction of two mandibular third molars based on the same surgical protocol and pharmacological approach. All individuals were subjected to kinesio taping application on one side of patients' face (test group - KT), in the immediate postoperative period. The other side of the face was not subjected to KT application, and it was used as control (No KT). An examiner assessed individuals' pain and edema based on the visual analog scale (VAS) and on the Todorović-Marković method, respectively, at the preoperative, immediate postoperative, and second and fifth postoperative days. Statistical analysis was based on the Scheirer-Ray-Hare test.

RESULTS

Edema (48 h and 120 h after surgery) and pain intensity (24 h, 48 h and 120 h after surgery) were lower on the KT side (p < 0.05). Moreover, edema and pain intensity fully reduced on the KT side 120 h after surgery (p < 0.05).

CONCLUSION

Kinesio taping adopted in the current study was effective in reducing edema and postoperative pain in patients subjected to oral surgery.

CLINICAL RELEVANCE

KT enables patients to experience a more comfortable postoperative period and helps improving their quality of life.

Analysis of the Preventative Influence of an Oral Hygiene Protocol on Ventilator-Associated Pneumonia

AbstractVentilator-associated pneumonia (VAP) is the most commonly reported nosocomial infection among intensive care unit (ICU) patients. This study aimed to evaluate the influence of an oral hygiene protocol on VAP incidence among mechanically-ventilated (MV) ICU patients. The dentate patients admitted without VAP to the hospital’s adult ICU requiring mechanical ventilation for ≥48 hours during a 4-month period in two consecutive years (2015 – Control group and 2016 – Experimental group) were included in this investigation. The oral hygiene protocol was implemented daily, once a day, in the morning hours, using a disposable brush with suction and ultrasoft bristles and 3 g of 0.12% chlorhexidine gel. Hospital-related respiratory infection data, including VAP diagnoses and microbiological analyses, were collected from the monthly health epidemiological notification bulletins issued by the hospital. T tests were applied to compare variables before versus after implementation of the oral hygiene protocol with a significance criterion of P < .05. 43.94% reduction in VAP rate after the protocol implementation was observed. Implementation of the protocol was associated with a significant reduction of Enterobacter spp infections and no cases of VAP related to the main etiological agents of the disease (i.e., S. aureus and C. albicans) were identified. It can be concluded that an oral hygiene protocol performed with a suction brush and 0.12% chlorhexidine gel can serve as an effective prophylaxis against VAP in patients under mechanical ventilation.Keywords: Intensive Care Units. Disease Prevention. Oral Hygiene.ResumoA pneumonia associada à ventilação (PAV) é a infecção nosocomial mais comumente relatada em pacientes de Unidade de Terapia Intensiva (UTI). Este estudo teve como objetivo avaliar a influência de um protocolo de higiene bucal na incidência de PAV entre pacientes sob ventilação mecânica (VM). Os pacientes dentados internados na UTI adulta do hospital sem PAV e que necessitaram de ventilação mecânica por ≥ 48 horas durante um período de 4 meses em dois anos consecutivos (2015 - grupo Controle e 2016 - grupo Experimental) foram incluídos nesta investigação. O protocolo de higiene bucal foi implementado diariamente, uma vez ao dia, nas primeiras horas da manhã, utilizando-se escova descartável com cerdas de sucção e ultramacia e 3 g de gel de clorexidina a 0,12%. Dados de infecção respiratória relacionada ao hospital, incluindo diagnósticos de PAV e análises microbiológicas, foram coletados dos boletins mensais de notificação epidemiológica de saúde emitidos pelo hospital. Testes t foram aplicados para comparar as variáveis antes e após a implementação do protocolo de higiene bucal com um critério de significância de P <0,05. Observamos uma redução de 43,94% na taxa de PAV após a implementação do protocolo. A implementação do protocolo foi associada à uma redução significativa das infecções por Enterobacter spp e não foram identificados casos de PAV relacionados aos principais agentes etiológicos da doença (isto é, S. aureus e C. albicans). Pode-se concluir que u protocolo de higiene bucal realizado com escova de sucção e gel de clorexidina a 0,12% pode servir como uma profilaxia efetiva contra a PAV em pacientes sob ventilação mecânica.Palavras-chave: Unidade de Terapia Intensiva. Prevenção de Doenças. Higiene Bucal.

Supranumerário: a Importância do Tratamento Ortodôntico Precoce

AbstractThe presence of supernumeraries may lead to irruptive problems, such as impacted teeth, functional and aesthetic disorders. The present study describes two clinical cases, with anterior teeth eruption disorders caused by additional dental elements, treated early. Patients presented with aesthetic involvement, with delay in the emergence of the upper incisors. The clinical and radiographic examinations detected the presence of obstacles to the teeth eruption. Early treatment with 2x4 appliance was realized, followed by final corrective orthodontics. After restoration of the dimension for retained teeth, there was spontaneous eruption in clinical case 1 and need of traction in clinical case 2. When patients reached the complete permanent dentition, a corrective phase was performed with the objective of detailing the dental occlusion and finishing the treatment. The early diagnosis of teeth impacted and supernumerary, provide the achievement of adequate occlusion and positive aesthetic of patients, with good prognosis, avoiding psychological and functional problems caused by absence of anterior teeth. Keywords Interceptive Orthodontics. Supernumerary Tooth. Ectopic Tooth Eruption. ResumoA presença de supranumerários pode ocasionar problemas irruptivos, como impacção de dentes, desordens funcionais e estéticas. O presente trabalho descreve dois casos clínicos abordados precocemente, com alterações na irrupção de dentes anteriores devido a presença de supranumerários. Os pacientes apresentavam queixas estéticas, com atraso no aparecimento dos incisivos superiores. Os exames clínico e radiográfico detectaram a presença de barreiras irruptivas.  Realizou-se tratamento precoce com auxílio da mecânica 4x2, seguido pela ortodontia corretiva final. Após etapa de restabelecimento da dimensão para os dentes retidos, houve irrompimento espontâneo no caso clínico 1 e necessidade de tracionamento no caso clínico 2. Quando pacientes atingiram a dentição permanente completa, realizou-se uma fase corretiva com o objetivo de detalhamento da oclusão dentária e finalização do tratamento. O diagnóstico precoce de impacção dentária e detecção de supranumerários favoreceu a restituição de oclusão adequada e estética dos pacientes, com prognóstico muito favorável, evitando problemas psicológicos e funcionais provocados pela ausência de dentes anteriores. Palavras-chave: Ortodontia interceptora. Dente supranumerário. Erupção ectópica de dente.

Stability of early treatment of anterior open bite: clinical performance of bonded lingual spurs

Anterior open bite (AOB) is a malocclusion that generates aesthetic, speech, feeding and psychological issues, a fact that emphasises the importance of conducting early treatments to fix the disorder. Finger-sucking, pacifiers and oral habits are the main aetiological factors of AOB; thus, it is necessary to apply interceptive treatments focused on correcting and improving bite stability during childhood in order prevent the need of undergoing advanced therapy. The aim of this article is to present the early diagnosis of aetiological factors causing severe AOB and the interceptive treatment based on the use of bonded lingual spurs for one year. Results showed excellent bite stability after two years of follow-up; in other words, the proper treatment applied for the recommended growth and developmental periods enabled case stability.

Using UV light for adhesive remnant removal after debonding of orthodontic accessories

The objective of this study was to assess the effect of a UV light-based auxiliary illumination on adhesive remnant (AR) removal after orthodontic debonding. Sixty human molars were divided according to the adhesive used for bonding: O-opaque; LF-low fluorescence; and HF-high fluorescence. After debonding, the teeth were subdivided according to the AR removal method: No UV light or With UV light. After AR removal, the teeth were polished. Direct visual analysis, scanning electron microscopy (SEM) and time quantification for AR removal analyses were performed (Fisher-Freeman-Halton, Fisher's exact, chi-square trend, ANOVA, and independent t-tests; α = 5%). Concerning the adhesives, there was no significant difference among direct visual, SEM and time analyses for AR removal (p ≥ 0.05). Regarding AR removal methods, a similarity among the subgroups was verified for direct visual and SEM analyses (p≥0.05). However, a significant trend was verified for the with UV light method to produce greater marks, and the no UV light method, to produce a greater rate of samples with AR before polishing (p = 0.015). AR removal with light was significantly quicker in comparison with the no UV light method (p < 0.0001). The use of UV light may aid orthodontists in removing AR more thoroughly and in less time. However, they should receive special training to apply this technology, and should never dismiss the final polishing procedure.

Dimensional Stability of Alginates Molds Tridimentionally Scanned

AbstractAlginate is among the most used materials in dentistry to create teeth negative printing and reproduction. The goal of this study was to compare dimensional changes of alginate scanned impression materials. Thirty impressions of a standard typodont were performed using three types of alginate (Hydrogum 5; Jeltrate Plus and Avagel). The impressions were scanned by the scanner 3Shape R700T and scans were performed immediately after molding. The analysis of digita models were performed at OrthoAnalyzer ™ 3D software. Measurements were carried out in relation to the transverse dimension (intercanine, interpremolares and intermolar). Method error was evaluated through the Intraclass Correlation Coefficient (ICC) and Bland-Altman. One-way ANOVA, Dunnet Post-test were used to compare the different groups in relation to Typodont (gold standard) for the different outcome variables. The data were tabulated in Statistical Package for Social Sciences version 20.0 and Minitab 17.0 softwares to compare groups. The significance level was 5%. The posterior transverse variables (D1PM, D2PM and DM) presented a statistically significant difference regarding the gold standard (Typodont) for the plaster models performed after the Avagel molding. In the digital models performed just after molding, only in DM, the Avagel material group presented values statistically higher than the control group. The alginates Hydrogum 5 and Jeltrate Plus presented dimensions closer to the gold standard.Keywords: Dental Impression Materials. Dental Models. Imaging, Three-Dimensional.ResumoO alginato está entre os materiais de moldagem mais utilizados na Odontologia para criar impressão e reprodução negativa dos dentes. O objetivo desse trabalho foi comparar alterações transversais de três marcas comerciais de alginato (Hydrogum, Jeltrate e Avagel) em moldes de alginatos. Trinta moldes de um Typodont padrão foram realizados, utilizando três tipos de alginato (Hydrogum 5; Jeltrate Plus e Avagel). Os moldes foram escaneados por meio do scanner 3Shape R700T e os escaneamentos realizados logo após a moldagem e logo após a obtenção dos modelos de gesso. As análises dos modelos digitais foram realizadas no software OrthoAnalyzer™ 3D. Foram realizadas mensurações em relação à discrepância transversal (inter-caninos, inter primeiro pré-molar, inter-segundo pré-molar e inter-molares). O erro do método foi avaliado por meio do Coeficiente de Correlação Intraclasse (CCI) e Bland-Altman. Utilizou-se Análise de Variância (one-way ANOVA, Pós-teste Dunnet) para comparação dos diferentes grupos em relação ao typodont (padrão-ouro) para as diferentes variáveis de desfecho. A análise estatística foi realizada nos programas Statistical Package for Social Sciences versão 20.0 e no programa Minitab 17.0 para comparação dos grupos. O nível de significância foi de 5%. As variáveis transversais posteriores (D1PM; D2PM e DM) apresentaram diferença estatisticamente significante em relação ao padrão-ouro (manequim) para os modelos de gesso realizados após a moldagem com Avagel. Nos modelos digitais realizados logo após a moldagem, apenas na DM, o grupo do material Avagel apresentou valores estatisticamente maiores do que o grupo controle. Os alginatos Hydrogum 5 e Jeltrate Plus apresentaram dimensões mais próximas do padrão-ouro.Palavras-chave: Materiais para Moldagem Odontológica. Modelos Dentários. Imagem Tridimensional.

Evaluation of Knowledge of the Oral Hygiene Protocol by the Nursing Team of the Intensive Care Unit of Two Hospitals In Londrina/PR

AbstractOral hygiene in the Intensive Care Unit - ICU is considered a basic and indispensable procedure whose goal is to maintain the patients’ healthy oral conditions, reducing complications and contributing to their recovery. The objective of this study was to evaluate the knowledge on  the oral hygiene protocol by the ICU nursing team of two hospitals in Londrina/PR. The sample of this study was composed by the nursing and nursing technicians team of the Intensive Care Unit of the Hospital A and Hospital B, regardless of gender or age, and considering who had worked at the ICU for at least three months. A self-administered, unidentified questionnaire was used to collect data. The analyzed variables were: profession, age, sex, working time and oral hygiene. More than 80% of the professionals were Nursing Technicians, with average age above 30, female and working in the ICU of the hospital for over 3.5 years. The results of this study demonstrate the lack of knowledge of the oral hygiene protocol by more than 30% of the Nursing staff in both hospitals. Based on the  methodology and the results analysis, it can be concluded that the oral hygiene protocol is unknown by more than a third of the ICU Nursing team of both  surveyed hospitals. Keywords: Intensive Care Units. Disease Prevention. Oral Hygiene.ResumoA higiene bucal em Unidade de Terapia Intensiva - UTI é considerada um procedimento básico e indispensável cujo objetivo é manter saudáveis as condições bucais dos pacientes, reduzindo agravos e contribuindo para sua recuperação. O objetivo deste estudo foi avaliar o conhecimento do protocolo de higiene bucal pela equipe de enfermagem da UTI de dois hospitais em Londrina/PR. A amostra deste estudo foi composta pela equipe de Enfermagem (Enfermeiros e Técnicos em Enfermagem) da Unidade de Terapia Intensiva do Hospital A e do Hospital B, independente do sexo e idade, e que trabalhavam na UTI, no mínimo, há três meses. Para a coleta de dados foi utilizado um questionário autoaplicável, não identificado. As variáveis analisadas foram: profissão, idade, sexo, tempo de trabalho e higiene bucal. Mais de 80% dos profissionais eram Técnicos em Enfermagem, com idade média acima dos 30 anos de idade, do sexo feminino e atuando na UTI do hospital, em média, acima de 3,5 anos. Os resultados deste estudo demonstram a falta de conhecimento do protocolo de higiene bucal, por mais de 30% da equipe de Enfermagem, em ambos os hospitais. Com base na metodologia e análise dos resultados, pode-se concluir que o protocolo de higiene bucal é desconhecido por mais de um terço da equipe de Enfermagem da UTI de ambos os hospitais pesquisados.Palavras-chave: Unidades de Terapia Intensiva. Prevenção de doenças. Higiene Bucal.

Dentoalveolar effects produced by different appliances on early treatment of anterior open bite: A randomized clinical trial

OBJECTIVES:

To compare different appliances for early anterior open bite (AOB) correction.

MATERIALS AND METHODS:

This was a parallel, randomized clinical trial. A prospective sample of patients with AOB was recruited consecutively. Eligibility criteria included angle class I malocclusion with AOB equal to or greater than 1 mm. Participants were allocated by simple randomization to 4 groups: bonded spurs, chin cup, fixed palatal crib, and removable palatal crib. Dentoalveolar changes among the groups were assessed by blinded observers by comparing lateral cephalograms taken before (T1) and 12 months after treatment (T2; analysis of variance followed by Tukey test). Of the measurements, 30% were reassessed for reliability (intraclass correlation coefficient and Bland-Altman agreement test; α = 5%; 95% confidence interval).

RESULTS:

A total of 99 patients with a mean AOB of 3.7 mm (mean age 8.4 ± 0.8 years, both genders) were recruited. Dropouts occurred in all the groups, yielding a final sample size of 81 analyzed individuals. Intergroup comparisons of differences (T2-T1) showed significant differences for the incisor positioning variables (1.1, 1-PP, 6-PP, IMPA, 1.NB and 1-GoMe). However, there was no significant difference in AOB reduction among the groups, with an average correction of 3.1 mm.

CONCLUSIONS:

All of the tested devices promoted dental changes, especially in the anterior region, and contributed to AOB reduction during the study period. However, fixed palatal crib demonstrated greater impact on the positioning of the incisors.

Health-related quality of life of patients with squamous cell carcinoma: a comparison according to tumor location

The aim of this study was to evaluate the health-related quality of life (QOL) of patients with squamous cell carcinoma (SCC) according to tumor location. The sample consisted of 27 patients with primary SCC in the oral cavity (n = 15), pharynx (n = 7), and larynx (n = 5) who were undergoing cancer treatment at the Cancer Hospital of Londrina, regardless of age, sex, clinical stage, and type of antineoplastic treatment. Health-related QOL was evaluated using the 30-item Cancer-Quality of Life Questionnaire (QLQ-C30), the 35-item Head and Neck Cancer-Quality of Life Questionnaire (QLQ-HN35), and the University of Washington Quality of Life Questionnaire (UW-QOL). These questionnaires were administered individually to each patient before ambulatory care. Sociodemographic data (age and sex) and clinical data (T stage, tumor location, and type of antineoplastic treatment) were collected from the patients' medical records. Scores were compared according to tumor location using the chi-squared test and one-way analysis of variance (p < 0.05). No score differed significantly according to tumor location. It can be concluded that the health-related QOL of patients with SCC was not influenced by tumor location.

Avaliação do Seio Maxilar: Radiografia Panorâmica Versus Tomografia Computadorizada de Feixe Cônico

O objetivo deste estudo retrospectivo implica em comparar a presença de velamento, o espessamento de mucosa e a presença de septo no seio maxilar em radiografias panorâmicas e tomografias computadorizadas de feixe cônico (TCFC). A amostra foi composta por 100 pacientes do arquivo, que apresentavam as radiografias panorâmicas e as TCFC antes do início do tratamento ortodôntico, sendo 57 mulheres e 43 homens, com média de idade de 19,08 anos. Foram incluídas nesta pesquisa apenas os exames que apresentavam boa qualidade e bom posicionamento do paciente. A avaliação do velamento, espessamento de mucosa e presença de septo no seio maxilar foi realizada por um único examinador calibrado, de forma independente, nas radiografias e nas TCFC. A concordância entre os exames foi avaliada por meio do teste Kappa. Os resultados demonstraram boa concordância entre as radiografias panorâmicas e TCFC (Kappa entre 0,62 a 0,72), com -90, -88 e 89% de convergência entre os métodos, para velamento do seio maxilar; espessamento de mucosa e presença de septo no seio maxilar, respectivamente. Pode-se concluir que foi encontrada concordância satisfatória na avaliação do velamento, espessamento de mucosa e presença de septo no seio maxilar entre as radiografias panorâmica e TCFC. Dessa forma, as características do seio maxilar foram identificadas, de maneira semelhante, na radiografia panorâmica e na TCFC.Palavras-chave: Tomografia Computadorizada por Raios X. Radiografia Panorâmica. Diagnóstico.AbstractThe objective of this retrospective study was to compare the presence of filled maxillary sinus, mucosal thickening and the presence of septum in the maxillary sinus on panoramic radiographs and concomitant computed tomography (CBCT) scans. The sample consisted of 100 patients from the archive who presented the panoramic radiographs and the CBCT before the beginning of the orthodontic treatment, being 57 women and 43 men, with a mean age of 19.08 years. Only the exams that presented good quality and good positioning of the patient were included in this study. The evaluation of the presence of filled maxillary sinus, mucosal thickening and the presence of septum in the maxillary sinus was performed by a single examiner, regardless of who was calibrated on panoramic radiograph and CBCT. The agreement among the exams was assessed by means of Kappa test. The results showed good agreement between panoramic radiograph and CBCT (Kappa between 0.62 and 0.72), with -90, -88 and 89% convergence between the methods, for the presence of filled maxillary sinus, mucosal thickening and presence of septum in the maxillary sinus, respectively. It can be concluded that satisfactory agreement was found in the evaluation of the the presence of filled maxillary sinus, mucosal thickening and presence of septum in the maxillary sinus between the panoramic and CBCT radiographs. Thus, the characteristics of the maxillary sinus were similarly identified in panoramic radiography and CBCT.Palavras-chave: Tomography, X-Ray Computed. Radiography, Panoramic. Diagnosis.

A comparative study of the effect of the intrusion arch and straight wire mechanics on incisor root resorption: A randomized, controlled trial

OBJECTIVE

To analyze and compare external apical root resorption (EARR) of maxillary incisors treated by intrusion arch or continuous archwire mechanics.

MATERIALS AND METHODS

This cone-beam computed tomography (CBCT) study analyzed 28 deep bite patients in the permanent dentition who were randomly divided into two groups: Group 1, 12 patients with initial mean age of 15.1 ± 1.6 years and mean overbite of 4.6 ± 1.2 mm treated with the Connecticut intrusion arch (CIA) in the upper arch (Ortho Organizers, Carlsbad, Calif) for a mean period of 5.8 ± 1.27 months. Group 2, 16 patients with initial mean age of 22.1 ± 5.7 years and mean overbite of 4.1 ± 1.1 mm treated with conventional leveling and alignment using continuous archwire mechanics for 6.1 ± 0.81 months. The degree of EARR was detected in 112 maxillary incisors by using CBCT scans and a three-dimensional program (Dolphin 11.7, Dolphin Imaging & Management Solutions, Chatsworth, Calif). The CBCT scans were obtained before (T1) and 6 months after initiation of treatment (T2). Differences between and within groups were assessed by nonpaired and paired t-tests, respectively, with a 5% significance level.

RESULTS

Significant differences were found for both groups between T1 and T2 ( P < .05) indicating that EARR occurred in both groups. However, there were no significant differences when EARR was compared between group 1 (-0.76 mm) and group 2 (-0.59 mm).

CONCLUSIONS

The Connecticut intrusion arch did not lead to greater EARR of maxillary incisors when compared with conventional orthodontic mechanics.

Evaluation of deflection forces of orthodontic wires with different ligation types

The aim of this study was to evaluate deflection forces of orthodontic wires of different alloys engaged into conventional brackets using several ligation types. Stainless steel, conventional superelastic nickel-titanium and thermally activated nickel-titanium archwires tied into conventional brackets by a ring-shaped elastomeric ligature (RSEL), a 8-shaped elastomeric ligature (8SEL) and a metal ligature (ML) were tested. A clinical simulation device was created especially for this study and forces were measured with an Instron Universal Testing Machine. For the testing procedure, the block representing the maxillary right central incisor was moved 0.5 and 1 mm bucco-lingually at a constant speed of 2 mm/min, and the forces released by the wires were recorded, in accordance with the ISO 15841 guidelines. In general, the RSEL showed lighter forces, while 8SEL and ML showed higher values. At the 0.5 mm deflection, the 8SEL presented the greatest force, but at the 1.0 mm deflection the ML had a statistically similar force. Based on our evaluations, to obtain lighter forces, the thermally activated nickel-titanium wire with the RSEL are recommended, while the steel wire with the 8SEL or the ML are recommended when larger forces are desired. The ML exhibited the highest force increase with increased deflections, compared with the elastomeric ligatures.

Evaluation of force released by deflection of orthodontic wires in conventional and self-ligating brackets

Introduction:

The aim of the study was to evaluate deflection forces of rectangular orthodontic wires in conventional (Morelli^TM), active (In-Ovation R^TM) and passive (Damon 3MX^TM) self-ligating brackets.

Material and Methods:

Two brands of stainless steel and nickel-titanium (NiTi) wires (Morelli^TM and GAC^TM), in addition to Ormco^TM copper-nickel-titanium wires were used. Specimens were assembled in a clinical simulation device especially designed for this study and tested in an Instron universal testing machine. For the testing procedures, an acrylic structure representative of the maxillary right central incisor was lingually moved in activations of 0 to 1 mm, with readings of the force released by deflection in unloading of 0.5, 0.8 and 1 mm at a constant speed of 2 mm/min. Inter-bracket forces with stainless steel, NiTi and CuNiTi were individually compared by two-way ANOVA, followed by Tukey’s tests.

Results:

Results showed that there were lower forces in conventional brackets, followed by active and passive self-ligating brackets. Within the brands, only for NiTi wires, the Morelli^TM brand presented higher forces than GAC^TM wires.

Conclusions:

Bracket systems provide different degrees of deflection force, with self-ligating brackets showing the highest forces.

Dentoskeletal effects produced by removable palatal crib, bonded spurs, and chincup therapy in growing children with anterior open bite

OBJECTIVE

To evaluate the dentoskeletal effects of different anterior open bite treatment modalities in children.

MATERIALS AND METHODS

This cephalometric study assessed changes resulting from different treatment approaches on 77 growing children with anterior open bite. A control group (n = 30) was used for comparison. Lateral cephalograms were available before treatment and after 12 months. The sample was divided into four groups: removable palatal crib associated with a chincup (G1), bonded spurs associated with a chincup (G2), chincup (G3), and nontreated control (G4). Statistical comparisons among the four groups were performed on T1 and the treatment changes using analysis of variance with Tukey's post hoc tests.

RESULTS

No statistically significant changes in skeletal variables were found among the groups, except for lower anterior face height (LAFH) increase in G1. Overall, effects in all of the treated groups were exclusively dentoalveolar. A larger overbite (OB) increase was observed in G1 and G2 when compared with G3 and G4. The maxillary incisors in G1 showed increased palatal tipping, retrusion, and more vertical dentoalveolar development as well as increased lingual tipping among mandibular incisors. There was less vertical development of maxillary and mandibular molars in G3.

CONCLUSIONS

A removable palatal crib provided an improvement in OB (97.5%), followed by the bonded spurs (84.5%). Conversely, the chincup-only group did not have positive OB effects.

Dimensional changes of dental arches produced by fixed and removable palatal cribs: A prospective, randomized, controlled study

OBJECTIVE

To evaluate the dimensional changes of dental arches on digital models of open bite treatment with fixed and removable palatal cribs.

MATERIALS AND METHODS

The sample comprised 41 patients of both sexes who were white, aged 7-10 years, and who had mixed dentition, Angle Class I molar relationship, and a negative overbite of at least 1 mm. The sample was randomly divided into two groups: G1, fixed palatal crib; and G2, removable palatal crib. Cast models, obtained initially (T1) and after 1 year of treatment (T2), were scanned by a three-dimensional (3D) scanner, 3Shape R700, producing a 3D image. Measurements were performed by a calibrated examiner using OrthoAnalyzer™ 3D software.

RESULTS

At T2-T1, differences were observed between the groups regarding vertical dentoalveolar development and overjet. There was more mandibular incisor extrusion for G1 (-1.66 mm) than for G2 (-0.54 mm). An overjet increase was observed in G1 (0.56 mm), in contrast to a reduction in G2 (-0.40 mm). There was a similar overbite increase for both groups (3.51 mm for fixed palatal crib and 3.88 mm for removable palatal crib).

CONCLUSIONS

Both the treatment protocols are similarly effective for anterior open bite correction, providing an overbite increase with dentoalveolar arch changes, especially in the anterior region.

Facial height in Japanese-Brazilian descendants with normal occlusion

OBJECTIVE:

The aim of this study was to determine the standards of facial height in 30 young (14-year-old) Japanese-Brazilian descendants with normal occlusion, and assess whether sexual dimorphism is evident.

METHODS:

The cephalometric measurements used followed the analyses by Wylie-Johnson, Siriwat-Jarabak, Gebeck, Merrifield and Horn.

RESULTS:

Results showed dimorphism for total anterior facial height (TAFH), lower anterior facial height (LAFH), anterior facial height (AFH), total posterior facial height (TPFH) and upper posterior facial height (UPFH) measurements.

CONCLUSIONS:

The standards of facial heights in young Japanese-Brazilian descendants with normal occlusion were observed. Sexual dimorphism was identified in five out of thirteen evaluated variables at this age range.

Comparative study of dental cephalometric patterns of Japanese-Brazilian, Caucasian and Mongoloid patients

INTRODUCTION

The objective of this study was to identify the patterns of dental variables of adolescent Japanese-Brazilian descendants 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 descendants were, in general, more similar to those of the Mongoloid sample.

Analysis of the reproducibility of the gray values and noise of a direct digital radiography system

The aim of this study was to evaluate the reproducibility of the gray values and noise of a direct digital radiography system (Visualix eHD) for various exposure times and analyzed regions. To obtain radiographic images in a standardized manner, the digital sensor of the system and a stepwedge were positioned in a phantom at a focus-film distance of 30 cm in a dental device at 70 kV, 7 mA and 2.2 mm filtration. Ten consecutive repetitions of X-ray imaging were performed at each exposure time (0.05, 0.07, 0.09 and 0.13 s). Gray values were analyzed using ImageJ software in five regions of interest (ROIs): alveolar bone (AB), soft tissue (ST) and three steps of the stepwedge (S1, S2 and S3). The results showed that both the variability of the gray values and the noise were statistically greater (p < 0.05) in the most radiolucent region (ST). Only the noise was affected by the exposure time. In conclusion, the reproducibility of the gray values and the noise of the Visualix eHD system can vary in specific areas with different radiolucency.

Comparative study of the soft tissue of young Japanese-Brazilian, Caucasian and Mongoloid patients

OBJECTIVE

To determine the normality mean values in the soft tissue cephalometric measurements of young Japanese-Brazilian, with normal occlusion and to compare the results of the variables with compatible samples of young Caucasians and Mongoloids.

METHODS

Forty radiographs of young Caucasians, 32 of Japanese-Brazilians and 33 of Mongoloids were used. The three samples presented individuals with normal occlusion and well-balanced face. The samples were divided by gender due to the soft tissue characteristics and to facilitate comparison. The following statistical tests were performed: Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) with p < 0.05.

RESULTS

The Japanese-Brazilian sample of females showed thinner soft tissues in the nasion region and smaller nose when compared to the Caucasians. The Mongoloid sample showed thinner tissues in the supramentonian and pogonion regions. In males, the Japanese-Brazilians had thinner tissues in the nasion region; thicker lower lip and supramentonian region in comparison to the Caucasian sample. For the Mongoloid, soft tissue was thicker in the glabella and ANS-Sn regions.

CONCLUSIONS

It is necessary to use specific soft tissue standards for this mixed race.

Comparison between 3D volumetric rendering and multiplanar slices on the reliability of linear measurements on CBCT images: an in vitro study

Objective

The purpose of this study was to determine the accuracy and reliability of two methods of measurements of linear distances (multiplanar 2D and tridimensional reconstruction 3D) obtained from cone-beam computed tomography (CBCT) with different voxel sizes.

Material and Methods

Ten dry human mandibles were scanned at voxel sizes of 0.2 and 0.4 mm. Craniometric anatomical landmarks were identified twice by two independent operators on the multiplanar reconstructed and on volume rendering images that were generated by the software Dolphin^®. Subsequently, physical measurements were performed using a digital caliper. Analysis of variance (ANOVA), intraclass correlation coefficient (ICC) and Bland-Altman were used for evaluating accuracy and reliability (p<0.05).

Results

Excellent intraobserver reliability and good to high precision interobserver reliability values were found for linear measurements from CBCT 3D and multiplanar images. Measurements performed on multiplanar reconstructed images were more accurate than measurements in volume rendering compared with the gold standard. No statistically significant difference was found between voxel protocols, independently of the measurement method.

Conclusions

Linear measurements on multiplanar images of 0.2 and 0.4 voxel are reliable and accurate when compared with direct caliper measurements. Caution should be taken in the volume rendering measurements, because the measurements were reliable, but not accurate for all variables. An increased voxel resolution did not result in greater accuracy of mandible measurements and would potentially provide increased patient radiation exposure.

Comparison of manual, digital and lateral CBCT cephalometric analyses

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.

Comparison of mesiodistal tooth widths in Caucasian, African and Japanese individuals with Brazilian ancestry and normal occlusion

OBJECTIVE: To observe the presence of sexual dimorphism and compare the mesiodistal width of the teeth in Caucasian, African and Japanese individuals with Brazilian ancestry not orthodontically treated and with normal occlusion. METHODS: One hundred pairs of dental casts were used. It was measured, from first molar to first molar in both arches, the teeth's mesiodistal widths, using a digital caliper. For the statistical analysis of results Kolmogorov-Smirnov, t test, ANOVA and Tukey's test (p < 0.05) were used. RESULTS: Sexual dimorphism occurred on the three evaluated groups, and the highest mesiodistal widths were found in males. There was statistically significant difference between racial groups in all evaluated teeth in males. However, in females, this same difference was found only on upper lateral incisor and first molar; and lower lateral incisor, canine, first premolar and first molar. CONCLUSION: Most of mesiodistal measures present particular characteristics in relation to gender, with higher values for males, and to race, with a tendency for African to present greater mesiodistal distance of the teeth, followed by Japanese and Caucasians, respectively, important for the correct diagnosis and orthodontic planning.

Correction of Class II malocclusion with Class II elastics: a systematic review

INTRODUCTION

Although Class II elastics have been widely used in the correction of Class II malocclusions, there is still a belief that their side effects override the intended objectives. The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment.

METHODS

A search was performed on PubMed, Scopus, Web of Science, Embase, Medline, and Cochrane databases, complemented by a hand search. Study eligibility criteria were the application of Class II elastics in Class II malocclusion treatment and the presentation of dental or skeletal outcomes of treatment. All age groups were included.

RESULTS

The search identified 417 articles, of which 11 fulfilled the inclusion criteria. Four studied the isolated effects of Class II elastics, and 7 were comparisons between a single use of elastics and another method for Class II malocclusion correction. Because of the differences in treatment modalities in these articles, a meta-analysis was not possible.

CONCLUSIONS

Based on the current literature, we can state that Class II elastics are effective in correcting Class II malocclusions, and their effects are primarily dentoalveolar. Therefore, they are similar to the effects of fixed functional appliances in the long term, placing these 2 methods close to each other when evaluating treatment effectiveness. Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment.

Influence of orthodontic treatment, midline position, buccal corridor and smile arc on smile attractiveness

OBJECTIVE

To assess the scientific evidence of the influence of some variables on smile attractiveness: orthodontic treatment, midline position, axial midline angulation, buccal corridor, and smile arc.

MATERIALS AND METHODS

Literature was searched through PubMed, Web of Science, Embase, and All EBM Reviews. The inclusion criteria consisted of studies written in English; published in the past three decades; concerning the influence of orthodontic treatment, midline position, axial midline angulation, buccal corridor, and smile arc on smile esthetics; and judged by a minimum of 10 raters. Quality features evaluated were adequate description of samples, absence of confounding factors, and description of methods used to evaluate the smiles and statistical analyses.

RESULTS

Initially, 203 articles were retrieved. Of these, 20 abstracts met the initial inclusion criteria and were selected. Thirteen articles were classified as high quality, seven as average, and none as low quality.

CONCLUSION

Four-premolar extraction or nonextraction treatment protocols seem to have no predictable effect on overall smile esthetics, meaning that if well indicated, extraction in orthodontics does not necessarily have a deleterious effect on facial esthetics. The selected articles recommend that a small dental midline deviation of 2.2 mm can be considered acceptable by both orthodontists and laypeople, whereas an axial midline angulation of 10° (2 mm measured from the midline papilla and the incisal edges of the incisors) is already very apparent, and considering studies dealing with real smiles, buccal corridor sizes and smile arc alone do not seem to affect smile attractiveness.