Dental Press Jounal of Orthodontics
Dental Press International

v. 15, no. 4

Dental Press Journal of Orthodontics – ISSN 2176-9451

Dental Press J. Orthod.

v. 15, no. 4

July / August

2010


Editorial

Innovation needs to be stimulated in Brazil by means of patent applications

Jorge Faber

Show abstract

The ability to innovate and develop new products and services is a touchstone to gauge a nation’s entrepreneurial spirit. Entrepreneurship means creating exchange value for a nation, often through technology development. Hence, developing technology—as measured by the number of patent application submissions—should be a top priority in Brazil.

Although technology and science are discrete subjects, they are so intricately entwined that they are aptly under the jurisdiction of the Brazilian Ministry of Science and Technology. The achievements attained by this Ministry over the years has paid handsome dividends. (Incidentally, it was established in 1985 to fulfill a commitment by then President Tancredo Neves towards the Brazilian scientific community). Our scientific output has grown dramatically. In dentistry, for example, Brazil ranks 4th in worldwide scientific production. Today it is often more convenient for a foreign dentist to pursue their studies in Brazil than the other way around, given the number of outstanding graduate programs available throughout the country.

However, there seems to be a split between the production of science and the production of technology in Brazil. Our number of patent applications is still negligible when compared with developed countries. Our history is partly to blame for this discrepancy. Our agricultural vocation was foreshadowed by Portuguese explorer Pero Vaz de Caminha’s letter, in his first description of the New World, where he stated that “... the land is so fertile that anything can be grown on it...”. As a result, when Brazilian companies were confronted with the challenges of globalization and free markets, they were unable to prove their mettle and innovative spirit in the face of highly competitive products and production processes. Their immediate alternative was to further the incorporation of foreign technology, thereby increasing the share of non-national components in Brazilian manufactured products and rendering patents virtually unnecessary.

The Brazilian academic community had to grapple with this dearth of technological entrepreneurship by lopsidedly prioritizing scientific production. The nature of the energy expended in scientific production was cleverly explained by Thomas Kuhn,1 who believed that the results achieved by normal science are significant since they help to enhance the accuracy and scope that can be applied by current knowledge— or paradigm. Most often, however, science is not engaged in shifting paradigms or giving rise to innovations, changes in behavior or thinking. Scientific attention is not focused on technological innovation.

We can address this issue in more pragmatic fashion by visiting the website of the Brazilian National Institute of Intellectual Property (www.inpi.gov.br). When you query the patent records using the word ‘orthodontics’ in the search field, only 16 files pop up. The first dates back to 1977 and the last one to 2005. This is the same number of files found with the same parameters in the U.S. Patent & Trademark Office (appft1.uspto.gov/netahtml/PTO/search-bool.html) within the 35 days that preceded the writing of this editorial. Using the same keyword, thirty-five days in the U.S. are equivalent to 28 years in Brazil. And let us not forget that nowadays orthodontics is a scientific area in which Brazil plays a leading role.

This scenario calls for improvement. We are hard-pressed to foster the development of national technology through educational and industrial policies. It is a fact that many Brazilian universities encourage and support the filing of patents, and additional measures are currently under way. Nevertheless, greater emphasis should be placed on this issue. One viable option would be to trade program completion projects— monographs, theses and dissertations—for patents. Such projects are invaluable assets in the CVs of researchers, and graduate course coordinators are expected to act accordingly.

Go ahead and innovate!

What´s new in Dentistry

Perception of dentofacial deformities: From psychological well-being to surgery indication

Jorge Faber, Ana Paula Megale Hecksher Faber

Show abstract

Patient perceptions of orthognathic surgery treatment, well-being, psychological and psychiatric status: a systematic review

Clinicians who attend to patients with dentofacial deformities often comment on the grief experienced by these patients due to their deformity. A recurring theme in this area is whether or not, and to what extent, we can help those undergoing treatment to have a better quality of life. With the purpose of better understanding this issue, Finnish authors conducted a systematic review of studies on the psychological well-being of orthodontic-surgical patients.1 They evaluated articles published in English between 2001 and 2009 on the PubMed, PsycInfo and Web of Science databases. The review was performed by two investigators who excluded publications that focused on methodological issues, cleft or syndromic patients, surgically assisted maxillary expansion or intermaxillary block. References to all review papers were searched manually with a view to retrieving new articles to support the study. Thirtyfive articles met the selection criteria and were included in the review. The main reasons for seeking treatment were linked to improvements in selfconfidence, appearance and oral function. After treatment patients reported improvement in their well-being, although such finding departed from current methods used to assess this issue. Changes in well-being were generally identified by study designs developed to analyze the impact of oral health on quality of life, such as quality of life questionnaires related to orthognathic surgery, and impact on oral health. The major conclusion was that, in general, patients do not experience psychiatric problems related to dentofacial deformity. Certain patient subgroups, however, may experience conditions such as anxiety or depression. One key hurdle in the analysis of these patients stems from the fact that most studies compare the means of patient groups with control subjects and/or population standards. In other words, no stratification or covariate analysis is allowed to influence the outcome of the sampled variables. This is fertile ground for new studies, particularly prospective studies that address daily mood swings and changes in well-being. [...]

Orthodontic Insight

Orthodontic traction: Possible consequences for maxillary canines and adjacent teeth

Alberto Consolaro

Show abstract

Some professionals are reluctant to indicate orthodontic traction, especially for upper canines. Among the most common reasons for restricting the indication of orthodontic traction are:

1) Root resorption in lateral incisors and premolars.

2) External cervical resorption of the canines under traction.

3) Alveolodental ankylosis of the canine(s) involved in the process.

4) Calcific metamorphosis of the pulp and aseptic pulp necrosis.

These conditions do not result primarily and specifically from orthodontic traction, and can be avoided if certain technical precautions are followed. For a better understanding of what these technical precautions are and how they work preventively against the possible consequences of orthodontic traction, we need a biological foundation. This is the goal of this series of studies on orthodontic traction, especially of upper canines, and its possible consequences.

What´s new in Dentistry

An interview with Anibal M. Silveira Jr.

José A. Bósio

Show abstract

• Graduated in Dentistry - Universidade Federal do Rio Grande do Norte (UFRN), 1972-77.

• Fellow - Pediatric Dentistry - Project HOPE – Natal, Brazil, 1977-78.

• Specialist in Pediatric Dentistry - Eastman Dental Center, University of Rochester; Rochester, New York, 1978-80.

• Specialist in Orthodontics - Eastman Dental Center, University of Rochester; Rochester, New York, 1981-83.

• Fellow in the Temporomandibular Joint Program, Eastman Dental Center, University of Rochester; Rochester, New York, 1983-85.

• Clinical Instructor - Orthodontic Department, Eastman Dental Center, NY, 1983-88.

• Chairman and Assistant Professor - Orthodontic Department, University of Colorado, Denver, 1988-91.

• Research Director and Associate Professor - University of Louisville Dental School (ULSD), KY. Orthodontic Program Director, ULSD Department of Orthodontic, Pediatric and Geriatric Dentistry - 1993-2007.

• Professor and Chairman - Department of Orthodontic, Pediatric and Geriatric Dentistry, University of Louisville School of Dentistry (ULSD).

• 45 Peer review publications (Scientific Articles and Abstracts).

• 5 Textbook Chapters on Orthodontic Topics. Recipient of 16 Grants from Federal, State and Other Educational Institutions or Dental Organizations as Principle Investigator or Co-Investigator.

• Supervised, as primary mentor, training of over 50 postdoctoral Master of Science Degrees in Oral Biology and Orthodontics.

• Recipient of “The Chancellor’s Award for Teaching Excellence”, the highest teaching award given by the University of Colorado Health Sciences Center - 1991.

• Recipient of the “University of Louisville Distinguished Teaching Professor Award”, the highest teaching award given by the University of Louisville - 1996.

• Nominated as the Vice President, NU Chapter Omicron Kappa Upsilon in 2004, and elected President, NU Chapter Omicron Kappa Upsilon in 2005.

Online Article

Study of the cephalometric features of Brazilian long face adolescents

Omar Gabriel da Silva Filho, Gleisieli C. Petelinkar Baessa Cardoso, Maurício Almeida Cardoso, Leopoldino Capelozza Filho

Face. Adolescent. Cranial circumference.

Show abstract

Objective: To set skeletal and dental cephalometric values for Brazilian long face adolescents.

Methods: The sample comprised lateral cephalograms of 30 long face patients, 17 females and 13 males, and 30 Pattern I adolescent patients, 15 males and 15 females, with permanent dentition. The features that characterize the long face pattern were defined clinically by facial analysis. The following cephalometric measurements were assessed: 1) Sagittal behavior of the apical bases (SNA, SNB, ANB, NAP, Co-A, Co- Gn), 2) Vertical behavior of the apical bases (SN.PP, SN.MP, gonial angle, TAFH, LAFH, MAFH, PFH, TAFHperp, LAFHperp), 3) Dentoalveolar behavior (1-PP, 6-PP, 1-MP, 6-MP, 1.PP, IMPA), and 4) Facial height ratios (LAFHPerp/TAFHPerp, LAFH/TAFH, MAFH/LAFH).

Results and Conclusions: The vertical error of the long face pattern is concentrated in the lower third. The maxilla exhibits a greater dentoalveolar height and the mandible, given its more vertical morphology, displays greater clockwise rotation. These morphological and spatial features entail sagittal and vertical skeletal changes as well as vertical dentoalveolar changes. The angles of facial convexity are increased in the sagittal direction. Vertically, the total and lower anterior facial heights are increased. The dentoalveolar component is longer.

In vitro flexural strength evaluation of a mini-implant prototype designed for Herbst appliance anchorage

Klaus Barretto-Lopes , Gladys Cristina Dominguez, André Tortamano, Jesualdo Luiz Rossi, Julio Wilson Vigorito

Orthodontic appliances. Orthodontics. Herbst appliance. Mini-implant.

Show abstract

Aim: The purpose of this study was to evaluate the limit of flexural strength of a miniimplant prototype designed for Herbst appliance anchorage.

Methods: After sample size calculation, four specimens with the new mini-implant were submitted to a single cantilever flexure test using a universal testing machine. The limit of flexural force strength was calculated.

Results: The mini-implant prototype showed a limit of flexural force of 98.2 kgf, which was the lowest value found.

Conclusion: The mini-implant prototype designed for Herbst appliance anchorage can withstand higher strength than the maximum human bite reported in the literature.

Orthodontic treatment in patients with reimplanted teeth after traumatic avulsion: A case report

Simone Requião Thá Rocha, Alexandre Moro, Ricardo César Moresca, Gilson Sydney, Fabian Fraiz

Tooth movement. Dental ankylosis. Tooth trauma.

Show abstract

Introduction: The high prevalence of individuals with dental trauma prior to orthodontic treatment justifies the precautions that should be followed before and during treatment, taking into account all possible effects of orthodontic movement on traumatized teeth. Among the major traumatic dental injuries, avulsion with subsequent tooth reimplantation entails a higher risk of complications, such as pulp necrosis, root resorption and ankylosis. Therefore, it gives orthodontists several reasons for concern.

Objective: This case report aims to analyze the implications of tooth reimplantation after traumatic avulsion in patients requiring orthodontic treatment.

Conclusions: Tooth movement of a reimplanted tooth after traumatic avulsion is viable, provided that no signs of abnormality are present. Ankylosed teeth, however, are not eligible for orthodontic movement but should be preserved as space maintainers until root resorption is completed, provided that the teeth do not present with severe infraposition. Should an ankylosed tooth be severely infraposed, crown amputation and root burial are indicated as a means to preserve the alveolar bone in the region, since resorption will occur by replacement of the buried root, as was the case in this report.

Original Article

Influence of the extraction protocol of two maxillary premolars on the occlusal stability of Class II treatment

Leonardo Tavares Camardella, Guilherme Janson , Janine Della Valle Araki, Marcos Roberto de Freitas, Arnaldo Pinzan

Stability. Class II malocclusion treatment. Tooth extraction.

Show abstract

Objective: With the purpose of evaluating the influence of two upper premolar extraction on the occlusal stability of full cusp Class II malocclusion treatment, a comparison was performed with a non-extraction treatment protocol.

Methods: To this end, a sample consisting of 59 patients with complete Class II malocclusion was selected from the files of the Department of Orthodontics of the Dental School of Bauru. This sample was split into two groups according to the following characteristics: Group 1 included 29 patients treated without extractions and Group 2 included 30 patients treated with the extraction of two upper premolars. Using the TPI and PAR occlusal indices the subjects’ study models were evaluated at the beginning and end of treatment, and at a minimum of 2.4 years after treatment. The occlusal conditions at the end of treatment and in the post-treatment period, the percentage of relapse and post-treatment occlusal changes were compared using Student’s t-test.

Results: The results showed no statistically significant differences between the nonextraction and the extraction of two maxillary premolars treatment protocols in terms of the occlusal stability of complete Class II malocclusion treatment in any of the evaluated variables.

Conclusions: The extraction of two upper premolars in the treatment of Class II malocclusion did not influence the stability of the occlusal results achieved at the end of the orthodontic treatment. Therefore, a similar stability is achieved by finishing a treatment with either a Class II or a Class I molar relationship.

Solitary median maxillary central incisor syndrome: Case report

Eduardo Machado, Patricia Machado, Betina Grehs, Renésio Armindo Grehs

Solitary median maxillary central incisor. Single median maxillary central incisor. SMMCI. Orthodontics.

Show abstract

Introduction: The presence of a single median maxillary central incisor is an uncommon event in the population. The prevalence of the Solitary Median Maxillary Central Incisor (SMMCI) syndrome is about 1:50,000 live births, occurring more in women. This alteration in the development of the dental occlusion is characterized by structural malformations, over all in midline region of the patient. The early diagnosis and the adequate treatment of this syndrome are of great importance, therefore this condition can be an indication that the patient can present other severe congenital malformations, not having to consider the SMMCI a simple dental anomaly. The orthodontic procedures, in these cases, vary depending on the degree of involvement of bone structures of the maxilla, the occlusion in itself, and mainly of the midpalatal suture.

Objectives: To discuss, based on scientific evidence, important aspects related to the SMMCI and present a clinical case of female patient with SMMCI, which was submitted to orthodontic treatment in the Children’s Dental Integrated Clinic of the Federal University of Santa Maria - RS/Brazil.

Conclusion: According to the critical analysis of literature, it is very important to correctly early diagnose this condition, since there is the possibility of this syndrome to be associated with other problems of development. Moreover, the patients affected by SMMCI should be attended by a multidisciplinary health team in order to optimize the clinical results and recover the quality of life of these patients.

Evaluation of antimicrobial activity of orthodontic adhesive associated with chlorhexidine-thymol varnish in bracket bonding

Carolina Freire de Carvalho Calabrich, Marcelo de Castellucci e Barbosa, Maria Regina Lorenzetti Simionato , Rogério Frederico Alves Ferreira

Chlorhexidine. Adhesives. Antimicrobial agents.

Show abstract

Objective: To assess the antimicrobial activity resulting from the association of an orthodontic adhesive with chlorhexidine-thymol varnish.

Methods: Thirty-two extracted human premolars were used, divided into four groups. In Group 1, the control group, the adhesive used to bond the bracket was not associated with any antimicrobial agent. Groups 2, 3 and 4 were bonded with an adhesive system associated with chlorhexidine-thymol varnish. Groups 3 and 4 were stored in water for 7 days and 30 days, respectively, while the specimens from group 2 were, soon after bonding, placed on agar seeded with Streptococcus mutans for 48 hours, at 37º C.

Results: The experimental groups, with the exception of the control group, showed antimicrobial activity whose action tended to decline commensurately with the amount of time that they remained immersed in water.

Conclusions: The association of chlorhexidinethymol varnish with an adhesive system used in orthodontics proved to be advantageous due to its antimicrobial activity.

Comparison of two extraoral radiographic techniques used for nasopharyngeal airway space evaluation

Mariana de Aguiar Bulhões Galvão, Marco Antonio de Oliveira Almeida

Adenoids. Nasopharynx. Radiography.

Show abstract

Objectives: The goal of this research was to compare lateral cephalometric radiography and cavum radiography in nasopharyngeal airway space evaluation.

Methods: The sample of this study consisted of 36 Brazilian mouth breathing children, no racial distinction, with ages ranging from 5 to 12. These children were selected in Recife/PE, Brazil (2005) and divided into 6 groups. In each group, the radiographs were taken on the same day. The sample was composed of 72 radiographs, 36 lateral cephalometric and 36 cavum.

Results: The results were based on the Schulhof method and, at the end, an Index representing a summary of all measurements taken was calculated. Student paired t-test, chi-square, Pearson correlation and Kappa index scores were calculated to analyze the results. Only the values of the Airway Occupation Percentage were significantly different (p = 0.006) among the analyzed radiographs. A high degree of correlation was found for all measurements, including the Index values.

Conclusions: It can be concluded that, both the lateral cephalometric radiography and the cavum radiography can be used for nasopharyngeal airway space evaluation.

Condylar hyperactivity: Diagnosis and treatment - case reports

Maria Christina Thomé Pacheco, Robson Almeida de Rezende, Rossiene Motta Bertollo, Gabriela Mayrink Gonçalves, Anita Sanches Matos Santos

Maxillomandibular anomalies. Facial asymmetry. Condylar hyperplasia.

Show abstract

Introduction: Condylar hyperactivity is a condition triggered by an imbalance in bone growth factors, which causes facial asymmetry. It can be classified into three different types: hemimandibular hyperplasia (HH), hemimandibular elongation (HE) and a hybrid form. It is essential that a correct diagnosis of these hyperactivities be reached since each type of anomaly requires a different approach. Treatment options include surgery and high condylectomy.

Objectives: The purpose of this article is to present two cases of facial asymmetry caused by condylar hyperactivity, showing the importance of an accurate diagnosis and the means used to achieve it while seeking an appropriate treatment for each case.

Comparison of soft tissue size between different facial patterns

Murilo Fernando Neuppmann Feres, Silvia Fernandes Hitos, Helder Inocêncio Paulo de Sousa, Mirian Aiko Nakane Matsumoto

Vertical pattern. Cephalometry. Lip. Chin.

Show abstract

Objective: This study was designed to compare the soft tissue morphology of individuals according to their facial patterns.

Methods: Were used cephalograms of 90 patients of both genders, aged 12 to 16 years, which were divided into three distinct groups, according to their morphological patterns, i.e., mesofacials, dolichofacials and brachyfacials. The groups were compared in terms of thickness and height of the upper and lower lips, and thickness of the soft tissue chin. Correlations between soft tissue variables and dental and skeletal cephalometric measurements were also investigated.

Results and Conclusions: Thickness of upper lip, lower lip and soft tissue chin showed no differences in all morphological groups. However, upper and lower lip heights were significantly greater in dolichofacials. Brachyfacials showed smaller upper lip height compared with mesofacials, although no differences were found between those two groups in terms of lower lip height. Assessment of the correlations between soft and skeletal/dental variables evidenced vertical development of the upper and lower lips, commensurate with the vertical development of the skeleton. The vertical positioning of upper incisors significantly correlated with the same parameters related to the lips, which ensured a similar exposure level of these teeth in all groups.

Malocclusion prevalence and comparison between the Angle classification and the Dental Aesthetic Index in scholars in the interior of São Paulo state - Brazil

Malocclusion. Angle classification. Dental Aesthetic Index. Prevalence. Index.

Show abstract

Introduction: The malocclusions are among the main buccal health problems all over the world, together with dental cavity and periodontal disease. Several indexes are being used for malocclusion registration. The present study verified the prevalence of this condition, using the Angle classification and the Dental Aesthetic Index (DAI), the severity and the necessity of orthodontic treatment registered with the DAI and the results of both indexes were compared, seeking to correlate collected data pattern and the viability of using them together.

Methods: The sample consisted of 734 schoolchildren with 12 years of age, both male and female from the public municipal schools in Lins-SP, Brazil. The exams were performed at the school’s playgrounds with the use of IPC probes with a naked eye.

Results: For the Angle classification, it was found that 33.24% of the children presented normal occlusion and 66.76% presented malocclusions. It was observed, with the DAI, that 65.26% of the children had no abnormalities or had slight malocclusions. The defined malocclusion was present in 12.81%, severe malocclusion was observed in 10.90% and very severe or disabling malocclusion in 11.03%. Most of the children (70.57%) presented normal molar relationship and the anterior maxillary overjet was the most frequently observed alteration. When the indexes were compared there were similarities and divergences.

Conclusion: DAI was not sensitive for some occlusion problems detected by the Angle classification, and vice-versa, demonstrating that both indexes have different points in malocclusions detection, so they could be used mutually in a complementary way.

Qualitative photoelastic study of the force system produced by retraction T-springs with different preactivations

Luiz Guilherme Martins Maia, Vanderlei Luiz Gomes , Ary dos Santos-Pinto, Itamar Lopes Júnior, Luiz Gonzaga Gandini Junior

Closing of orthodontic space. T loop. Photoelastic study. Retraction.

Show abstract

Objective: Evaluate the force system produced by the T-spring used for space closure.

Methods: By means of the experimental photoelastic method, we evaluated the Tspring— used for space closure—with two different preactivations on its apical portion, i.e., one with 30° and one with 45º. The springs were fabricated with rectangular 0.017 X 0.025-in titanium-molybdenum alloy (TMA), centered in a 27.0 mm interbracket space and activated at 5.0 mm, at 2.5 mm, and in a neutral position. For more reliable results, tests were repeated on three photoelastic models duplicated and prepared by the same operator. To better understand the results, the fringes seen in the polariscope were photographed and analyzed qualitatively.

Results: Through qualitative analysis of the fringes order in the photoelastic model it was noted that at the retraction and anchoring ends the T-spring with 30° apical activation showed a slightly greater accumulation of energy relative to the force system that was generated.

Assessment of the accuracy of cephalometric prediction tracings in patients subjected to orthognathic surgery in the mandible

Thallita Pereira Queiroz, Jéssica Lemos Gulinelli, Francisley Ávila Souza, Liliane Scheidegger da Silva, Zanetti, Osvaldo Magro Filho, Idelmo Rangel Garcia Júnior, Eduardo Hochuli Vieira

Surgery. Cephalometry. Mandible.

Show abstract

Objective: The purpose of this study was to assess the accuracy of cephalometric prediction tracings—performed for orthognathic surgery—by means of the cephalometric analysis of preoperative and seven-day postoperative tracings, in patients subjected to correction of mandibular deformities.

Methods: The lateral cephalograms of 17 patients who had been submitted to mandibular orthognathic surgery, three years earlier, were used. Cephalometric tracings were performed in the preoperative and seven-day postoperative periods and the following landmarks were traced: condyle (Co), pogonion (Pog), gonial (Go), menton (Me), B (B) and incisor (I). The analysis was based on the difference obtained by superimposing preoperative, prediction and postoperative tracings. The landmarks were projected onto a Cartesian plane for measuring distances between points in millimeters. The data were statistically analyzed using the paired Student t test (? = 0.05).

Results: A statistically significant mean difference was observed between the planned change and the change effectively achieved in the postoperative cephalometric tracings for points Pog (p = 0.014) and I (p = 0.008) on the horizontal axis. No statistically significant difference was found for the aforementioned cephalometric points on the vertical axis (p > 0.05).

Conclusions: Cephalometric prediction tracings contributed to the preoperative evaluation of the patients and consequently to treatment optimization. However, they was not entirely reliable in these cases due to a slight underestimation of horizontal skeletal changes. These changes should be considered in planning and postoperative follow-up of patients subjected to orthognathic surgery in the mandible.

Assessment of the accuracy of cephalometric prediction tracings in patients subjected to orthognathic surgery in the mandible

Thallita Pereira Queiroz, Jéssica Lemos Gulinelli, Francisley Ávila Souza, Liliane Scheidegger da Silva, Zanetti, Osvaldo Magro Filho, Idelmo Rangel Garcia Júnior, Eduardo Hochuli Vieira

Surgery. Cephalometry. Mandible.

Show abstract

Objective: The purpose of this study was to assess the accuracy of cephalometric prediction tracings—performed for orthognathic surgery—by means of the cephalometric analysis of preoperative and seven-day postoperative tracings, in patients subjected to correction of mandibular deformities.

Methods: The lateral cephalograms of 17 patients who had been submitted to mandibular orthognathic surgery, three years earlier, were used. Cephalometric tracings were performed in the preoperative and seven-day postoperative periods and the following landmarks were traced: condyle (Co), pogonion (Pog), gonial (Go), menton (Me), B (B) and incisor (I). The analysis was based on the difference obtained by superimposing preoperative, prediction and postoperative tracings. The landmarks were projected onto a Cartesian plane for measuring distances between points in millimeters. The data were statistically analyzed using the paired Student t test (? = 0.05).

Results: A statistically significant mean difference was observed between the planned change and the change effectively achieved in the postoperative cephalometric tracings for points Pog (p = 0.014) and I (p = 0.008) on the horizontal axis. No statistically significant difference was found for the aforementioned cephalometric points on the vertical axis (p > 0.05).

Conclusions: Cephalometric prediction tracings contributed to the preoperative evaluation of the patients and consequently to treatment optimization. However, they was not entirely reliable in these cases due to a slight underestimation of horizontal skeletal changes. These changes should be considered in planning and postoperative follow-up of patients subjected to orthognathic surgery in the mandible.

Assessment of the accuracy of cephalometric prediction tracings in patients subjected to orthognathic surgery in the mandible

Thallita Pereira Queiroz, Jéssica Lemos Gulinelli, Francisley Ávila Souza, Liliane Scheidegger da Silva, Zanetti, Osvaldo Magro Filho, Idelmo Rangel Garcia Júnior, Eduardo Hochuli Vieira

Surgery. Cephalometry. Mandible.

Show abstract

Objective: The purpose of this study was to assess the accuracy of cephalometric prediction tracings—performed for orthognathic surgery—by means of the cephalometric analysis of preoperative and seven-day postoperative tracings, in patients subjected to correction of mandibular deformities.

Methods: The lateral cephalograms of 17 patients who had been submitted to mandibular orthognathic surgery, three years earlier, were used. Cephalometric tracings were performed in the preoperative and seven-day postoperative periods and the following landmarks were traced: condyle (Co), pogonion (Pog), gonial (Go), menton (Me), B (B) and incisor (I). The analysis was based on the difference obtained by superimposing preoperative, prediction and postoperative tracings. The landmarks were projected onto a Cartesian plane for measuring distances between points in millimeters. The data were statistically analyzed using the paired Student t test (? = 0.05).

Results: A statistically significant mean difference was observed between the planned change and the change effectively achieved in the postoperative cephalometric tracings for points Pog (p = 0.014) and I (p = 0.008) on the horizontal axis. No statistically significant difference was found for the aforementioned cephalometric points on the vertical axis (p > 0.05).

Conclusions: Cephalometric prediction tracings contributed to the preoperative evaluation of the patients and consequently to treatment optimization. However, they was not entirely reliable in these cases due to a slight underestimation of horizontal skeletal changes. These changes should be considered in planning and postoperative follow-up of patients subjected to orthognathic surgery in the mandible.

Evaluation of indirect methods of digitization of cephalometric radiographs in comparison with the direct digital method

Cleomar Donizeth Rodrigues, Márcia Maria Fonseca da Silveira, Orivaldo Tavano, Ronaldo Henrique Shibuya, Giovanni Modesto, Carlos Estrela

Digital dental radiography. Orthodontics. Radiographic image interpretation. Computer-assisted cephalometrics.

Download pdf

Show abstract

Objective: To evaluate the indirect digitization method of cephalometric radiographs in comparison with the direct digital method.

Methods: The sample was composed of ten cephalometric radiographs acquired by Orthopantomograph OP100/Orthocef OC100 (GE – Instrumentarium), digital direct. In the Adobe™ Photoshop program, five cephalometric landmarks were set in the images and the impression in transparencies was made. The indirect digitization of the images was performed through the Sony™ DSC-W5 and Canon™ Rebel XT/EOS 350D digital photographic cameras—fixed in a copy stand, at the distances of 25 cm and 60 cm—and through the Hewlett Packard™ Scan Jet 4C scanner. The direct digital images and the indirect ones were inserted and gauged in the Radiocef Studio (Radiomemory™, Brazil) software and the center of the previously marked landmarks was set. The cephalometric computerized analysis generated three angular measurements and four linear ones which were submitted to statistical analysis.

Results: The images from the scanner demonstrated small statistically significant alterations, without clinical significance. When digitizing the radiographs at 60 cm, both cameras caused distortions which were statistically significant, but clinically acceptable. At 25 cm, the cameras caused the largest distortions, being more expressive and with clinical significance in the images of Canon™ Rebel XT.

Conclusions: The Hewlett Packard™ Scan Jet 4C scanner with transparency reader and the Sony™ DSC-W5 and Canon™ Rebel XT/EOS cameras operating at 60 cm were shown appropriate for the digitization of cephalometric radiographs. In 25 cm, the digital cameras caused distortions in the image which altered the linear measurements with possibilities of jeopardizing the orthodontic diagnosis.

BBO Case Report

Angle Class I malocclusion treated with extraction of first permanent molars*

Ivan Tadeu Pinheiro da Silva

Angle Class I malocclusion. Tooth extraction. Corrective Orthodontics.

Show abstract

Angle Class I malocclusion is characterized by normal anteroposterior molar relationship, which may or may not be accompanied by skeletal changes—in the vertical or transverse planes—or dental changes. Bimaxillary dental protrusion, characterized by pronounced labial inclination of maxillary and mandibular incisors combined with excessive overjet, expose patients to dental trauma and compromise aesthetics. In deciding which teeth to extract for Class I correction the first or second premolars are usually selected due to their location in the dental arch. However, the extraction of a first permanent molar compromised by caries or extensive restoration may be an alternative that ensures the preservation of a healthy tooth instead of one that has already been manipulated. This case, treated in an unusual manner by the extraction of four first permanent molars, was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as representative of category 2, as part of the requirements for obtaining the BBO diplomate title.

Special Article

Alveolar corticotomies in orthodontics: Indications and effects on tooth movement

Dauro Douglas Oliveira , Bruno Franco de Oliveira, Rodrigo Villamarim Soares

Alveolar corticotomies. Orthodontic tooth movement. Accelerated orthodontics. Orthodontic treatment.

Show abstract

Introduction: The systematic search for increased efficiency in orthodontic treatment is shared by several areas of orthodontics. Performing alveolar corticotomies shortly before the application of orthodontic forces has been suggested as a method to enhance tooth movement and, consequently, orthodontic treatment as a whole.

Objective: This article reviews the historical perspective of this therapeutic approach, presents and illustrates with clinical cases its main indications and finally discusses the biological reasons underlying its use.

Dental Press Journal of Orthodontics - v. 15, no. 4 Download full issue pdf