A Odontologia visa o equilíbrio e a manutenção das estruturas bucais para atingir os objetivos anatomofuncionais, musculares e estruturais. Os hábitos bucais deletérios são caracterizados como comportamentos que quebram esse equilíbrio, por meio de qualquer função anormal exercida pela musculatura orofacial. Interferem no desenvolvimento normal da oclusão e são motivos para estudos em relação as suas origens e consequências. Na Ortodontia, sabendo-se que esses comportamentos afetam a oclusão e as características ideais dos arcos dentários, a preocupação com o desenvolvimento normal da oclusão dentária motivou a realização de uma revisão de literatura sobre os hábitos bucais deletérios e o estabelecimento de uma sistematização de tratamento. Foi realizada uma revisão de literatura, nas bases de dados  eletrônicas: Pubmed, SciELO e Google Acadêmico. Sendo selecionados os artigos em inglês e português, que versam sobre os fatores etiológicos envolvidos nos hábitos bucais deletérios, seu diagnóstico, suas implicações clínicas e possibilidades de tratamento. Apresentam fatores etiológicos, diagnóstico e implicações clínicas para nortear as atitudes do cirurgião-dentista diante de possíveis más oclusões advindas de um hábito. É de suma importância a identificação precoce dos aspectos clínicos e físicos presentes nos pacientes com hábitos bucais deletérios para tratamento adequado, no momento certo. Foi possível verificar que o diagnóstico correto e a intervenção precoce trazem benefícios estéticos e funcionais ao paciente, evitando-se que as más oclusões incipientes originem deformidades esqueléticas permanentes de difícil tratamento, minimizando o tratamento corretivo posterior e atribuindo maior estabilidade nos resultados alcançados.   Palavras-chave: Hábitos. Etiologia. Má Oclusão.   Abstract Dentistry aims to balance and maintain oral structures to achieve anatomical, functional, muscular and structural objectives. Abnormal habits are characterized as behaviors that break this balance, through any abnormal function performed by the orofacial muscles. They interfere with the normal  occlusion development and are grounds for studies regarding its origins and consequences. In orthodontics, it is known that these behaviors affect the occlusion and ideal characteristics of dental bows, the concern with the normal development of dental occlusion motivated a literature review on deleterious oral habits and the establishment of a treatment systemization. The aim of this study was to conduct a literature review, based on a search conducted in the electronic databases Pubmed, SciELO and Google Scholar. Articles that dealt with the etiological factors involved in abnormal oral habits, their diagnosis, clinical implications and treatment possibilities were selected. They present etiological factors, diagnosis and clinical implications to guide the dentist's attitudes towards possible malocclusions arising from a habit. It is extremely important to identify the clinical and physical aspects present in patients with harmful oral habits for appropriate treatment at the right time. Correct diagnosis and early intervention bring aesthetic and functional benefits to the patient, preventing incipient malocclusions from causing permanent skeletal deformities that are difficult to treat, minimizing subsequent corrective treatment and giving greater stability to the results achieved. A narrative literature review was carried out.   Keywords: Habits. Etiology. Malocclusion.

Background: The aim of this study was to evaluate the effects of the toothbrushing with a dentifrice containing antimicrobial phthalocyanine derivative (APD) for the intraoral reduction of viral load of SARS-CoV-2.Material and methods: Twenty COVID-19 positive dentate patients were selected and toothbrushes with a dentifrice containing APD for 2 minutes. Self-collected samples of unstimulated saliva were carried out three times: T0 (baseline, before toothbrushing), T5 (5 minutes after toothbrushing), and T30 (30 minutes after toothbrushing). The analysis of RNA viral was performed by RT-PCR using TaqPath™ COVID-19 multiplex Real-Time RT-PCR test for detection of three viral genes (ORF1ab, N and S genes). Evaluation of the effects was based on difference in cycle threshold (Ct) value. Friedman's test and pairwise comparison with Bonferroni corrections were used, with a significance level of 5%. Results: The Ct values were significantly higher (p=0.020) at T30 in comparison to T0 and T5. The greatest difference in the Ct values was between T30 and T0 (3.83). Conclusion: This pilot study suggests that oral hygiene action associated with an antimicrobial chemical dentifrice may be an important tool for SARS-CoV2 viral load reduction in oral cavity.

Objective: The aim of this study was to test the null hypothesis that there is no difference at the midpalatal suture opening after rapid maxillary expansion (RME) using Expander with Differential Opening (EDO), Hyrax-type and Haas-type expanders. Methods: Occlusal radiographs of 52 patients (19 males and 33 females; average age= 9.46?1.20 years) treated with RME were divided into three groups, according to the expander used: EDO (n=17), Hyrax-type (n=21) and Haas-type (n=14). The evaluated variables were: A) Distance between the maxillary central incisors at the incisal edge; B) Distance between the alveolar ridges at the midpalatal suture; C) Suture opening at 10-mm distance from the crest to posterior, at the midpalatal suture; D) Suture opening at 20-mm distance from the crest to posterior, at the midpalatal suture; and E) Suture opening at 30-mm distance from the crest to posterior, at the midpalatal suture. To assess the normality of variables, the Shapiro-Wilk test was performed. For intergroup comparison, ANOVA with a significance level of 5% was used. Results: At the region A, Hyrax-type (4.66 mm) and EDO (4.87 mm) groups presented larger openings than the Haas-type group (3.43 mm). In regions B and C, EDO showed a statistically significant greater opening than the Haas-type group. In region D, a smaller opening of the midpalatal suture was observed in the Haas-type group, compared to the Hyrax-type and EDO groups. Conclusions: EDO and Hyrax-type produced greater immediate skeletal effects, compared with Haas-type, but these differences were about 1 mm and might not be clinically significant.

Objective Compare changes in arch form after RME achieved by Expander with Differential Opening (EDO), Hyrax‐type and Haas‐type expanders. Materials and Methods Dental models were obtained from 61 patients aged 7‐11 years before expansion (T1) and 6 months after the active phase when the appliances were removed (T2). The groups were formed according to the expander used: EDO (n = 18, mean age: 9.46 ± 0.82 years), Hyrax‐type (n = 22, mean age: 9.62 ± 1.57 years) and Haas‐type (n = 21, mean age: 9.29 ± 1.05 years). The expander`s activation protocol consisted of 7 mm, except for EDO`s anterior screw, which was 9 mm. The measurements of upper and lower intercanine distance, inter‐first permanent molar, arch perimeter and length, maxillary canine and first‐permanent molar inclination, and palatal depth were performed using the OrthoAnalyzer 3D software. Intergroup comparisons of T1 and between changes (T2‐T1) were performed using ANOVA followed by Tukey. Results In the upper intercanine distance EDO provided a greater increase than Haas‐type. In the distance between upper fist permanent molars EDO showed higher values than Haas‐type and Hyrax‐type. In the lower intercanine distance and maxillary arch length, Haas‐type promoted higher increase than EDO. Conclusions The EDO promoted greater transverse changes in anterior region than Haas‐type and greater transverse changes in posterior region of the maxilla than both conventional expanders. The appliance used for RME influences dental arch changes after treatment; therefore, it is recommended to individualize the choice of expander depending on the clinical necessity of each case.

Rapid maxillary expansion (RME) is the protocol of choice for early treatment of transverse malocclusions and it is achieved with fixed expanders that produce heavy forces to achieve midpalatal suture opening. One third of patients with maxillary constriction have a greater transversal deficiency at the intercanine width than at the intermolar. The aim of this article is to present a protocol for early treatment of posterior crossbite with the use of the expander with differential opening (EDO) for RME. It is a new appliance to perform RME and its main advantage would be to allow the expansion individualization. EDO was proposed aiming to promote greater expansion on the anterior rather than on the posterior region. A 9 year-old female sought treatment. The interceptive treatment plan was based on using EDO for RME. The post-expansion orthopedic response showed an opening of 7.5 mm between the maxillary central incisors, at the level of the incisal edge. It was observed an opening of 4.8mm in the midpalatal suture. The opening at a distance of 10 mm and 20 mm from the crest to posterior at the midpalatal suture were 3.9mm and 2.8mm. The upper intercanine distance showed an increase of 9.31 mm. The upper intermolar distance had increased 8.04 mm. The upper arch perimeter showed a difference from 74.02 mm to 80.11 mm . And the upper arch length, from 29.83 mm to 31.56 mm. The posterior crossbite was 2 mm overcorrected. Early diagnosis and treatment of posterior crossbite has a very favorable prognosis. Keywords: Palatal Expansion Technique. Interceptive Orthodontics. Malocclusion. Resumo A expansão rápida da maxila (ERM) é a técnica de escolha para o tratamento precoce das más oclusões transversais e é ativada com expansores fixos que produzem forças pesadas para possibilitar a abertura da sutura palatina mediana. Um terço dos pacientes com atresia maxilar apresenta uma maior deficiência transversal na região intercaninos do que na região intermolares. O objetivo desse artigo é apresentar um protocolo de tratamento precoce para a mordida cruzada posterior utilizando o expansor maxilar Diferencial (EMD) para realizar a ERM. EMD é um novo dispositivo que pode ser empregado para realização da ERM e sua principal vantagem seria permitir a individualização da expansão. EMD foi proposto para proporcionar maior expansão na região anterior do que na região posterior da maxila. Uma menina de 9 anos de idade buscou tratamento. O plano de tratamento interceptativo proposto foi ERM utilizando o dispositivo EMD. A resposta ortopédica pós-expansão mostrou uma abertura de 7,5 mm entre os incisivos centrais superiores, ao nível da borda incisal. Foi observada uma abertura de 4,8 mm na sutura palatina mediana. A abertura a uma distância de 10 mm e 20 mm da crista para posterior na sutura palatina mediana foi de 3,9 mm e 2,8 mm. A distância intercaninos superior apresentou aumento de 9,31 mm. A distância intermolares superiores aumentou 8,04 mm. O perímetro do arco superior apresentou diferença de 74,02 mm para 80,11 mm. E o comprimento do arco superior, de 29,83 mm para 31,56 mm. A mordida cruzada posterior foi sobrecorrigida em 2 mm. O diagnóstico precoce e o tratamento da mordida cruzada posterior tem um prognóstico muito favorável. Palavras-chave: Técnica de Expansão Palatina. Ortodontia Interceptora. Má Oclusão.

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PurposeThis clinical trial aimed to evaluate the use of a mouthwash and a dentifrice containing antimicrobial phthalocyanine derivative (APD) on the reduction of clinical symptoms in COVID-19 patients.MethodsThis randomized triple-blinded clinical trial enrolled 500 patients aged 18 years or older submitted to COVID-19 test by nasopharyngeal swab RT-qPCR in a reference center for the diagnosis of COVID-19, had no clinical contraindications to perform mouthwash and gargle, and had access to cell phone with communication application. Patients were randomly assigned (1:1) to use a mouthwash, and a dentifrice both containing antimicrobial phthalocyanine derivative (APD Group) or Non-APD (Control Group). All participants were instructed to floss twice a day, toothbrushing during 2 minutes/three times a day, and for gargling/rising (5ml) during 1 minute/three times a day for 7 days. An online questionnaire was sent to collect the clinical symptoms of COVID-19 in three times: T0 (baseline - before using the oral hygiene products); T3 (three days after); and T7 (seven days after). The investigators, patients, and outcomes assessor were blinded to group assignment. Mann-Whitney test, Chi-Square test, Exact Fisher test, and Cochran’s test were used according to the nature of the variables studied, with the level of significance set at P < 0.05.ResultsNo statistically significant difference was found in the prevalence of symptoms between the groups at baseline. A statistically significant reduction of clinical symptoms was found in the Control Group (fatigue, shortness of breath, hoarse voice, sore throat, nasal congestion, and chest pain) and in APD Group (cough, fatigue, shortness of breath, hyposmia/anosmia, dysgeusia, hoarse voice, sore throat, nasal congestion, chest pain, diarrhea and irritability/confusion) during the follow-up period. There were statistically significant differences with a higher symptoms’ prevalence for the Control Group at T3 and T7. Dysgeusia, sore throat, irritability/confusion was less prevalent at the APD Group at T3, and shortness of breath, hyposmia/anosmia, dysgeusia, hoarse voice, sore throat, diarrhea, and irritability/confusion were more prevalent in the Control Group at T7.ConclusionsBased on methodology, the results demonstrated that the regular use of mouthwash and dentifrice containing APD had a positive impact on the clinical symptoms reported by COVID-19 patients.