Introduction: The search for more aesthetic and comfortable orthodontic devices has led to an increase in the use of clear aligners. Objective: To increase knowledge on biological mechanisms of orthodontic tooth movement using Invisalign aligners. Methods: This study included 11 patients with a mean age of 23.6 ± 4.8 years. Cases planning included alignment and leveling of lower incisors using Invisalign aligners. Gingival crevicular fluid samples were collected from the lower incisors on the day of delivery of aligner number 1 (T0) and after 1 (T24h), 7 (T7d), and 21 (T21d) days. During the observation period of the study, the patients used only the aligner number 1. Levels of nine cytokines were quantified using Luminex’s multi-analysis technology. Non-parametric tests were used for comparisons between cytokine expression levels over time. Results: Cytokine expression levels remained constant after 21 days of orthodontic activation, except those of MIP-1β, which presented a statistical difference between T24h and T21d with a decrease in the concentration levels. IL-8, GM-CSF, IL-1β, MIP-1β, and TNF-α showed the highest concentrations over time. Conclusions: The different behavior in the levels of the investigated cytokines indicates a role of these biomarkers in the tissue remodeling induced by Invisalign.
This case report describes the treatment of a severe anterior and lateral open bite combined with multiple congenitally missing teeth. A 10-year-old girl presented with an open gonial angle, absence of lip sealing, and soft tissue pogonion retrusion. She had an open bite of 8.5 mm, agenesis of the upper right and left lateral incisors and the upper left first premolar, and transverse maxillary deficiency. Nonsurgical treatment was planned aiming at controlling the vertical pattern, establishing the correct overbite, and closing the spaces on the upper arch, to provide satisfactory occlusion and facial and dental esthetics.
A healthy 15-year-old boy with anterior open bite, edge-to-edge transverse discrepancy, and Class III skeletal relationship sought a nonsurgical orthodontic treatment. The patient was treated with premolars extraction, a Hyrax expander and intrusion mechanics with vertical elastics. This mechanics allowed for excellent facial and occlusal results. The final occlusion presented Class I molar and canine relationships, ideal overjet and overbite, and straight facial profile. Analysis of the posttreatment and follow-up radiographs showed that the treatment outcomes remained stable seven years after active orthodontic treatment. Thus, although combined orthodontic and surgical treatment should be considered for patients with this skeletal malocclusion, this case report proves that well controlled orthodontic movement with the patient’s cooperation can be a valid alternative treatment, with good and stable outcomes for patients who refuse surgery.
Introduction: The most currently recommended method for sterilization of orthodontic pliers is the autoclave, while peracetic acid has also been shown to be effective in the chemical sterilization process. Objective: This study sought to compare the corrosive effects of peracetic acid and autoclave sterilization process of orthodontic pliers. Methods: Four active tungsten carbide (WC) stainless steel tie-cutting pliers from the manufacturers Quinelato (Rio Claro, SP, Brazil) and ICE (Cajamar, SP, Brazil) were selected. The active ends of the pliers were sectioned, and six active tips were obtained and distributed into the following groups: 1) control group (no sterilization); 2) AC group (two active pliers tips submitted to 100 autoclave sterilization cycles); and 3) AP group (two active pliers tips submitted to 100 cycles of sterilization by immersion in 2% peracetic acid solution for 30 minutes). Results: Chemical analysis using X-ray dispersive energy spectroscopy showed that after autoclave sterilization, only the ICE pliers presented oxidation corrosion (Δ[O] = +24.5%; Δ[Fe] = +5.8%; Δ[WC] = -1.9%). In comparison, following peracetic acid sterilization, both manufacturers ICE (Δ[O] = +1.8%; Δ[Fe] = +18.0%; Δ[WC] = -1.1%) and Quinelato (Δ[O] = +5.3%; Δ[Fe] = -10.4%; Δ[WC] = -15.2%) showed corrosion. The morphological analysis revealed that peracetic acid caused a pitting and localized corrosion in both brands, while the autoclave caused uniform surface corrosion on the ICE pliers. Conclusion: Autoclave application was the sterilization method that generated less corrosive damage to the orthodontic cutting pliers, when compared to the immersion in 2% peracetic acid.
Treating skeletal class III malocclusions is one of the biggest challenges in Orthodontics. Given the complexity of these cases, orthognathic surgery is often the best treatment option. However, many patients refuse this treatment due to its risks, morbidity, and costs involved. Alternatively, dental compensation can be planned for some of these skeletal problems. This case report presents a dentoalveolar compensation in the orthodontic treatment of a 20-year-old female patient with class III malocclusion, concave profile, anterior crossbite, mandibular prognathism, maxillary retrusion, and a vertical deficiency in the posterior region. Treatment planning involved a multiloop edgewise archwire (MEAW) associated with intermaxillary elastics with counterclockwise rotation of the occlusal plane in the posterior region of the maxilla aiming at obtaining an increased posterior vertical dimension. After 24 months of treatment, the severe anterior crossbite was corrected, and the skeletal class III relationship was camouflaged. At the end of the orthodontic treatment, it was possible to observe an improved facial profile, a nice smile, and a functional occlusion. The results remained stable at a three-year follow-up. The MEAW, associated with the use of elastics, seems to be an effective treatment option for class III camouflage with reduced posterior vertical dimension with no need for additional anchoring devices but requiring adequate bending of wires and patient compliance.
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