The 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. 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.
Objectives. To evaluate the microhardness of tooth enamel remineralized with enamel matrix protein solution as well as the shear bond strength of orthodontic brackets bonded to this surface. Materials and Methods. In total, 24 human premolars were selected and divided into 3 experimental groups (n = 8): SE—sound enamel, DE—demineralized enamel, and TE—demineralized enamel treated with amelogenin solution. Samples from DE and TE groups were subjected to pH cycling to induce initial artificial caries lesion. TE group was treated with amelogenin solution. Samples were placed in artificial saliva for 7 days. Knoop microhardness was measured before any intervention (T0), after pH cycling (T1) and after amelogenin solution treatment application (T2). Twenty-four hours after ceramic orthodontic brackets were bonded, samples were subjected to shear test in a universal testing machine. Microhardness and shear measurement distributions were subjected to Kolmogorov–Smirnov normality test, which was followed by parametric tests (α = 0.05): 2-way analysis of variance (factors: enamel condition × treatment) and Tukey posttest for all three groups (SE, DE, and TE) in T0 and T2 for microhardness; analysis of variance and Tukey’s test, for shear bond strength test. Results. Means recorded for Knoop microhardness in T2, for the SE (366.7 KHN) and TE (342.8 KHN) groups, were significantly higher than those recorded for the DE group (263.5 KHN). The shear bond strength of the SE (15.44 MPa) and TE (14.84 MPa) groups statistically differed from that of the DE group (11.95 MPa). Conclusion. In vitro demineralized enamel treatment with amelogenin solution was capable of taking samples’ hardness back to levels similar to those observed for sound enamel. The shear bond strength on the enamel subjected to this treatment was similar to that observed for healthy enamel and higher than that observed for demineralized enamel.
The aim of this study is to evaluate the degree of conversion of light-cured resin cement subjected to activation through the interposition of lithium disilicate ceramic produced according to two manufacturing techniques. Cylindrical specimens of RelyX ™ Veneer resin cement were generated based on each manufacturing technique (CAD/CAM-computer aided design/computer assisted manufacturing, n = 5 or pressed ceramic technique, n = 5). Next, the specimens were washed in distilled water, dried with absorbent paper and stored in containers filled with distilled water at 37 °C for 24 h. Specimens from each group were subjected to attenuated total reflectance Fourier transform infrared (ATR-FTIR) in order to evaluate their degree of conversion. Data about the degree of conversion (%) were subjected to analysis of variance and to Student's t-test (α = 0.05%). The degree of conversion of RelyX ™ Veneer was statistically higher in the CAD/CAM manufacturing technique (39.83 ± 0.35%) than in the Press one (37.59 ± 0.62%). The light-cured resin cement activated through ceramic structure reinforced with lithium disilicate generated through the CAD/CAM manufacturing technique showed higher degree of conversion than the one generated through the Press manufacturing technique.
A respiração bucal tem influência direta sobre o crescimento e desenvolvimento da face e, consequentemente, sobre a oclusão dentária. As mudanças no posicionamento da língua e da mandíbula causadas pela respiração bucal geram desequilíbrio das forças, que atuam sobre os ossos da face e afetam o desenvolvimento da maxila, gerando constrição do arco e da cavidade nasal. Diante da fundamental importância desses fatores, este trabalho possui o objetivo de revisar a literatura existente sobre os tratamentos da mordida cruzada (MCP) com expansão rápida da maxila (ERM) e seus efeitos nas vias aéreas. As bases de dados acessadas para a busca foram: PubMed/MEDLINE, Cochrane Library e EMBASE. O tratamento da MCP por atresia da maxila pode ser realizado com alguns tipos de aparelhos removíveis ou fixos. Quando o paciente apresenta uma atresia dento alveolar é indicado que seja tratado com expansão lenta. Caso seja uma atresia esquelética, o tratamento recomendado é com expansão rápida da maxila. Esta pode ser realizada por meio de aparelhos disjuntores fixos dentomucossuportados ou dentosuportados, a exemplo do aparelho tipo Haas e Hyrax, respectivamente. A expansão maxilar pode gerar alterações no volume das vias aéreas. A tomografia computadorizada de feixe cônico (TCFC) tornou possível realizar essa avaliação, por meio da aquisição de imagens de todas as estruturas do complexo maxilofacial em volume. Após esta revisão, percebe-se que a maioria dos estudos apresenta limitações metodológicas, vieses e ausência de grupo controle não tratados com expansão, havendo inconsistência entre os estudos. Palavras-chave: Ortodontia. Mordida Cruzada. Expansão Maxilar. Abstract Mouth breathing has a direct influence on the face growth and development, and consequently on dental occlusion. Changes in the tongue and jaw positioning caused by mouth breathing generate an imbalance of forces acting on the face bones and affect the jaw development, causing the arch and nasal cavity constriction. In view of the fundamental importance of these factors, this study aims to review the existing literature on crossbite treatments with rapid maxillary expansion and its effects on the airways. The treatment of posterior crossbite for the maxilla atresia can be performed with some types of removable or fixed devices. When the patient has an alveolar atresia, it is indicated that he or she be treated with slow expansion. If it is a skeletal atresia, the recommended treatment is with rapid maxillary expansion (ERM). This can be carried out by means of fixed dento-muco-supported or dento supported circuit breakers, such as the Haas and Hyrax type apparatus, respectively. Maxillary expansion can cause changes in airway volume. Conical beam computed tomography (CBCT) made it possible to perform this evaluation by acquiring images of all the structures of the maxillofacial complex in volume. After this review, it is clear that most studies have methodological limitations, bias and the absence of a control group not treated with expansion, with inconsistency between the studies. Keywords: Orthodontics. Crossbite. Maxillary Expansion.
Os fios de níquel-titânio são uma grande preocupação devido ao alto índice de níquel e sua possível liberação quando expostos principalmente ao flúor. Assim, o objetivo neste estudo foi avaliar a rugosidade de fios de niquel-titânio (NiTi) utilizados no tratamento ortodôntico quando expostos à solução fluoretada. Os fios foram divididos em grupos de acordo com sua composição (Flexy NiTi Super Elástico, Flexy NiTi Thermal 35°, Flexy NiTi Copper e Flexy Blue-Ti), tempo (0 dias – T0, 7 dias – T1, 14 dias – T2, e 28 dias – T3) e imersão (solução de saliva artificial ou saliva artificial mais solução fluoretada). Para o ensaio de rugosidade foram utilizadas seções retas (24 mm de comprimento) de cada fio, com velocidade constante de 0,25 mm/s, comprimento de 2,5 mm e cut-off de 0,25 mm. A rugosidade da superfície para cada fio ortodôntico foi composta pela média de três leituras. Os resultados foram submetidos ao teste de normalidade Kolmogorov-Smirnov, seguidos de análise de variância para comparação entre os diferentes tempos e teste t de Student para comparação da diferença dos tempos para cada grupo e na comparação entre os grupos. Não houve diferença estatisticamente significante da rugosidade intra e intergrupos entre diferentes composições, tempos ou imersão. O uso de flúor na concentração de 0,2% uma vez por semana não causou alterações significativas na rugosidade da superfície dos fios utilizados.
The aims of this clinical study were to evaluate the Color change - ΔE (based on spectrophotometry and visual analysis) and luminosity - L* (based on spectrophotometry) of dental enamel surface (after orthodontic treatment) around the area where orthodontic brackets were fixed, based on different cementing materials such as a resin (R group) and resin-modified glass ionomer cement (RMGIC group). The split-mouth study initially comprised 14 patients. Orthodontic brackets were fixed to the upper central incisors with resin or RMGIC. The color of the buccal surface of each tooth was measured through spectrophotometry and visual examination before the bracket-fixation process. Four individuals were excluded during the follow-up; thus 10 patients were evaluated (n=10). Brackets were removed after 12 months of orthodontic treatment, tooth color measurement and visual examination were performed again, and Adhesive Remaining Index (ARI) was also measured. ΔE and L* results were subjected to Student's t-test and by repeated-measures analysis of variance, respectively (α=0.05). ARI data were analyzed in percentages. There was statistically significant difference in ΔE between groups; the R group showed statistically higher values of L* after orthodontic treatment. ARI of 2 and 3 prevailed in the RMGIC group, whereas the R group presented 0 and 1. After orthodontic treatment, the RMGIC group presented smaller changes in ΔE, and the increase in the white scale was observed on the enamel surface around the area where brackets were fixed in the R group. The visual analysis did not show color change on the evaluated teeth.
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