OBJECTIVE: To assess short-term tomographic changes in the upper airway dimensions and quality of life of mouth breathers after rapid maxillary expansion (RME). METHODS: A total of 25 mouth breathers with maxillary atresia and a mean age of 10.5 years old were assessed by means of cone-beam computed tomography (CBCT) and a standardized quality of life questionnaire answered by patients' parents/legal guardians before and immediately after rapid maxillary expansion. RESULTS: Rapid maxillary expansion resulted in similar and significant expansion in the width of anterior (2.8 mm, p < 0.001) and posterior nasal floor (2.8 mm, p < 0.001). Although nasopharynx and nasal cavities airway volumes significantly increased (+1646.1 mm3, p < 0.001), oropharynx volume increase was not statistically significant (+1450.6 mm3, p = 0.066). The results of the quality of life questionnaire indicated that soon after rapid maxillary expansion, patients' respiratory symptoms significantly decreased in relation to their initial respiratory conditions. CONCLUSIONS: It is suggested that RME produces significant dimensional increase in the nasal cavity and nasopharynx. Additionally, it also positively impacts the quality of life of mouth-breathing patients with maxillary atresia.

Crib therapy appears to be effective on a short time basis. As for other habit-interception appliances, insufficient evidence could not provide reliable conclusions.

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Objetivo: Investigar as diferenças entre crianças respiradoras nasais e bucais quanto às características oclusais e dimensões do palato. Método: Foram empregados 60 modelos de estudo de crianças de 6 a 10 anos divididas em um grupo composto por respiradores nasais e outro por respiradores bucais, selecionados mediante diagnóstico otorrinolaringológico. Os modelos foram avaliados em relação à distância intermolares (DIM), intercaninos (DIC), profundidade de palato (PP), relação molar, e presença de mordida cruzada posterior. Resultados: Quanto às dimensões do palato, observou-se diferença significativa entre os dois grupos em relação à DIM, menor para respiradores bucais (p<0,05); quanto à PP, esta foi significativamente maior para o mesmo grupo em relação aos respiradores nasais (p<0,05). No entanto, em relação à DIC, nenhuma diferença foi observada (p>0,05). Na análise das características oclusais, não houve diferença significativa entre os dois grupos quanto ao posicionamento dos primeiros molares permanentes (p>0,05) ou em relação à presença de mordida cruzada posterior (p=0,184). Conclusão: A ausência de diferenças entre os grupos quanto à DIC, associada à diferença encontrada em relação à DIM sugere uma tendência de estreitamento maxilar em uma posição mais posterior em decorrência do padrão respiratório alterado. Os dados obtidos em relação às características oclusais sugerem que o respirador bucal não pode ser considerado como portador de um tipo de maloclusão específica. No entanto, a detecção da presença de uma maior PP e, principalmente, de uma menor DIM nos respiradores bucais pode indicar uma tendência de evolução de contração do arco maxilar e subseqüente instalação de mordida cruzada posterior que, eventualmente, pode se pronunciar com maior evidência com o passar da idade.Respiração bucal; Ortodontia; Má oclusão.Objective: To investigate differences between nose and mouthbreathing children with respect to the occlusal characteristics and palatal dimensions. Method: For this study were used 60 study models of children aged 6 to 10 years, assigned to a group of nose-breathing children and a group of mouth-breathing children, selected based on the otorhinolaryngological diagnosis. The models were evaluated with respect to the intermolar distance (IMD), intercanine distance (ICD), palatal depth (PD), molar relationship and presence of posterior crossbite. Results: Regarding the palatal dimensions, a statistically significant difference was observed between the groups as to IMD, which was smaller for the mouth-breathing children (p<0.05). PD was significantly greater for the mouth-breathers compared to the nosebreathers (p<0.05). Nevertheless, no significant difference was observed with respect to ICD (p>0,05). The analysis of occlusal characteristics revealed no significant differences between the groups as to the position of the first permanent molars (p>0.05) or presence of posterior crossbite (p=0.184). Conclusion: The lack of difference between the groups as to ICD allied to the difference found f...

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Additional efforts must still be directed to perform, whenever possible, RCTs; or to conduct prospective controlled trials with adequate sample sizes, consecutively assembled subjects, with the comparison of contemporary and equivalent groups.

INTRODUCTION:It has been reported that Class II, division 2 maxillary central incisors frequently demonstrate increased collum angles, which indicates an excessive palatal “bend” of the crown. However, evidence supporting such observation is mostly derived from radiographic studies.OBJECTIVE:The objective of this study was to evaluate and compare the collum angle of maxillary central incisors in Class I, Class II, division 1, and Class II, division 2 cases using cone-beam computed tomography.MATERIALS AND METHODS:Forty-eight consecutive orthodontic cases (16 Class I, 16 Class II, division 1, and 16 Class II, division 2 malocclusion) with cone-beam computed tomography as part of their initial diagnostic records were evaluated. Cross-sections including maxillary right and left central incisors were used to calculate the angulation between the crown and root long axes (collum angle). Comparisons between groups were performed using analysis of variance for multiple and post-hoc Tukey for paired analyses.RESULTS:Mean collum angle observed in Class II, division 2 cases was significantly larger (5.2 ± 1.3°) than the ones obtained for Class I (1.1 ± 4.2°) (P = 0.034) or Class II, division 1 cases (0.1 ± 0.7°) (P = 0.014).CONCLUSIONS:Our findings suggest that Class II, division 2 individuals demonstrate accentuated lingual inclination of the maxillary central incisor crown compared to the other types of malocclusion studied here. Such morphological feature indicates the need for better tooth movement planning, especially in regard to root palatal torqueing of the maxillary central incisors.

Objective: To evaluate the effectiveness of the transpalatal arch (TPA) as an anchorage device in preventing maxillary molar mesialization during retraction of the anterior teeth after premolar extraction. Materials and Methods: This systematic review intended to include patients indicated for upper premolar bilateral extraction and subsequent retraction of anterior teeth, considering the use of TPA as an anchorage tool in one of the treatment groups. The search was systematically performed, up to April 2015, in the following electronic databases: Medline, Embase, and all evidence-based medicine reviews via OVID, Cochrane Library, Scopus, PubMed, and Web of Science. Risk of bias assessment was performed using Cochrane's Risk of Bias Tool for randomized clinical trials (RCTs) and Methodological Index for Nonrandomized Studies (MINORS) for non-RCTs. Results: Fourteen articles were finally included. Nine RCTs and five non-RCTs presented moderate to high risk of bias. Only one study investigated the use of TPA in comparison with no anchorage, failing to show significant differences regarding molar anchorage loss. A meta-analysis showed a significant increase in anchorage control when temporary anchorage devices were compared with TPA (mean difference [MD] 2.09 [95% confidence interval {CI} 1.80 to 2.38], seven trials), TPA þ headgear (MD 1.71 [95% CI 0.81 to 2.6], four trials), and TPA þ utility arch (MD 0.63 [95% CI 0.12 to 1.15], 3 trials). Conclusion: Based on mostly moderate risk of bias and with some certainty level, TPA alone should not be recommended to provide maximum anchorage during retraction of anterior teeth in extraction cases. (Angle Orthod. 2017;87:147-158)