No abstract

Objective: To assess the scientific evidence of the influence of some variables on smile attractiveness: orthodontic treatment, midline position, axial midline angulation, buccal corridor, and smile arc. Materials and Methods: Literature was searched through PubMed, Web of Science, Embase, and All EBM Reviews. The inclusion criteria consisted of studies written in English; published in the past three decades; concerning the influence of orthodontic treatment, midline position, axial midline angulation, buccal corridor, and smile arc on smile esthetics; and judged by a minimum of 10 raters. Quality features evaluated were adequate description of samples, absence of confounding factors, and description of methods used to evaluate the smiles and statistical analyses. Results: Initially, 203 articles were retrieved. Of these, 20 abstracts met the initial inclusion criteria and were selected. Thirteen articles were classified as high quality, seven as average, and none as low quality. Conclusion: Four-premolar extraction or nonextraction treatment protocols seem to have no predictable effect on overall smile esthetics, meaning that if well indicated, extraction in orthodontics does not necessarily have a deleterious effect on facial esthetics. The selected articles recommend that a small dental midline deviation of 2.2 mm can be considered acceptable by both orthodontists and laypeople, whereas an axial midline angulation of 10u (2 mm measured from the midline papilla and the incisal edges of the incisors) is already very apparent, and considering studies dealing with real smiles, buccal corridor sizes and smile arc alone do not seem to affect smile attractiveness. (Angle Orthod. 2011;81:153-161.)

All of the tested devices promoted dental changes, especially in the anterior region, and contributed to AOB reduction during the study period. However, fixed palatal crib demonstrated greater impact on the positioning of the incisors.

BackgroundThe aim of this study was to evaluate the effects of Class II malocclusion treatment with the Jasper Jumper and the Bionator, associated with fixed appliances.MethodsThe sample comprised 77 young individuals divided into 3 groups: Group 1 consisted of 25 patients treated with the Jasper Jumper appliance associated with fixed appliances for a mean period of 2.15 years; group 2 had 30 patients, treated with the Bionator and fixed appliances, for a mean treatment time of 3.92 years; and the control group included 22 subjects followed for a mean period of 2.13 years. The initial and final lateral cephalograms of the patients were evaluated. Intergroup comparison at the initial stage and of the treatment changes were performed by analysis of variance.ResultsTheir effects consisted in a restrictive effect on the maxilla, a slight increase in anterior face height, retrusion and extrusion of the maxillary incisors, labial tipping and protrusion of the mandibular incisors in both groups and intrusion with the Jasper Jumper appliance, maxillary molar distalization with the Jasper Jumper, extrusion and mesialization of the mandibular molars, both appliances provided significant improvement of the maxillomandibular relationship, overjet, overbite and molar relationship.ConclusionsThe effects of both appliances in class II malocclusion treatment are similar; however, treatment with the Jasper Jumper was shorter than with the Bionator.

Objective: To evaluate the dentoskeletal effects of different anterior open bite treatment modalities in children. Materials and Methods: This cephalometric study assessed changes resulting from different treatment approaches on 77 growing children with anterior open bite. A control group (n ¼ 30) was used for comparison. Lateral cephalograms were available before treatment and after 12 months. The sample was divided into four groups: removable palatal crib associated with a chincup (G1), bonded spurs associated with a chincup (G2), chincup (G3), and nontreated control (G4). Statistical comparisons among the four groups were performed on T1 and the treatment changes using analysis of variance with Tukey's post hoc tests. Results: No statistically significant changes in skeletal variables were found among the groups, except for lower anterior face height (LAFH) increase in G1. Overall, effects in all of the treated groups were exclusively dentoalveolar. A larger overbite (OB) increase was observed in G1 and G2 when compared with G3 and G4. The maxillary incisors in G1 showed increased palatal tipping, retrusion, and more vertical dentoalveolar development as well as increased lingual tipping among mandibular incisors. There was less vertical development of maxillary and mandibular molars in G3. Conclusions: A removable palatal crib provided an improvement in OB (97.5%), followed by the bonded spurs (84.5%). Conversely, the chincup-only group did not have positive OB effects. (Angle Orthod. 2016;86:969-975)

Objective: To evaluate the dimensional changes of dental arches on digital models of open bite treatment with fixed and removable palatal cribs. Materials and Methods: The sample comprised 41 patients of both sexes who were white, aged 7–10 years, and who had mixed dentition, Angle Class I molar relationship, and a negative overbite of at least 1 mm. The sample was randomly divided into two groups: G1, fixed palatal crib; and G2, removable palatal crib. Cast models, obtained initially (T1) and after 1 year of treatment (T2), were scanned by a three-dimensional (3D) scanner, 3Shape R700, producing a 3D image. Measurements were performed by a calibrated examiner using OrthoAnalyzer™ 3D software. Results: At T2–T1, differences were observed between the groups regarding vertical dentoalveolar development and overjet. There was more mandibular incisor extrusion for G1 (−1.66 mm) than for G2 (−0.54 mm). An overjet increase was observed in G1 (0.56 mm), in contrast to a reduction in G2 (−0.40 mm). There was a similar overbite increase for both groups (3.51 mm for fixed palatal crib and 3.88 mm for removable palatal crib). Conclusions: Both the treatment protocols are similarly effective for anterior open bite correction, providing an overbite increase with dentoalveolar arch changes, especially in the anterior region.

Objective The purpose of this study was to determine the accuracy and reliability of two methods of measurements of linear distances (multiplanar 2D and tridimensional reconstruction 3D) obtained from cone-beam computed tomography (CBCT) with different voxel sizes.Material and Methods Ten dry human mandibles were scanned at voxel sizes of 0.2 and 0.4 mm. Craniometric anatomical landmarks were identified twice by two independent operators on the multiplanar reconstructed and on volume rendering images that were generated by the software Dolphin®. Subsequently, physical measurements were performed using a digital caliper. Analysis of variance (ANOVA), intraclass correlation coefficient (ICC) and Bland-Altman were used for evaluating accuracy and reliability (p<0.05).Results Excellent intraobserver reliability and good to high precision interobserver reliability values were found for linear measurements from CBCT 3D and multiplanar images. Measurements performed on multiplanar reconstructed images were more accurate than measurements in volume rendering compared with the gold standard. No statistically significant difference was found between voxel protocols, independently of the measurement method.Conclusions Linear measurements on multiplanar images of 0.2 and 0.4 voxel are reliable and accurate when compared with direct caliper measurements. Caution should be taken in the volume rendering measurements, because the measurements were reliable, but not accurate for all variables. An increased voxel resolution did not result in greater accuracy of mandible measurements and would potentially provide increased patient radiation exposure.

Objective:The aim of this study was to compare the reliability of three different methods of cephalometric analysis.Material and Methods:Conventional pretreatment lateral cephalograms and cone beam computed tomography (CBCT) scans from 50 subjects from a radiological clinic were selected in order to test the three methods: manual tracings (MT), digitized lateral cephalograms (DLC), and lateral cephalograms from CBCT (LC-CBCT). The lateral cephalograms were manually analyzed through the Dolphin Imaging 11.0(tm) software. Twenty measurements were performed under the same conditions, and retraced after a 30-day period. Paired t tests and the Dahlberg formula were used to evaluate the intra-examiner errors. The Pearson's correlation coefficient and one-way analysis of variance (ANOVA) tests were used to compare the differences between the methods. Results:Intra-examiner reliability occurred for all methods for most of the measurements. Only six measurements were different between the methods and an agreement was observed in the analyses among the 3 methods. Conclusions:The results demonstrated that all evaluated methodologies are reliable and valid for scientific research, however, the method used in the lateral cephalograms from the CBCT proved the most reliable.