RESUMO
INTRODUCTION: The use of lingual spurs has been described as one efficient option, with great stability of results, but with scarce information of toleration for use in the mixed and permanent dentition phases. OBJECTIVE: The purpose of this study was to assess the impact of lingual spurs on the oral health-related quality of life of children and/or adolescents during anterior open bite treatment. METHODS: The review was recorded in the PROSPERO database. Eight electronic databases and partial gray literature were searched, without restrictions until march 2022. A manual search was also performed in the references of the included articles. Studies assessing the impact of lingual spurs on the oral health-related quality of life were included. Risk of bias was assessed using JBI or ROBINS-I tool, according to the study design. The level of evidence was assessed through GRADE. RESULTS: Five studies met the eligibility criteria. Two non-randomized clinical trials had a serious risk of bias. Of the case-series studies, two had a low risk of bias and the other, a moderate risk of bias. The certainty of the evidence was classified as very low for all the evaluated results. In general, the studies reported an initial negative impact with the use of lingual spurs, however this was transitory in nature. A quantitative analysis was not performed due to the great heterogeneity between the studies. CONCLUSION: Current evidence, although limited, suggests that lingual spurs have an initial transient negative impact during interceptive treatment. Additional well-conducted randomized clinical trials are needed.
Assuntos
Mordida Aberta , Criança , Adolescente , Humanos , Mordida Aberta/terapia , Qualidade de Vida , Língua , Dentição PermanenteRESUMO
Resumo A correção da sobremordida profunda com o uso de alinhadores ortodônticos é um desafio para o ortodontista. O sucesso do tratamento depende de mecânicas auxiliares para melhor controle dos movimentos desejados. O objetivo do presente artigo foi descrever um caso clínico sobre a correção da sobremordida profunda associada a má oclusão dentária de Classe II, tratada com alinhadores ortodônticos. A paciente adulta apresentava Classe II, divisão 2 e subdivisão direita, linha média inferior desviada para direita, sorriso gengival e sobremordida exagerada, com apinhamentos em ambos os arcos. Ao final do tratamento, correta relação de sobremordida e sobressaliência foi adquirida, assim como relação molar e canino de Classe I, linhas médias coincidentes e adequado arco do sorriso, mantendo simetria e estética facial. Considerando as limitações do uso de alinhadores para a correção da sobremordida profunda, o caso apresentou resultados satisfatórios, com oclusão, função e relação estética adequadas. O correto plano de tratamento auxiliado aos acessórios ortodônticos e colaboração do paciente, tornaram possível a correção da sobremordida e Classe II com alinhadores ortodônticos. (AU)
Abstract Correcting deep overbite using orthodontic aligners is a challenge for orthodontists. Successful treatment depends on auxiliary mechanics to a better control of the desired movements. The aim of this article was to describe a clinical case of deep overbite correction associated with Class II malocclusion, treated with orthodontic aligners. The patient presented with Class II, division 2, and right subdivision, lower midline deviated to the right, gummy smile, and exaggerated overbite, with crowding in both arches. At the end of treatment, a correct overbite and overjet relationship were achieved, as well as a Class I molar and canine relationship, coincident midlines and an adequate smile arch, maintaining facial symmetry and aesthetics. Considering the limitations of using aligners to correct deep overbite, the case presented satisfactory results, with adequate occlusion, function and aesthetic relationship. The correct treatment plan, aided by orthodontic accessories and the patient's cooperation, made it possible to correct the overbite and Class II with orthodontic aligners(AU)
Assuntos
Humanos , Feminino , Adulto , Aparelhos Ortodônticos Removíveis , Sobremordida , Má Oclusão Classe II de AngleRESUMO
ABSTRACT Introduction: The use of lingual spurs has been described as one efficient option, with great stability of results, but with scarce information of toleration for use in the mixed and permanent dentition phases. Objective: The purpose of this study was to assess the impact of lingual spurs on the oral health-related quality of life of children and/or adolescents during anterior open bite treatment. Methods: The review was recorded in the PROSPERO database. Eight electronic databases and partial gray literature were searched, without restrictions until march 2022. A manual search was also performed in the references of the included articles. Studies assessing the impact of lingual spurs on the oral health-related quality of life were included. Risk of bias was assessed using JBI or ROBINS-I tool, according to the study design. The level of evidence was assessed through GRADE. Results: Five studies met the eligibility criteria. Two non-randomized clinical trials had a serious risk of bias. Of the case-series studies, two had a low risk of bias and the other, a moderate risk of bias. The certainty of the evidence was classified as very low for all the evaluated results. In general, the studies reported an initial negative impact with the use of lingual spurs, however this was transitory in nature. A quantitative analysis was not performed due to the great heterogeneity between the studies. Conclusion: Current evidence, although limited, suggests that lingual spurs have an initial transient negative impact during interceptive treatment. Additional well-conducted randomized clinical trials are needed.
RESUMO Introdução: O uso de esporões linguais tem sido descrito como uma opção eficiente, com grande estabilidade de resultados, mas com poucas informações quanto à tolerância de seu uso nas fases de dentição mista e permanente. Objetivo: O objetivo deste estudo foi avaliar o impacto dos esporões linguais na qualidade de vida relacionada à saúde bucal de crianças e/ou adolescentes durante o tratamento da mordida aberta anterior. Métodos: Essa revisão foi registrada no banco de dados PROSPERO. Oito bases de dados eletrônicas e parte da literatura cinzenta foram pesquisadas, sem restrições, até março de 2022. Uma busca manual também foi realizada nas referências dos artigos incluídos. Estudos avaliando o impacto dos esporões linguais na qualidade de vida relacionada à saúde bucal foram incluídos. O risco de viés foi avaliado usando a ferramenta JBI ou ROBINS-I, de acordo com o desenho do estudo. O nível de evidência foi avaliado por meio do GRADE. Resultados: Cinco estudos preencheram os critérios de elegibilidade. Dois ensaios clínicos não randomizados apresentaram sério risco de viés. Dos estudos de série de casos, dois tiveram baixo risco de viés e o outro, risco moderado de viés. A certeza da evidência foi classificada como muito baixa para todos os resultados avaliados. Em geral, os estudos relataram um impacto negativo inicial com o uso dos esporões linguais; porém, de caráter transitório. Não foi realizada análise quantitativa, devido à grande heterogeneidade entre os estudos. Conclusão: As evidências atuais, embora limitadas, sugerem que os esporões linguais têm um impacto negativo transitório inicial durante o tratamento interceptativo. São necessários mais ensaios clínicos randomizados bem conduzidos.
RESUMO
INTRODUCTION: The literature reports the association of external root resorption (ERR) with orthodontic movement. In cases of premolars extractions, orthodontic movement of anterior teeth is usually quite expressive, which are precisely the most susceptible teeth to suffer from ERR. OBJECTIVE: The aim of this study was to assess the root morphology of maxillary canines and incisors in patients submitted to four premolar extraction and orthodontic retraction of the anterior teeth, by means of 3D surface models superimposition and mapping. METHODS: The sample consisted of six adult patients, five female and one male, with a mean age of 23.5 ± 6.5 years, who underwent orthodontic treatment. All patients presented bimaxillary dental protrusion, with indication of maxillary and mandibular first premolar extractions, followed by the retraction of anterior teeth and space closure. Cone beam CT scans were performed before the beginning of the treatment (T0) and right after space closure (T1). 3D models were built at both times and superimposed to identify the root changes for the given period. RESULTS: All average differences were close to zero and, even when evaluating the extreme values, the observed changes were always smaller than the accuracy of the CBCT. CONCLUSION: A mild resorption trend was observed, although it was not clinically significant, with values lower than the tomography accuracy.
Assuntos
Má Oclusão , Reabsorção da Raiz , Tomografia Computadorizada de Feixe Cônico Espiral , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Incisivo/diagnóstico por imagem , Masculino , Maxila/diagnóstico por imagem , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/etiologia , Técnicas de Movimentação DentáriaRESUMO
ABSTRACT Introduction: The literature reports the association of external root resorption (ERR) with orthodontic movement. In cases of premolars extractions, orthodontic movement of anterior teeth is usually quite expressive, which are precisely the most susceptible teeth to suffer from ERR. Objective: The aim of this study was to assess the root morphology of maxillary canines and incisors in patients submitted to four premolar extraction and orthodontic retraction of the anterior teeth, by means of 3D surface models superimposition and mapping. Methods: The sample consisted of six adult patients, five female and one male, with a mean age of 23.5 ± 6.5 years, who underwent orthodontic treatment. All patients presented bimaxillary dental protrusion, with indication of maxillary and mandibular first premolar extractions, followed by the retraction of anterior teeth and space closure. Cone beam CT scans were performed before the beginning of the treatment (T0) and right after space closure (T1). 3D models were built at both times and superimposed to identify the root changes for the given period. Results: All average differences were close to zero and, even when evaluating the extreme values, the observed changes were always smaller than the accuracy of the CBCT. Conclusion: A mild resorption trend was observed, although it was not clinically significant, with values lower than the tomography accuracy.
RESUMO Introdução: A literatura relata a associação de reabsorção radicular externa (RRE) com a movimentação ortodôntica. Nos casos de extrações de pré-molares, a movimentação ortodôntica costuma ser bastante expressiva nos dentes anteriores, que são justamente os dentes mais suscetíveis à RRE. Objetivo: O objetivo do presente estudo foi avaliar a morfologia radicular de caninos e incisivos superiores em pacientes submetidos à extração de quatro pré-molares e retração ortodôntica dos dentes anteriores, por meio da sobreposição e mapeamento de modelos 3D. Métodos: A amostra foi composta por seis pacientes adultos, cinco do sexo feminino e um do masculino, com média de idade de 23,5 ± 6,5 anos, submetidos a tratamento ortodôntico. Todos os pacientes apresentavam biprotrusão dentária, com indicação de extração dos primeiros pré-molares superior e inferior, seguida de retração dos dentes anteriores e fechamento do espaço. A tomografia computadorizada de feixe cônico (TCFC) foi realizada antes do início do tratamento (T0) e logo após o fechamento de espaços (T1). Modelos 3D foram construídos em ambos os momentos e sobrepostos para identificar as mudanças nas raízes dentárias no período determinado. Resultados: Todas as médias das diferenças foram próximas de zero e, mesmo avaliando os valores extremos, as mudanças observadas foram sempre menores que a sensibilidade da TCFC. Conclusão: Observou-se tendência de leve reabsorção, embora não clinicamente significativa, com valores inferiores à sensibilidade tomográfica.