Dental Press Jounal of Orthodontics
Dental Press International

v. 18, no. 1

Dental Press Journal of Orthodontics – ISSN 2176-9451

Dental Press J. Orthod.

v. 18, no. 1

Mes / Mes



The following years

David Normando

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If you want a year of prosperity, grow grain. 

If you want ten years of prosperity, grow trees. 

If you want a hundred years of prosperity, grow people.

(Chinese Proverb)

As we start a new year, our intention is to reassess our activities and focus on enlightening the future. On the second half of 2013, the Dental Press Journal of Orthodontics will complete 18 full years providing service to the science of Orthodontics. As adulthood nears, we begin our second year in control of this important information vehicle for the orthodontic science. We feel it is now time to reconsider our conducts and harvest in pursuit of the ?grain? prosperity.

Through the collaboration of knowledgeable peers, who have turned into great friends throughout this challenging path, we have established goals that have been followed diligently. One of our main goals was to speed up the process between reviewing and publishing articles. Currently, the DPJO accepts one in four articles submitted. That parameter was set in the beginning of our journey to regulate our flow of articles and we accomplished a mean range of approximately 118 days between the submission process and a final decision to those articles that are approved. Our interval rate of acceptance and evaluation is similar to most major orthodontic journals worldwide.

Our belief is that an article denial should be disclosed as fast as possible, therefore the time frame between an article submission and rejection is, on average, three weeks and almost half of those articles receive an instant answer in less than a week. Usually, the rejected articles contain information that provides a less significant contribution to the innovation of the scientific orthodontic knowledge.

These mainly include clinical cases that reproduce procedures that have been extensively described in the past literature and non-original laboratory trials. The articles that pass through this initial selection go through a more detailed analysis by our reviewers, which may take up to two months on average to determine a final denial. The articles rejected on this phase are usually articles which ideas present prosperity, but the cultivating method impaired a proper harvest.

Besides working on speeding up the submission process, we have worked on reducing the interval between the approval of an article and its publication. At the end of 2011, the time frame between article approval and publication was 3 years; nowadays we have been able to reduce it to an average of 2 years. 

Our goal is to publish all articles submitted in 2013 within 12 months from its final approval. A modest task to a journal that reaches adulthood and wishes to transcend decades in search and preservation of excellence, which is symbolized by the image of a strong tree on the proverb cited above.

As we approach adulthood, I would like to express my profound gratitude, on behalf of the Dental Press Publisher, to all the people responsible for the ongoing success of the Dental Press Journal of Orthodontics. It is my honor and pleasure to express thanks to our staff, authors, reviewers and editorial board for dedicating their precious time in contributing with the quality of science that we publish. 

The DPJO foresees to continue spreading innovative orthodontic ideas with integrity and responsibility, which allows our readers to obtain prosperous orthodontic results day by day, grain by grain, tree by tree and by people?s delighted smiles. After all, in contradiction with Woody Allen?s thought; What kind of world would be wonderful if it wasn?t for its own people?

Working together

Ricardo Machado Cruz

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This is a historic edition of the Dental Press Journal of Orthodontics! It officially marks a great partnership between the well-known Dental Press and the Brazilian Association of Orthodontics ? ABOR.  

As readers will notice, from this volume on, the cover of the Dental Press Journal of Orthodontics will have an official publication seal from ABOR right next to its logo. This is the manifestation of an important partnership that has been happening for quite some time. We have always found great support from the Dental Press Publisher on our scientific events, either national or international, and a large number of our board members are either on the Dental Press Journal of Orthodontics editorial or review board.

The Brazilian Association of Orthodontics and Facial Orthopedics was founded in 1994, and is now about to complete 20 years of existence. During this period it has established itself as an important orthodontic entity in the nation, as the consulting board for the Federal Dental Council, fighting for the interests of our specialty. Its Board comprises representatives from all the Brazilian states, facilitating the analysis of different relevant orthodontics matters and the search for solutions in a local and a national level. Some of the latest accomplishments of this entity are the recent increase in hours of all Graduate Programs in Orthodontics for a minimum of 2,000 educational hours and a new project called The Smile Brazil Project, created in partnership with the Federal Government, in which we will act as an instructive organization for the orthodontic care provided by public health service.

Since it was founded, ABOR envisioned having its own official scientific journal. Several possibilities and proposals were analyzed over the years, some advocating the creation of a new scientific journal and some suggesting a partnership with an existing one.

In 2010, the ABOR executive board suggested the Dental Press Journal of Orthodontics to become the official ABOR scientific journal. This possibility started to be considered by the Head Council of the entity and after some final adjustments it was confirmed at a concluding board meeting on November 10, 2012. 

This decision will bring countless benefits for both parties as it represents a strong alliance between the most prestigious orthodontic entity in Brazil and one of the world?s best and most well-indexed scientific periodicals in the field of Orthodontics.

Our members will soon receive information about the benefits they will have access to due to this partnership, and that?s just the beginning. As the American author of the new thought, Napoleon Hill, once said ?Coming together is a beginning, staying together is progress, and working together is success.?

Orthodontic Insight

In adults: 47.2% have periodontitis! How about in orthodontic patients?

Alberto Consolaro

Orthodontics. Periodontics. Gingivitis. Periodontitis.

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The occurrence of chronic inflammatory periodontal disease due to dental plaque in adults over 30 years of age was noticed in 47.2% of the 3,742 subjects studied, representing a 64.7 million people population in the 50 states of the U.S. and the District of Columbia. The methods used by the authors were uniquely precise and the results brought us to great insight on the correlation between orthodontic treatment and periodontal health, which is described below.

Orthodontics Highlights

Orthodontics highlights

Matheus Melo Pithon

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Widely spread, studied and used, rapid maxillary expansion (RME) became an important ally of orthodontists. Basically, this procedure takes place with an active phase, where the expander is activated, and a passive phase, when the appliance is kept in place until complete restructuring of the expanded suture and formation of bone tissue. Reducing the stabilization period of these appliances would help the reduction in total orthodontic treatment time and the discomfort caused by the presence of the appliance. While searching for a method that would strengthen this process, Brazilian researchers1 evaluated, through a study in animals, histological effects of applying the laser in the palatine sutures after maxillary expansion. The results showed that the laser appears to stimulate the repair process of suturing and also osteogenesis. It is noteworthy that, although encouraging, results are primary and obtained in dogs, requiring confirmation in humans.


An interview with José Rino Neto

Adilson Luiz Ramos, Gilberto Vilanova Queiroz, João Batista de Paiva, José Valladares Neto, Roberto Macoto

  • - Graduated by the School of Dentistry of Bauru, São Paulo University (FOB-USP), Brazil.

    -MSc and PhD in Orthodontics, School of Dentistry, University of São Paulo(FOUSP), São Paulo, Brazil. 

    - Full Professor in Orthodontics, FOUSP.

    - Associate Professor of the Department of Orthodontics, University of São Paulo (FOUSP), São Paulo Brazil.

It is an honor for me to present this interview with Professor José Rino Neto. Famous professor of the University of São Paulo (USP), José Rino Neto has built his academic career founded on solid basis at the University of São Paulo (USP), attending there from dental school (FOB-USP) until his complete training as a professor (MSc, PhD and Full Professor of FOUSP). For this reason, he is a great messenger of the works of memorable professors, such as Sebastião Interlandi and Julio Wilson Vigorito. Besides being a legitimate representative of orthodontic quality in Brazil, our interviewee has particular academic and personal characteristics worth mentioning. His career path has enabled him to create a summarized coherent understanding of ?Dentofacial Morphology?, which lead him to be the clinic coordinator of the Orthognathic Surgery graduate program at USP. We are convinced that orthodontics has gone forward under the critical eyes of this young and wise educator, who ponders over the probabilities of science, in order to achieve permanent success and demystify innovations. The intimate coexistence with his mentors has allowed him to become a skillful professor, who knows how to be strict, yet humble, kind and a true perfectionist in science and in the clinic, enabling him to build noble relationships with his students. Professor Rino kindly granted us with the following interview, where he expresses his reflections about orthodontics as one of the most significant professors in Brazil and based on his own clinic and scientific experience.

José Valladares Neto

Online Article

Association of breastfeeding, pacifier use, breathing pattern and malocclusions in preschoolers

Sebastião Batista Bueno, Telmo Oliveira Bittar, Fabiana de Lima Vazquez, Marcelo de Castro Meneghim, Antonio Carlos Pereira

Breastfeeding. Malocclusion. Primary dentition.

Objective: To evaluate the association of breastfeeding duration, pacifier use and nasal air flow with occlusal disorders among children. 

Methods: This cross-sectional observational study included 138 children aged 4 and 5 years selected in all the daycare centers of the city of Campo Limpo Paulista, Brazil. Questionnaires were applied to mothers to identify total duration of exclusive breastfeeding and non-nutritive sucking. The independent variables were: Sucking (pacifier, bottle, finger), breastfeeding duration and nasal air flow. The dependent variables were: Open bite, crossbite, overjet, overbite, diastema and maxillary deficiency. Frequency distribution calculations were performed, a chi-square test, the Fisher exact test and, after that, stepwise logistic regression were used for statistical analysis, and the level of significance was set at 5%.

Results: The use of a pacifier was the most deleterious factor and increased chances of having open bite in 33.3 times, marked overjet in 2.77 times and posterior crossbite in 5.26 times. 

Conclusion: There was a significant association between non-nutritive sucking, particularly the use of a pacifier, and occlusal disorders. These findings are important to plan the treatment of preschoolers.

Halogen light versus LED for bracket bonding: Shear bond strength

Paulo Eduardo Guedes Carvalho, Valdemir Muzulon dos Santos, Hassan Isber, Flávio Augusto Cotrim-Ferreira

Orthodontics. Shear bond strength. Orthodontic brackets. Dental bonding.

Introduction: LED light-curing devices seek to provide a cold light activator which allows protocols of material polymerization with shorter duration. 

Objective: The present study aimed to evaluate the shear bond strength of bracket bonding using three types of light-curing devices: One with halogen light (Optilight Plus - Gnatus) and two with LEDs (Optilight CL - Gnatus and Elipar Freelight - 3M/ESPE). 

Results: Comparing the results by analysis of variance, the Gnatus LED device showed an inferior statistical behavior in relation to other light sources, when activated by a short time. But, when it was used for 40 seconds, the polymerization results were consistent with the other evaluated sources. The device with the best average performance was the halogen light, followed by the 3M/ESPE LED. 

Conclusion: It was concluded that the LEDs may be indicated in orthodontic practice, as long as a protocol is used for the application of light with the activation time of 40 seconds.

Profile of the orthodontist practicing in the State of São Paulo - Part 2

Fabio Brandalise Rampon, Celestino Nóbrega, José Luiz Gonçalves Bretos, Telmo Oliveira Bittar, Sérgio Jakob, Maria Cristina Jimenez-Pellegrin

Orthodontics. Dental research. Materials.

Introduction: The choice of brackets, bands and wires is a very important aspect of orthodontic treatment. Stainless steel prevailed for a long time, but new alloys and resources have emerged to diversify the orthodontic wire mechanics. 

Objective: This study aimed to investigate the profile and materials used by orthodontists practicing in the State of São Paulo, Brazil. 

Methods: A questionnaire was sent to 2,414 specialists in Orthodontics and Dentofacial Orthopedics registered with the Regional Board of Dentistry of São Paulo State (CRO-SP). To assess the association between qualitative variables, the Chi-square association test was employed at 5% significance level. 

Results: Five hundred and ninety-three (24.65%) questionnaires were completed and sent back. Efficiency was the key reason given by the professionals for choosing a particular material. The majority showed a preference for metal brackets (98%), followed by ceramics (32%) and polycarbonate (7.8%). The most widely used brackets had 0.022 x 0.028-in slots (73.2%). Regarding orthodontic wires, 88.2% employed round steel wires and conventional round NiTi wires, while 52.6% used round heat-activated NiTi and 46.5% rectangular TMA wires. Elastics (92.9%) were the most widely used method to tie the orthodontic archwire to the bracket. 

Conclusions: In this survey, the orthodontists claimed that efficiency was the major motivator for choosing orthodontic materials. Conventional brackets tied with conventional elastic ligatures are still the most used by the professionals. Among steel and conventional Nitinol wires, round wires ranked first. The use of resources recently available to Brazilian orthodontists, such as self-ligating brackets and mini-implants, was not significant. 

Evaluation of two protocols for low-level laser application in patients submitted to orthodontic treatment

Mariana Marquezan, Ana Maria Bolognese, Mônica Tirre de Souza Araújo

Lasers. Low-level laser therapy. Tooth movement. Angiogenesis inducing agents.

Introduction: Different low-level laser (LLL) irradiation protocols have been tested to accelerate orthodontic tooth movement (OTM). Nevertheless, divergent results have been obtained. It was suggested that the stimulatory action of low level laser irradiation occurs during the proliferation and differentiation stages of bone cellular precursors, but not during later stages. 

Objective: The purpose of this study was to determine the effect of two protocols of LLL irradiation on experimental tooth movement: One with daily irradiations and another with irradiations during the early stages. 

Methods: Thirty-six rats were divided into control groups (CG1, CG2, CG3) and irradiated groups (IrG1, IrG2, IrG3) according to the presence of: experimental tooth movement, laser irradiation, type of laser irradiation protocol and date of euthanasia (3th or 8th day of experiment). At the end of experimental periods, a quantitative evaluation of the amount of OTM was made and the reactions of the periodontium were analyzed by describing cellular and tissue reactions and by counting blood vessels. 

Results: The amount of OTM revealed no significant differences between groups in the same experimental period (p < 0.05). Qualitative analysis revealed the strongest resorption activity in irradiated groups after seven days, especially when using the daily irradiation protocol. There was a higher number of blood vessels in irradiated animals than in animals without orthodontic devices and without laser irradiation (p < 0.05). 

Conclusion: Moreover, angiogenesis was verified in some of the irradiated groups. The irradiation protocols tested were not able to accelerate OTM and root resorption was observed while they were applied.

Occlusal characteristics and orthodontic treatment need in Black adolescents in Salvador/BA (Brazil): An epidemiologic study using the Dental Aesthetics Index

Arthur Costa Rodrigues Farias , Maria Cristina Teixeira Cangussu, Rogério Frederico Alves Ferreira, Marcelo de Castellucci e Barbosa

Malocclusion. Orthodontics. Esthetics. Dental. Dental Health Surveys.

Objective: The objective of this article is to evaluate the need of orthodontic treatment, prevalence and severity of the malocclusions in individuals of black ethnicity in a representative sample of schoolchildren of the city of Salvador/Brazil, as well as to verify if the malocclusion was affected by socio-demographic conditions such as age and gender.

Methods: The reference population was constituted of schoolchildren with age between 12 and 15 years, enrolled in public and private schools. The malocclusion was evaluated in 486 students of black ethnicity, with ages varying from 12 to 15 years, selected in random sample in multiple stages. The adopted significance level was 1% and the power of the test was 90%. A questionnaire registering demographic characteristics was filled out by each individual. The Dental Aesthetics Index (DAI) was used by previously calibrated examiners (kappa 0.89), according to criteria of the World Health Organization.

Results: It was verified that most of the individuals (76%) had little or any need for orthodontic treatment. About 24% showed a condition of severe malocclusion, culminating in a vital need for orthodontic treatment. The main occlusal characteristics found in the group with high need of orthodontic treatment were dental crowding and accentuated overjet. The age was positively related to the improvement of the maxillary overjet and to the presence of crowding.

Conclusion: The development of public politics that aim the insertion of orthodontic treatment among the procedures of health programs, with the implementation and development of specialized centers, is fundamental.

Original Article

Angle Class II correction with MARA appliance

Kelly Chiqueto, José Fernando Castanha Henriques, Sérgio Estelita Cavalcante Barros, Guilherme Janson

Angle?s Class II malocclusion. Functional orthodontic appliances. Mandibular advancement.

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Objective: To assess the effects produced by the MARA appliance in the treatment of Angle?s Class II, division 1 malocclusion. 

Methods: The sample consisted of 44 young patients divided into two groups: The MARA Group, with initial mean age of 11.99 years, treated with the MARA appliance for an average period of 1.11 years, and the Control Group, with initial mean age of 11.63 years, monitored for a mean period of 1.18 years with no treatment. Lateral cephalograms were used to compare the groups using cephalometric variables in the initial and final phases. For these comparisons, Student?s t test was employed. 

Results: MARA appliance produced the following effects: Maxillary growth restriction, no change in mandibular development, improvement in maxillomandibular relationship, increased lower anterior facial height and counterclockwise rotation of the functional occlusal plane. In the upper arch, the incisors moved lingually and retruded, while the molars moved distally and tipped distally. In the lower arch, the incisors proclined and protruded, whereas the molars mesialized and tipped mesially. Finally, there was a significant reduction in overbite and overjet, with an obvious improvement in molar relationship. 

Conclusions: It was concluded that the MARA appliance proved effective in correcting Angle?s Class II, division 1 malocclusion while inducing skeletal changes and particularly dental changes.

Miniscrew-supported coil spring for molar uprighting: Description

Antônio Carlos de Oliveira Ruellas, Matheus Melo Pithon, Rogério Lacerda dos Santos

Molar tooth. Corrective orthodontics. Dental implant.

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Introduction: Since the beginning of miniscrews as orthodontic anchorage, many applications have been described in the literature. Among these, one is the uprighting of mesially inclined molars. In regard to the mechanical aspects, however, there is little information about the application of orthodontic forces using such devices. 

Objective: The objective of this study was to describe a miniscrew supported spring for uprighting of mesially inclined molars. With this device, one can achieve the correct use of orthodontic biomechanics, thus favoring more predictable tooth movements and preventing unwanted movements from occurring.

Correlation between transverse and vertical measurements in Brazilian growing patients, evaluated by Ricketts-Faltin frontal analysis

Regina Helena Lourenço Belluzzo, Kurt Faltin Junior, Cristina Ortolani, Adolpho Chelotti

Frontal teleradiograph. Longitudinal study. Correlation.

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Introduction: Currently in orthodontic diagnosis, besides the lateral cephalometric analysis which evaluates the anteroposterior and vertical direction, the frontal analysis may be added, leading us to another important dimension in space: the transverse dimension. 

Objective: Few longitudinal samples with the frontal radiograph were published, so this cephalometric study was designed to correlate the transversal and vertical measures by Ricketts-Faltin frontal analysis into two radiographic times. 

Methods: The sample consisted of 45 Brazilian children, 25 girls and 20 boys, all presenting mixed dentition, with balanced facial aesthetics and no previous orthodontic/orthopedic treatment. The initial average age (T1) was 7.7 years and the final (T2) 13.3 years. The measurements evaluated were: FTD, MxTD, NTD, LITD, MdTD (transversal), OVD and TVD (vertical). 

Results: All transversal measures were positively correlated with a medium or high correlation with each other and the vertical measurements; only LITD presented a low correlation with these measurements. 

Conclusion: It was concluded that the face has interdependent regions and that this feature remains with growth.

In vitro evaluation of force degradation of elastomeric chains used in Orthodontics

André Weissheimer, Arno Locks, Luciane Macedo de Menezes, Adriano Borgatto, Carla D’Agostini Derech

Elastomers. Shear bond strength. Biomedical and dental materials.

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Objective: To analyze the in vitro force degradation of four different brands of elastomeric chains: American Orthodontics, Morelli, Ormco and TP Orthodontics. 

Methods: The sample consisted of 80 gray elastomeric chains that were divided into four groups according to their respective manufacturers. Chain stretching was standardized at 21 mm with initial force release ranging from 300 g to 370 g. The samples were kept in artificial saliva at a constant temperature of 37°C and the degradation force was recorded at the following time intervals: initial, 1, 3, 5, 7 and 9 hours, and 1, 7, 14, 21, 28, and 35 days. 

Results: There was a statistically significant difference between the groups regarding the force degradation, mainly within the first day, as a force loss of 50-55% was observed during that time in relation to the initial force. The force delivered at 35 days ranged from 122 g to 148 g. 

Conclusion: All groups showed force degradation over time, regardless of their trademarks, a force loss of 59-69% was observed in the first hour compared to baseline. However, because the variation in force degradation depends on the trademark, studies such as the present one are important for guiding the clinical use of these materials.

Effect of saliva contamination on bond strength with a hydrophilic composite resin

Mauren Bitencourt Deprá, Josiane Xavier de Almeida, Taís de Morais Alves da Cunha, Luis Filipe Siu Lon, Luciana Borges Retamoso, Orlando Motohiro Tanaka

Saliva. Orthodontic brackets. Bond strength. Adhesives.

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Objective: To evaluate the influence of saliva contamination on the bond strength of metallic brackets bonded to enamel with hydrophilic resin composite. 

Methods: Eighty premolars were randomly divided into 4 groups (n?=?20) according to bonding material and contamination: G1) bonded with Transbond XT with no saliva contamination, G2) bonded with Transbond XT with saliva contamination, G3) bonded with Transbond Plus Color Change with no saliva contamination and G4) bonded with Transbond Plus Color Change with saliva contamination. The results were statistically analyzed (ANOVA/Tukey). 

Results: The means and standard deviations (MPa) were: G1)10.15 ± 3.75; G2) 6.8 ± 2.54; G3) 9.3 ± 3.36; G4) 8.3 ± 2.95. The adhesive remnant index (ARI) ranged between 0 and 1 in G1 and G4. In G2 there was a prevalence of score 0 and similar ARI distribution in G3. 

Conclusion: Saliva contamination reduced bond strength when Transbond XT hydrophobic resin composite was used. However, the hydrophilic resin Transbond Plus Color Change was not affected by the contamination.

Comparative analysis of the anterior and posterior length and deflection angle of the cranial base, in individuals with facial Pattern I, II and III

Guilherme Thiesen, Guilherme Pletsch, Michella Dinah Zastrow, Caio Vinicius Martins do Valle, Karyna Martins Valle-Corotti, Mayara Paim Patel

Cranial base. Orthodontics. Maxillofacial development. Face.

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Objective: This study evaluated the variations in the anterior cranial base (S-N), posterior cranial base (S-Ba) and deflection of the cranial base (SNBa) among three different facial patterns (Pattern I, II and III). 

Method: A sample of 60 lateral cephalometric radiographs of Brazilian Caucasian patients, both genders, between 8 and 17 years of age was selected. The sample was divided into 3 groups (Pattern I, II and III) of 20 individuals each. The inclusion criteria for each group were the ANB angle, Wits appraisal and the facial profile angle (G?.Sn.Pg?). To compare the mean values obtained from (SNBa, S-N, S-Ba) each group measures, the ANOVA test and Scheffé?s Post-Hoc test were applied. 

Results and Conclusions: There was no statistically significant difference for the deflection angle of the cranial base among the different facial patterns (Patterns I, II and III). There was no significant difference for the measures of the anterior and posterior cranial base between the facial Patterns I and II. The mean values for S-Ba were lower in facial Pattern III with statistically significant difference. The mean values of S-N in the facial Pattern III were also reduced, but without showing statistically significant difference. This trend of lower values in the cranial base measurements would explain the maxillary deficiency and/or mandibular prognathism features that characterize the facial Pattern III.

Periodontal evaluation of different toothbrushing techniques in patients with fixed orthodontic appliances

Patricia Oehlmeyer Nassar, Carolina Grando Bombardelli, Carolina Schmitt Walker, Karyne Vargas Neves, Karine Tonet, Rodolfo Nishimoto Nishi, Roberto Bombonatti, Carlos Augusto Nassar

Dental plaque. Tooth brushing. Orthodontic appliances.

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Introduction: Plaque control is the major consensus during orthodontic treatment to prevent the occurrence of cavities and periodontal inflammation. The mechanic resource of greater effectiveness and frequent use in this control is the oral hygiene. The tooth brushing techniques most used in orthodontic patients are: Ramfjord?s method, Modified Stillman technique and Bass method. 

Objective: Since control studies evaluating the effectiveness of usual tooth brushing techniques do not show clear advantage, the objective of this study was to evaluate the effectiveness of three brushing methods, through periodontal clinical parameters of patients with fixed orthodontic appliances. 

Methods: Thirty patients were selected, with ages between 14 and 22 years old, with fixed orthodontic appliances. After basic periodontal treatment the following factors were evaluated: 1???Plaque index and 2???Gingival index and each patient was randomly included in one of the three selected groups according to the brushing technique: Group 1???Scrubbing technique; Group 2???Modified Stillman technique and Group 3???Bass technique. Patients were evaluated for 9 months. 

Results: The results showed a significant reduction of clinical parameters by the end of this period, however there was a very significant reduction of Gingival index on group 3 (13.6%) when compared to the other groups. 

Conclusion: Thus, it can be suggested that the Bass technique can be effective on the reduction of periodontal clinical parameters of Plaque index and Gingival index in patients with fixed orthodontic appliances. 

Does self-ligating brackets type influence the hysteresis, activation and deactivation forces of superelastic NiTi archwires?

José Rino Neto, Gilberto Vilanova Queiroz, João Batista de Paiva, Rafael Yagüe Ballester

Corrective orthodontics. Orthodontic brackets. Orthodontic wires.

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Objective: To compare hysteresis, activation and deactivation forces produced by first-order deformation of Contour 0.014-in NiTi wire (Aditek, Brazil) in four brands of self-ligating brackets: Damon MX, Easy Clip, Smart Clip and In-Ovation. 

Method: Activation and deactivation forces were measured in an Instron universal tensile machine at 3 mm/minute speed to a total displacement of 4 mm. Tests were repeated eight times for each bracket/wire combination. Statistical analysis comprised ANOVA and Tukey?s multiple comparisons test. 

Results: Using a 4-mm deformation, mean activation forces increased in the following order: Damon = 222 gf, Easy Clip = 228 gf, In-Ovation = 240 gf and Smart Clip = 306 gf. The same order was observed for mean hysteresis values, i.e., 128 gf, 140 gf, 150 gf and 206 gf, respectively. The respective values of deactivation forces for the Damon, Easy Clip, In-Ovation and Smart Clip brackets were 94 gf, 88 gf, 90 gf and 100 gf. 

Conclusions: Brackets with higher activation forces were accompanied by higher hysteresis values, which resulted in clinically similar deactivation forces, regardless of the type of self-ligating brackets used. 

Evaluation of ionic degradation and slot corrosion of metallic brackets by the action of different dentifrices

Gustavo Antônio Martins Brandão, Rafael Menezes Simas, Leandro Moreira de Almeida, Juliana Melo da Silva, Marcelo de Castro Meneghim, Antonio Carlos Pereira, Haroldo Amorim de Almeida, Ana Maria Martins Brandão

Orthodontic brackets. Corrosion. Scanning Electron Microscopy.

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Objective: To evaluate the in vitro ionic degradation and slot base corrosion of metallic brackets subjected to brushing with dentifrices, through analysis of chemical composition by Energy Dispersive Spectroscopy (EDS) and qualitative analysis by Scanning Electron Microscopy (SEM). 

Methods: Thirty eight brackets were selected and randomly divided into four experimental groups (n?=?7). Two groups (n?=?5) worked as positive and negative controls. Simulated orthodontic braces were assembled using 0.019 x 0.025-in stainless steel wires and elastomeric rings. The groups were divided according to surface treatment: G1 (Máxima Proteção Anticáries®); G2 (Total 12®); G3 (Sensitive®); G4 (Branqueador®); Positive control (artificial saliva) and Negative control (no treatment). Twenty eight brushing cycles were performed and evaluations were made before (T0) and after (T1) experiment. 

Results: The Wilcoxon test showed no difference in ionic concentrations of titanium (Ti), chromium (Cr), iron (Fe) and nickel (Ni) between groups. G2 presented significant reduction (p < 0.05) in the concentration of aluminium ion (Al). Groups G3 and G4 presented significant increase (p < 0.05) in the concentration of aluminium ion. The SEM analysis showed increased characteristics indicative of corrosion on groups G2, G3 and G4. 

Conclusion: The EDS analysis revealed that control groups and G1 did not suffer alterations on the chemical composition. G2 presented degradation in the amount of Al ion. G3 and G4 suffered increase in the concentration of Al. The immersion in artificial saliva and the dentifrice Máxima Proteção Anticáries® did not alter the surface polishing. The dentifrices Total 12®, Sensitive® and Branqueador® altered the surface polishing. 

Influence of intentional ankylosis of deciduous canines to reinforce the anchorage for maxillary protraction

Luís Fernando Castaldi Tocci, Omar Gabriel da Silva Filho, Acácio Fuziy, José Roberto Pereira Lauris

Malocclusion. Angle Class III. Crossbite. Interceptive orthodontics.

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Introduction: This retrospective cephalometric study analyzed the influence of intentional ankylosis of deciduous canines in patients with Class III malocclusion and anterior crossbite, in the deciduous and early mixed dentition stages, treated by orthopedic maxillary expansion followed by maxillary protraction. 

Methods: Lateral cephalograms of 40 patients were used, divided in 2 groups paired for age and gender. The Ankylosis Group was composed of 20 patients (10 boys and 10 girls) treated with induced ankylosis and presenting initial and final mean ages of 7 years 4 months and 8 years 3 months, respectively, with a mean period of maxillary protraction of 11 months. The Control Group comprised 20 patients (10 boys and 10 girls) treated without induced ankylosis, with initial and final mean ages of 7 years 8 months and 8 years 7 months, respectively, with a mean period of maxillary protraction of 11 months. Two-way analysis of variance and covariance analysis were applied to compare the initial and final cephalometric variables and the treatment changes between groups. 

Results: According to the results, the variables evidencing the significant treatment changes between groups confirmed that the intentional ankylosis enhanced the sagittal response of the apical bases (Pg-NPerp) and increased the facial convexity angles (NAP and ANB). 

Conclusions: The protocol involving intentional ankylosis of deciduous canines enhanced the sagittal response of the apical bases.

Orthodontic treatment need for Brazilian schoolchildren: A study using the Dental Aesthetic Index

Gracemia Vasconcelos Picanço, Isabel Cristina Gonçalves Leite

Malocclusion. Prevalence. Health services needs and demand.

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Objective: To determine the normative orthodontic treatment need among 12-year-old Brazilian schoolchildren, in the municipality of Juiz de Fora, Minas Gerais, Brazil, and compare with the need as perceived by the children themselves and their parents or caregivers, assessing putative associated sociodemographic factors. 

Methods: Four hundred and fifty one children without a previous history of orthodontic treatment were randomly selected from a population of 7,993 schoolchildren regularly attending the public and private educational sectors of the municipality of Juiz de Fora, Minas Gerais, Brazil. 

Results: The prevalence of normative orthodontic treatment need in 12-year-old children, assessed with the Dental Aesthetic Index (DAI) was 65.6% (n = 155). The need perceived by the caregivers was 85.6%, and by the children was 83.8%. Only the perception by the caregivers maintained a significant correlation with the normative need of treatment when adjusted to the parents? schooling and economical level (p = 0.023). 

Conclusions: There is a high prevalence (65.6%) of malocclusion requiring orthodontic treatment in 12-year-old Brazilian schoolchildren. The most prevalent malocclusions in the study were: Crowding, Class II molar relationship and increased overjet. There was no significant correlation between the Index of Orthodontic Treatment Need ? Aesthetic Component (IOTN-AC) related to dental aesthetic perception and the normative treatment need assessed with the DAI. 

Predisposing factors to severe external root resorption associated to orthodontic treatment

Gracemia Vasconcelos Picanço, Karina Maria Salvatore de Freitas, Rodrigo, Fabricio Pinelli Valarelli, Paulo Roberto Barroso Picanço, Camila Pontes Feijão

Root resorption. Tooth movement. Orthodontics.

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Objective: The aim of this study was to evaluate predisposing factors among patients who developed moderate or severe external root resorption (Malmgren?s grades 3 and 4), on the maxillary incisors, during fixed orthodontic treatment in the permanent dentition. 

Methods: Ninety-nine patients who underwent orthodontic treatment with fixed edgewise appliances were selected. Patients were divided into two groups: G1 ? 50 patients with no root resorption or presenting only apical irregularities (Malmgren?s grades 0 and 1) at the end of the treatment, with mean initial age of 16.79 years and mean treatment time of 3.21 years; G2 ? 49 patients presenting moderate or severe root resorption (Malmgren?s grades 3 and 4) at the end of treatment on the maxillary incisors, with mean initial age of 19.92 years and mean treatment time of 3.98 years. Periapical radiographs and lateral cephalograms were evaluated. Factors that could influence the occurrence of severe root resorption were also recorded. Statistical analysis included chi-square tests, Fisher?s exact test and independent t tests. 

Results: The results demonstrated significant difference between the groups for the variables: Extractions, initial degree of root resorption, root length and crown/root ratio at the beginning, and cortical thickness of the alveolar bone. 

Conclusion: It can be concluded that: Presence of root resorption before the beginning of treatment, extractions, reduced root length, decreased crown/root ratio and thin alveolar bone represent risk factors for severe root resorption in maxillary incisors during orthodontic treatment.

Evaluation of the friction force generated by monocristalyne and policristalyne ceramic brackets in sliding mechanics

Roberta Ferreira Pimentel, Roberto Sotto Maior Fortes de Oliveira, Maria das Graças Afonso Miranda Chaves, Carlos Nelson Elias , Marco Abdo Gravina

Friction. Orthodontic brackets. In vitro. Biomedical and dental materials. Biomechanics.

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Objective: To evaluate and compare ?in vitro? the maximum friction force generated by three types of esthetic brackets, two types of polycrystalline conventional ceramic brackets (20/40 and InVu) and one type of sapphire monocrystalline bracket (Radiance) in dry and artificial saliva wet settings. Also, to evaluate the influence exerted by artificial saliva on the friction forces of those brackets. 

Methods: Tests were performed in dry and artificial saliva wet setting (Oral Balance) by using an EMIC DL 10000 testing machine, simulating a 2 mm slide of 0.019 x 0.025-in rectangular stainless steel wires over the pre-angulated and pre-torqued (right superior canine, Roth prescription, slot 0.022 x 0.030-in) brackets (n = 18 for each bracket). In order to compare groups in dry and wet settings, the ANOVA was used. For comparisons related to the dry versus wet setting, the student t test was used for each group. 

Results: The results showed that in the absence of saliva the Radiance monocrystalline brackets showed the highest friction coefficients, followed by the 20/40 and the InVu polycrystalline brackets. In tests with artificial saliva, the Radiance and the 20/40 brackets had statistically similar friction coefficients and both were greater than that presented by the InVu brackets. The artificial saliva did not change the maximum friction force of the Radiance brackets, but, for the others (20/40 and InVu), an increase of friction was observed in its presence. 

Conclusion: The InVu brackets showed, in the absence and in the presence of saliva, the lowest friction coefficient.

Comparison of space analysis performed on plaster vs. digital dental casts applying Tanaka and Johnston?s equation

Júlia Olien Sanches, Lourdes Aparecida Martins dos Santos-Pinto, Ary dos Santos-Pinto, Betina Grehs, Fabiano Jeremias

Three-dimensional image. Dental casts. Test reproducibility.

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Objective: The purpose of this study was to compare dental size measurements, their reproducibility and the application of Tanaka and Johnston regression equation in predicting the size of canines and premolars on plaster and digital dental casts. 

Methods: Thirty plaster casts were scanned and digitized. Mesiodistal measurements of the teeth were then performed with a digital caliper on the plaster and digital casts using O3d software system (Widialabs©).The sum of the sizes of the lower incisors was used to obtain predictive values of the sizes of the premolars and canines using the regression equation, and these values were compared with the actual sizes of the teeth. The data were statistically analyzed by applying to the results Pearson?s correlation test, Dahlberg?s formula, paired t-test and analysis of variance (p<0.05). 

Results: Excellent intraexaminer agreement was observed in the measurements performed on both dental casts. No random error was present in the measurements obtained with the caliper and systematic error (bias) was more frequent in the digital casts. Space prediction obtained by applying the regression equation was greater than the sum of the canines and premolars on the plaster and digital casts. 

Conclusions: Despite an adequate reproducibility of the measurements performed on both casts, most measurements on the digital casts were higher than those on the plaster casts. The predicted space was overestimated in both models and significantly higher in the digital casts.

Mini-implants: Mechanical resource for molars uprighting

Susiane Allgayer , Deborah Platcheck, Ivana Ardenghi Vargas, Raphael Carlos Drumond Loro

Corrective orthodontics. Orthodontic anchorage procedures. Impacted tooth.

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Introduction: The early orthodontic treatment allows correction of skeletal discrepancies by growth control, and the elimination of deleterious habits, which are risk factors for the development of malocclusions, favoring for the correction of tooth positioning later in a second treatment stage. During development of teeth and occlusion, the mandibular second molars commonly erupt in the oral cavity after all other teeth of the anterior region. In their eruptive process there may be a condition known as tooth impaction, which precludes its complete eruption and requires proper uprighting treatment. The temporary anchorage devices allow disimpaction and movement of these teeth directly to their final position, without the need of patient compliance or reaction movements in other parts of the arch. 

Objective: This paper aims at describing a case report of the treatment of a patient with Angle Class II malocclusion, performed in two phases, in which mini-implants were used for uprighting the impacted mandibular second molars.

BBO Case Report

Surgical treatment of dental and skeletal Class III malocclusion

Ione Helena Vieira Portella Brunharo

Class III malocclusion. Surgery. Orthosurgical preparation.

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Orthodontic preparation for surgical treatment of skeletal Class III malocclusion involves joint planning with an oral and maxillofacial surgeon to address the functional and esthetic needs of the patient. In order to allow surgical manipulation of the jaws in the preoperative phase, the need to achieve a negative overjet through incisor decompensation often leads the orthodontist to extract the upper first premolars. This report illustrates an orthodontic preparation case where due to specific factors inherent in the patient?s psychological makeup retroclination of the upper incisors and proclination of the mandibular incisors was achieved without removing any teeth. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) in partial fulfillment of the requirements for obtaining the BBO Diploma.

Special Article

Relationship between temporomandibular disorders and orthodontic treatment: A literature review

Ronaldo Antônio Leite, Joacir Ferreira Rodrigues, Maurício Tatsuei Sakima, Tatsuko Sakima

Orthodontics. Temporomandibular joint disorders. Dental occlusion.

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Objective: The objective of this study was to review the most recent studies from the last 15 years, in search of clinical studies that report the relationship between TMD and orthodontic treatment and/or malocclusion. Our intention was to determine whether orthodontic treatment would increase the incidence of signs and symptoms of TMD, and whether orthodontic treatment would be recommended for treating or preventing signs and symptoms of TMD. 

Methods: Literature reviews, editorials, letters to the editor, experimental studies in animals and short communications were excluded from this review. Were included only prospective, longitudinal, case-control or retrospective studies with a large sample and significant statistical analysis. Studies that dealt with craniofacial deformities and syndromes or orthognathic surgery treatment were also excluded, as well as those that reported only the association between malocclusion and TMD.

Results: There were 20 articles relating orthodontics to TMD according to the inclusion criteria. The studies that associated signs and symptoms of TMD to orthodontic treatment showed discrepant results. Some have found positive effects of orthodontic treatment on signs and symptoms of TMD, however, none showed a statistically significant difference. 

Conclusions: All studies cited in this literature review reported that orthodontic treatment did not provide risk to the development of signs and symptoms of TMD, regardless of the technique used for treatment, the extraction or non-extraction of premolars and the type of malocclusion previously presented by the patient. Some studies with long-term follow-up concluded that orthodontic treatment would not be preventive or a treatment option for TMD.

Dental Press Journal of Orthodontics - v. 18, no. 1 Download full issue pdf