Fernanda Ramos de Faria

Introduction: Lower incisor inclinations can be orthodontically performed for better aesthetic results or to camouflage a skeletal problem. However, when buccolingual tooth movement occurs beyond the adaptive limits of the bone, it is associated with the onset of periodontal problems after treatment. Objective: This study aimed to evaluate the effects of natural and orthodontically induced buccolingual inclination of the lower incisors on the interproximal bone crest (IBC) at the end of orthodontic treatment. Material and Methods: A retrospective analysis of cephalometric and periapical radiographs obtained from the initial (T0) and final (T1) orthodontic documentation of 60 orthodontically treated individuals was performed. The lower incisor inclination in relation to the mandibular plane (IMPA), the thickness of the alveolar process and mandibular symphysis and the height of the IBC were measured. Results: There was no significant change in IMPA during treatment in the evaluated sample. Men had significantly thicker mandibular symphysis than women. A significant reduction was observed in alveolar process thickness and IBC height throughout the sample. Age showed a significant positive correlation with change in IBC height. Although IMPA was not directly correlated with IBC change during treatment, it was indirectly correlated when evaluated in conjunction with other variables. Conclusion: IMPA was not directly related to IBC height change. IMPA, alveolar process thickness and mandibular symphysis together were related to IBC height change.

Objective: To identify and discuss the impact of the application of chitosan gels on the dental and periodontal health of patients. Material and Methods: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and its protocol was registered in the International Prospective Register of Systematic Reviews. Searches were performed in the Embase, MEDLINE/PubMed, Elsevier/Scopus, and Web of Science databases using the descriptors "dentistry", "chitosan", "gels", "hydrogels", "oral health", "tooth", "gingiva", and "periodontics" combined with the Boolean operators "AND" and "OR". The risk of bias was assessed using the Cochrane Risk of Bias 2 tool for randomized controlled trials. Results: A total of 30 studies were retrieved; after reviewing titles, abstracts, and full articles and applying the inclusion and exclusion criteria, only three were included. Subsequently, two studies were manually added through reference searches, bringing the total to 5. In the overall risk-of-bias analysis, only one study was classified as having a low risk of bias, three as having some concern, and one as having a high risk of bias. Conclusion: Gels containing chitosan appear to have a promising positive impact on patients' dental and periodontal health. However, these results should be evaluated with caution due to the risk of bias identified in the studies.

Introduction: The ANB angle and the Wits appraisal are common cephalometric tools for assessing anteroposterior jaw discrepancies. Assessment of a patient’s anatomy in the anteroposterior disharmony of the maxillary and mandibular should not be limited to hard-tissue relationships, but should also consider soft tissue involvement, such as the soft tissue facial profile angle. Objective: To evaluate the correlations between sagittal skeletal relationships established through ANB angle and Wits appraisal and to evaluate the soft-tissue facial profile angle, assessed by the G-Sn-Pog’ angle. Material and methods: The sample consisted of 300 individuals (129 male and 171 female). The ANB angle, the Wits appraisal, and by the G-Sn-Pog’ angle were obtained through lateral cephalograms. The facial profile was categorized into three groups. The correlation coefficients between ANB angle and Wits appraisal and between the soft-tissue facial profile angle and skeletal pattern were evaluated. Results: A significant correlation (p <.001) was observed between ANB angle and Wits appraisal (r= .738), between G-Sn-Pog’ and ANB angle (r= -.708), and between G-Sn-Pog’ and Wits appraisal (r= -.586). When assessed separately according to different groups of soft-tissue facial profiles, there was a weak correlation between ANB and Wits assessment in the low soft-tissue facial profile angle subjects (Group II), and a moderate correlation in the high soft-tissue facial profile angle subjects (Group III). Conclusion: The correlation between ANB angle and Wits was moderate to high, except in Group II soft-tissue facial profile subjects.

Introduction: The use of clear aligners as an alternative to fixed orthodontic appliances has become popular due to the aesthetic demands of adult patients seeking orthodontic treatment. However, orthodontists’ lack of knowledge about the legal consequences of their activities, and the lack of solid scientific evidence raise concerns regarding civil liability in this type of treatment. Marketing campaigns of manufacturing companies often exaggerate promises of results, and ignore the lack of scientific evidence. Patients, as consumers, are protected by the Consumer Protection Code, whereas orthodontists are considered treatment providers. Therefore, they can be held liable for damage caused to patients, whether by subjective or objective fault. Objective: This article aims to identify the civil responsibilities of orthodontists and aligner manufacturing companies, by means of a literature review, providing basic legal guidance to help professionals protect themselves from possible lawsuits related to treatment with orthodontic aligners. Conclusions: The study highlights the importance of knowledge of legal notions in treatments with orthodontic aligners by orthodontists, who should legally safeguard themselves through individual written contracts, avoiding obligation of results. In addition, in cases of legal claims, it is possible that the manufacturing companies are jointly and severally liable for possible damages claimed by the patient.

Santos IG, et al. Imaging Sci Dent. 2023 May;53:e16. https://doi.org/10.5624/isd.20230042

We aimed to investigate the impact of the suspension of orthodontic care during the Covid-19 pandemic on patients' anxiety, treatment, and quality of life. This is a cross-sectional study conducted from data collected by an online questionnaire on Google Forms. A total of 65 questionnaires were evaluated, 37 from patients over 18 years old (adult group) and 28 from those responsible for patients under 18 years old (children/adolescents group). The questionnaire contained 27 questions, which addressed anxiety about the pandemic and treatment after discontinued care, and the impact of oral problems on quality of life (OHIP-14). According to the anxiety scale, adults were more anxious than children/adolescents about the pandemic (p=0.033). Adults showed a greater need for urgent care (p=0.002) or maintenance of treatment (p=0.040) than children/adolescents, and in both, private care was more sought after than public care (p=0.038). Speech problems (p=0.043) and severe pain (p=0.050) were more frequent in children/adolescents than in adults. Children/adolescents more often reported that life in general was made worse because of problems with their teeth, mouth, or braces, compared to adults (p=0.047). We concluded that adults and children/adolescents were anxious about the impacts of missed appointments during the Covid-19 pandemic on orthodontic treatment. The quality of life of the patients was affected by the suspension of care and was more relevant among children/adolescents.

Aim: Facial orthopaedic treatments based on the stimulation or restrictions of craniofacial bone growth are more effective when carried out during the pubertal growth spurt. The aim of this cross-sectional study was to evaluate the reproducibility of two cervical vertebrae methods (CVM) with manual tracing and direct visual inspection. Methods: A sample of 60 lateral cephalometric radiographs (10 of each of the 6 CVM stages) was randomly selected from 171 records. 5 orthodontists classified these radiographs according to the skeletal maturation stage in 2002 and 2005, and the application of both methods was conducted by direct visual inspection and evaluation through manual tracing. Results: The average reliability of the two methods determination and the two forms of evaluation was substantial. The direct visual inspection evaluation showed the highest reliability and agreement interexaminer values for both methods, as well as the intraexaminers evaluation. Conclusion: The reproducibility of CVM method was substantial, indicating its clinical use to determine the skeletal maturity and the ideal moment for treatment execution.

Introdução: A qualidade óssea pode ser avaliada pela análise de textura nos exames de imagem, por meio da mensuração da dimensão fractal (DF) e lacunaridade (Lac). A DF está relacionada com a complexidade da organização estrutural óssea e a Lac representa a distribuição e o tamanho dos espaços vazios. Objetivo: Avaliar a qualidade óssea trabecular em região posterior da mandíbula por meio da DF e Lac e analisar o volume ósseo no exame de tomografia computadorizada de feixe cônico (TCFC), em indivíduos saudáveis, e, ainda, comparando homens e mulheres. Material e Métodos: 21 exames de TCFC foram utilizados. Utilizou-se o software ImageJ com dez cortes axiais sequenciais de cada paciente, delimitando a região de interesse (ROI) entre canino e primeiro molar inferiores, de ambos os lados. Foram avaliados os parâmetros: a) Bone Volume (BV), Tissue Volume (TV) e BV/TV, pelo processo de binarização; b) DF e Lac pelo método de Box-couting, em escala de cinza, sem binarização. Resultados: Na comparação entre os lados, BV e TV apresentaram diferença significativa (p=0,02 e 0,01, respectivamente), com maiores valores para o lado direito. Na comparação entre os sexos não houve diferença significativa. Os valores de DF apresentaram média de 0,87 para mulheres e 0,86 para homens. Valores de Lac foram em média 0,17 para mulheres e 0,15 para homens. A idade apresentou correlação negativa significativa com o volume ósseo. Conclusão: DF e Lac são parâmetros viáveis para serem analisados quando se trata de acessar a qualidade óssea trabecular em mandíbula. Foram encontrados valores menores que 1 para DF, e abaixo de 0,17 para Lac, em indivíduos saudáveis. Tanto DF quanto Lac não mostraram diferenças entre homens e mulheres. O osso trabecular na região posterior da mandíbula apresentou maior volume no lado direito em comparação ao esquerdo, e não houve diferença entre os sexos.

Introdução: O uso de mini-implantes tem se tornado comum na prática ortodôntica por aumentar a possibilidade de ancoragem esquelética. O palato constitui um local de escolha para a inserção de mini-implantes por ser um local com relativa segurança, espessura óssea adequada e menor chance para inflamação. Objetivo: Avaliar quantitativamente a espessura do osso palatino para inserção de mini-implantes. Material e Métodos: Foram selecionados 47 conjuntos de imagens de tomografia computadorizada de feixe cônico (TCFC). A amostra foi composta por 20 homens e 27 mulheres (idade média de 22 anos; ± 3 anos). A espessura óssea palatina (EOP) foi medida em milímetros (mm) em 5 regiões de interesse (ROIs) delimitadas em vistas coronais da área patatal 4, 6, 8 e 10 mm posteriores ao forame incisivo. Resultados: Foram avaliados 940 ROIs. Diferenças significativas foram observadas para EOP entre várias seções palatais (p Conclusões: A espessura do osso palatino diminui do forame palatino para a região posterior. Transversalmente, o osso era mais espesso na sutura palatina do que nas áreas paramedianas, principalmente nas secções coronais mais laterais.