Tratamento ortodôntico e cirúrgico com a técnica lingual

Introduction: Adult and young adult patients have been increasingly seeking for orthodontic treatments and almost all of them want it to be done by an aesthetic appliance with maximum invisibility. The lingual technique has emerged in the late 1970s and has now become a very viable alternative to perform orthodontic treatments, however, many cases of treatment or retreatment involve correction through orthognathic surgery. The surgical technique is more sedimented and simplified as a great aid in the correction of skeletal discrepancies. Objectives: This article aims to show the correction of malocclusion and discrepancy between dental arches, with the lingual orthodontic technique and the surgical association. Conclusion: It is possible to provide to the patient an adequate correction of malocclusion, maintaining the desired aesthetics through the lingual technique and orthognathic surgery

Percepção da atratividade mentual feminina por cirurgiões bucomaxilofaciais, ortodontistas e leigos

Objectives- Evaluate the perception of the female chin attractiveness by maxillofacial surgeons, orthodontists and lay people through simulations of mentoplasty performed with the aid of a software. Profile photography along with lateral face teleradiography were manipulated using Dolphin Imaging Software version 11.8, and different clinical situations were designed. Methods: The alterations were performed with anteroposterior movements, with images of mentoplasty of advancement (+2, +3 and +4), and recoil (-2, -3, -4). The reference of the movement was given in relation to the True Vertical Line (TVL). Ninety people were interviewed. 30 orthodontists, 30 maxillofacial surgeons and 30 lay people. They observed the photos and classified the profile according to extremely pleasant, pleasant, unpleasant and extremely pleasant. To evaluate the presence of significant difference between the groups in relation to the profile analysis, the Fisher Exact test was used. Results: Most lay people, surgeons and orthodontists (46%) considered the chin at the limit of the TVL as an extremely attractive profile. 34.4% considered the chin 2 mm before the TVL as an attractive profile; chin 3 mm beyond the TVL as unattractive (45.5%), and the most unattractive ones were 4 mm beyond the TVL (75.6%). Conclusion: So the great majority of the people interviewed showed a preference for the positioning of the chin in the TVL or slightly Class II profile in female patients, which can guide professionals in a better planning.

Abordagem precoce da má oclusão de Classe II esquelética com atresia maxilar e mordida aberta anterior e o uso de alinhadores ClearCorrect – relato de caso

Adequate planning and early treatment of Angle Class II malocclusion with maxillary atresia and anterior open bite provides harmonization of maxillomandibular bone bases in the three planes of space. Orthodontic aligners have emerged as an alternative treatment having the following advantages: being more aesthetic and more comfortable for the patient, less treatment time when they are correctly indicated, less chairside time, less complications, possibility of remote monitoring, easier feeding, and dental hygiene. On the other hand, they offer difficulties to treat adults with severe skeletal Class II malocclusions, posterior crossbite and anterior open bite. Therefore, the objective of this clinical case report is to early correct skeletal Class II malocclusion with maxillary atresia through the use of mechanical orthopedics and devices that help eliminate habits and close the anterior open bite, and later the use of orthodontic aligners to finish the treatment. It was concluded that the early interceptive treatment of malocclusion was efficient to harmonize the bone bases in the anteroposterior, vertical, and transversal directions, changing this malocclusion from high to low complexity and, consequently, highly predictable and with an excellent prognosis for treatment with orthodontic aligners. The treatment with ClearCorrect aligners corrected the occlusion in a shorter period of time when compared to corrective orthodontics and with a high predictability in relation to the virtual setup.

Tratamento da Classe II com Invisalign

Complete correction of Class II malocclusion in an adult patient is not an easy task. In a case with large skeletal discrepancy, orthognathic surgery is the treatment of choice. However, in case of slight or borderline discrepancy, other treatment options are available, such as tooth extractions and miniscrews. Intermediate cases can also be treated with Class II correctors and elastics. This clinical report presents the orthodontic treatment of a 25-year-old female patient with Class II malocclusion. Clinically, the maxilla was well positioned, and the mandible was slightly retruded. The patient presented vestibularized upper incisors, well-positioned lower incisors and opted for a more aesthetically attractive orthodontic appliance. The treatment plan included teeth leveling and aligning in both arches, Class II correction, establishment of Class I molar and canine relationships, correction of overjet and overbite, midline correction, and improvement of facial and dental aesthetics. The orthodontic treatment consisted of removable Invisalign aligners and Class II elastics.

Como realizar a análise tridimensional das vias aéreas superiores em pacientes ortodônticos?

The upper airways (UA) are influenced by the growth and development of the craniofacial complex and any alteration in the maxillary bones during orthodontic treatment can narrow or increase the size of the pharyngeal spaces. The three-dimensional analysis of the volume and the minimum axial area of the respective sub-spaces is beneficial for case planning as it allows the identification of possible physical barriers that compromise the air passage and the respiratory flow, besides being an auxiliary diagnostic method for disorders related to this function. The request for cone-beam computed tomography (CBCT) is necessary for the correct digital evaluation with the appropriate protocols for the acquisition and reconstruction of the image exams, calibration of the methodology, and standardization of their analysis. The objective of this work is to demystify the specific step-by-step analysis in the Dolphin Imaging® software and to describe the technical and anatomical factors for delimiting the spaces corresponding to the UA. To illustrate this protocol, CBCT of a patient with Angle Class II malocclusion, first division were analyzed before the installation (T1) of a mandibular thruster (fixed cemented Herbst appliance with dental anchorage) and after 12 months of treatment (T2). From the measurement of the spaces corresponding to VAS, comparing the two treatment times, it was possible to analyze the changes in the pharyngeal space after the use of mandibular thruster and to highlight the importance of the three-dimensional assessment of the air dimension for individualized orthodontic planning.

Pista direta planas para tratamento de mordida cruzada anterior funcional – relato de caso

Anterior crossbite is a malocclusion frequently found in deciduous and mixed dentitions, it can be classified as dental, skeletal or functional. This last one has a favorable prognosis when the treatment occurs in early stages. Considering this, Planas direct tracks have been showing to be an effective and less invasive alternative when few dental elements are involved. This paper presents a clinical case of a 6-year-old patient with functional unilateral anterior crossbite whose differentiated diagnosis and early intervention allowed a successful treatment. By manipulating the jaw and positioning the condyles in centric relation (CR), the presence of occlusal interference between the upper and lower deciduous canines on the right side was noticed, which are the causes of mandible anterior displacement with occlusion in MIH. For correction, Planas direct track therapy was used on the upper right canine with composite resin followed by slight wear on the lower right canine. The premature contacts were eliminated, creating an inclined plane of approximately 45 degrees on the palatal face of the upper canine and a slight occlusal adjustment on the incisal surface of the lower right canine. The use of this technique allowed the correction of the functional anterior crossbite immediately after the removal of the occlusal interference. This case shows that the early treatment of crossbites increases the chances of a successful rehabilitation of stomatognathic system. The use of Planas direct tracks proved to be an effective, low-cost, and easy to implement alternative for functional crossbites correction.

Tratamento de mordida aberta com a técnica ortodôntica fixa sem bráquetes, com tecnologia tridimensional 3DBOT (bracketless orthodontics treatment)

Anterior open bite is a type of malocclusion in which there is the presence of a negative vertical overlap between the incisal edges of the upper and lower anterior teeth. It is considered a complex anomaly with distinct characteristics and difficult to treat with prevalence of 25% to 38% of patients orthodontically treated. The aim of this article is to report a clinical case of Class III right subdivision and open bite using 3DBOT technique, a fixed, comfortable, predictable, imperceptible technique with 3D technology and with extreme clinically proven satisfaction. Case report: Patient V.B.V.S., 23 years and 1 month old, leukoderma, male, mild dholico, straight profile, symmetrical, Class ¼ of Class III of molar and canine right subdivision, anterior open bite, inverted smile, mild upper and anterior dental crowding. Treatment plan: The use of 3DBOT was planned along with the use of intermaxillary elastics and refinement with the aid of MyAligner® aligners. Conclusion: The 3DBOT technique showed to be a viable option for treating anterior open bite

O tratamento compensatório da Classe II e mordida aberta esquelética com bráquetes autoligados – relato de caso

Class II malocclusion can be dental, skeletal or a combination of both and is present in approximately 60% of patients seeking corrective orthodontic treatment. Facial Pattern II patient often needs dental decompensation associated with orthognathic surgery to correct the bone bases. With the increasing use of the self-ligating system in Orthodontics, the number of patients who were indicated for extraction as part of their treatment has decreased considerably. Compensatory treatment aims to minimize skeletal deformities with dento-alveolar movements. This paper reports through a clinical case, the efficiency of the self-ligating system in Pattern II patient without extractions with expansionist therapeutic goals in association with the use of Class II elastics. Due to the patient’s rejection of orthognathic surgery, the compensatory treatment resulted in the camouflage of the skeletal discrepancies through the self-ligating system. Despite the surgical indication, the compensatory treatment presented significant dental movements, resulting in treatment success with considerable facial improvement.