Orientador: Francisco Antônio Bertoz / Banca: Eduardo César Almada Santos / Banca: José Alberto de Souza Freitas / Banca: Francisco Antônio Bertoz / Resumo: O presente estudo cefalométrico longitudinal investigou as alterações espontâneas ocorridas em crianças com má oclusão Classe II, divisão 1, Padrão II, em crescimento. Foram selecionadas 40 crianças, 20 meninos e 20 meninas, distribuídas na faixa etária compreendida entre 6 anos e 14 anos de idade. Para avaliar o comportamento das bases apicais, dos incisivos e do tecido mole, as seguintes grandezas cefalométricas foram mensuradas: SN.Ba, SNA, SNB, SND, SN.Pog, ANB, NAP, SN.PP, SN.GoGn, SN.Gn, Ar.Go.Gn, 1.PP, 1.NA, 1.SN, IMPA e ANL. As seguintes grandezas alcançaram significância estatística com o crescimento: SNB, SND, SN.Pog, ANB, NAP, SN.GoGn, SN.Gn, Ar.Go.Gn e IMPA. Os resultados demonstraram que as principais alterações quantitativas registradas estavam relacionadas com o crescimento mandibular, independentemente do sexo. A mandíbula deslocou-se para frente, com tendência de rotação no sentido anti-horário e com conseqüente redução nos ângulos de convexidade facial. No entanto, as oscilações quantitativas nas grandezas cefalométricas não foram suficientes para mudar a morfologia dentofacial ao longo do período de acompanhamento. Conclui-se, portanto, que a morfologia facial é definida precocemente e é mantida, configurando o determinismo genético na determinação do arcabouço esquelético. / Abstract: The current longitudinal cephalometric study investigated the spontaneous alterations in growing Class II, division 1, Pattern II patients. Forty children (twenty boys and twenty girls) with ages ranging between 6 and 14 years were selected to comprise the sample. The behavior of the apical bases, incisors and facial profile was evaluated on the basis of the following cephalometric measurements: SN.Ba, SNA, SNB, SND, SN.Pog, ANB, NAP, SN.GoGn, SN.PP, SN.Gn, Ar.Go.Gn, 1.PP, 1.NA, 1.SN, IMPA and nasolabial angle. The following measurements were statistically significant along growth: SNB, SND, SN.Pog, ANB, NAP, SN.GoGn, SN.Gn, Ar.Go.Gn and IMPA. The results showed that the main quantitative alterations were related to mandibular growth, regardless of gender. The mandible was anteriorly displaced and tended to present a counter-clockwise rotation and consequent decrease in the facial convexity angles. However, the quantitative changes in the cephalometric measurements were not sufficient to change the dentofacial morphology during the follow-up period. Therefore, facial morphology seems to be defined early and does not change along growth. / Mestre

Orientador: Ary dos Santos-Pinto / Banca: Ana Claudia Moreira Melo / Banca: Dirceu Barnabé Raveli / Resumo: A deficiência de dados na literatura nos levou a avaliar o efeito do tratamento com o aparelho Bionator de Balters nas alterações das dimensões e relacionamento dos arcos dentários em crianças com má-oclusão Classe II, divisão 1 de Angle. O grupo experimental foi consistituido de 36 pares de modelos de pacientes leucodermas com idades entre 7 anos e 10 meses e 11 anos e 8 meses sendo 10 do gênero feminino e 8 do gênero masculino. A seleção da amostra teve como critérios de inclusão a presença dos incisivos centrais e laterais erupcionados, ausência de apinhamento dentário e relação transversal dos arcos normais. Um grupo controle (pseudo-amostra controle) foi simulado a partir de uma amostra obtida por Moyers com idade e gêneros aproximadamente iguais ao grupo experimental. A análise dos modelos constou de 24 medidas das quais 18 puderam ser comparadas com a pseudo-amostra. A aplicação do teste de Levene mostrou evidências estatísticas de semelhança entre os grupos. Procedeu-se então a análise estatística que mostrou alterações significantes (p<0,005) nas variáveis indicativas de distância intermolares superiores, sobressaliência horizontal, comprimento total do arco superior, comprimento anterior do arco superior, comprimento posterior do arco superior, relação molar direita, relação molar esquerda, relação canino direita e relação canino esquerda. Por outro lado não houve alteração significante em relação as medidas do arco inferior e distancia intercaninos do arco superior. Pode ser concluído com base nos resultados encontrados que o uso do aparelho Bionator de Balters teve efeito favorável na melhora da correção da má-oclusão de Classe II (diminuição das relações molares e caninos) e um aumento transversal do arco superior, principalmente na região posterior do arco. / Abstract: The deficiency of data in the literature took us to evaluate the Bionator of Balters appliance in the alterations of the dimensions and relationship of the dental archs in children with malocclusion Class II, Division 1 of Angle. The experimental group was constituted of 36 pairs of cast of leucodermas patients between the age of 7 years and 10 months and 11 years and 8 months, being 10 females and 8 males. The sample selection had as criterion of inclusion the presence of the central and lateral incisor erupted, absence of crowded teeth and normal transversal relationship. A control group (pseudo-sample group) was simulated beginning from a sample obtained by Moyers with approximately the same age and gender to the experimental group. The analysis of the casts consisted of 24 measures and 18 of them could be compared with the pseudo-sample. The Leveneþs test showed statistical evidences of likeness among the groups. Statistical analysis was proceeded with showed significant alterations (p<0,005) in the variable indicatives of distance of maxillary first molars, over jet, total length of upper arch, anterior length of the upper arch, right molar relationship, left molar relationship, right canine relationship and left canine relationship. On the other hand, there wasn't significant alteration related to the lower arch and maxillary intercanines distance. It be concluded with the use of the Bionator of Balters appliance that it had a favorable effect in the improvement of the correction of the malocclusion in Class II (decrease of the molars and canines relationship) and transversal increase of the upper arch, mainly in the posterior area of arch. / Mestre

Introduction : Certaines études ont démontré que les patients présentant un trouble du déficit de l’attention et de l’hyperactivité (TDAH) ont plus de problèmes respiratoires du sommeil et d’habitudes orales parafonctionnelles. Bien que ces facteurs puissent être liés aux malocclusions dentaires, aucune donnée n’a encore permis de déterminer si la prévalence de malocclusions dentaires et la nécessité d'un traitement orthodontique sont plus élevés chez les enfants atteints d’un TDAH. Ainsi, une étude plus approfondie de la prévalence et de la sévérité des malocclusions dentaires chez ces patients est importante pour favoriser un diagnostic précoce et une planification optimale de leur traitement orthodontique. Objectifs : Les objectifs primaires de la présente étude sont de : (i) comparer la sévérité des malocclusions des patients avec TDAH et des patients sans TDAH et de (ii) déterminer le type de malocclusion le plus fréquent chez les patients avec TDAH. Les objectifs secondaires de l’étude sont d’évaluer le lien entre : (i) les habitudes orales parafonctionnelles et les malocclusions des patients avec TDAH et (ii) la prise de médicaments utilisés dans le traitement du TDAH et les malocclusions dentaires. Matériels et méthodes : Les patients ont été divisés en deux groupes : un groupe de patients avec TDAH (n = 44) et un groupe contrôle (n = 44). Un questionnaire médical et un examen orthodontique ont été complétés pour chaque patient. Résultats : Les patients atteints de TDAH présentaient une plus grande sévérité de malocclusion (p=0,042), un plus grand nombre de rotation dentaire (p=0,021) et plus d’habitudes orales parafonctionnelles (p=0,001) que le groupe contrôle. Les habitudes orales présentent de façon plus significative chez les patients atteints d’un TDAH comparativement au groupe contrôle étaient le bruxisme (p=0,005) et l’utilisation de la suce pendant l’enfance (p=0,009). Conclusion : Il est important de prendre conscience du risque accru d’habitudes orales parafonctionnelles et de malocclusion dentaire chez les patients atteints de TDAH et de développer des programmes de prévention ainsi que des stratégies thérapeutiques à leur égard. / Introduction: Evidence has shown that patients with attention deficit and hyperactivity disorder (ADHD) have more sleep-breathing problems and parafunctional oral habits. Although these factors can be related to dental malocclusion, it is still unclear if the prevalence of malocclusion and need for orthodontic treatment are higher in children with ADHD. Thus, the knowledge about its prevalence and severity in children with ADHD is valuable in their early diagnosis and treatment planning. Objectives: The primary objectives of this study are: (i) to compare the type of malocclusions of patients with ADHD and patients without ADHD and (ii) to determine the most common type of malocclusion in patients with ADHD. The secondary objectives of the study are to assess the link between: (i) parafunctional oral habits and malocclusions of patients with ADHD and (ii) the drugs used in the treatment of ADHD and malocclusions. Materials and Methods: Patients were divided in two groups: ADHD (n=44) and control (n=44). A medical questionnaire and an orthodontic examination were completed for each patient. Results: Compared to the control group, patients with ADHD had a significantly higher severity of malocclusion (p=0.042), more dental rotation (p=0.021) and more parafunctional oral habits (p=0.001), especially bruxism (p=0.005) and history of pacifier use (p=0.009). Conclusion: It is important to be aware of the increased risk of oral habits and dental malocclusion among ADHD patients and to develop preventive programs as well as therapeutic strategies for them.

Introduction : La scaphocéphalie est la craniosynostose monosuturaire la plus commune (1/2000). Celle-ci est causée par la fusion prématurée de la suture sagittale. Une chirurgie corrective de la voûte crânienne peut être effectuée dans la première année de vie de l’enfant. Il n’existe actuellement aucune donnée précise dans la littérature scientifique étudiant l’occlusion chez les patients scaphocéphales, ainsi que les impacts potentiels de la chirurgie de la voûte crânienne sur celle-ci. Objectifs : L’objectif primaire de cette étude est de décrire et comparer la malocclusion dento-squelettique d’un groupe de patients scaphocéphales à une population pédiatrique normale. L’objectif secondaire est d’évaluer la différence au niveau de l’occlusion entre un sous-groupe de patients scaphocéphales ayant eu une chirurgie corrective de la voûte crânienne et un sous-groupe ne l’ayant pas eu. Méthodologie : Quatre-vingt-onze patients scaphocéphales (2-11 ans; 71 garçons) de la banque de données de la Clinique de Craniofacial du CHU Ste-Justine ont formé le groupe expérimental. Tous les patients ont eu un examen orthodontique complet et ont été suivis. Parmi ceux-ci, quarante-quatre avaient eu une chirurgie corrective de la voûte crânienne et quarante-sept n’en avaient pas eu, mais étaient suivis régulièrement à la clinique. Trente-huit (33 garçons; 17 opérés) de ces patients ont eu des radiographies céphalométriques latérales et parmi ceux-ci, un certain nombre ont reçus des suivis de croissance radiologiques. Résultats : Les valeurs cliniques de la classification dentaire, ainsi que la mesure du surplomb horizontal, ont indiqué une augmentation de la prévalence de malocclusions de classe II chez les enfants scaphocéphales. Par contre, les valeurs céphalométriques indicatrices de malocclusion squelettique de classe II (ex. : N-A perp HP, N-B perp HP, N-Pog perp HP, Wits, N-A-Pog) sont demeurées dans les limites de la normale. Certaines valeurs céphalométriques présentent une différence statistiquement significative entre les patients opérés et non opérés (ANS-PNS t2, p=0.025; /1-FH t2, p=0.028), mais ces variations individuelles ne sont pas reliées à la scaphocéphalie. Conclusion : Les enfants scaphocéphales présentent cliniquement davantage de malocclusions de classe II que les enfants normaux. Par contre, les valeurs radiologiques antéro-postérieures et transverses demeurent dans les limites de la normale. La chirurgie corrective de la voûte crânienne n’affecte également pas l’occlusion chez ces patients. / Introduction: Scaphocephaly, the most common unisutural craniosynostosis (1/2000), results from a premature fusion of the sagittal suture. Usually, cranial vault corrective surgery is performed during the first year of life. There is currently no scientific data regarding occlusion of scaphocephalic patients, or the potential effect of craniovault surgery on the occlusion. Objectives: The primary objective of this study is to describe occlusion in scaphocephalic patients and to compare with a general pediatric population matched for age and gender. The second objective is to compare the difference in occlusion of surgically treated scaphocephalic subgroup versus unoperated scaphocephalic subgroup. Methods: Ninety-one scaphocephalic patients (2-11 y.o.; 71 boys) from the craniofacial clinic of CHU Ste-Justine’s database formed our experimental group. All patients received an orthodontic assessment and were followed up. Among them, forty-four underwent craniovault surgery while forty-seven remained unoperated. Thirty-eight (33 boys; 17 operated) had lateral cephalometric radiographies, some of whom also had cephalometric growth follow-ups. Results: Clinical values for dental classification and overjet indicate an increased prevalence of class II malocclusions in scaphocephalic patients. However, cephalometric values indicative of skeletal class II malocclusions (i.e. N-A perp HP, N-B perp HP, N-Pog perp HP, Wits, N-A-Pog) remained within normal limits. Some cephalometric values present statistically significant differences between operated and unoperated patients (ANS-PNS t2, p=0.025; /1-FH t2, p=0.028), but these are individual variations not related to scaphocephaly. Conclusion: Scaphocephalic patients clinically present more class II malocclusions when compared with normal children. Radiographic values remain however within normal limits for both antero-posterior and transverse dimensions. Corrective craniovault surgery does not affect occlusion in these patients.

Introduction : La scaphocéphalie est la craniosynostose monosuturaire la plus commune (1/2000). Celle-ci est causée par la fusion prématurée de la suture sagittale. Une chirurgie corrective de la voûte crânienne peut être effectuée dans la première année de vie de l’enfant. Il n’existe actuellement aucune donnée précise dans la littérature scientifique étudiant l’occlusion chez les patients scaphocéphales, ainsi que les impacts potentiels de la chirurgie de la voûte crânienne sur celle-ci. Objectifs : L’objectif primaire de cette étude est de décrire et comparer la malocclusion dento-squelettique d’un groupe de patients scaphocéphales à une population pédiatrique normale. L’objectif secondaire est d’évaluer la différence au niveau de l’occlusion entre un sous-groupe de patients scaphocéphales ayant eu une chirurgie corrective de la voûte crânienne et un sous-groupe ne l’ayant pas eu. Méthodologie : Quatre-vingt-onze patients scaphocéphales (2-11 ans; 71 garçons) de la banque de données de la Clinique de Craniofacial du CHU Ste-Justine ont formé le groupe expérimental. Tous les patients ont eu un examen orthodontique complet et ont été suivis. Parmi ceux-ci, quarante-quatre avaient eu une chirurgie corrective de la voûte crânienne et quarante-sept n’en avaient pas eu, mais étaient suivis régulièrement à la clinique. Trente-huit (33 garçons; 17 opérés) de ces patients ont eu des radiographies céphalométriques latérales et parmi ceux-ci, un certain nombre ont reçus des suivis de croissance radiologiques. Résultats : Les valeurs cliniques de la classification dentaire, ainsi que la mesure du surplomb horizontal, ont indiqué une augmentation de la prévalence de malocclusions de classe II chez les enfants scaphocéphales. Par contre, les valeurs céphalométriques indicatrices de malocclusion squelettique de classe II (ex. : N-A perp HP, N-B perp HP, N-Pog perp HP, Wits, N-A-Pog) sont demeurées dans les limites de la normale. Certaines valeurs céphalométriques présentent une différence statistiquement significative entre les patients opérés et non opérés (ANS-PNS t2, p=0.025; /1-FH t2, p=0.028), mais ces variations individuelles ne sont pas reliées à la scaphocéphalie. Conclusion : Les enfants scaphocéphales présentent cliniquement davantage de malocclusions de classe II que les enfants normaux. Par contre, les valeurs radiologiques antéro-postérieures et transverses demeurent dans les limites de la normale. La chirurgie corrective de la voûte crânienne n’affecte également pas l’occlusion chez ces patients. / Introduction: Scaphocephaly, the most common unisutural craniosynostosis (1/2000), results from a premature fusion of the sagittal suture. Usually, cranial vault corrective surgery is performed during the first year of life. There is currently no scientific data regarding occlusion of scaphocephalic patients, or the potential effect of craniovault surgery on the occlusion. Objectives: The primary objective of this study is to describe occlusion in scaphocephalic patients and to compare with a general pediatric population matched for age and gender. The second objective is to compare the difference in occlusion of surgically treated scaphocephalic subgroup versus unoperated scaphocephalic subgroup. Methods: Ninety-one scaphocephalic patients (2-11 y.o.; 71 boys) from the craniofacial clinic of CHU Ste-Justine’s database formed our experimental group. All patients received an orthodontic assessment and were followed up. Among them, forty-four underwent craniovault surgery while forty-seven remained unoperated. Thirty-eight (33 boys; 17 operated) had lateral cephalometric radiographies, some of whom also had cephalometric growth follow-ups. Results: Clinical values for dental classification and overjet indicate an increased prevalence of class II malocclusions in scaphocephalic patients. However, cephalometric values indicative of skeletal class II malocclusions (i.e. N-A perp HP, N-B perp HP, N-Pog perp HP, Wits, N-A-Pog) remained within normal limits. Some cephalometric values present statistically significant differences between operated and unoperated patients (ANS-PNS t2, p=0.025; /1-FH t2, p=0.028), but these are individual variations not related to scaphocephaly. Conclusion: Scaphocephalic patients clinically present more class II malocclusions when compared with normal children. Radiographic values remain however within normal limits for both antero-posterior and transverse dimensions. Corrective craniovault surgery does not affect occlusion in these patients.

Made available in DSpace on 2014-06-11T19:33:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-10-29Bitstream added on 2014-06-13T20:05:10Z : No. of bitstreams: 1 farias_ac_dr_araca.pdf: 7772446 bytes, checksum: d72f25c93e09f3c730b41f634d9cc7ea (MD5) / Neste trabalho foram avaliadas as alterações esqueléticas e dentárias ocorridas após o tratamento da má-oclusão de classe II, divisão1ª, com a utilização do aparelho extrabucal com tração cervical tipo Kloehn (KHG), forças ortopédicas e expansão rápida da maxila. O tratamento foi realizado em 28 pacientes com idade cronológica entre 9 anos e 6 meses e 11 anos completos e maturação das vértebras cervicais nos estágios de iniciação (12 pacientes), aceleração (10 pacientes) ou transição (6 pacientes), os quais foram avaliados por meio de cefalometria de Ricketts em telerradiografias em norma lateral nas fases pré-tratamento (T1), pós-tratamento ou após a correção da relação molar (T2) e 12 meses pós-tratamento (T3). Após a análise estatística realizada pelo teste de Newman-Keuls para comparações múltiplas e análise de variância (P<0,05%), os resultados mostraram que não houve deslocamento posterior da maxila, mas o deslocamento anterior foi inibido. O crescimento mandibular normal e a concomitante inibição do deslocamento anterior da maxila contribuíram para a obtenção de uma relação molar de Classe I. Houve movimento distal dentoalveolar dos caninos e molares superiores. A expansão maxilar previamente à utilização do AEB com forças ortopédicas não contribuiu para o movimento posterior da maxila. O tempo médio para a correção da relação molar foi de 6 meses. / This study evaluated the skeletal and dental changes after Class II, Division 1 malocclusion treatment with Kloehn cervical headgear (KHG), orthopedics forces and previous maxillary expansion. The sample consisted of 28 subjects, all with chronological ages between 9 years and 6 months and 11 years and Cervical Vertebral Maturation (CVM) at the stages initiation (12 subjects), acceleration (10 subjects) or transition (6 subjects). Ricketts lateral cephalograms were taken at three phases: pretreatment (T1), posttreatment or after the correction of the molar relation (T2) and 12 months posttreatment (T3). Statistical analysis was performed with the test of Newman-Keuls for multiple comparisons and analysis of variance (P<0.05%) to determine the skeletal and dental changes. Results demonstrated that the maxilla was not displaced posteriorly, but its anterior displacement was inhibited. The normal mandibular growth and the inhibition of the anterior displacement of the maxilla contributed for the achievement of the Class I molar relationship. Cuspids and upper molars dentoalveolar distal movement were found. Maxillary expansion previously to the use of KHG with orthopedics forces did not contribute for the posterior maxillary movement. The average time for molar correction was six months.

Made available in DSpace on 2014-06-11T19:27:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-12-21Bitstream added on 2014-06-13T20:36:30Z : No. of bitstreams: 1 silvafilho_og_me_araca.pdf: 3432692 bytes, checksum: 28a43fbdf51085c316a78ddb24c2abf2 (MD5) / Universidade Estadual Paulista (UNESP) / O presente estudo cefalométrico longitudinal investigou as alterações espontâneas ocorridas em crianças com má oclusão Classe II, divisão 1, Padrão II, em crescimento. Foram selecionadas 40 crianças, 20 meninos e 20 meninas, distribuídas na faixa etária compreendida entre 6 anos e 14 anos de idade. Para avaliar o comportamento das bases apicais, dos incisivos e do tecido mole, as seguintes grandezas cefalométricas foram mensuradas: SN.Ba, SNA, SNB, SND, SN.Pog, ANB, NAP, SN.PP, SN.GoGn, SN.Gn, Ar.Go.Gn, 1.PP, 1.NA, 1.SN, IMPA e ANL. As seguintes grandezas alcançaram significância estatística com o crescimento: SNB, SND, SN.Pog, ANB, NAP, SN.GoGn, SN.Gn, Ar.Go.Gn e IMPA. Os resultados demonstraram que as principais alterações quantitativas registradas estavam relacionadas com o crescimento mandibular, independentemente do sexo. A mandíbula deslocou-se para frente, com tendência de rotação no sentido anti-horário e com conseqüente redução nos ângulos de convexidade facial. No entanto, as oscilações quantitativas nas grandezas cefalométricas não foram suficientes para mudar a morfologia dentofacial ao longo do período de acompanhamento. Conclui-se, portanto, que a morfologia facial é definida precocemente e é mantida, configurando o determinismo genético na determinação do arcabouço esquelético. / The current longitudinal cephalometric study investigated the spontaneous alterations in growing Class II, division 1, Pattern II patients. Forty children (twenty boys and twenty girls) with ages ranging between 6 and 14 years were selected to comprise the sample. The behavior of the apical bases, incisors and facial profile was evaluated on the basis of the following cephalometric measurements: SN.Ba, SNA, SNB, SND, SN.Pog, ANB, NAP, SN.GoGn, SN.PP, SN.Gn, Ar.Go.Gn, 1.PP, 1.NA, 1.SN, IMPA and nasolabial angle. The following measurements were statistically significant along growth: SNB, SND, SN.Pog, ANB, NAP, SN.GoGn, SN.Gn, Ar.Go.Gn and IMPA. The results showed that the main quantitative alterations were related to mandibular growth, regardless of gender. The mandible was anteriorly displaced and tended to present a counter-clockwise rotation and consequent decrease in the facial convexity angles. However, the quantitative changes in the cephalometric measurements were not sufficient to change the dentofacial morphology during the follow-up period. Therefore, facial morphology seems to be defined early and does not change along growth.

Introduction: L’arthrite juvénile idiopathique (AJI) est la maladie rhumatologique la plus répandue chez les enfants. Lorsque l’articulation temporo-mandibulaire est touchée, le processus inflammatoire peut causer une perturbation de la croissance cranio-faciale et une destruction du condyle, ce qui peut engendrer des difformités dentofaciales et des malocclusions dentaires. Des facteurs environnementaux, tels que les médicaments et les habitudes parafonctionnelles, ont le potentiel d’influencer la progression de la maladie et, par conséquent, jouer un rôle dans l’étiologie des malocclusions des patients avec AJI. Objectifs : L’objectif principal est de comparer la fréquence et la sévérité des malocclusions des patients avec et sans AJI. L’objectif secondaire est d’investiguer la relation entre la sévérité des malocclusions des patients avec AJI et leurs médicaments et habitudes parafonctionnelles. Méthodes: L’échantillon était divisé en deux groupes: AJI (n=30) et contrôle (n=30). Un questionnaire médical, un examen orthodontique et un examen radiologique ont été complétés pour chaque patient. Résultats : Par rapport au groupe contrôle, les enfants avec AJI avaient plus d’asymétries dentofaciales (p=0.009), de classe II canines (p=0.05) et molaires (p<0.001), de surplombs vertical > 3.5 mm (p=0.011) et horizontal > 5.0 mm (p=0.033) augmentés, des courbes de Spee (p=0.044), de Wilson (p=0.044) et de Monson (p=0.003) accentuées, de chevauchement incisif mandibulaire (p=0.042) et de manque transverse maxillaire (p<0.001). Les médicaments et les habitudes parafonctionnelles n’avaient pas d’impact sur les malocclusions. Conclusion : Les enfants avec AJI avaient des malocclusions plus sévères. Un diagnostic précoce et des traitements médicaux et orthodontiques opportuns sont essentiels pour prévenir les dommages irréversibles causés par la maladie. / Introduction: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease found in children. In cases affecting the temporomandibular joint (TMJ), the inflammatory process may cause disturbances in craniofacial growth and condylar destruction, both of which can lead to dentofacial deformities and dental malocclusions. Environmental factors such as medication and parafunctional habits have the potential to influence the disease progression and therefore play a role in the etiology of malocclusions of children with JIA. Objectives: The main objective of this study was to compare the frequency and the severity of malocclusions of patients with and without JIA. The secondary objective was to investigate the relationship between the severity of malocclusions of patients with JIA and their medication and parafunctional habits. Methods: The sample was divided into two groups: JIA (n=30) and control (n=30). A health questionnaire, an orthodontic examination, and radiographic records were completed for each patient. Results: Compared to the control group, children with JIA had more dentofacial asymmetry (p=0.009), Class II canine (p=0.05) and molar (p<0.001) relationships, increased overbite > 3.5 mm (p=0.011) and overjet > 5.0 mm (p=0.033), accentuated curves of Spee (p=0.044), Wilson (p=0.029) and Monson (p=0.003), lower incisor crowding (p=0.042) and maxillary transverse discrepancy (p<0.001). Medication and parafunctional habits did not influence malocclusions. Conclusion: Children with JIA have more severe malocclusions. An early diagnosis and timely medical and orthodontic treatment are crucial to prevent the irreversible damage caused by the disease.

published_or_final_version / abstract / Dentistry / Doctoral / Doctor of Philosophy

The purpose of this prospective clinical study was to investigate differences in outcomes from two common treatment modalities used to reduce deep overbite: maxillary incisor intrusion using an intrusion arch and posterior tooth eruption using an anterior bite plate and to assess their influence on smile esthetics. Pre-treatment and post-overbite correction records were gathered from 40 patients with deep overbite malocclusions at the Virginia Commonwealth University orthodontic clinic. Intrusion arch patients displayed significant reductions in maxillary incisor display accompanying documented incisor intrusion. Bite plate patients showed significant lower incisor intrusion and increases in the mandibular plane angle. When compared to the bite plate group, there was a greater tendency for flattening of the smile arc seen in the intrusion arch group. Changes in the smile arc were likely partially a result of the mechanics used but may also have been due to other factors involved in orthodontic tooth alignment.