Bakgrund: Ortodontisk behandling utförs vanligtvis på ungdomar och kan innebära en risk för den orala hälsan. Studier har visat att patienter med fast apparatur löper större risk att utveckla svullen gingiva och karies. Syfte: Syftet med studien är att undersöka tandvårdspersonalens rutiner kring munhygien hos patienter med fast apparatur på ortodontikliniker. Metod: Studien är en kvantitativ tvärsnittsstudie i form av en enkät med 11 frågor. Enkäten skickades till fyra ortodontikliniker i fyra olika län i södra Sverige. Enkäten innehöll frågor gällande munhygien-rutiner och tandhygienistprofessionen. Sammanlagt 59 personer tillfrågades delta i studien. Resultat: Enkäten besvarades av 38 personer. Resultatet visade att majoriteten av deltagarna in-struerade munhygieninstruktion vid insättning av fast apparatur och vid uppvisad dålig munhy-gien. Samtliga deltagare instruerade munhygien på patienten och större delen gav även samtal och uppföljning. Gällande tandhygienistprofessionen har majoriteten av klinikerna inte någon tandhygienist anställd. Av samtliga deltagare ansåg 29% (n=11) att det skulle vara bra att ha en tandhygienist anställd på ortodontikliniker och 45% (n=17) såg behov av kontakt. Slutsats: Det fanns inte några större skillnader mellan professionerna och klinikerna gällande munhygienru-tiner och hur de utförs. Nästan hälften av deltagarna såg behov av kontakt med tandhygienist vid insättning av fast apparatur och vid munhygieninstruktion. / Background: Orthodontic treatment is usually performed on adolescents and increase risks for the oral health. Studies have shown that patients with fixed appliances more likely develop gingival enlargement and caries. Aim: The aim of this study was to investigate the dental pro-fessional’s routines including oral hygiene in patients with fixed appliances on orthodontic clin-ics. Method: The study was a quantitative cross-sectional study with questionnaire regarding 11 questions. The questionnaire was sent to four orthodontic clinics in four counties in southern Sweden and contained questions regarding oral hygiene routines and dental hygienists. Alto-gether 59 individuals were asked to participate. Results: The questionnaire was answered by 38 individuals. The result showed that the majority gave oral hygiene instructions at insertion of fixed appliances and when oral hygiene was poor. All participants practice oral hygiene in-structions on patients and almost everyone had conversations and follow-up visits. The majority of clinics didn´t have dental hygienists employed. Of all participants 29% (n=11) thought it would be good to have dental hygienists employed and 45% (n=17) saw need of contact. Conclusion: No major differences between professions and clinics were shown regarding oral hy-giene routines and performance. Almost half of the participants saw need of contact with dental hygienists.

Thesis (MScEng)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Orthodontics is the eld of dentistry concerned with the treatment of maloc- clusion and anomalies of the dento-facial complex. This thesis is concerned with studying the underlying biomechanical principles of orthodontic tooth movement. It aims to develop a novel treatment approach and an orthodontic appliance to facilitate said approach by employing advanced technologies. A thorough review of the literature is used to form a comprehensive knowledge base pertaining to the factors a ecting orthodontic tooth movement. It is hypothesised that an electromechanical orthodontic appliance could improve treatment by characterising orthodontic cases based on the relationship be- tween the applied mechanical stimulus and the resulting changes to the af- fected structures, which can then be sensed by the appliance. A prototype is built using electronically controllable linear actuators and a custom built force transducer system for measuring orthodontic forces. Electronic circuits are de- veloped to connect the appliance to a USB port and allow it to be controlled from a graphical user interface (GUI). This further facilitates real-time viewing of important orthodontic parameters. Experiments are carried out to evaluate the appliance functionality with regard to the proposed hypothesis. To con- clude, the relevance of the results to the orthodontic eld is highlighted and recommendations for further development of an electromechanical orthodontic appliance are provided. / AFRIKAANSE OPSOMMING: Ortodonsie is die vakgebied in tandheelkunde gemoeid met die behandeling van wanpassing en abnormaliteit van die tand- en gesig-area. Hierdie tesis bestudeer die onderliggende biomeganiese beginsels van ortodontiese tandbeweging om sodoende 'n nuwe benadering sowel as 'n ortodontiese apparaat te ontwikkel om die genoemde benadering te fasiliteer deur gebruik te maak van gevorderde tegnologie. 'n Deeglike oorsig van die literatuur word gebruik om 'n omvattende kennisbasis op te bou rondom die faktore wat ortodontiese tandbeweging a ekteer. Die hipotese word gestel dat 'n elektromeganiese ortodontiese apparaat behandeling kan verbeter deur ortodontiese gevalle te identi seer/- karakteriseer gebaseer op die verhouding tussen die toegepaste meganiese stimulus en die gevolglike veranderinge aan die gea ekteerde strukture wat deur die apparaat aangevoel word. Elektronies-beheerbare lineêre aandrywers en 'n pasgemaakte krag-oordraerstelsel vir die meet van ortodontiese kragte word gebruik om 'n prototipe te vervaardig. Elektroniese stroombane word ontwikkel om die apparaat te koppel aan 'n USB poort sodat dit beheer kan word d.m.v. 'n gra ese gebruikerskoppelvlak. Eksperimente poog om die apparaat funksioneel te evalueer volgens die voorgestelde hipotese. Ter afsluiting: die toepaslikheid van die verwerfde resultate in die ortodontiese vakgebied word beklemtoon en aanbevelings word gemaak vir toekomstige/verdere ontwikkelings m.b.t. 'n elektromeganiese ortodontiese apparaat.

Self-etching primers (SEP) have recently simplified the orthodontic bonding process and questions have arisen regarding their reliability and efficiency. The goal of this study was to assess the importance of a pumice prophylaxis prior to bonding with SEP (Transbond Plus, 3M Unitek, Monrovia, CA) in reducing bond failures. Thirty orthodontic patients volunteered to participate in this split-mouth prospective clinical trial. A pumice prophylaxis experimental group and a non-pumice control group of teeth were randomly assigned in a contralateral quadrant pattern within each patient. A total of 508 teeth were bonded and monitored over 3 months for bond failures. There were 35 total failures (6.9%) with 6 (2.4%) in the pumice group and 29 (11.4%) in the non-pumice group. Bond failures were compared as a total number between groups and also as the number of patients who experienced bond failures with each method using Chi-square analysis. There were statistically significant differences both in the total number of bond failures (P < .001) and in the number of patients with bond failures between groups (P < .01). A significantly lower and clinically acceptable bond failure rate was demonstrated when using Transbond Plus SEP after pumice prophylaxis. This study produced strong evidence to suggest the need for pumice prophylaxis in orthodontic bonding when using SEP.

Following eruption of a tooth into the oral cavity, enamel is thought to continue to calcify. The continued calcification and maturation of enamel is described as "post-eruptive enamel maturation." It is believed that an observed decrease in enamel pore size and increase in the calcification of enamel matrix over time can be attributed to this process. In recent years, there has been a significant increase in the number of adult patients seeking orthodontic treatment. Since orthodontic attachments are bonded directly to the etched enamel using composite resin, post-eruptive enamel maturation may affect the bonding process. The purpose of this study was to determine whether there were differences in bond strength between mature and newly erupted teeth when using both conventional and self-etching primer techniques for bonding orthodontic appliances. The nature of adhesive bond failure among the groups was also compared using an adhesive remnant index (ARI). Etched surfaces were examined under scanning electron microscopy (SEM) and representative photomicrographs were taken. Human premolars were collected and bonded randomly with either the conventional or self-etching technique. Brackets were debonded using an Instron testing machine in shear-testing mode. There were no statistically significant differences in the bond strengths between the self-etching primer and conventional etching groups. ARI scores showed differences between mature and newly erupted teeth. Mature teeth had more cohesive bond failures whereas newly erupted teeth had more adhesive failures at the enamel-composite resin interface. Scanning electron micrographs (SEMs) of self-etched enamel revealed smooth areas of resin with filler particles. Conventionally etched enamel had rougher surfaces. There were no differences in etch pattern of new versus mature enamel. Further research may be needed as new bonding materials and techniques become available to determine the effects, if any, of post-eruptive enamel maturation on their success.

INTRODUCTION: Alors qu’il existe aujourd'hui différents genres de traitements orthodontiques esthétiquement acceptables, les patients s'inquiètent maintenant de la durée des traitements. L'appareil AcceleDent® a été introduit sur le marché par OrthoAccel Technologies en 2009. Ce dispositif, placé entre les dents pendant 20 minutes par jour, vibre à une fréquence de 30 Hz et est préconisé pour accélérer le traitement. L’objectif primaire est d’évaluer la précision de la simulation ClinCheck® par rapport aux résultats finaux réels pour les deux groupes. L’objectif secondaire est de déterminer si le résultat final est influencé par une progression plus rapide des gouttières d’alignement. MATÉRIELS & MÉTHODES: Une étude rétrospective qui comprend 38 patients traités avec la technique Invisalign®. Le groupe expérimental, c’est-à-dire celui qui utilise l’AcceleDent®, comprend 13 patients tandis que le groupe contrôle inclut 25 patients. La sévérité de la malocclusion a été quantifiée avec le «Discrepancy Index de l’ABO». Concernant la prédiction des résultats de la simulation ClinCheck® et le résultat du traitement final, l’«Objective Grading System de l’ABO » a été utilisé pour quantifier ces derniers. Toutes les données ont été prises à partir du logiciel OrthoCAD (Cadent, Fairview, NJ). RÉSULTATS ET DISCUSSION: Il n'y a pas de différence statistiquement significative entre la malocclusion des 2 groupes. (p=0,761). Pour les résultats finaux, il existe une différence statistiquement significative. L'alignement est meilleur dans le groupe contrôle (p=0,002). Au sein de chaque groupe, la différence entre les résultats prédits et réels n’est pas statistiquement significative (p=0,056). L’utilisation de l’AcceleDent® semble donner un surplomb horizontal plus proche de celui prédit, cependant ceci n’est pas cliniquement significatif. CONCLUSION: L’utilisation de l’appareil AcceleDent® combiné à une progression plus rapide des coquilles aux sept jours influence négativement l’alignement final chez les patients traités par la technique Invisalign®. / INTRODUCTION: While there are presently many different options for aesthetic orthodontic treatment, patients are now concerned with the length of treatment. The AcceleDent® device was introduced by OrthoAccel Technologies in 2009. This device is placed between the teeth for 20 minutes a day, vibrates at a frequency of 30 Hz and is recommended to accelerate orthodontic treatment. This study’s primary objective is to evaluate the accuracy of the ClinCheck® simulation versus the actual final results. The secondary objective is to determine if the end result is influenced by the increased rate of treatment progression with the aligners. MATERIALS AND METHODS: A retrospective study design was used with 38 patients treated with Invisalign®. The experimental group consisted of 13 patients, while the control group included 25 patients. The severity of malocclusion was quantified with the Discrepancy Index approved by the American Board of Orthodontics. In addition, the ABO’s Objective Grading System was used to compare the prediction of the final result provided by the ClinCheck® simulation and the actual final treatment result. All data were taken from the OrthoCAD software (Cadent, Fairview, NJ). RESULTS AND DISCUSSION: There is no statistically significant difference between the two groups regarding their initial malocclusion (p= 0.761). For the final results, there is a statistically significant difference. The alignment is better in the control group (p = 0.002). Within each group, the difference between the predicted and the actual results are not statistically significant (p = 0.056). The use of AcceleDent® seems to give an overjet similar to that which was predicted; however, this finding is not clinically significant. CONCLUSION: The use of the AcceleDent® combined with changing aligners every seven days negatively influence the final alignment in patients treated with Invisalign®.

A dentição mista é suscetível a uma diversidade de fatores que podem alterar as dimensões do arco dentário, dificultando a erupção dos dentes permanentes. Este trabalho teve como objetivo avaliar as alterações nas dimensões do arco dentário superior, decorrentes do uso de aparelho parcial fixo 4 x 2. A amostra total foi composta por 48 pacientes, dos gêneros masculino e feminino, na faixa etária de 8 a 11 anos, com boa saúde periodontal, dentição mista no período intertransitório do desenvolvimento da oclusão, com presença dos incisivos centrais, laterais e primeiros molares permanentes, ausência dos segundos molares permanentes, que apresentavam falta de espaço para irromper caninos e pré-molares, relação classe II de molar, os quais foram divididos igualmente em dois grupos. No grupo experimental (G1), 24 pacientes foram tratados na clínica de Ortodontia Preventiva da Faculdade de Odontologia da Universidade de São Paulo, com aparelho parcial fixo 4 x 2, associado a fios ortodônticos expandidos de CuNiTi e molas abertas de NiTi. O grupo controle (G2) foi composto por 24 pacientes, os quais não foram tratados e foram avaliados quanto às alterações decorrentes do crescimento, sem intervenção ortodôntica, no mesmo período de tempo do grupo experimental. Foram realizadas moldagens em alginato no início, em cada consulta de ativação e no final do tratamento ortodôntico preventivo e os modelos em gesso foram escaneados e medidos. As telerradiografias laterais foram obtidas no início (T1) e ao final (T5) do tratamento com aparelho parcial fixo 4 x 2 e suas medidas avaliadas. No grupo controle (G2), os modelos e as radiografias foram escaneados e medidos no início (T1) e ao final (T2) do período de observação. Os resultados encontrados no grupo experimental (G1) mostraram aumento médio significativo no perímetro (p= 0) e na profundidade da arcada (p= 0), no entanto não houve alteração significativa na distância intermolares (p= 0.14). Ocorreu aumento não significativo (p= 0.37) da distância da coroa do incisivo central superior à linha Sela perpendicular (Sperp), e do ângulo 1 . Plano palatino, também não significativo (p= 0.13), entre os tempos (T1 e T5). Ocorreu diminuição média significativa da distância da coroa e da raiz do molar à linha Sperp, p= 0 e p= 0.004, respectivamente, assim como do ângulo 6 . Plano palatino (p= 0.03). Após análise dos resultados, concluímos que o aparelho parcial fixo 4 x 2 promoveu aumento no perímetro e na profundidade do arco dentário, distalização de corpo do molar superior (com distalização da coroa, da raiz e com controle da inclinação) e controlou a inclinação vestibular dos incisivos superiores. / The mixed dentition stage is susceptible to a number of factors that can change the dental arch dimensions, making it difficult for permanent teeth to erupt. The objective of this study was to evaluate the changes in the dimensions of an upper dental arch resulting from the use of 2 x 4 fixed partial appliance. In total, 48 male and female patients were selected, aged 8 to 11 years, of good periodontal health, mixed dentition in the intertransitional period of occlusion development, with presence of central and lateral incisors and first permanent molars, absence of permanent second molars, insufficient space for the eruption of canines and premolars, and class II molar relationship, which were equally divided in two groups. In the experimental group (G1), 24 patients were treated at the Preventive Orthodontics Clinic of the School of Dentistry of the University of São Paulo, with 2 x 4 fixed partial appliance, associated with expanded orthodontic CuNiTi wires and open NiTi springs. The control group (G2) consisted of 24 children who were not treated, but evaluated in terms of growth-related changes, without orthodontic intervention, in the same period as the experimental group. Alginate moldings were created in the beginning, at each visit, and at the end of the preventive orthodontic treatment, and the gypsum models were scanned and measured. Lateral teleradiographs were obtained in the beginning (T1) and at the end (T2) of the treatment with 2 x 4 fixed partial appliance, and the measurements were evaluated. In the control group (G2), the models and radiographs were scanned and measured in the beginning (T1) and at the end (T2) of the observation period. The results obtained in the experimental group (G1) showed a significant mean increase in the perimeter (p= 0) and depth (p= 0) of the arch; however, no significant change was observed in the intermolar distance (p= 0.14). An increase was observed, but not significant (p= 0.37), in the distance between the perpendicular Sella line (Sperp) and the crown of the maxillary central incisor, and between Sperp and 1 . Palatal plane angle, also not significant (p= 0.13), between T1 and T2. A significant mean reduction was observed in the distance between the Sperp line and the molar crown and root, p= 0 and p= 0.004, respectively, and between Sperp and 6 . Palatal plane angle (p= 0.03). After analyzing the results, this study concluded the 2 x 4 fixed partial appliance promoted an increase in the dental arch perimeter and depth, upper molar distalization (with distalization of the crown and root, and inclination control), and controlled buccal inclination of the upper incisors.

A proposta deste estudo consistiu em avaliar, por meio de telerradiografias em norma lateral, as alterações dentoesqueléticas e tegumentares promovidas pelo aparelho distalizador intrabucal Distal Jet. A amostra foi composta por 44 pacientes, divididos em dois grupos. O grupo 1, experimental, constituí-se de 22 pacientes, 5 do gênero masculino e 17 do feminino, com má oclusão de Classe II, sendo que, 72,72% apresentavam ½ Classe II, 18,18% ¼ de Classe II e 9,09% ¾ de Classe II. A idade inicial variou entre 10,54 anos e 14,77 anos (média de 12,71 anos). Estes pacientes receberam o tratamento com o distalizador intrabucal Distal Jet, por um período médio de 1,20 anos. O grupo 2, controle, composto por 22 pacientes, 13 do gênero masculino e 9 do feminino, com idade ao início da observação variando entre 11,03 e 14,63 anos (média de 12,27 anos), apresentava má oclusão de Classe II não tratada, e foram observados por um tempo médio de 1,18 anos. Realizou-se a compatibilização dos grupos de acordo com a idade, tempo de tratamento/observação, severidade da má oclusão e variáveis cefalométricas iniciais. Utilizou-se o teste t de student, para amostras independentes, a fim de se comparar as idades iniciais e finais, tempo de tratamento/observação, variáveis iniciais cefalométricas e alterações médias reais na comparação intergrupos. A severidade da má oclusão entre os grupos foi analisada pelo teste do Qui-quadrado. Para avaliar as alterações iniciais e finais dentro do grupo experimental, realizou-se o teste t para amostras dependentes. O distalizador Distal Jet não alterou o posicionamento ântero-posterior da maxila e mandíbula, entretanto, provocou um aumento no padrão de crescimento facial decorrente da alteração significante do ângulo do plano mandibular (FMA). Os primeiros molares superiores apresentaram uma distalização significante, porém, não sofreram uma inclinação distal e extrusão estatisticamente significantes. Os segundos molares superiores inclinaram-se distalmente, extruíram e distalizaram significantemente. O efeito recíproco do Distal Jet, sobre a unidade de ancoragem, promoveu uma significante vestibularização e protrusão dos incisivos superiores, bem como uma mesialização dos primeiros pré-molares superiores, repercutindo no aumento do overjet. Não ocorreram alterações significantes na extrusão dos primeiros pré-molares e incisivos superiores, no overbite e no perfil facial. / This study evaluated the dentoskeletal and soft tissue changes promoted by the intraoral distalizer Distal Jet, by analysis of lateral cephalograms. The sample was composed of 44 patients, divided into two groups, as follows. Group 1 (study group) was composed of 22 patients, being 5 males and 17 females, with Class II malocclusion, among which 72,72% exhibited ½ Class II, 18,18% ¼ Class II, and 9,09% ¾ Class II. The initial age ranged from 10,54 years to 14,77 years (mean 12,71 years). These patients were treated with the intraoral distalizer Distal Jet for a mean period of 1,20 years. Group 2 (control group) comprised 22 patients, being 13 males and 9 females, aged 11,03 to 14,63 years (mean 12,27 years) at the onset of follow-up, presenting with untreated Class II malocclusion, who were followed for a mean period of 1,18 years. The groups were rendered compatible as to age, period of treatment/observation, severity of malocclusion and initial cephalometric variables. The Student t test for independent samples was applied to compare the initial and final ages, period of treatment/observation, initial cephalometric variables and actual mean changes in the comparison between groups. The severity of malocclusion between groups was analyzed by the chi-square test. The initial and final changes for the study group were evaluated by the t test for dependent samples. The Distal Jet distalizer did not change the anteroposterior positioning of maxilla and mandible, yet promoted an increase in facial growth pattern due to a significant change in mandibular plane angle (FMA). The maxillary first molars exhibited significant distalization, yet did not present statistically significant distal inclination and extrusion. The maxillary second molars presented significant distal inclination, extrusion and distalization. The reciprocal effect of Distal Jet on the anchorage unit promoted significant buccal tipping and protrusion of maxillary incisors, as well as mesialization of the maxillary first premolars, leading to an increased overjet. There were no significant changes in the extrusion of maxillary first premolars and incisors, overbite and facial profile.

A movimentação dentária ortodôntica ocorre através de dois processos, nos quais o osso alveolar é reabsorvido nas áreas de pressão, enquanto que novo osso é formado na área de tração. O processo de reabsorção óssea ocorre pela ação de células multinucleadas, os osteoclastos. Os bisfosfonatos constituem um grupo de fármacos com propriedade de inibir a reabsorção óssea, foi utilizado no presente estudo com a finalidade de interferir na remodelação óssea induzida ortodonticamente. Para isso, força contínua de 15 cN foi aplicada aos primeiros molares superiores de ratos machos Wistar de 2 1/2 meses, utilizando uma biomecânica com fios superelásticos. Os animais foram divididos aleatoriamente em 4 grupos: 1) O grupo controle constituído por dezoito ratos, os quais foram injetados solução salina por 7 dias antes da instalação da biomecânica passiva, que permaneceu por 3, 10 e 18 dias; 2) Dezoito animais foram tratados com ALN (dose 2,5 mg/Kg) por 7 dias antes da instalação da biomecânica passiva que permaneceu por 3, 10 e 18 dias; 3) Dezoito animais foram tratados com alendronato com a mesma dose citada acima por 7 dias antes da instalação da biomecânica ativa que permaneceu por 3, 10 e 18 dias; 4) Dezoito animais foram injetados com solução salina 7 dias antes da instalação da biomecânica ativa que permaneceu por 3, 10 e 18 dias. As maxilas foram fixadas com 4% de formaldeído + 0,1% de glutaraldeído, descalcificadas em EDTA a 4,13% e incluídas em parafina ou resina Spurr. Os cortes foram corados com HE para análise morfológica. Alguns cortes foram submetidos à imuno-histoquímica para detecção de RANKL e OPG. Foi utilizado o método TRAP, marcador de osteoclastos e microscopia eletrônica de transmissão para análise ultraestrutural. Alguns espécimes tiveram a cortical óssea vestibular do primeiro molar superior congelada em nitrogênio líquido para análise da expressão de RANKL por Western Blotting. O ALN inibiu a reabsorção óssea e radicular de todos os grupos tratados. As células clásticas apresentaram-se em estado latente. No grupo da movimentação ortodôntica o osso alveolar foi remodelado e com 18 dias a superfície radicular apresentou-se reabsorvida e o TRAP revelou clastos ativos, achados confirmados pela microscopia eletrônica de transmissão. A expressão de RANKL, molécula ativadora de células clásticas, nao foi inibida pela droga. A expressão de OPG foi aumentada nos animais tratados. Os resultados demonstram que o uso de alendronato sódico na movimentação ortodôntica não interfere no recrutamento dos osteoclasto, ele aparentemente inibe sua ativação, o que pode interferir no processo de remodelação óssea e talvez diminua a quantidade de movimentação dentária. / Orthodontic tooth movement occurs through two processes in which the alveolar bone is resorbed in the pressure areas, whereas new bone is formed in the tension area. The bone resorption occurs by multinucleated cell, the osteoclasts. The bisphosphonates are drugs with capability to inhibit clastic activity were used in the present study in order to interfere with the bone remodeling induced orthodontic. For this continuous force of 15 cN was applied to the first molars of Wistar male rats of 2 1/2 months, using a biomechanical with superelastic wire. The animals were randomly divided into 4 groups: 1) The control group consisted of eighteen mice, which received sterile saline solution saline for 7 days prior to installation of passive biomechanics, which remained for 3, 10 and 18 days; 2) Eighteen animals were treated with ALN (dose 2.5 mg / kg) for 7 days prior to installation of the passive biomechanical to remain for 3, 10 and 18 days; 3) Eighteen animals were treated with alendronate with the same dose quoted above for 7 days prior to the biomechanical installation that remains active for 3, 10 and 18 days; 4) Eighteen animals were injected with sterile saline solution 7 days prior to the biomechanical installation that remains active for 3, 10 and 18 days. The maxillae were fixed with 4% formaldehyde + 0.1% glutaraldehyde, decalcified in EDTA 4.13% and embedded in paraffin or Spurr resin. The specimens were morphologically analyzed in HE stained sections. Some stained sections were used for immunolabeling for RANKL and OPG. The osteoclasts were marked by tartrate-resistant acid phosphatase (TRAP) histochemistry. The ultrathin sections were examined in a trasnmission electron micrsocpe. Some specimens were frozen in liquid nitrogen for protein extraction and Western Blotting protein expression analyzes. The ALN inhibited bone resorption and root of all the treated groups. The clastic cells present in a latent state. In the orthodontic movement group alveolar bone was remodeled with 18 days to root surface presented itself reabsorbed and the TRAP revealed clasts assets, findings confirmed by transmission electron microscopy. Expression of RANKL activating molecule clastic cells was not inhibited by the drug. The OPG expression was increased in treated animals. The results demonstrate that the use of alendronate in the orthodontic movement does not interfere with osteoclast recruitment, it apparently inhibits their activation, which can interfere in the bone remodeling process and may reduce the amount of tooth movement.

O objetivo do trabalho foi avaliar a resistência ao cisalhamento de bráquetes ortodônticos cerâmicos com base de retenção química e mecânica, colados com diferentes compósitos e irradiados com laser de CO2. Foram utilizados 120 pré-molares humanos hígidos, suas coroas foram incluídas em resina acrílica e as faces vestibulares planificadas e polidas com lixas d\'água até exposição de 5mm esmalte. Posteriormente, as raízes dos dentes foram incluídas em tubos de PVC também com resina acrílica de forma que a face vestibular ficasse perpendicular à base do tubo. Os 120 corpos de prova foram divididos em 8 grupos (n=15), sendo 2 controles e 6 experimentais. Nos grupos 1 e 2 (controles) o compósito utilizado para colagem foi o Transbond XT, sendo que no grupo 1 foi colado o bráquete cerâmico Mystique (retenção mecânica) e no grupo 2 o bráquete cerâmico Fascination (retenção química). Nos grupos experimentais 3, 4 e 5 foi colado o bráquete Mystique com os compósitos Transbond XT, Concise e Z250, respectivamente. Nos grupos 6, 7 e 8 foi colado o bráquete Fascination com os mesmos compósitos dos grupos 3, 4 e 5, na mesma sequência. Nos grupos experimentais, após a colagem, os bráquetes foram irradiados com laser de CO2 com 10W de potência por 3 segundos e pulso de 0,01 segundo. Imediatamente após a irradiação foi realizado o teste de resistência ao cisalhamento da colagem em máquina universal de ensaios mecânicos (Emic DL 500) à velocidade de 0,5 mm/minuto. Após o teste, as superfícies avaliadas por meio do Índice de Remanescente Adesivo (IRA) e submetidas à Microscopia Eletrônica de Varredura (MEV) para investigação de eventuais fraturas. Os dados de resistência ao cisalhamento foram submetidos à Análise de Variância ANOVA e posteriormente teste de Tukey. O teste de Mann-Whitney foi utilizado para a avaliação do IRA. Os resultados mostraram que os grupos experimentais apresentaram valores de resistência ao cisalhamento menores quando comparados aos controle (p 0,05). O bráquete Mystique (retenção mecânica) apresentou valores maiores de resistência ao cisalhamento e o compósito Z 250 foi o que apresentou menor força de adesão após irradiação com laser de CO2. Os grupos 5 e 8 foram os que apresentaram maior média do IRA e para todas as superfícies avaliadas o modo de fratura mais prevalente foi a fratura adesiva . Concluiu-se que o laser de CO2 foi eficaz como auxiliar na descolagem de bráquetes cerâmicos de retenção química e mecânica. / The objective of this study was to evaluate the shear strength of the ceramic orthodontic brackets based in chemical and mechanical restraint, bonded with different composites and irradiated with CO2 laser was evaluated. Healthy human premolars (120) were used and their crowns were embedded in acrylic resin and the buccal surfaces flattened and polished with sandpaper until exposure of 5 mm of enamel. Subsequently, the roots of the teeth were included in PVC pipes also with acrylic resin so that the labial surface was perpendicular to the base of the pipe. The 120 samples were divided into 8 groups (n = 15), 2 being the control groups and 6, the experimental groups. In groups 1 and 2 (controls) the composite used for bonding was Transbond XT. Group 1 was glued to the ceramic bracket Mystique (by mechanical retention) and the group 2, with ceramic bracket Fascination (by chemical restraint). In the experimental groups 3, 4 and 5 Mystique brackets were glued with Transbond XT, Concise and Z250, respectively. In groups 6, 7 and 8 the Fascination bracket were glued with the same composites of groups 3, 4 and 5 and in the same sequence. In the experimental groups, after bonding, the brackets were irradiated with CO2 laser with 10W of power for 3 seconds and per pulse 0.01 seconds. Immediately after irradiation shear strength tests were performed on shear bonding with mechanical universal testing machines (Emic DL 500) at a speed of 0.5 mm/minute. After testing, the surfaces were evaluated using the Adhesive Remnant Index (ARI) and submitted to scanning electron microscopy (SEM) to investigate possible fractures. The shear strength data were subjected to analysis of variance with ANOVA and Tukey test later. The Mann-Whitney test was used to evaluate the ARI. The results showed that experimental groups showed lower shear strength values, comparing to the control groups (p 0.05). The bracket Mystique (mechanical retention) showed higher shear strength values and the Z 250 composite showed the lowest adhesion strength after irradiation with CO2 laser. Groups 5 and 8 presented the highest average of IRA and for all the surfaces that were evaluated the most prevalent fracture mode was the adhesive one. It was concluded that the CO2 laser was effective as an aid in bracket debonding of ceramic with chemical and mechanical retention.

O objetivo deste trabalho foi avaliar a influencia da proximidade entre miniimplantes autoperfurantes e as raizes dentarias sobre a estabilidade destes dispositivos de ancoragem. A amostra consistiu de 40 mini-implantes inseridos entre as raizes do primeiro molar e segundo pre-molar superiores de 21 pacientes, como recurso de ancoragem para retracao anterior. A largura do septo no local de insercao (LSI) e a menor distancia da cabeca do mini-implante a raiz dentaria (MDR) foram mensuradas nas 40 radiografias pos-cirurgicas. Sob este aspecto, os miniimplantes foram divididos em duas categorias de grupos: de acordo com a largura do septo no local de insercao, grupos G1L (LSI3mm) e G2L (LSI>3mm), e de acordo com a proximidade do mini-implante a raiz adjacente, grupos G1P (MDR0mm) e G2P (MDR>0mm). A estabilidade dos mini-implantes foi avaliada mensalmente pela quantificacao do grau de mobilidade, e a partir desta variavel foi calculada a proporcao de sucesso. Tambem foi avaliada a influencia das seguintes variaveis sobre o grau de estabilidade: caracteristica do tecido mole no local de insercao, o grau de sensibilidade, a quantidade de placa, a altura de insercao e o periodo de observacao. As duas categorias de grupos foram comparadas quanto ao grau de mobilidade e proporcao de sucesso por meio do teste de Mann-Whitney e do teste Exato de Fisher, respectivamente. Adicionalmente, avaliou-se a influencia das demais variaveis sobre a estabilidade deste sistema de ancoragem atraves do teste t e do teste do Qui-quadrado. Os resultados obtidos demonstraram que não houve diferenca estatisticamente significante para o grau de mobilidade e proporção de sucesso entre os mini-implantes inseridos em septos do grupo G1L e G2L. A proximidade entre os mini-implantes avaliados e as raizes dentarias adjacentes (grupos G1P e G2P) tambem nao influenciou na estabilidade e proporcao de sucesso deste sistema de ancoragem. A proporcao de sucesso total encontrada foi de 90% e nenhuma variavel demonstrou estar relacionada ao insucesso dos miniimplantes. No entanto, observou-se maior sensibilidade nos pacientes cujos miniimplantes apresentavam mobilidade, e que a falha destes dispositivos de ancoragem ocorria logo apos sua insercao. / The purpose of this study was to evaluate the influence of the proximity between self-drilling miniscrews and dental roots on the stability degree. The sample consisted of 40 miniscrews inserted in the interradicular septum between maxillary second premolars and first molars to provide skeletal anchorage for anterior retraction. The forty post-surgical radiographs were used to measure the septum width in the insertion site (SWI) and the smallest distance between miniscrew head and dental root (SDR). In this regard, the miniscrews were divided in two categories of groups: according to the septum width in the insertion site, groups G1W (SWI 3mm) and G2W (SWI>3 mm), and according to the miniscrew dental root proximity, groups G1P (SDR0mm) and G2P (SDR>0mm). The mobility degree (MD) was monthly quantified to determine miniscrew stability, and the success rate of these devices was calculated. This study also evaluated the influence of following variables on the stability degree: soft tissue characteristics in the insertion site (attached gingiva, mucogingival junction and alveolar mucosa), sensitivity degree during miniscrew load, plaque amount around miniscrew, insertion height, and total evaluation period. All the groups were compared regarding mobility degree and success rate using t test and Fisher exact test, respectively. The results showed no significant difference in mobility degree and success rate between groups G1W and G2W. The miniscrew dental root proximity did not influence the stability and success rate of this anchorage system when G1P and G2P were compared. The total success rate found was 90% and no variable was associated with the miniscrew failure. Nevertheless, the results showed that greater patient sensitivity degree was associated to the miniscrews mobility and the failure of these anchorage devices happened in a short time after their insertion.