The purposes of this study were to systematically review the evidence on the clinical use of self-ligating brackets (SLBs) and the validity of digital models, and to compare maxillary arch dimensional change during alignment with conventional brackets (CBs) and active or passive self-ligation in a clinical study. In the systematic reviews, multiple databases were searched, study selection, quality assessment and data extraction were performed, and meta-analyses conducted, where appropriate. In a laboratory study a technique to measure molar inclination change incorporating digital models was developed and validated. A multicentre, 3- arm parallel-group trial was conducted with 96 patients aged 16 and above randomly allocated into 3 equal groups (OvationTM, InOvationCTM or Damon QTM) and undergoing alignment with a DamonTM wire sequence for at least 34 weeks. Meta-analyses demonstrated no difference in arch dimensional changes between SLBs and CBs; however, a greater treatment time was found with self-ligation (2.2 months, 95% CI: 0.4, 3.98). The validity of direct measurement on digital models was confirmed in the other review, although meta-analysis was not possible. Complete data were obtained from 87 subjects in the trial. Bracket type had no significant effect on transverse dimensional changes with no difference in inter-molar width between passive self-ligation and CBs (0.32mm, 95% CI: -0.41, 1.05, p= 0.38) or active selfligation (0.4mm, 95% CI: -0.31, 1.11, p= 0.27). Incisor inclination changes with Damon QTM could not be differentiated from the conventional system (0.44 degrees, 95% CI: - 1.93, 2.8, p=0.71) or InOvationCTM (-0.22 degrees, 95% CI: -2.58, 2.14, p=0.85). Based on the systematic reviews, measurement of digital models is a valid alternative to plaster models, while little evidence to support the use of self-ligation was found. In the clinical trial no differences in arch dimensional changes during alignment between CBs and either active or passive self-ligation was found.

O objetivo desta pesquisa foi avaliar as áreas de tensões produzidas por arcos ortodônticos expandidos associados a diferentes tipos de bráquetes durante a fase de alinhamento e nivelamento ortodôntico. A partir de modelos de gesso adquiridos durante a fase de nivelamento ortodôntico do arco dentário inferior de um mesmo paciente, obteve-se 3 modelos fotoelásticos que receberam 3 diferentes tipos de bráquetes: convencional (Ovation®, GAC International, New York, EUA), autoligável ativo (In-Ovation®, GAC International, New York, EUA) e autoligável passivo (Damom 3MX®, Ormco, Califórnia, EUA), associados a arcos de liga de níquel-titânio 0.014\" e 0.014\" x 0.025\" e de liga de aço 0.019\" x 0.025\". Os modelos fotoelásticos com os respectivos arcos e bráquetes ortodônticos foram observados em polariscópio circular, e as imagens fotográficas das regiões dos incisivos, pré-molares e molares foram analisadas qualitativa e quantitativamente. A análise qualitativa foi realizada pela identificação da ordem e coloração das franjas nos locais onde ocorreram, e a quantitativa foi realizada utilizando o software Matlab® para a identificação dos padrões de cores RGB nas áreas dos terços médio-apicais dos dentes de cada região. Os dados obtidos das diferentes associações arcos/bráquetes ortodônticos foram comparados estatisticamente pelo teste de Wilcoxon. Pode-se concluir que, na região dos incisivos, as maiores tensões ocorreram quando os arcos ortodônticos foram associados aos bráquetes autoligados passivos. Na região dos pré-molares, as maiores tensões ocorreram quando o arco 0.014\" foi associado ao bráquete convencional, em movimentos de segunda ordem (extrusão) e de angulação, e quando os arcos retangulares foram associados aos bráquetes autoligados passivos. Na região dos molares, as maiores tensões ocorreram quando os arcos retangulares foram associados aos tubos ortodônticos com maior prescrição de inclinação (Ovation® e In-Ovation®). / The aim of this research was to evaluate the areas of tension produced by expanded orthodontic arches associated with different types of brackets during the orthodontic leveling phase. From plaster models of a single patient lower dental arch obtained during the orthodontic alignment and leveling phase, three photoelastic models were developed that received three different types of brackets: convencional (Ovation®, GAC International, New York, EUA); active self ligation bracktes (In-Ovation®, GAC International, New York, EUA) e passive self ligation bracktes (Damom 3MX®, Ormco, Califórnia, EUA), associated with 0.014\" and 0.014\" ? 0.025\" titanium-nickel alloy arches and 0.019\" ? 0.025\" alloy steel arches. These models were analyzed in a circular polariscope; photographic images of the incisor, premolar, and molar regions were qualitatively and quantitatively analyzed. The first analysis was obtained by identifying the photoelastic fringe order at sites where they occurred, and the second one was obtained using Matlab® software to identify RGB color patterns in middle apical tooth areas of each region. Data from the different orthodontic arches and brackets were compared using the Wilcoxon test. Our results showed that in the incisors region the greatest tensions occurred when the orthodontic arches were associated to the self-ligating passive brackets; in the premolars region, by the association of the 0.014\" arch and conventional bracket in second order (extrusion) and angulation movements and when the rectangular arches were associated with the passive self-ligating brackets. The greatest tensions in the molar regions occurred by association of rectangular arches and inclination high prescriptions orthodontics tubes (Ovation® and In-Ovation®).

PROPOSIÇÃO: O objetivo deste trabalho foi descrever as alterações das dimensões dos arcos dentários e das inclinações dos incisivos produzidas pelo Sistema Damon, durante a fase de alinhamento e nivelamento. Outro objetivo foi verificar a correlação destas alterações com o padrão de crescimento dos indivíduos. MATERIAL E MÉTODOS: modelos de estudo, telerradiografias convencionais e telerradiografias reconstruídas a partir de tomografias computadorizadas cone-beam de 22 casos tratados com o bráquetes Damon 3MXTM foram avaliados durante a fase de alinhamento e nivelamento. Os modelos de estudo foram obtidos ao início do tratamento (T0), após a primeira troca de fio (T1) e na inserção do fio de aço 0,019 x 0,025 (T2). Foram verificados os comprimentos de arco e as dimensões transversais nas regiões de caninos, primeiros e segundos pré-molares e primeiros molares mensuradas a partir das pontas de cúspides e margens gengivais linguais dos dentes, a cada etapa. Nas telerradiografias foram verificadas as alterações das inclinações dos incisivos inferiores e superiores, bem como o padrão de crescimento dos indivíduos. RESULTADOS: os comprimentos dos arcos e todas as distâncias transversais apresentaram aumentos significantes, com exceção da distância intercervical dos caninos superiores; houve aumento significante das inclinações vestibulares dos incisivos superiores e inferiores; o padrão de crescimento dos pacientes apresentou correlação significante com os aumentos transversais na região de pré-molares inferiores. CONCLUSÕES: o alinhamento e nivelamento de casos tratados sem extrações com o uso do Sistema Damon resultou no aumento significante das dimensões dos arcos dentários e das inclinações dos incisivos para vestibular. / OBJECTIVE: This study aimed to evaluate the dental arch widths and incisor torque changes produced by the Damon System during leveling and alignment. Other objective was to verify the correlation between these changes and the growth pattern. MATHERIAL AND METHODS: study casts and lateral radiographs derived from cone-beam computed tomographies of 22 subjects treated with Damon 3MXTM brackets were evaluated. The study casts were obtained at the start of treatment (T0), the first archwire change (T1), and the placement of the final 0,019 x 0,025-in archwire (T2). Arch depth and widths (intercanine, interpremolar and intermolar) were assessed at each stage. The incisor torques changes and the growth pattern were measured on the cephalometric records at T0 and T2. RESULTS: There was significant increase of the arch depths and lateral expansion of the arches for all measures, except for the intercervical of maxillary canines. The maxillary and mandibular incisors were significantly tipped labially; the growth pattern showed significant correlation with the lateral increases in lower premolars region. CONCLUSIONS: nonextraction cases treated with Damon System show significant increases in arch dimensions and incisors proclination.

PROPOSIÇÃO: O objetivo deste trabalho foi descrever as alterações das dimensões dos arcos dentários e das inclinações dos incisivos produzidas pelo Sistema Damon, durante a fase de alinhamento e nivelamento. Outro objetivo foi verificar a correlação destas alterações com o padrão de crescimento dos indivíduos. MATERIAL E MÉTODOS: modelos de estudo, telerradiografias convencionais e telerradiografias reconstruídas a partir de tomografias computadorizadas cone-beam de 22 casos tratados com o bráquetes Damon 3MXTM foram avaliados durante a fase de alinhamento e nivelamento. Os modelos de estudo foram obtidos ao início do tratamento (T0), após a primeira troca de fio (T1) e na inserção do fio de aço 0,019 x 0,025 (T2). Foram verificados os comprimentos de arco e as dimensões transversais nas regiões de caninos, primeiros e segundos pré-molares e primeiros molares mensuradas a partir das pontas de cúspides e margens gengivais linguais dos dentes, a cada etapa. Nas telerradiografias foram verificadas as alterações das inclinações dos incisivos inferiores e superiores, bem como o padrão de crescimento dos indivíduos. RESULTADOS: os comprimentos dos arcos e todas as distâncias transversais apresentaram aumentos significantes, com exceção da distância intercervical dos caninos superiores; houve aumento significante das inclinações vestibulares dos incisivos superiores e inferiores; o padrão de crescimento dos pacientes apresentou correlação significante com os aumentos transversais na região de pré-molares inferiores. CONCLUSÕES: o alinhamento e nivelamento de casos tratados sem extrações com o uso do Sistema Damon resultou no aumento significante das dimensões dos arcos dentários e das inclinações dos incisivos para vestibular. / OBJECTIVE: This study aimed to evaluate the dental arch widths and incisor torque changes produced by the Damon System during leveling and alignment. Other objective was to verify the correlation between these changes and the growth pattern. MATHERIAL AND METHODS: study casts and lateral radiographs derived from cone-beam computed tomographies of 22 subjects treated with Damon 3MXTM brackets were evaluated. The study casts were obtained at the start of treatment (T0), the first archwire change (T1), and the placement of the final 0,019 x 0,025-in archwire (T2). Arch depth and widths (intercanine, interpremolar and intermolar) were assessed at each stage. The incisor torques changes and the growth pattern were measured on the cephalometric records at T0 and T2. RESULTS: There was significant increase of the arch depths and lateral expansion of the arches for all measures, except for the intercervical of maxillary canines. The maxillary and mandibular incisors were significantly tipped labially; the growth pattern showed significant correlation with the lateral increases in lower premolars region. CONCLUSIONS: nonextraction cases treated with Damon System show significant increases in arch dimensions and incisors proclination.

O objetivo desta pesquisa foi avaliar as áreas de tensões produzidas por arcos ortodônticos expandidos associados a diferentes tipos de bráquetes durante a fase de alinhamento e nivelamento ortodôntico. A partir de modelos de gesso adquiridos durante a fase de nivelamento ortodôntico do arco dentário inferior de um mesmo paciente, obteve-se 3 modelos fotoelásticos que receberam 3 diferentes tipos de bráquetes: convencional (Ovation®, GAC International, New York, EUA), autoligável ativo (In-Ovation®, GAC International, New York, EUA) e autoligável passivo (Damom 3MX®, Ormco, Califórnia, EUA), associados a arcos de liga de níquel-titânio 0.014\" e 0.014\" x 0.025\" e de liga de aço 0.019\" x 0.025\". Os modelos fotoelásticos com os respectivos arcos e bráquetes ortodônticos foram observados em polariscópio circular, e as imagens fotográficas das regiões dos incisivos, pré-molares e molares foram analisadas qualitativa e quantitativamente. A análise qualitativa foi realizada pela identificação da ordem e coloração das franjas nos locais onde ocorreram, e a quantitativa foi realizada utilizando o software Matlab® para a identificação dos padrões de cores RGB nas áreas dos terços médio-apicais dos dentes de cada região. Os dados obtidos das diferentes associações arcos/bráquetes ortodônticos foram comparados estatisticamente pelo teste de Wilcoxon. Pode-se concluir que, na região dos incisivos, as maiores tensões ocorreram quando os arcos ortodônticos foram associados aos bráquetes autoligados passivos. Na região dos pré-molares, as maiores tensões ocorreram quando o arco 0.014\" foi associado ao bráquete convencional, em movimentos de segunda ordem (extrusão) e de angulação, e quando os arcos retangulares foram associados aos bráquetes autoligados passivos. Na região dos molares, as maiores tensões ocorreram quando os arcos retangulares foram associados aos tubos ortodônticos com maior prescrição de inclinação (Ovation® e In-Ovation®). / The aim of this research was to evaluate the areas of tension produced by expanded orthodontic arches associated with different types of brackets during the orthodontic leveling phase. From plaster models of a single patient lower dental arch obtained during the orthodontic alignment and leveling phase, three photoelastic models were developed that received three different types of brackets: convencional (Ovation®, GAC International, New York, EUA); active self ligation bracktes (In-Ovation®, GAC International, New York, EUA) e passive self ligation bracktes (Damom 3MX®, Ormco, Califórnia, EUA), associated with 0.014\" and 0.014\" ? 0.025\" titanium-nickel alloy arches and 0.019\" ? 0.025\" alloy steel arches. These models were analyzed in a circular polariscope; photographic images of the incisor, premolar, and molar regions were qualitatively and quantitatively analyzed. The first analysis was obtained by identifying the photoelastic fringe order at sites where they occurred, and the second one was obtained using Matlab® software to identify RGB color patterns in middle apical tooth areas of each region. Data from the different orthodontic arches and brackets were compared using the Wilcoxon test. Our results showed that in the incisors region the greatest tensions occurred when the orthodontic arches were associated to the self-ligating passive brackets; in the premolars region, by the association of the 0.014\" arch and conventional bracket in second order (extrusion) and angulation movements and when the rectangular arches were associated with the passive self-ligating brackets. The greatest tensions in the molar regions occurred by association of rectangular arches and inclination high prescriptions orthodontics tubes (Ovation® and In-Ovation®).

Objective: The objective of this study was to determine the effect of pulsating vibration on the sliding resistance between orthodontic brackets and stainless steel wires. Brackets were placed at two different angulations (0° and 5°) to simulate leveling of a tipped tooth during tooth movement. Pulsating vibration was delivered via the AcceleDent device. Background: Friction is defined as a force that retards or resists the relative motion of two objects in contact, and its direction is tangential to the common boundary of the two surfaces in contact. This has been of interest to the orthodontist since the mid-20th century. Since the time of Stoner’s paper in 1960, the orthodontic literature has been full of studies done on friction in orthodontics including: friction with different ligation methods, friction among different arch wire materials, friction and different bracket materials, and friction with various slot designs. Understanding friction has led to the emergence of new technologies in orthodontics. One of the most popular is the self-ligating bracket. This popularity arose from claims that they reduce friction during treatment. Other innovations have been introduced in the field of orthodontics to help accelerate tooth movement. Among these innovations is the application of a pulsating vibration during active orthodontic treatment. Such pulsating vibration can be delivered during orthodontic treatment by AcceleDent, which is a hands- free device designed by OrthoAccel Technologies, Inc., Bellaire, TX. The company claims the output force helps accelerate bone turnover. The following study investigated whether it could decrease treatment time via a different mechanism: decreasing frictional resistance to tooth movement along the arch wire. Methods: A paper template was made of a typodont tooth with a bracket window cut out. The bracket cut out was made with the bracket window angulated 0° and 5°. 0.022” x 0.028” standard prescription edgewise brackets (American Orthodontics, Sheboygan, WI) of ceramic, twin and self-ligating design were bonded to 3 maxillary 1st premolar typodont teeth using the template. The teeth were leveled with a 0.019” x 0.025” SS arch wire and placed in a metal scaffold. They were held in place with Aquasil Ultra XLV wash material PVS (DENTSPLY Caulk, Milford, DE.). Only the middle bracket was adjusted for angulation and accuracy was checked with the iPhone 6 level. The AcceleDent Aura device (OrthoAccel Technologies, Inc., Bellaire, TX). was attached to the occlusal surface of the teeth via cable ties. The AcceleDent Aura device provided 30 Hz of pulsating vibration. All tests were performed with a 0.019” x 0.025” SS arch wire pulled through the brackets via a Universal Testing Machine (Instron, Grove City, PA) at a crosshead speed of 2.5mm/min for 30 seconds. Frictional resistance was measured by averaging 6 recordings every 5 seconds. Results: The pulsating vibration provided by the AcceleDent device significantly reduced the resistance to sliding for each bracket type at both 0° and 5° (p<0.05). Ceramic brackets had the highest resistance to sliding of all bracket types. Conclusions: Pulsating vibration via the AcceleDent Aura device reduces the resistance to sliding between a bracket and arch wire in vitro. This may potentially decrease overall treatment time but more in vivo studies need to be done to evaluate this.

Objetivos: O objetivo desta pesquisa foi comparar a resistência ao deslocamento de fios de níquel e titânio superelásticos termoativados sobrepostos, em braquetes ortodônticos metálicos autoligáveis passivos. Material e Métodos: Foram utilizadas três espessuras de fios de níquel e titânio superelásticos termoativados (NiTi-TA): 0,014 sobreposto ao 0,016 e 0,020 (FlexyNiTi Thermal - Orthometric, Marília, SP, BR), associados a dois tipos de braquetes metálicos autoligáveis passivos: SmartClip SL3® (3M Unitek, Monrovia, CA, EUA) e OrthoClip SLB® (Orthometric, Marília, SP, BR). Um dispositivo que continha 5 braquetes de cada tipo (do incisivo central superior direito ao 2º pré-molar superior direito) foi desenvolvido para realização dos testes. O braquete do canino foi colado em uma barra de aço inoxidável móvel que permitia alterar sua posição vertical, enquanto os demais braquetes foram colados a uma barra fixa de acrílico. As forças obtidas por meio do deslocamento vertical do braquete do canino de 0mm para 1,5mm, 3,0 mm, 4,5mm e 6,0 mm foram registradas. O ambiente de teste foi seco com temperatura controlada de 36,5º C ± 1º C. Um total de 160 testes foi realizado na máquina de ensaios universal Instron. Os testes estatísticos de Shapiro-Wilk, teste t de Student não pareado e ANOVA com testes post-hoc de Tukey foram aplicados aos dados (p<0,05). Resultados: A distribuição normal da amostra foi confirmada, e os testes paramétricos demonstraram que houve diferenças estatisticamente significativas no braquete SmartClip SL3® quando associados aos fios de NiTi-TA 0,020 e 0,014 sobreposto ao 0,016 nas alturas de 1,5mm (p=0,003) e 6mm (p0,0001). Porém, não foram encontradas diferenças estatísticas nas alturas de 3mm (p=0,76) e 4,5mm (p=0,09). No braquete OrthoClip SLB® houve diferenças estatisticamente significativas entre os fios de NiTi-TA 0,020 e 0,014 sobreposto ao 0,016 em todas as alturas avaliadas (p0,0001). Na comparação entre os braquetes, quando associados ao fio 0,020 de NiTi-TA houve diferenças estatisticamente significativas na altura de 1,5mm; 3mm e 6mm (p0,0001). No entanto, na altura de 4,5mm as diferenças não foram significativas estatisticamente (p=0,32). Quando associados aos fios de NiTi-TA 0,014 e 0,016 sobrepostos, as diferenças em todas as alturas avaliadas foram significativas estatisticamente (1,5mm - p=0,0006; nas demais alturas p0,0001). Conclusão: Nos braquetes SmartClip SL3®, em desnivelamentos de 1,5mm, os fios de NiTi-TA 0,014 e 0,016 sobrepostos apresentaram menor resistência ao deslocamento, enquanto que na altura de 6mm a menor resistência foi obtida com o fio de NiTi-TA 0,020. Nas demais alturas não houve diferenças estatísticas entre os fios. Para os braquetes OrthoClip SLB®, os fios de NiTi-TA 0,014 e 0,016 sobrepostos apresentaram menor resistência ao deslocamento em todas as alturas avaliadas. Na comparação entre os dois tipos de braquetes, associados ao fio de NiTi-TA 0,020 na altura de 1,5mm, o braquete OrthoClip SLB® apresentou menor resistência ao deslocamento, ao passo que nas alturas de 3mm e 6mm foi o braquete SmartClip SL3®. Na altura de 4,5mm não foram encontradas diferenças estatisticamente significativas entre os dois braquetes avaliados. / Objective: The objective of this research was to compare the displacement resistance of overlapped heat-activated superelastic nickel titanium wires, in passive self-ligating metallic brackets. Material and Methods: Three thicknesses of heat-activated superelastic nickel titanium wires (NiTi-TA) were used: 0.014 overlapped with 0.016 and 0.020 (FlexyNiTi Thermal - Orthometric, Marília, SP, BR), associated with two types of passive self-ligating metallic brackets: SmartClip SL3® (3M Unitek, Monrovia, CA, EUA) and OrthoClip SLB® (Orthometric, Marília, SP, BR). A device with 5 brackets of each type (from right central incisor to the second maxillary premolar) was developed for this research. The canine bracket was attached to a sliding stainless steel bar which allowed the alteration of its vertical position, while the remaining brackets were attached to a fixed acrylic bar. The forces generated by means of the canine bracket vertical displacement from 0mm to 1.5mm; 3.0mm; 4.5mm and 6.0mm were recorded. The test environment was dry with a controlled temperature of 36.5º C ± 1º C. A total of 160 tests were carried out in the Instron Testing Machine. The Shapiro-Wilk test, non-paired Student t-test and ANOVA with Tukey post hoc test were applied to the data (p<0.05). Results: The normal distribution was confirmed, and the parametric tests showed that there were statistically significant differences in the SmartClip SL3® when associated with the NiTi-TA 0.020 and 0.014 wires overlapped to the 0.016 wire in the height of 1.5mm (p=0.003) and 6mm (p<0.0001). However, statistically significant differences were not found in the heights of 3mm (p=0.76) and 4.5mm (p=0.09). For the OrthoClip SLB® brackets, there were statistically significant differences between the NiTi-TA 0.020 and 0.014 wires overlapped with the 0.016 wire in all the heights assessed (p<0.0001). In the comparison between the brackets when associated with the NiTi-TA 0.020 wire, there were statistically significant differences in the heights of 1.5mm, 3mm and 6mm (p<0.0001). However, in the height of 4.5mm the differences were not statistically significant (p=0.32). When associated with the overlapped NiTi-TA 0.014 and 0.016 wires, the differences in all assessed heights were statistically significant (1.5mm - p=0.0006; other height - p0.0001). Conclusion: For the SmartClip SL3® brackets, with 1.5mm of displacement, the overlapped NiTi-TA 0.014 and 0.016 wires showed less displacement resistance, while in the height of 6mm the least displacement resistance was found with the NiTi-TA 0.020. In the remaining heights, there were no statistically significant differences between the wires. For the OrthoClip SLB® brackets, the overlapped NiTi-TA 0.014 and 0.016 wires showed the least displacement resistance in all the assessed heights. In the comparison between the two types of brackets, associated with the NiTi-TA 0.020 wire, for the height of 1.5mm, the OrthoClip SLB® bracket showed less displacement resistance, while for the heights of 3mm and 6mm the SmartClip SL3® brackets showed less displacement resistance. For the height of 4.5mm there were no statistically significant differences found between the assessed brackets.

Objetivos: O objetivo desta pesquisa foi comparar a resistência ao deslocamento de fios de níquel e titânio superelásticos termoativados sobrepostos, em braquetes ortodônticos metálicos autoligáveis passivos. Material e Métodos: Foram utilizadas três espessuras de fios de níquel e titânio superelásticos termoativados (NiTi-TA): 0,014 sobreposto ao 0,016 e 0,020 (FlexyNiTi Thermal - Orthometric, Marília, SP, BR), associados a dois tipos de braquetes metálicos autoligáveis passivos: SmartClip SL3® (3M Unitek, Monrovia, CA, EUA) e OrthoClip SLB® (Orthometric, Marília, SP, BR). Um dispositivo que continha 5 braquetes de cada tipo (do incisivo central superior direito ao 2º pré-molar superior direito) foi desenvolvido para realização dos testes. O braquete do canino foi colado em uma barra de aço inoxidável móvel que permitia alterar sua posição vertical, enquanto os demais braquetes foram colados a uma barra fixa de acrílico. As forças obtidas por meio do deslocamento vertical do braquete do canino de 0mm para 1,5mm, 3,0 mm, 4,5mm e 6,0 mm foram registradas. O ambiente de teste foi seco com temperatura controlada de 36,5º C ± 1º C. Um total de 160 testes foi realizado na máquina de ensaios universal Instron. Os testes estatísticos de Shapiro-Wilk, teste t de Student não pareado e ANOVA com testes post-hoc de Tukey foram aplicados aos dados (p<0,05). Resultados: A distribuição normal da amostra foi confirmada, e os testes paramétricos demonstraram que houve diferenças estatisticamente significativas no braquete SmartClip SL3® quando associados aos fios de NiTi-TA 0,020 e 0,014 sobreposto ao 0,016 nas alturas de 1,5mm (p=0,003) e 6mm (p0,0001). Porém, não foram encontradas diferenças estatísticas nas alturas de 3mm (p=0,76) e 4,5mm (p=0,09). No braquete OrthoClip SLB® houve diferenças estatisticamente significativas entre os fios de NiTi-TA 0,020 e 0,014 sobreposto ao 0,016 em todas as alturas avaliadas (p0,0001). Na comparação entre os braquetes, quando associados ao fio 0,020 de NiTi-TA houve diferenças estatisticamente significativas na altura de 1,5mm; 3mm e 6mm (p0,0001). No entanto, na altura de 4,5mm as diferenças não foram significativas estatisticamente (p=0,32). Quando associados aos fios de NiTi-TA 0,014 e 0,016 sobrepostos, as diferenças em todas as alturas avaliadas foram significativas estatisticamente (1,5mm - p=0,0006; nas demais alturas p0,0001). Conclusão: Nos braquetes SmartClip SL3®, em desnivelamentos de 1,5mm, os fios de NiTi-TA 0,014 e 0,016 sobrepostos apresentaram menor resistência ao deslocamento, enquanto que na altura de 6mm a menor resistência foi obtida com o fio de NiTi-TA 0,020. Nas demais alturas não houve diferenças estatísticas entre os fios. Para os braquetes OrthoClip SLB®, os fios de NiTi-TA 0,014 e 0,016 sobrepostos apresentaram menor resistência ao deslocamento em todas as alturas avaliadas. Na comparação entre os dois tipos de braquetes, associados ao fio de NiTi-TA 0,020 na altura de 1,5mm, o braquete OrthoClip SLB® apresentou menor resistência ao deslocamento, ao passo que nas alturas de 3mm e 6mm foi o braquete SmartClip SL3®. Na altura de 4,5mm não foram encontradas diferenças estatisticamente significativas entre os dois braquetes avaliados. / Objective: The objective of this research was to compare the displacement resistance of overlapped heat-activated superelastic nickel titanium wires, in passive self-ligating metallic brackets. Material and Methods: Three thicknesses of heat-activated superelastic nickel titanium wires (NiTi-TA) were used: 0.014 overlapped with 0.016 and 0.020 (FlexyNiTi Thermal - Orthometric, Marília, SP, BR), associated with two types of passive self-ligating metallic brackets: SmartClip SL3® (3M Unitek, Monrovia, CA, EUA) and OrthoClip SLB® (Orthometric, Marília, SP, BR). A device with 5 brackets of each type (from right central incisor to the second maxillary premolar) was developed for this research. The canine bracket was attached to a sliding stainless steel bar which allowed the alteration of its vertical position, while the remaining brackets were attached to a fixed acrylic bar. The forces generated by means of the canine bracket vertical displacement from 0mm to 1.5mm; 3.0mm; 4.5mm and 6.0mm were recorded. The test environment was dry with a controlled temperature of 36.5º C ± 1º C. A total of 160 tests were carried out in the Instron Testing Machine. The Shapiro-Wilk test, non-paired Student t-test and ANOVA with Tukey post hoc test were applied to the data (p<0.05). Results: The normal distribution was confirmed, and the parametric tests showed that there were statistically significant differences in the SmartClip SL3® when associated with the NiTi-TA 0.020 and 0.014 wires overlapped to the 0.016 wire in the height of 1.5mm (p=0.003) and 6mm (p<0.0001). However, statistically significant differences were not found in the heights of 3mm (p=0.76) and 4.5mm (p=0.09). For the OrthoClip SLB® brackets, there were statistically significant differences between the NiTi-TA 0.020 and 0.014 wires overlapped with the 0.016 wire in all the heights assessed (p<0.0001). In the comparison between the brackets when associated with the NiTi-TA 0.020 wire, there were statistically significant differences in the heights of 1.5mm, 3mm and 6mm (p<0.0001). However, in the height of 4.5mm the differences were not statistically significant (p=0.32). When associated with the overlapped NiTi-TA 0.014 and 0.016 wires, the differences in all assessed heights were statistically significant (1.5mm - p=0.0006; other height - p0.0001). Conclusion: For the SmartClip SL3® brackets, with 1.5mm of displacement, the overlapped NiTi-TA 0.014 and 0.016 wires showed less displacement resistance, while in the height of 6mm the least displacement resistance was found with the NiTi-TA 0.020. In the remaining heights, there were no statistically significant differences between the wires. For the OrthoClip SLB® brackets, the overlapped NiTi-TA 0.014 and 0.016 wires showed the least displacement resistance in all the assessed heights. In the comparison between the two types of brackets, associated with the NiTi-TA 0.020 wire, for the height of 1.5mm, the OrthoClip SLB® bracket showed less displacement resistance, while for the heights of 3mm and 6mm the SmartClip SL3® brackets showed less displacement resistance. For the height of 4.5mm there were no statistically significant differences found between the assessed brackets.

Magister Scientiae Dentium - MSc(Dent) (Orthodontics) / Orthodontic treatment has the ability to improve the aesthetics and the function of patients. In order to create space, orthodontic treatment often requires removal of teeth. The most common teeth removed for orthodontic treatment are the premolars. It has become popular to remove second premolars in certain cases where the soft tissue profile should not be altered. The Damon self-ligating orthodontic system is renowned for not requiring dental extractions in the majority of cases. The effect of extractions on the soft tissue profile of patients, in conjunction with using the Damon system, has therefore not been researched. It is important to understand the effect that orthodontic treatment and extractions can have on the soft tissue profile of patients. This effect can accurately be determined by making use of the soft tissue cephalometric analysis, developed by Dr Reed A. Holdaway in 1983.

Magister Scientiae Dentium - MSc(Dent) / Background and aim: Managing orthodontic pain traditionally involves the prescription of non-steroidal anti-inflammatory drugs combined with other analgesic medication. Sugar-free chewing gum has been advocated in the control of orthodontic pain due to its mechanical and physiological effects on periodontal tissue; however, the literature is scant. The ‘placebo effect’ that conventional sugar-free chewing gum may have in the relief of orthodontic pain has not been documented. The aim of this study was to compare the effectiveness of conventional sugar-free chewing gum in reducing orthodontic pain associated with fixed appliances with a placebo (sugar-free sweets) medicament. Objectives: The objectives of the study were to determine if there were differences in pain reporting between the sugar-free chewing gum and the placebo, to ascertain whether gender influenced pain scores and to observe any differences in pain reporting between different orthodontic techniques.