Indiana University-Purdue University Indianapolis (IUPUI) / Anchorage control is fundamental to successful orthodontic treatment. Dental implants can serve as ideal anchorage units because of their stability in bone. Previous studies limit the use of existing implants for anchorage because of their large size. Minimizing the size of the implant would reduce the extent of the surgery and may result in a decreased and less traumatic healing period. The objective of this study was to histomorphometrically analyze the use of miniature implants. A total of 96 miniature implants (1.0 x 5.0 mm; 48 loaded and 48 healing control) were placed in the mandible and maxilla of 8 male dogs. The implants were allowed to heal for three different periods (3, 6, and 12 weeks) followed by 12 weeks of 200 to 300 g of orthodontic force application. Bone specimens containing implants were collected for histomorphometric analysis. The results indicate that clinical rigidity (osseointegration) was achieved by 96.9 percent of the miniature implants. Histomorphometric analysis revealed that the amount of bone contact at the implant-bone interface ranged from 11.3 to 68 percent (mean ± SEM=34.4 ± 4.6 percent) in the healing control groups and from 18.8 to 63 percent (mean=43.l ± 4.0 percent) in the force applied groups in the maxilla. On the other hand, in the mandible, bone-implant contact ranged from 7 to 82 percent (mean=44.1 ± 6.8 percent) in the healing control groups and from 12 to 72 percent (mean=50.7 ± 5.3 percent) in the force applied groups. Results from bone formation rate, mineralizing surface/bone surface and mineral appositional rate showed a significant difference in the 3-week healing control group compared to those in other groups. From these results, we concluded that miniature implants are able to function as rigid osseous anchorage for orthodontics with minimal (less than 3 weeks) healing period. This study was supported by Matsumoto Research fund.

Orientador: Luiz Gonzaga Gandini Júnior / Resumo: A perda de primeiros molares permanentes é uma situação clínica frequente levando a uma inclinação gradual no sentido mesial de segundos molares. O primeiro estudo avaliou por meio da técnica da fotoelasticidade as tensões geradas por três mecanismos ortodônticos de verticalização: Cantilever, Mola de correção radicular e Mola de Sander (NiTi- SE- Stahl-Aufrichtefeder) com ativação a 90°e a 135°. No segundo estudo, foram avaliados a inserção de seis tipos fios contínuos de Níqueltitânio (NiTi), separados em 2 grupos: fios redondos e fios retangulares. No primeiro estudo foram utilizados 7 modelos fotoelásticos e no segundo 5 modelos fotoelásticos. Todos os modelos fotoelásticos seguiram o mesmo padrão de confecção: A réplica de uma má oclusão de perda de primeiro molar inferior com segundo molar inferior inclinado a 30° e a presença dos dentes adjacentes, pré-molares e caninos. Utilizouse um polariscópio circular de transmissão plana da Universidade Estadual de Campinas (Faculdade de Odontologia de Piracicaba, FOP/UNICAMP). Todos os testes, de ambos os estudos, foram realizados de forma randomizada. Para a análise quantitativa e qualitativa utilizou-se o software Fringes® demarcando no total 18 pontos ao longo das raízes de todos os dentes. Primeiramente foi aplicado o teste de normalidade Shapiro-Wilk em todos os dados, todos as análises foram feitas com o teste não-paramétrico Kruskal-Wallis seguido do pós teste Dunn, com nível de significância de 5%. No primeiro estudo foi... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Loss of first permanent molars in adult patients is very commonly encountered. Frequent consequences are mandibular second molars tipped mesially. The aim of the first study was to analyze and compare the stress distributions in three molar uprighting techniques: cantilever, uprighting spring and Sander's Spring, using quantitative and qualitative photoelastic analysis (NiTi- SE- Stahl-Aufrichtefeder) bended 90° and 135°. The aim of the second study was to analyze and compare the stress distributions of six types of nickel-titanium wires: round wires and rectangular wires, using a quantitative and qualitative photoelastic analysis. Seven photoelastic models were used in the first study, five was used in the second. In all models used we made the same replication of malocclusion: second mandibular molar was tipped forward 30º and the mandibular right canine and the first and second premolars were present. We used a circular polariscope of horizontal transmission to do the analyzes (Piracicaba Dental School, University of Campinas, Sao Paulo, Brazil). All tests were randomly. A software Fringes® was used to quantify the model's shear stress and qualify the fringe order. Eighteen points of interest were determined along all the roots of the teeth. All quantitative data included in this study were tested concerning normality by Shapirowilk test. When normality was not found in the data, thus opting for the nonparametric Kruskal-wallis test and the post hoc test by Dunn) were perf... (Complete abstract click electronic access below) / Mestre

Orientador: Dirceu Barnabé Ravelli / Resumo: O objetivo deste estudo foi avaliar, por meio do método de elementos finitos (MEF), as tensões produzidas nos dentes e ligamento periodontal na verticalização de segundos molares utilizando mecânicas segmentadas. Foi utilizado o software Rhinoceros 5 para modelar um modelo tridimensional de uma hemi-mandíbula direita com os dentes, exceto o primeiro molar, ligamento periodontal, osso trabecular e osso cortical à partir de um biomodelo e de informações do banco de dados do CTI Renato Archer. Os braquetes, tubo e fios ortodônticos foram construídos segundo as dimensões de objetos reais por meio de engenharia reversa. Foram simuladas a verticalização do segundo molar utilizando cantilever simples (modelo 1), cantiliver duplo (modelo 2) e alça de correção radicular (modelo 3). O modelo mandibular, dentes e os acessórios ortodônticos foram unidos para a geração da malha de elementos finitos. A simulação da mecânica e a obtenção dos resultados foram feitos através dos softwares Hypermesh, Optistruct e Hyperview da plataforma Hyperworks 2017.2 (Altair Engineering Inc., Troy, MI, EUA). A análise dos resultados foi realizada pela distribuição das tensões principais nas estruturas avaliadas, Os resultados mostraram que o cantilever simples produziu maior extrusão do 2º molar inferior. O cantilever duplo e a alça de correção radicular controlaram a extrusão do 2º molar, porém, mostraram uma tendência inclinação da coroa para vestibular. Nos dentes anteriores de ancoragem, a coroa do can... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The objective of this study was to evaluate the stress and strain produced on the teeth and periodontal ligament in the second molar uprighting using segmented mechanics through the finite element method (FEM). The software Rhinoceros 5 was used to model a three-dimensional model of a right hemi-mandible. This model had teeth, except the first molar, periodontal ligament, trabecular bone and cortical bone obtained from a biomodel and the CTI Renato Archer's database. Orthodontic brackets, tube and orthodontic wires were modeled according to the dimensions of real objects by reverse engineering. The second molar uprighting was simulated using one single cantilever, double cantilever and root correction spring. The boundary conditions of the model, teeth and orthodontic devices were determined to generate the finite element mesh.The mechanical simulation and the results were performed by Hypermesh, Optistruct and Hyperview softwares from Hyperworks 2017.2 platform (Altair Engineering Inc., Troy, MI, USA). The results were assessed by maximum principal stress and strain. The results showed that the one cantilever produced greater extrusion of the lower second molar. The double cantilever and the root correction spring controlled the extrusion of the second molar, however, it showed a slight tendency for buccal crown tipping for the second molar. The canine crown had a greater displacement tendency with one cantilever at anterior anchorage teeth. The second premolar had a greater... (Complete abstract click electronic access below) / Doutor

A retração dos dentes anteriores por meio de técnicas ortodônticas é indicada quando existe a vestibularização excessiva dos incisivos, evidente nos casos de classe I de Angle com biprotrusão dento-alveolar, classe II de Angle divisão 1ª, ou classe III de Angle de origem dentária - comprometendo a função oral e a estética facial. Existem diversas mecânicas para se realizar tal movimento. O objetivo deste estudo foi analisar, por meio da fotoelasticidade, como se distribuem as tensões geradas, por diferentes tipos de mecânicas de retração, ao longo das raízes dos dentes anteroinferiores. Um modelo fotoelástico foi confeccionado em resina epóxi flexível, simulando um arco com os primeiros pré-molares extraídos, pronto para se iniciar a retração anteroinferior. Foram preparados sessenta arcos de retração, sendo quinze para cada tipo de mecânica avaliada: deslize, alça de Bull modificada, alça T e arco de dupla chave. A força de ativação da retração foi padronizada em 240 gramas para cada lado do arco - sendo sempre aferida com dinamômetro ortodôntico. Estratégias para o controle vertical do segmento anterior foram realizadas durante a ativação de retração, tais como efeito Gable e ganchos longos na mecânica de deslize. O comportamento das tensões foi observado no modelo fotoelástico, com o polariscópio circular na configuração de campo escuro, e fotografado sob três perspectivas: frontal, oclusal e oblíqua. Na frontal foram observados os incisivos, e comparadas as tensões entre as mecânicas, entre os terços radiculares e entre estes dentes. Na oclusal foram comparadas as tensões entre as mecânicas e entre os seis dentes anteriores. Na oblíqua foram comparadas as tensões entre as mecânicas e entre os terços radiculares do canino esquerdo. As fotografias foram analisadas e as ordens de franjas fotoelásticas anotadas em planilhas. A repetibilidade do método foi feita pela análise de kappa. A análise estatística foi realizada pelo teste de Kruskal-Wallis complementado pelo teste de Dunn. Os resultados mostraram que na perspectiva frontal não foram observadas diferenças estatisticamente significantes entre as quatro mecânicas de retração, avaliadas ao longo das raízes dos incisivos; entretanto, a mecânica de alça de Bull modificada apresentou discreta tendência em apresentar maiores tensões; em uma mesma mecânica, as maiores magnitudes de tensões concentraram-se nas regiões cervicais e de maneira homogênea ao longo dos quatro incisivos. Na perspectiva oclusal, a mecânica da alça de Bull modificada apresentou maiores tensões, seguida da mecânica com alça T, arco dupla chave e deslize; em uma mesma mecânica, as tensões concentraram-se nos caninos em relação aos incisivos. Na perspectiva oblíqua, a alça de Bull modificada gerou maiores tensões nas regiões cervicais do canino, sendo que nas regiões apicais não houve diferenças de tensões entre as quatro mecânicas; em uma mesma mecânica, existiu a formação de maiores tensões nas regiões cervicais. Ao se comparar as mecânicas, observou-se que a técnica do deslize apresentou as menores tensões e a alça de Bull modificada as maiores tensões nas regiões estudadas. / The orthodontic retraction of the anterior teeth is indicated when the patient have a malocclusion with excessive vestibularization of the incisors, evident in cases of Angle class I with biprotrusion, Angle class II first division, or Angle class III with dental origin; compromising oral function and facial aesthetics. Several mechanics are indicated to perform this movement. The objective of this study was to analyze, using photoelasticity, how strains generated by different types of retraction mechanics are distributed along the roots of the anteroinferior teeth. A photoelastic model was made of flexible epoxy resin, simulating an arch with the first premolars extracted, ready to initiate the anteroinferior retraction. Sixty retraction arches were prepared, fifteen for each type of mechanics evaluated: slide, teardrop loop, T loop and double-key loop. The activation force of retraction was standardized in 240 grams for each side of the arch, always measured with orthodontic dynamometer. Strategies were performed for vertical control of the anterior segment during the activation of retraction, such as Gable bend and long hooks in sliding mechanics. The behavior of the strains was observed in the photoelastic model with a circular polariscope in the dark field configuration, and photographed in three perspectives: frontal, occlusal and oblique. In the frontal perspective the incisors were observed, and the strains were compared among the mechanics, among the root thirds and among these teeth. In the occlusal perspective, the strains were compared among the mechanics and among the six anterior teeth. From the oblique perspective, tensions were compared among mechanics and among root thirds of the left canine. The photographs were analyzed and the photoelastic fringe orders were annotated in spreadsheets. The repeatability of the method was done by kappa analysis. Statistical analysis was performed by the Kruskal-Wallis test complemented by the Dunn test. The results showed that in the frontal perspective there were no statistically significant differences among the four retraction mechanics evaluated along the roots of the incisors; however, the teardrop loop mechanics showed a slight tendency to present higher strains; in the same mechanics the largest magnitudes of strains were concentrated in the cervical regions and homogeneously along the four incisors. In the occlusal perspective, the teardrop loop mechanics presented greater strains, followed by T loop, double key loop and sliding; in the same mechanics, the strains were concentrated in the canines in relation to the incisors. From the oblique perspective, the teardrop loop mechanics generated greater strains in the cervical regions of the canine, and in the apical regions there were no differences in strains among the four mechanics; in the same mechanics there was the formation of greater strains in the cervical regions. When comparing the mechanics, it was observed that the sliding presents the lower strains and the teardrop loop the greater tensions in the studied regions.

O objetivo deste ensaio clínico foi avaliar a velocidade do movimento dentário durante o fechamento dos espaços das extrações dos pré-molares com a mecânica de deslize e avaliar tridimensionalmente as diferenças entre os grupos que foram submetidos à mecânica tradicional ou às micro-osteoperfurações para aceleração do movimento. Foram selecionados 24 pacientes, com idades entre 18 e 36 anos, portadores de discrepância maxillomandibular indicativa à cirurgia ortognática, que possuíam todos os dentes e apresentavam boa saúde e higiene oral, não fumantes, e que não usavam corticoides ou bifosfonatos. Os pacientes foram alocados aleatoriamente aos grupos controle e experimental. A retração anterior para o fechamento dos espaços foi realizada com a mecânica de deslize ativada sobre dispositivos de ancoragem temporária e a intervenção para aceleração do movimento, as microosteoperfurações, realizada nas sessões de ativação enquanto houvesse espaço disponível e seguro para as mesmas. Moldagens foram realizadas a cada uma das sessões de ativação até o fechamento completo dos espaços. Exames de tomografia computadorizada do feixe cônico foram feitos ao início do tratamento e ao fechamento do espaço das extrações. Para a avaliação da taxa de fechamento dos espaços, os modelos de gesso foram digitalizados e medida linear entre os dentes canino e segundo pré-molar foram feitas no programa de código aberto SlicerCMF. Para a avaliação tridimensional, modelos de superfície foram confeccionadas a partir de reconstruções 3D por meio de mapas coloridos, em seguida foram feitas sobreposições destes modelos entre os tempos, para avaliar os deslocamentos obtidos com o tratamento. Os dados foram analisados usando teste paramétrico t- Student e foi aplicado modelo linear ANCOVA para avaliar a dependência entre as variáveis. Dezoito pacientes completaram o estudo, incluindo 11 do sexo feminino e 7 do sexo masculino, com idade média de 25 anos. Os participantes do grupo experimental eram mais velhos que os do grupo controle (20,4 anos e 27,8 anos, respectivamente). O tempo médio para fechamento dos espaços foi de 247 dias. Não foram encontradas diferenças estatisticamente significantes (p=0,492) na comparação entre as taxas de fechamento dos espaços das extrações (0,614 mm/mês para o grupo controle e 0,672 mm/mês para o experimental). Na análise tridimensional, o grupo controle apresentou maior movimentação coronária para mesial nos segundos pré-molares (direito p=0.024 e esquerdo p=0.018); já o grupo experimental apresentou maior movimentação coronária para o incisivo central direito (p=0,006). Não se observou resultado estatisticamente significante para as outras variáveis analisadas. Neste ensaio clínico a hipótese nula foi aceita, as microosteoperfurações não induziram a aceleração do movimento dentário durante a retração anterior com a mecânica de deslize. Na análise tridimensional, foram encontradas diferenças entre os grupos para os segundos pré-molares, que apresentaram maior movimentação coronária para a mesial no grupo controle, e para o incisivo central direito, que teve maior movimentação coronária para o grupo experimental. / The objective of this \"2-arm parallel\" trial was to assess the rate of tooth movement and three-dimensional differences between patients who were designated for premolar extraction and decompensation and sliding mechanics for anterior retraction with conventional procedure or micro-osteoperforations for accelerated orthodontics. Patients assigned for ortho-surgical treatment and pre-molar extraction were randomly allocated to anterior retraction performed with conventional implant-assisted sliding mechanics or with micro-osteoperforations performed previously to the anterior retraction. CBCT was done pre-treatment and after space closure for threedimensional analysis; Dental impressions were performed every activation session and plaster models were digitally converted in three-dimensional models for rate of tooth movement assess. Patients with maxillomandibular discrepancy indicative for orthognathic surgery, no previous dental extractions, good oral and general health, non-smokers, and no use of systemic corticosteroids or bisphosphonates were eligible for inclusion. The primary outcome was micro-osteoperforations accelerate tooth movement for the experimental group. Randomization was accomplished using Microsoft Excel random numbers function. Blinding was not applicable to outcome assessment. Data were analyzed using t-Student test, and general linear model, ANCOVA was used to evaluate variables dependency. 18 patients were allocated to the orthodontic treatment, including 11 female and 7 male patients with the mean age of 25 years. Subjects from experimental group were older than the control group (20.4 and 27.8). The average follow-up period for this assessment was 247 days. For rate of tooth movement assessment, groups were categorized equally, with 0.614 mm/month for the control group and 0.672 mm/month for the experimental group (EG) with no statistically differences (p=0.492). For three-dimensional analysis, control group showed higher crown movement for the second premolars (right p=0.024 and left p=0.018), and the experimental group presented greater crown movement for the right central incisive (p=0.006). Micro-osteoperforations were inefficient to accelerated tooth movement during anterior retraction for the experimental group. Threedimensional differences were found for the second premolars in the crown movement, showing greater values for the control group, and central incisors which had more lingual movement for the experimental group.

O objetivo deste ensaio clínico foi avaliar a velocidade do movimento dentário durante o fechamento dos espaços das extrações dos pré-molares com a mecânica de deslize e avaliar tridimensionalmente as diferenças entre os grupos que foram submetidos à mecânica tradicional ou às micro-osteoperfurações para aceleração do movimento. Foram selecionados 24 pacientes, com idades entre 18 e 36 anos, portadores de discrepância maxillomandibular indicativa à cirurgia ortognática, que possuíam todos os dentes e apresentavam boa saúde e higiene oral, não fumantes, e que não usavam corticoides ou bifosfonatos. Os pacientes foram alocados aleatoriamente aos grupos controle e experimental. A retração anterior para o fechamento dos espaços foi realizada com a mecânica de deslize ativada sobre dispositivos de ancoragem temporária e a intervenção para aceleração do movimento, as microosteoperfurações, realizada nas sessões de ativação enquanto houvesse espaço disponível e seguro para as mesmas. Moldagens foram realizadas a cada uma das sessões de ativação até o fechamento completo dos espaços. Exames de tomografia computadorizada do feixe cônico foram feitos ao início do tratamento e ao fechamento do espaço das extrações. Para a avaliação da taxa de fechamento dos espaços, os modelos de gesso foram digitalizados e medida linear entre os dentes canino e segundo pré-molar foram feitas no programa de código aberto SlicerCMF. Para a avaliação tridimensional, modelos de superfície foram confeccionadas a partir de reconstruções 3D por meio de mapas coloridos, em seguida foram feitas sobreposições destes modelos entre os tempos, para avaliar os deslocamentos obtidos com o tratamento. Os dados foram analisados usando teste paramétrico t- Student e foi aplicado modelo linear ANCOVA para avaliar a dependência entre as variáveis. Dezoito pacientes completaram o estudo, incluindo 11 do sexo feminino e 7 do sexo masculino, com idade média de 25 anos. Os participantes do grupo experimental eram mais velhos que os do grupo controle (20,4 anos e 27,8 anos, respectivamente). O tempo médio para fechamento dos espaços foi de 247 dias. Não foram encontradas diferenças estatisticamente significantes (p=0,492) na comparação entre as taxas de fechamento dos espaços das extrações (0,614 mm/mês para o grupo controle e 0,672 mm/mês para o experimental). Na análise tridimensional, o grupo controle apresentou maior movimentação coronária para mesial nos segundos pré-molares (direito p=0.024 e esquerdo p=0.018); já o grupo experimental apresentou maior movimentação coronária para o incisivo central direito (p=0,006). Não se observou resultado estatisticamente significante para as outras variáveis analisadas. Neste ensaio clínico a hipótese nula foi aceita, as microosteoperfurações não induziram a aceleração do movimento dentário durante a retração anterior com a mecânica de deslize. Na análise tridimensional, foram encontradas diferenças entre os grupos para os segundos pré-molares, que apresentaram maior movimentação coronária para a mesial no grupo controle, e para o incisivo central direito, que teve maior movimentação coronária para o grupo experimental. / The objective of this \"2-arm parallel\" trial was to assess the rate of tooth movement and three-dimensional differences between patients who were designated for premolar extraction and decompensation and sliding mechanics for anterior retraction with conventional procedure or micro-osteoperforations for accelerated orthodontics. Patients assigned for ortho-surgical treatment and pre-molar extraction were randomly allocated to anterior retraction performed with conventional implant-assisted sliding mechanics or with micro-osteoperforations performed previously to the anterior retraction. CBCT was done pre-treatment and after space closure for threedimensional analysis; Dental impressions were performed every activation session and plaster models were digitally converted in three-dimensional models for rate of tooth movement assess. Patients with maxillomandibular discrepancy indicative for orthognathic surgery, no previous dental extractions, good oral and general health, non-smokers, and no use of systemic corticosteroids or bisphosphonates were eligible for inclusion. The primary outcome was micro-osteoperforations accelerate tooth movement for the experimental group. Randomization was accomplished using Microsoft Excel random numbers function. Blinding was not applicable to outcome assessment. Data were analyzed using t-Student test, and general linear model, ANCOVA was used to evaluate variables dependency. 18 patients were allocated to the orthodontic treatment, including 11 female and 7 male patients with the mean age of 25 years. Subjects from experimental group were older than the control group (20.4 and 27.8). The average follow-up period for this assessment was 247 days. For rate of tooth movement assessment, groups were categorized equally, with 0.614 mm/month for the control group and 0.672 mm/month for the experimental group (EG) with no statistically differences (p=0.492). For three-dimensional analysis, control group showed higher crown movement for the second premolars (right p=0.024 and left p=0.018), and the experimental group presented greater crown movement for the right central incisive (p=0.006). Micro-osteoperforations were inefficient to accelerated tooth movement during anterior retraction for the experimental group. Threedimensional differences were found for the second premolars in the crown movement, showing greater values for the control group, and central incisors which had more lingual movement for the experimental group.

Orientador: Marcos Rogério Mendonça / Coorientador: Osmar Aparecido Cuoghi / Banca: André Pinheiro de Magalhães Bertoz / Banca: Luhana Santos Gonzales Garcia / Resumo: Introdução: O tratamento da má oclusão Classe III em pacientes em crescimento é um desafio pela estabilidade e colaboração do paciente. A etilologia da Classe III pode ser por natureza esquelética, genética e fatores ambientais. Os aspectos encotrados são deficiência maxilar com mandíbula bem posicionada ou protruída da sua base ósseas, maxila bem posicionada com prognatismo mandibular ou a combinação de retrognatismo maxilar com prognatismo mandibular. A deficiência de maxila é frequentemente encontrada em pacientes com má oclusão Classe III sendo o tratamento indicado, a protração maxilar. Material e métodos: Foram selecionadas 8 crianças na faixa etária de 7 a 10 anos, com características faciais e esqueléticas para Classe III. Como terapêutica ortopédica, foi utilizado o aparelho expansor tipo Hyrax modificado com ganchos soldados na mesial dos segundos molares decíduos e primeiros molares permanentes. Para o inferior foi um arco lingual de Nance modificado com ganchos soldados na altura de caninos e segundos molares decíduos. O protocolo para disjunção maxilar com dois quartos de volta por dia em média de 7 a 10 dias, em seguida indicado o uso de elásticos para Classe III 3/16" de força média na primeira semana e a partir da segunda semana, elásticos 1/8" médio de cada lado da arcada até a correção da mordida cruzada anterior. Para a análise dos efeitos dentoesqueléticos foram usadas as teleradiografias iniciais (T1), as obtidas após a correção da MCA (T2) e as telerradi... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Treatment of Class III malocclusion in growing patients is a challenge for patient stability and collaboration. Class III etiology may be by skeletal, genetic, and environmental factors. The aspects found are maxillary deficiency with well positioned or protruding mandible of its base bone, maxilla well positioned with mandibular prognathism or the combination of maxillary retrognathism with mandibular prognathism. Jaw deficiency is often found in patients with Class III malocclusion and the indicated treatment is maxillary protraction. Material and methods: We selected 8 children aged 7 to 10 years, with facial and skeletal characteristics for Class III. As an orthopedic therapy, the modified Hyrax type expander was used with welded hooks in the mesial of the second deciduous and first permanent molars. For the lower one was a lingual arch of Nance modified with welded hooks at the height of deciduous canines and second molars. The protocol for maxillary disjunction with two quarters of a turn in a mean of 7 to 10 days, then indicated the use of Class III 3/16 "elastic force in the first week and from the second week, elastic 1 / 8 "on each side of the arcade until the correction of the anterior crossbite. The initial teleradiographs (T1), those obtained after correction of the MCA (T2) and the cephalograms performed three months after the correction (T3) were used to analyze the dento-skeletal effects. Results: According to the proposed mechanics and applied m... (Complete abstract click electronic access below) / Mestre

Orientador: Daniela Leal Zandim-Barcelos / Resumo: A movimentação dentária ortodôntica em pacientes adultos com histórico de doença periodontal requer um planejamento complexo, devido à reabsorção óssea, e a dificuldade de se obter uma ancoragem satisfatória por consequência da perda de elementos dentários. O objetivo deste trabalho foi avaliar as alterações longitudinais no perfil microbiológico e nos parâmetros clínicos periodontais de incisivos centrais superiores com periodonto reduzido durante e após término do movimento de intrusão dentária. Vinte pacientes com doença periodontal foram selecionados de acordo com os critérios do estudo. Estes pacientes deveriam apresentar incisivos centrais superiores vestibularizados e extruídos com perda de inserção ≥ 5 mm e indicação de intrusão dentária. Todos os sítios com atividade de doença periodontal receberam raspagem e alisamento radicular (RAR) e para o tratamento ortodôntico ser iniciado, os incisivos centrais superiores deveriam apresentar estabilidade no nível clínico de inserção após 90 dias do término do tratamento periodontal ativo. Os parâmetros clínicos Índice de placa (IP), Índice Gengival (IG), profundidade de sondagem (PS), nível clínico de inserção (NCI), recessão gengival (RG), sangramento à sondagem (SS) e tamanho de coroa clínica (TCC) foram avaliados antes do procedimento de RAR, no início do movimento de intrusão (T1- Baseline), durante o movimento de intrusão (90 e 180 dias), imediatamente após o término da intrusão ortodôntica (T2), 90 e 180 dias após o tér... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Orthodontic tooth movement in adult patients with a history of periodontal disease requires complex planning, due to bone resorption, and the difficulty of achieving satisfactory anchorage as a result of loss of dental elements. The objective of this study was to evaluate longitudinal changes in microbiology and clinical periodontal parameters of upper central incisors, in patients with reduced periodontium, before, during and after orthodontic intrusion. Twenty patients with periodontal disease were selected according to the study criteria. These patients should have vestibularized and extruded upper central incisors with insertion loss ≥ 5 mm and indication of dental intrusion. All sites with activity of periodontal disease received scaling and root planing (RAR) and for orthodontic treatment to be started, the upper central incisors should have stability in the clinical level of insertion after 90 days of the end of active periodontal treatment. Clinical parameters Plaque index (PI), Gingival index (GI), probing depth (PD), clinical level of insertion (CLI), gingival recession (GR), probing bleeding (PB) and clinical crown size (CCS) were evaluated before the RAR procedure, at the beginning of the intrusion movement (T1- Baseline), during the intrusion movement (90 and 180 days), immediately after the end of the orthodontic intrusion (T2), 90 and 180 days after the end of the intrusion treatment. Sample collections of gingival crevicular fluid (GFC) were performed during t... (Complete abstract click electronic access below) / Mestre

Indiana University-Purdue University Indianapolis (IUPUI) / External apical root resorption (EARR) is a common complication of orthodontic treatment. Genetic factors account for approximately 50% of the variation in EARR. Data have indicated variation in histological root resorption associated with orthodontic force (RRAOF) among different inbred strains of mice. Differences in expression of RANKL and OPG were investigated in two strains of mice with different susceptibility to RRAOF using irnmunohistochemistry. Increased localization of RANKL was detected in the tissues surrounding the root of the susceptible strain compared to the resistant strain and the controls. In contrast, increased localization of OPG was found in the tissues surrounding the roots in the resistant A/J strain compared to the susceptible DBA/2J strain. We conclude that differences in the expression of these key bone resorption mediators play a role in determining RRAOF susceptibility. Changes in serum TRAP 5b level in response to orthodontic force were investigated among female A/J, DBA/2J and BALB/cJ mice. The three strains differed in their TRAP positive cell numbers as well as their serum TRAP 5b level at baseline and when treated. A significant increase in the serum TRAP 5b level with treatment was only detected in the RRAOF susceptible DBA/2J strain, and not in RRAOF resistant strains. Our analysis indicates that differences in osteoclast/odontoclast activity play a role in susceptibility to RRAOF that is genetically determined. Serum TRAP 5b levels have a potential role in screening for individuals with greater susceptibility to root resorption. RRAOF was determined for male and female mice of the A/J, DBA/2J and BALB/cJ strains, as well as A/J x DBA/2J and A/J x BALB/cJ crosses. Sex differences were observed among the BALB/cJ strain only, with females more resistant to RRAOF when compared to males. Fis from the A/J x BALB/cJ cross were resistant suggesting that the A/J have dominant resistance alleles, while Fis from the A/J x DBA/2J cross had RRAOF intermediate between their parental A/J and DBA/2J mice, suggesting a polygenic trait. We concluded that the mode of inheritance of RRAOF in mice was polygenic in nature.

Indiana University-Purdue University Indianapolis (IUPUI) / According to one theory of root resorption, occlusal trauma during orthodontic tooth movement damages the cementum covering the root dentin. The body detects the exposed dentin and seeks to remove it, and the result is root resorption. This experiment will explore an aspect of this theory by quantifying the amount and location of damage in mechanically fatigued teeth. Nine dog mandibles were sectioned at the mandibular symphysis. Each half was mounted in orthodontic resin with the incisors upright and exposed. The block was inserted into a jig and placed into a servohydraulic mechanical testing machine. The left central incisor was fatigue loaded with a 2Hz, 10-90 N sinusoidal force for 100,000 cycles (approximately 14 hours). The right central incisor served as the control. Both specimens were scanned with a micro-CT unit, stained with basic fuchsin, and then sectioned along the sagittal plane. Because the experimental and control specimens were stained before sectioning, only microdamage due to the loading process would be evident in the sections. Microdamage which occurred during the sectioning process would not be stained. Central sections through the long axes of the samples were examined for the presence of microdamage with a light microscope and a micro-CT unit. Based on preliminary findings, two types of staining patterns were measured and recorded. The first was called "diffuse stain" and consisted of large stained areas in the dentinal tubules. Diffuse stain was not associated with any visible features at the dentinocemental junction. The second type of staining pattern was called "stained defects." Stained defects were stained irregularities at the dentinocemental junction. For statistical analysis, the roots were divided into buccal-cervical, buccal-middle, buccal-apical, lingual-cervical, lingual-middle, and lingual-apical regions. Comparisons between the fatigued and non-fatigued teeth for differences in area, length, and depth were made under the generalized estimating equation (GEE) framework applied to normally-distributed data. Because the measurements were not normally distributed, a rank transformation of the measurements was performed before conducting the analyses. Comparisons between the fatigued and non-fatigued teeth for differences in presence or absence of stain or defects were made using Cochran-Mantel-Haenszel tests. Repeatability of the measurements was assessed using intraclass correlation coefficients (ICCs), paired t-tests, and Bland-Altman plots. The ICC's ranged from 0 .85 to 1.00, thus making the repeatability of the measurements generally very good. The statistical analysis showed there were no significant differences between the experimental and control teeth for stained defects or diffuse staining for length, depth, or area measurements. However, analyses comparing the distribution of stained defects and diffuse stain within the control and experimental specimens showed significant differences in the distribution of stained defects within the experimental specimens. In the experimental specimens, the stained defects were distributed in a gradient, with the most in the apical region and progressing to the least amount in the cervical region. In the control specimens, there was only a difference in the stained defects between the cervical and apical regions. This distribution is consistent with the biomechanical model which shows increasing stress moving from the cervical region towards the apex. These results show that the test and control specimens differed in how the stained defects were distributed throughout the root, even though there were no differences in the amount of staining between the control and experimental specimens. Whole tooth and histologic slides were scanned with the micro-CT unit, but the dentinocemental junction could not be delineated enough to make any measurements. No data could be collected regarding microdamage in this area using the micro-CT unit. It was recommended that future studies use a tomography unit with better resolution, use a larger samples size, employ a contrast agent when trying to visualize microdamage with the micro-CT unit, and incorporate a way to measure the intensity of the staining in addition to the location and size.