Magister Scientiae Dentium - MSc(Dent) / A public orthodontic system generally is designed to prioritize patients so that those who have the greatest need receive treatment. The aim of this study was to compare the subjective perceptions of the occlusal appearance of 11 to 12 year-old schoolchildren of Nairobi with the modified Aesthetic Component (AC) scale of the Index of Orthodontic Treatment Need (IOTN). The objectives were to assess the children’s perception of their occlusal appearance, categorise the occlusal appearance using the AC scale, by both the children and researcher; and to compare the children’s’ perception and the AC of the IOTN. / South Africa

Magister Chirurgiae Dentium (MChD) / Epidemiological studies on malocclusion have been primarily concerned with its aetiology and distribution. However, due to the varied and often subjective methods of assessment, many of these studies provide conflicting data related to malocclusions (Solow, 1970). To address this, the Fédération Dentaire Internationale (FDI) in close collaboration with the World Health Organisation (WHO) developed an objective method for measuring occlusal traits (Baume et al., 1973). This method was used to obtain the epidemiological data on occlusal traits for 14-year-old children Kampala in order to provide baseline data related to malocclusion. A total of 402 subjects were examined. Of these 65% were female and 35% were male. Thirty percent of the sample had at least one dental anomaly. The most commonly extracted teeth were mandibular first molars (43.6%) and maxillary canines (17.3%). The high frequency of extracted permanent canines in this sample is unique. By and large, many of the occlusal traits related to the canine are attributable to the practice of ebinyo, a form of dental mutilation, which still seem to be rife in many communities in Uganda. Similar to other studies (Massler and Frankel, 1951; de Muňiz, 1986; Ferguson, 1988; Kaka, 1993), mandibular first molars were five times more likely to be missing than maxillary first molars while the ratio of missing maxillary to mandibular canines was found to be 2.5:1. Crowding was most frequently observed in the mandibular incisal segment while spacing was mostly in the maxillary incisal region, thus supporting the view of Brunelle et al., (1996) that although prevalence may vary from study to study, more people have malaligned mandibular incisors than maxillary incisors concurs with these studies. Of the subjects studied, 6.8% had a diastema of 3mm and more. Regarding space measurements, 17.9% of the sample population had at least one segment with crowding, 18.2% had at least one segment with spacing while 33.6% had some degree of incisor malalignment and 54.2% of the sample population had some form of space anomaly. About 70% of the subjects had symmetric molar relationships of which 54.2% were Class I, 9.2% Class II and 3.2% Class III similar to the universal distributional pattern. Crossbites were not a major finding, and were present in only 7% of the sample. The distribution of overjet was relatively symmetrical on the left and right. Negative overjet (anterior open bite) was a rare occurrence in an average of 2.4% of the population. In 77.6% of the population, the overjet ranged from 1 to 4mm, and in 22.4%, the overjet was either edge-to-edge, reverse or 5mm and over. About 7.3% had an overjet of 5-6mm while only 2.1% had an overjet greater than 6mm. Approximately 53.7% of the population had an overbite of 1-3mm. Edge-to-edge and open bite incisor relationships were found in less than 10% of the sample. Although ideal occlusion as described by Angle (1907) in the Ugandan sample is very rare, using the data derived from this study, normal occlusion as defined by statistical distribution can be described. / South Africa

Magister Chirurgiae Dentium (MChD) / state funded programmes are essential to provide a treatment for the dentally handicapped. To address this need a study was undertaken under the auspices of the Orthodontic Department of the University of the Western Cape to assess the orthodontic needs of children in the Western Cape. The purpose of this study was to determine the occlusal traits of Indian children in the Western Cape and to compare them with samples internationally. The sample consisted of 355 children, 12-14 years old, from schools administered by the House of Delegates. They were examined and recorded according to the methods set out by Baume et al. (1973), and Angle's Classification (1899) with the Dewey- Anderson (1919 and 1960) and EI-Mangoury and Mustafa (1991) modifications The results of this study showed that bilateral molar relationships were: normal in 72.9%; mesial in 5.8% and distal in 15.5% of the children examined. The remaining had an asymmetrical molar relationship (5.8%). The upper incisal area was found to be the most crowded area in the mouth followed by the lower incisal area. Anterior crowding was present in 58.2% and spacing in 12.7% of the sample. The mean overjet was 2.7mm and the mean overbite 2 .1mm. In the posterior segments, open bites accounted for approximately 6.5% and crossbites for 8.3% On the basis of Angle's Classification it was found that 17.1% had a normal occlusion and 54.9% an Angles Class I malocclusion, 16.9% an Angle's Class II malocclusion and 5.5% an Angle's Class III malocclusion. 5.6% of the candidates had an asymmetrical molar relationship. In comparison to other population groups the results suggest that the incidence of some occlusal traits of this Western Cape sample was similar to that of other population groups while some traits were more prevalent. The pattern of the distribution of Angles Classification was also similar to that reported in studies done elsewhere.

Made available in DSpace on 2016-08-03T16:31:15Z (GMT). No. of bitstreams: 1 IVAN DELGADO RICCI.pdf: 1269802 bytes, checksum: 7496457c509408d4b688ae6ae2ae730f (MD5) Previous issue date: 2010-10-06 / Introduction: The Bolton analysis, analysis that quantifies the tooth size is an important reference for professionals seeking appropriate orthodontic finishing. Objective: The objective of this study is to verify that there is discrepancy between the subjects with normal occlusion and malocclusion Class I and Class II division 1 belonging to the selected sample, compared to the values reported by Bolton and also check difference related to sexual dimorphism. Methods: 3 groups of 35 pairs of plaster casts each, separated by the type of occlusion, pertaining to the program of graduate orthodontics at the Methodist University of Sao Paulo were measured with a digital caliper at its greatest distance mesiodistal since 1st right molar to 1st molar left, the upper and lower arches, with permanent teeth. The values were tabulated and the proportion of Bolton has been applied. Results: Respectively for groups 1, 2 and 3, the total ratio found was 90.36 (SD ± 1.70), 91.17 (SD ± 2.58) and 90.76 (SD ± 2.45) and the anterior ratio was 77.73 (SD ± 2.39), 78.01 (SD ± 2.66) and 77.30 (SD ± 2.65). Conclusion: there was no sexual dimorphism or statistically significant difference compared to the values suggested by Bolton. / Introdução: A análise de Bolton, análise que quantifica o tamanho dentário, é uma referência importante para profissionais que buscam finalizações ortodônticas adequadas. Objetivo: O objetivo deste trabalho é verificar se há discrepância entre os indivíduos com oclusão normal natural e maloclusões de Classe I e de Classe II divisão 1 de Angle pertencentes a amostra selecionada, em relação aos valores encontrados por Bolton, bem como verificar também se há dimorfismo sexual. Metodologia: 3 grupos contendo 35 pares e modelos em gesso cada, separados pelo tipo de oclusão, pertencentes ao acervo do programa de pós-graduação em Ortodontia da Universidade Metodista de São Paulo foram medidos com paquímetro digital em sua maior distância mésiodistal desde 1º molar direito a 1º molar esquerdo, dos arcos superiores e inferiores, com dentição permanente. Os valores foram tabulados e a proporção de Bolton foi aplicada. Resultados: Respectivamente para os grupos 1, 2 e 3, a proporção total encontrada foi de 90,36 (DP±1,70), 91,17 (DP±2,58) e 90,76 (DP±2,45), e a proporção anterior foi de 77,73 (DP±2,39), 78,01 (DP±2,66) e 77,30 (DP±2,65). Conclusão: não houve dimorfismo sexual nem diferença estatisticamente significante comparando os valores aos sugeridos por Bolton.

Objective: The purpose was to compare orthodontists’ and parents’ perception of orthodontic treatment outcomes in the anterior-posterior (AP) dimension. Assessment of treatment time and compliance were also investigated. Material and Methods: Parallel surveys for orthodontists (n=1000) and parents (n=750) displayed occlusions from 3 mm Class III (Cl III:3) to 3 mm Class II. Participants rated occlusal relationships on a 100 mm VAS from least to most acceptable (0-100). Results: 233 orthodontists (23%) and 243 parents (32%) responded. Orthodontists (mean=93.9, 25.9) and parents (mean=80.7, 40.9) rated Class I (Cl I) occlusion most and Cl III:3 least acceptable. No significant difference was found between outcomes at 18 months versus 24 months. For all cases, parents were willing to extend treatment duration longer than orthodontists. Conclusions: Orthodontists and parents viewed treatment outcomes in the AP dimension differently, rating Cl I as most acceptable. Parents were willing to extend treatment longer than orthodontists.

INTRODUÇÃO: O ceceio tem sido descrito como uma alteração de fala esperada para pacientes com fissura de lábio e palato acompanhado de deficiência de crescimento maxilar. A relação entre as distorções na produção dos sons fricativos linguo-alveolares e a severidade da má oclusão não estão estabelecidos na população com fissura. OBJETIVO: Relacionar a presença de ceceio nos fonemas /s/ e /z/ com a deformidade dentofacial, de acordo com o índice oclusão, em crianças com fissura labiopalatina. METODOLOGIA: A amostra de fala e os modelos de gesso foram obtidos de 106 crianças com fissura labiopalatina operada durante a dentição mista e antes do tratamento ortodôntico. Foram realizadas filmagens com os indivíduos repetindo as frases /u sasi saiw sedu / e /zizi powzow na kaza da zeze/ e avaliadas por fonoaudiólogos com a intenção de identificar o ceceio nos fonemas de /s/ e /z/. Os modelos de gesso foram avaliados por ortodontistas usando o índice oclusal para identificar a relação inter-arcos. LOCAL: Hospital de Reabilitação de Anomalias Craniofaciais, USP, Bauru. RESULTADOS: Foram encontradas concordância substancial intra-juízes (k=0,65) e concordância moderada a perfeita inter-juízes (k=0,58 1,00) durante a avaliação de ceceio para o fonema /s/ e /z/. Entre os ortodontistas foi encontrada uma concordância quase perfeita (k=0,81) durante a avaliação por meio do índice oclusal. A análise de regressão logísticas mostrou nenhuma associação significante entre o ceceio e o índice oclusal (p=0,802) e entre a idade (p=0,662) para o fonema /s/, e também sem significância entre o ceceio e o índice oclusal (p=0,525) e entre a idade (p=0,755) para o fonema /z/. CONCLUSÃO: Este estudo revelou que não houve relação estatisticamente significante, entre a presença de ceceio na fala, durante a produção dos fonemas /s/ e /z/, e a deformidade dentofacial, de acordo com o índice oclusal, em crianças com fissura transforame unilateral operada. / INTRODUCTION: Lisping has been described as an expected aspect of speech of individuals with history of cleft lip and palate who present with midfacial growth deficiency. The relationship between distortions during production of linguoalveolar fricative sounds and the severity of malocclusion has not been established for the population with cleft. OBJECTIVE: Correlation between lisping and dental arches relationship, according to oclusal index, in children with operated unilateral cleft lip and palate (UCLP). METHODOLOGY: Speech samples and dental arch casts were obtained from 106 children with operated UCLP during mixed dentition and before orthodontic treatment. Video-taped productions of the phrases /u sasi saiw sedu/ and /zizi powzow na kaza da zeze/ were rated by speech-language pathologists for the identification of lisping during /s/ and /z/. Dental arches casts were rated by orthodontists using the occlusal index to establish dental arches relationships. LOCAL: Hospital of Rehabilitation of Craniofacial Anomalies, USP, Bauru -SP, Brazil. RESULTS: Substantial inter-judge agreement during auditory-perceptual ratings of lisping during /s/ and /z/ (kappa = 0.65) and moderate to perfect intra-judge agreement during auditory-perceptual ratings during /s/ e /z/ (k=0.58 1.00) were found. Almost perfect agreement was found between orthodontists while establishing five-years index (k=0.81). Multiple logistic regression showed no significant association between lisping and occlusal index (p=0.802) and age (p=0.662) for /s/, and between lisping and occlusal index (p=0.252) and age (p=0.755) for /z/. CONCLUSION: This study failed to reveal an association between lisping and dental arches relationship in children with operated UCLP.

A relação oclusal dos arcos dentários de 105 bebês brasileiros com idades entre 1 a 3 anos, foi avaliada neste estudo. Estes apresentaram os seguintes requisitos para participarem da amostra: presença de dentes decíduos hígidos (sem cárie ou qualquer tipo de anomalia de forma e estrutura), sem histórico de traumatismo dentário e assimetrias, maxilar e facial. A amostra foi dividida em 4 grupos: Grupo 1: Bebês que apresentem no mínimo quatro incisivos, sendo dois superiores e dois inferiores irrompidos; Grupo 2: Bebês que apresentem incisivos e primeiros molares irrompidos; Grupo 3: Bebês que apresentem incisivos, primeiros molares e caninos irrompidos; Grupo 4 : Bebês que apresentem incisivos, primeiros molares, caninos e segundos molares irrompidos. A avaliação constou de exame clínico de cada criança e a análise das respostas dos questionários preenchidos pelos responsáveis. Os dados encontrados foram tabulados e analisados através de análise descritiva. Os resultados deste estudo sugerem que as más oclusões aparecem em uma época precoce do desenvolvimento da dentição decídua em 19,05% das crianças estudadas. / The aim of the present study was to evaluate the oclusal relationship of the dental arch of 105 brasilian babies with age from 1 to 3 years old. The sample showed the following characteristics: presence of primary teeth (without dental decay or any kind of size or structure anomaly), without dental injuries or maxilar/mandibular assimetry. The sample was divided into 4 following groups: Group 1: Babies showing four incisors at least, being two upper and two lower erupted incisive teeth; Group 2: Babies showing incisors and erupted first molars; Group 3: Babies showing incisors, first molars and erupted canines; Group 4: Babies showing incisors, first molars, canines and erupted second molars. The evaluation was compound by clinical exam of each child and by analysis of the answers from questionary given to the guardians. The data was analyzed through descriptive analysis. The results pointed out that malocclusions presented in 19,05% of the sample on early age of the primary teeth development.

Neste estudo retrospectivo, controlado, de 94 adolescentes consecutivos com maloclusão de Classe II, divisão 1ª de Angle e retrognatismo mandibular, no surto de crescimento puberal, foram avaliadas as mudanças dentoesqueléticas decorrentes do tratamento com aparelho de Herbst (Grupo A coroas de aço e B splints acrílicos) e de acompanhamento (Grupo C - controle), em um período de 12 meses. As telerradiografias laterais foram obtidas em T1 (inicial) e T2 (no final do período de observação). As variáveis cefalométricas foram analisadas com testes paramétricos. Os resultados mostraram que os dois grupos tratados caracterizaram-se diferencialmente do grupo controle, com restrição do crescimento maxilar e maior crescimento mandibular, o que permitiu melhorar a relação sagital. Da mesma forma, no aspecto dentoalveolar houve melhora da sobressaliência pela retroinclinação dos incisivos superiores e vestibularização dos incisivos inferiores, distalização com controle vertical dos molares superiores e mesialização dos molares inferiores. Os três grupos mostraram semelhança na extrusão dos molares inferiores, na preservação da morfologia mandibular e do padrão facial. O plano oclusal rotacionou no sentido horário nos grupos tratados e anti-horário no grupo controle. Pode-se concluir que no tratamento com dois tipos de aparelho de Herbst da maloclusão de classe II, em adolescentes no pico máximo de crescimento, observaram-se um conjunto de mudanças que melhoraram as relações dentoesqueléticas sagitais, independentemente do crescimento. No aspecto vertical, apesar das pequenas mudanças observadas houve preservação do padrão facial assim como no grupo controle. / This retrospective controlled study enrolled 94 consecutive adolescents during growth spurt with Angle class II division 1 malocclusion and mandibular retrognathism and evaluated skeletal and dental changes resulting from treatment with a Herbst appliance (Group A: steel crowns; Group B: acrylic splints) and compared them with results of a follow-up group (Group C: control) for 12 months. Lateral radiographs were obtained in the beginning of the treatment (T1) and at the end of the observation period (T2). Cephalometric variables were analyzed using parametric tests. The results of the two treatment groups were different from those found for the control group. Maxillary growth was restricted, whereas mandibular growth was greater, which resulted in a better sagittal relation. At the same time, the analysis of dentoalveolar aspects revealed that overjet was reduced due to distal tipping of maxillary incisors and buccal inclination of mandibular incisors, vertical control of maxillary molars and mesial movement of mandibular molars. The three groups had similar extrusion of mandibular molars, preservation of mandibular morphology and facial pattern. The occlusal plane rotated clockwise in the treated groups and counterclockwise in the control group. It can be concluded that the treatment of class II malocclusion in adolescents during growth spurt with two types of Herbst appliance resulted in a set of changes that improved sagittal skeletal and dental relations, regardless of growth. Vertically, facial pattern was preserved in treatment and control groups, despite some small differences.

Embriologicamente, o tecido ósseo surge posteriormente aos músculos. A musculatura temporomandibular e facial apresentam-se definidas quando da ossificação da face e crânio, com os ossos se desenvolvendo dentro de um envelope de músculo e fascia. Quando contrações ativas se iniciam em um músculo, ele passa a exercer contínuo efeito sobre os ossos aos quais pertencem sua origem e inserção. O tecido ósseo é tido como um dos mais plásticos e responde prontamente às forças e tensões geradas pelos músculos. Evidenciase que os músculos, desde a fase pré-natal, desempenham papel na conformação dos ossos, e continuam a direcionar o crescimento pelo efeito de suas funções. Oito pacientes (4? e 4?) com idade entre 7 e 12 anos, com maloclusão dental classe III de Angle, foram submetidos a registros eletromiográficos do músculo masseter, subdividido em três regiões: superior, média e inferior, empregando-se o eletromiógrafo K6-I/EMG Eight Channel Surface Electromyograph (Myo-tronics Co., Seatle, WA, EUA), em 17 condições clínicas, e à análise cefalométrica através do programa Radiocef (RadioMemory, Floresta, BH, Brasil), de 15 medidas angulares e lineares. Os dados obtidos foram submetidos ao teste de correlação de Spearman, por meio do programa Statistica, release 4.3D (StatSoft, Inc., 1993, EUA). Correlações estatisticamente significantes foram encontradas entre as condições clínicas de repouso, propulsão livre da mandíbula, mastigação molar, oclusão cêntrica forçada, desvio lateral, deglutição de água, mastigação incisiva, fechamento contra-resistência e deglutição de saliva; e, entre as medidas cefalométricas, ângulo SNA, ângulo incisivo superior.NA, distância incisivo superior-NA, ângulo ANB, ângulo IMPA, distância Pog-NB, ângulo SN.Gn(Y), ângulo incisivo inferior.NB, ângulo interincisivo, distância incisivo inferior-NB, ângulo SN.GoGn, ângulo SN.Plano Oclusal, ângulo SNB e ângulo SND. As regiões superior, média e inferior do músculo masseter participaram em 32, 18 e 50% dos resultados estatisticamente significantes, respectivamente. Os resultados corroboram com hipóteses sobre a influência da musculatura no estabelecimento da maloclusão dental, e a relação entre a função dos músculos do sistema estomatognático e o desenvolvimento craniofacial precisa ser compreendida para se poder predizer o desenvolvimento craniofacial. / Embryologically, the bone tissue develops after muscle tissue. The temporomandibular and facial muscles are well defined when the cranial and facial ossifications occur, with bone structures developing inside of a muscle and fascia envelope. When active contractions begin in a muscle, it exerts an uninterrupted effect over bones to which belongs its origin and insertion. The bones tissues are one of the most plastic tissues, and interact readily to any tension and pressure developed by muscles. It\'s axiomatic that since previous to childbirth, muscles exert a role in bone structure development, and keep directing the skeletal growth with the effect of its functions. Eight patients (4? and 4?), between 7 and 12 years of age, with Angle\'s class III dental malocclusion were studied using electromyographic registers of the masseter muscle, divided in three regions: superior, middle and inferior, and cephalometric analysis. The K6-I/EMG Eight Channel Surface Electromyograph (Myo-tronics Co., Seatle, WA, EUA) was employed to get the registers in 17 clinical conditions, and the Radiocef (RadioMemory, Floresta, BH, Brasil) software was employed to get cephalometric analysis of 15 linear and angular measurements. The data obtained were submitted to statistical analysis by Spearman correlation test, with the Statistica, release 4.3D (StatSoft, Inc., 1993, EUA) software. Correlations were found among the clinical conditions of rest, free protraction of the jaw, molar chewing, centric occlusion, lateral movement without occlusal contact, swallowing water, incisal chewing, clenching the jaw against resistance and swallowing saliva; and among the following cephalometric measurements: the SNA angle, the Upper Incisor.NA angle, Upper Incisor-NA distance, ANB angle, IMPA angle, Pog-NB distance, SN.Gn(Y) angle, Lower Incisor.NB angle, Interincisors angle, Lower Incisor-NB distance, SN.GoGn angle, SN.Occlusal Plane angle, SNB angle and SND angle. The superior, middle and inferior regions of the masseter muscle were present in 32, 18 and 50% of the statistically significant results, respectively. The results reinforce the assumption of muscle influence over the development of dental malocclusion, and that the interaction of muscle function and skeletal growth must be understood to predict craniofacial development.

A parte superficial do músculo masseter, subdividido em três regiões - superior, média e inferior - foi estudado por meio da eletromiografia de superfície em pacientes com maloclusão dental classe III de Angle. Participaram deste estudo 14 pacientes (4 do sexo masculino, 10 do sexo feminino, com idade de 7 a 12 anos). Utilizou-se o “scan" nº. 9 do eletromiógrafo modelo K6-I/EMG Eight Channel Surface Electromyograph (Myo-tronics Co., Seatle, WA, EUA). Empregou-se na análise estatística não-paramétrica o teste de Wilcoxon para a comparação entre os lados, e o teste de Friedman para a comparação entre as regiões. Concluiu-se que: (1) nos movimentos de Abertura e Fechamento, Deglutição de Saliva, Oclusão Cêntrica Forçada e Mordida Molar Bilateral com Algodão, houve diferença estatística significante de atividade entre os lados, e o músculo masseter esquerdo apresentou maior atividade eletromiográfica que o músculo masseter direito; (2) a atividade da região superior predominou nas posições de Repouso e Repouso Pós-Exercícios, com diferença estatística significante, seguida pelas atividades das regiões média e inferior, respectivamente; (3) a atividade da região inferior predominou nos movimentos de Propulsão Livre, Deglutição de Água, Deglutição de Saliva e Desvio Lateral Esquerdo sem Contato, com diferença estatística significante, seguida pelas atividades das regiões média e superior, respectivamente; (4) a atividade da região inferior também foi predominante nos movimentos de Abaixamento Livre, Abertura e Fechamento, Abertura contra Resistência e Propulsão contra Resistência, com diferença estatística significante; e (5) a região média apresentou atividade intermediária às demais regiões nas posições de Repouso e Repouso Pós-Exercícios, e nos movimentos de Abertura e Fechamento, Abertura contra Resistência, Propulsão Livre, Deglutição de Água e de Saliva, e Desvio Lateral Esquerdo sem Contato, com diferença estatística significante. / The participation of superior, middle and inferior regions of superficial masseter was evaluated by surface electromyography of 14 patients, 04 male and 10 female, ranging in age from 7 to 12 years, with Angle’s class III dental malocclusion. The Scan #9 of the computerized program of K6-I/EMG Eight Channel Surface Electromyograph system (Myo-tronics Co., Seatle, WA, EUA) was employed with bipolar surface double electrodes. The non-parametric test of Wilcoxon was employed to the comparison between sides, and the non-parametric test of Friedman was employed to the comparison among regions. It was concluded that: (1) at the “opening and closing", “swallowing saliva", “centric occlusion" and “clenching with cotton rolls bilaterally at molar region", there was statistical differences between sides, and the left masseter developed more activity; (2) the superior region developed more activity with statistical differences at “rest" and “rest after exercises" positions, and was followed by the activity of middle and inferior regions, respectively; (3) the inferior region developed more activity with statistical differences at “free protraction of the jaw", “swallowing water", “swallowing saliva" and “lateral movement to the left side without occlusal contact", and was followed by the activity of middle and superior regions, respectively; (4) the inferior region developed more activity with statistical differences at “free opening", “opening and closing", “opening of the jaw against resistance" and “protraction of the jaw against resistance"; and (5) the middle region developed intermediary activity with statistical differences at “rest" and “resting after exercises", and at “opening and closing", “opening the jaw against resistance", “free protraction", “swallowing water", “swallowing saliva", and “lateral movement to the left side without occlusal contact".