Made available in DSpace on 2014-10-09T12:28:52Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T13:57:06Z (GMT). No. of bitstreams: 0 / Dissertacao (Mestrado Profissionalizante em Lasers em Odontologia) / IPEN/D-MPLO / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP; Faculdade de Odontologia, Universidade de Sao Paulo, Sao Paulo

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O objetivo deste trabalho foi avaliar a quantidade de resina residual após a descolagem de braquetes e a perda e/ou desgaste de esmalte ocorrido durante as fases de: colagem, descolagem e remoção dos remanescentes resinosos, na área do braquete e adjacente. A amostra foi constituída de 150 pré-molares, dividida em dois grupos de acordo com o tipo de material do braquete utilizado: metálico (n=75) e cerâmico (n=75), nas duas primeiras fases do estudo, colagem e descolagem. Os procedimentos de colagem foram realizados de acordo com a International Organization for Standardization (2003), e a descolagem segundo a orientação preconizada pelo fabricante. Na fase de remoção dos remanescentes resinosos foram considerados cinco grupos de acordo com o protocolo de acabamento/polimento e prescrição dos respectivos fabricantes: FF diamantada + Soflex; Pedra Shofu; Dentaurum Carbide; Komet Carbide e Jet Carbide, com auxilio de lupas telescópicas sob a magnificação 3x. A avaliação qualitativa (ARIm e ESI) foi realizada por meio de fotografias digitais (lupa estereoscópica - Olympus SZ61). A avalição quantitativa foi realizada pelo método de medição por Coordenada - Coordinate Measuring Machines (Mitutoyo), mod. Legex CNC 9106 - Perfil de linha. As possíveis diferenças entre os protocolos de acabamento/polimento foram avaliadas pela análise de variância (ANOVA) e pelo teste de comparações múltiplas de Tukey. As quantidades médias de resina residual encontrada na área sob a base do braquete, após acabamento/polimento foram: Diamantada FF + Soflex (10,4 m ±10,5), Pedra Shofu (18,5 m ± 12,1), Dentaurum Carbide (11,2 m ± 11,9), Komet Carbide (9,5 m ± 10,8) e Jet Carbide (22,8 m ± 24,0). E na área adjacente: Diamantada FF + Soflex (14,9 m ± 13,0), Pedra Shofu (22,8 m ±19,5), Dentaurum Carbide (21,4 m ±18,5), Komet Carbide (9,6 m ± 7,7), Jet Carbide (27,8 m ± 24,5). Desta forma, constatou-se que, em geral, os protocolos de acabamento/polimento deixaram maior quantidade de resina residual sobre a área adjacente que na área do braquete, com exceção do protocolo Komet Carbide, que teve desempenho semelhante em ambas as áreas. E as quantidades médias de perda e/ou desgaste do esmalte na área do braquete foram: Diamantada FF + Soflex (-134,9 m ± 56,4), Pedra Shofu ( 39,2 m ± 12,8), Dentaurum Carbide ( 70,5 m ± 27,9), Komet Carbide (-44,8 m ± 14,3) e Jet Carbide ( 68,2 m ± 35,7) na área do braquete, enquanto na área adjacente: Diamantada FF + Soflex (-124,7 m ± 133,1), Pedra Shofu (- 37,9 m ± 25,1), Dentaurum Carbide (- 60,1 m ±32,4), Komet Carbide (-36,6 m ± 19,5) e (Jet Carbide 65,4 m ± 65,0) (Tabela 5.9). Ressalta-se que em ambas as áreas de avaliação, o protocolo (Diamantada FF + Soflex) foi responsável pela maior quantidade de perda e/ou desgaste, diferenciando-se com significância estatística dos demais protocolos. Com base nestes resultados podemos concluir que os protocolos de acabamento/polimento avaliados demonstraram excelente desempenho na remoção dos remanescentes resinosos embora nenhum deles tenha sido capaz de remover totalmente o material de colagem, todos danificaram o esmalte, sendo o protocolo Komet carbide o mais diferenciado. / The objective of this study was to evaluate the quantity of residual resin after removal of brackets and the loss and//or wear-and-tear of enamel occurring during the phases of fixing, detaching and removal of remnant resin in the bracket area and its adjacent. The sample was made up of 150 premolars, divided into two groups in accordance with the type of bracket material used: metal (n=75) and ceramic (n=75), in the two initial phases of study, fixing and removal. Fixing procedures were carried out in accordance with the International Organization for Standardization, (2003), and removal according to orientation advocated by the manufacturer. In the removal of remnant resin phase five groups were considered, all in agreement with the finishing/polishing protocol and prescription of the respective manufacturers: FF diamantada + Soflex; Pedra Shofu; Dentaurum Carbide; Komet Carbide and Jet Carbide, and with the aid of telescopic magnifying glass of three-fold magnification Qualitative evaluation (ARIm and ESI) was done by means of digital photographs(stereoscopic magnifying glass Olympus SZ61). Quantitative evaluation was conducted using the coordinate medication method - Coordinate Measuring Machines (Mitutoyo), mod. Legex CNC 9106 - line profile. Possible differences between finishing/polishing protocols were evaluated via variance analysis (ANOVA), and by Tukey Multiple Comparison test. Median quantities of residual resin found in the region below the base of the bracket, following finishing/polishing were: Diamantada FF + Soflex (10,4 m ±10,5), Pedra Shofu (18,5m ± 12,1), Dentaurum Carbide (11,2 m ± 11,9), Komet Carbide (9,5 m ± 10,8) and Jet Carbide (22,8 m ± 24,0). In this way, it was confirmed that finishing/polishing protocols, in general, left the major part of residual resin below the adjacent area than in the bracket area, with the exception of Komet Carbide protocol, displaying similar performance in both areas Median quantities of loss and/or wearand- tear of enamel in the bracket area were: Diamantada FF + Soflex (-134,9 m ± 56,4), Pedra Shofu ( 39,2 m ± 12,8), Dentaurum Carbide ( 70,5 m ± 27,9), Komet Carbide (-44,8 m ± 14,3) and Jet Carbide ( 68,2 m ± 35,7) in bracket area, while in adjacent area: Diamantada FF + Soflex (-124,7 m ± 133,1), Pedra Shofu (- 37,9 m ± 25,1), Dentaurum Carbide (- 60,1 m ±32,4), Komet Carbide (-36,6 m ± 19,5) and (Jet Carbide 65,4 m ± 65,0) (Table 5.9) Standing out in both areas of evaluation, protocol (Diamantada FF + Soflex) was responsible for the major quantity of loss and /or wear and tear, differentiating itself from the other protocols by significant statistics. Based on these results, we can conclude that the finishing/polishing protocols evaluated, displayed excellent performance in the removal of remnant resin, although none have totally been capable of removing fixing material, and all damaged the enamel, with Komet protocol being the most differentiated.

O objetivo deste trabalho foi estudar os efeitos dos lacebacks ativos e passivos na biomecânica da fase de nivelamento, utilizando-se a técnica MBT. A amostra foi constituída de 29 sujeitos de pesquisa (22 do gênero feminino e 7 do gênero masculino), brasileiros, leucodermas e pardos, portadores de má oclusão de Classe I e com idade média de 15 anos e 5 meses. O tratamento ortodôntico foi planejado com as extrações dos primeiros pré-molares e, durante a fase estudada, foram empregados apenas fios de aço inoxidável (0.014”, 0.016”, 0.018”, 0.020” e 0.019” x 0.025”). Os recursos de ancoragem utilizados para os arcos dentários superior e inferior foram, respectivamente, o aparelho extrabucal tipo IHG e o arco lingual fixo. De acordo com a indicação dos lacebacks, a amostra foi dividida em quatro grupos: grupo I – 14 sujeitos que utilizaram lacebacks ativos no arco dentário superior; grupo II – 9 sujeitos que utilizaram lacebacks passivos no arco dentário superior; grupo III – 19 sujeitos que utilizaram lacebacks ativos no arco dentário inferior e grupo IV – 10 sujeitos que utilizaram lacebacks passivos no arco dentário inferior. Para cada indivíduo da amostra foram tomadas duas telerradiografias laterais, uma ao início e outra ao término da fase de nivelamento, com um intervalo médio de 21 meses. Os dados foram coletados utilizando-se o método cefalométrico computadorizado. Para a análise de erros, o método cefalométrico foi repetido em todos os sujeitos da amostra, pelo mesmo operador, com um intervalo mínimo de 15 dias entre as medidas. Os resultados indicaram que as variações observadas foram compatíveis com as estimativas de erros operacionais em estudos cefalométricos. Após a análise estatística e a interpretação dos resultados, verificou-se que, no grupo I, apenas a coroa do primeiro molar superior sofreu um movimento mesial e que tanto a coroa como a raiz do incisivo central superior apresentaram um movimento em direção lingual. No entanto, as inclinações destes dentes não foram alteradas. No grupo II, o primeiro molar superior se manteve estável e somente a coroa do incisivo central superior se movimentou em direção lingual, produzindo uma rotação horária deste dente. No grupo III, observou-se uma mesialização, tanto da coroa como da raiz, e extrusão do primeiro molar inferior, enquanto a posição do incisivo central inferior permaneceu inalterada. As inclinações destes dentes também não foram alteradas. No grupo IV, verificou-se que nem o primeiro molar inferior nem o incisivo central inferior apresentaram variações no sentido ântero-posterior. Verticalmente, houve extrusão apenas do primeiro molar inferior. / The purpose of this study was to evaluate the effects of active and passive lacebacks in the biomechanics of the leveling phase, using the MBT technique. The sample was composed of 29 Brazilian subjects (22 female and 7 male), Caucasian, with Class I malocclusion and mean age of 15 years and 5 months. The orthodontic treatment was planned with the extraction of the first premolars, and the leveling phase was performed with stainless steel wire only (0.014”, 0.016”, 0.018”, 0.020” e 0.019” x 0.025”). The anchorage control devices used in the upper and lower arches were, respectively, the IHG extraoral appliance and the fixed lingual arch. According to the type of laceback prescription, the sample was divided into four groups: group I – 14 subjects in which active lacebacks were used in the upper arch; group II – 9 subjects in which passive lacebacks were used in the upper arch; group III – 19 subjects in which active lacebacks were used in the lower arch; group IV – 10 subjects in which passive lacebacks were used in the lower arch. For each subject of the sample two lateral cephalometric radiographs were taken: one at the beginning and another at the end of the leveling phase, with a mean interval of 21 months. The data were collected using the resources of computerized cephalometry. To perform the analysis of errors, the cephalometric method was repeated in all subjects of the sample, by the same operator, with a minimum interval of 15 days between the measurements. The results revealed that the observed variations were compatible with the estimates of operational errors in cephalometric studies. After statistical analysis and interpretation of the results, it was observed that in group I, only the crown of the upper first molar presented a mesial movement. As to the upper central incisor, both the crown and the root presented a lingual movement. However, the inclination of these teeth was not affected. In group II, the upper first molar remained stable and only the crown of the upper central incisor moved lingually, leading to a clockwise rotation of this tooth. In group III, a mesial movement of both the crown and the root of the lower first molar was observed, along with its extrusion, whereas the position of the lower central incisor remained unchanged. The inclination of these teeth was not affected either. In group IV, it was observed that neither the lower first molar nor the lower central incisor experienced variations in the anteroposterior sense. Vertically, there only was extrusion of the lower first molar.

Background: The National Health Service (NHS) aims to achieve maximum health gains with its limited resources, while also ensuring that it provides services according to need, irrespective of factors such as socioeconomic position (SEP). Aim: The aim of this thesis is to explore the relationships between SEP and various aspects of the NHS orthodontic service, including need, demand, supply, and outcomes. Methods: Three main data sources were used: two population-based surveys (the 2003 United Kingdom (UK) Children’s Dental Health Survey (CDHS) and the 2008-2009 NHS Dental Epidemiology Programme for England Oral Health Survey (OHS) in the North West) and an administrative data set (containing 2008-2012 North West NHS orthodontic activity data). The data were used to investigate levels of need and willingness to have orthodontic treatment, treatment utilisation, assessment procedures, and treatment outcomes, and the costs associated with the service. Subsequently, regression analyses were carried out to explore the associations between SEP and the various orthodontic variables. Results: Over a third of 12-year-olds had normative need for orthodontic treatment and over half had patient-defined need. Those in the most deprived groups in the North West tended to have lower levels of treatment compared to those in the least deprived group (despite the fact that normative need was not shown to vary by SEP), and they were more likely to discontinue treatment and have residual post-treatment need (RPTN). There was a great deal of variation among practices/orthodontic clinicians in terms of the percentages of patients with repeated assessments, treatment discontinuations, and RPTN. The major sources of potential inefficiency costs in the NHS orthodontic service in the North West are treatments that result in discontinuations (which cost £2.4 million per year), RPTN (which cost £1.8 million per year), and unreported treatment outcomes (which cost £13.0 million per year). Discussion: The NHS is not delivering orthodontic care equitably between SEP groups in the North West, as those from more deprived groups are more likely to fail to receive treatment, and to have poor outcomes if they do receive treatment. In addition, the wide range of process and outcome indicators between practices/orthodontic clinicians raises issues about quality of the overall service. In particular, treatment outcomes are frequently unreported, which highlights the need to improve the outcome monitoring systems in the NHS orthodontic service.

No description available.

The aim of this study was to evaluate the prevalence and severity of malocclusion and orthodontic treatment needs in a sample of 12-year-old South African school children using the Dental Aesthetic Index (DAI), and to assess the relationship between malocclusion and certain socio-demographic variables. The sample comprised 6142, 12-year-old children attending school in seven of the nine provinces of South Africa. For each subject the standard demographic information such as gender, population group, location type and employment status of the parents were collected, after which an intra-oral examination for occlusal status using the DAI was performed. The results showed that 47.7 per cent of the children in the sample presented with good occlusion or minor malocclusion, just over 52.1 per cent presented with identifiable malocclusion, a DAI score larger than 26. Of these, 21.2 per cent had definite malocclusion, 14.12 per cent had severe malocclusion and 16.89 per cent had very severe or handicapping malocclusion. Malocclusion as defined in this study was found to be significantly associated with the different provinces, the different population groups in South Africa, gender and dentition stage, but not with the location type or the employment status of parents. The results of the individual variables showed that anterior maxillary and mandibular irregularity occurred in more than 50 per cent of the sample. More than 40 per cent of the children examined showed signs of crowding. Spacing in the incisal segments occurred in almost 28 per cent of the sample and maxillary midline diastema was present in 16.66 per cent of the sample. At the age of 12 years, Black children, showed a higher prevalence of maxillary midline diastema, larger than 2mm, than their White, Coloured and Asian counterparts. A maxillary midline diastema, larger than 2mm, was more prevalent in 12-year-old females than in males. Thirty one per cent of the sample had an increased overjet larger than 3mm and a severe overjet of 6mm or more occurred in only 2.18 per cent of the sample. More Black 12-year-old children presented with an edge-to-edge anterior relationship and significantly less Black children had an increased overjet. Mandibular overjet affected only 10.43 per cent of the sample and was more prevalent in the late mixed dentition stage than in the early permanent dentition stage. Anterior openbite occurred in 7.7 per cent of the sample and ranged from 1mm to 8mm. Almost 44 per cent of the sample had a antero-posterior molar relation discrepancy. The results of this study indicated a high prevalence of malocclusion in 12-year-old South African children. The findings provide reliable base-line data regarding the prevalence, distribution and severity of malocclusion as well as useful epidemiological data on the orthodontic treatment needs of 12-year-old children in selected rural and urban areas in South Africa. The inclusion of occlusal traits as part of the index provided an opportunity to assess several occlusal characteristics in 12-year-old South African children, separately. / Thesis (MChD (Orthodontics))--University of Pretoria, 2004. / Orthodontics / unrestricted

Please read the abstract in the section 00front of this document / Dissertation (MChD (Orthodontics))--University of Pretoria, 2007. / Orthodontics / unrestricted

Magister Chirurgiae Dentium - MChD / The purpose of this study was to evaluate in vitro, the tensile bond strengths of some conventional and light cured resins, to study the effects of etchants on polished and ground enamel using the scanning electron microscope, and to the resin/etched enamel examlne electron interface by scanning microscopy This study was divided into: 1) laboratory tensile bond strength study of 'four composite resin materials. 2) a scanning electron microscopic study of the effect of four etchants on enamel. 3) the S.E.M. examination of the interfacial zone after the application of a demineralizing agent. The tensile bond strength study consisted of testing the bond strengths of two macrofilled and two microfilled resins in common use. These resins were applied directly to the etched enamel surfaces of extracted human teeth by utilizing newly developed perpex stubs which allowed a uniform surface area and for light curing of the resin. In this laboratory study the extracted teeth and the composite filled stubs were stressed to failure of the material bond to tooth in an Instron Machine. Bond strengths were recorded and tabulated in Newtons/mm2. The application of statistical analysis by Analysis of Variance and Duncans Multiple Range Test showed that there was a significant difference in the bond strengths of some of the four materials. The scanning electron microscope study consisted of an examination of etched enamel, either polished or ground using the etchants supplied by the two manufacturers i.e. 3 M Dental Company and J&J Dental Company. The interfacial zones of the resin/tooth interface systems were examined, using the two macrofilled and the two microfilled resijs in the stUdY.! Differences were found to exis.t at this zone.

Indiana University-Purdue University Indianapolis (IUPUI) / One of the most common concern among patients who need orthodontic treatment is treatment duration. The ability to accelerate orthodontic tooth movements would be bene cial to reduce the undesired side-effects of prolonged treatment. Methods have been used in conjugate with common orthodontic appliances to shorten the treatment. One of them is to use vibrational force (VF), which is non-invasive. The VF stimulates bone modeling and remodeling, which is essential to tooth movement. However, commercial devices used in the clinic failed to deliver consistent outcomes. The effects of the VF highly depend on its intensity the tooth receives. There must be a range of stimulation that optimizes the ffeects. The stimulation outside the range either have no effects or creates damages, which adversely affects the orthodontic treatment. Since these devices have generic mouthpiece and teeth are in di erent heights, hence some teeth cannot get force stimulation and others may be overloaded. The current designs also do not have ability to adjust the level of VF intensity that individual tooth needs, as in some cases orthodontists are required to move a tooth faster than others or even slower, which needs the device to be personalized. There- fore, the primary cause of inconsistent clinical outcomes is the inadequate design of the mouthpiece of the current device. The goal of this study is to design a better vibratory device that not only guarantees VF delivery but also enables orthodontists to control the level of VF on the individual tooth, which meets the patient's treat- ment needs. This is a preliminary study to understand the effects of different design parameters affecting the VF distribution on teeth. A nite element model, which consists of human upper and lower jaws in their occlusal positions and a mouthpiece, was created. The VF was from a vibratory source with a peak load of 0.3N and speci ed frequencies (30 and 120 Hz). The element size was determined through a convergence test and the model was validated experimentally. Results showed that the VF distribution among the teeth relies on the material property of the mouthpiece. The distribution is uneven, meaning some teeth bearing much more load than others. This means, with the current device design, teeth would be a ected with di erent level of force stimulation, which results in di erent clinical outcomes consequently. Dynamic load (VF) changes the force distribution on the teeth comparing to the dis- tribution from a static load. Frequency does not affect the peak load. Finally, the study demonstrated that the level of VF stimulation can be adjusted by introducing clearance or interference between the teeth and mouthpiece. It is feasible to control the level of the VF intensity for individual tooth based on treatment requirement.