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Biomedical subjects

Guilherme Janson

Publications and source records attributed to Guilherme Janson.

30 records · Page 2Linked to original sources

Postretention relapse of mandibular anterior crowding in patients treated without mandibular premolar extraction.

Treatment stability is one of the most important objectives in orthodontics, but, despite decades of research, it is still agreed that the stability of aligned teeth is variable and largely unpredictable. This study aimed to evaluate the relapse of mandibular anterior crowding in patients treated without mandibular premolar extraction. The sample comprised 40 patients of both sexes with Class I or II malocclusions who received nonextraction treatment in the mandibular arch with edgewise mechanics. Lateral cephalograms and dental casts of each patient were obtained at pretreament, posttreatment, and 5 years postretention. Relapse of mandibular anterior crowding was assessed, and associations between this relapse and other clinical factors were also investigated. Mandibular anterior crowding was measured by the Little irregularity index, and the data were evaluated by the Mann-Whitney test. The mean relapse of mandibular anterior crowding was 1.95 mm (26.54%) over the long term. No clinical factor studied was predictive of crowding relapse in the long term.

Bicuspid↗

Class II treatment success rate in 2- and 4-premolar extraction protocols.

This study compared the occlusal success rate of Class II orthodontic treatment results with either 2- or 4-premolar extraction protocols. Group 1 comprised dental study models of 81 patients treated with 2 premolar extractions, and group 2 comprised dental study models of 50 patients treated with 4 premolar extractions. The initial mean ages of the groups were 13.9 and 12.9 years, respectively. Grainger's treatment priority index (TPI) was used to assess the initial and final occlusal status of each patient. Individual variables, such as maxillary canine anteroposterior positioning, overjet, and overbite improvements were also evaluated. Independent t tests were used to compare the variables at the pretreatment and posttreatment stages and their improvement between the groups. The results showed a statistically significant difference in most of the variables and in their improvement at the end of treatment between the groups. The variables showed a better dental relationship in group 1, and the improvements in group 1 were larger than in group 2. Treatment of Class II malocclusion with 2 premolar extractions gives a better occlusal success rate than treatment with 4 premolar extractions.

Adolescent↗

Orthodontic therapy in a patient with white sponge nevus.

An undesirable effect of fixed orthodontic appliances is irritation of the oral mucosa. Lesions are common, but they usually heal quickly because of the fast metabolism of oral mucosa cells. Alterations accompanying some injuries are temporary, but some are irreversible because of attrition. White sponge nevus constitutes a special situation, and little information about it is available in the orthodontic literature. This report presents a patient with white sponge nevus who received orthodontic treatment over a 40-month period. The condition was also noted in a sibling. Because of the similarity between white sponge nevus and other diseases, including some that are malignant, a thorough clinical history and differential diagnosis are essential.

Adolescent↗

Dentoskeletal treatment changes in Class II subdivision malocclusions in submentovertex and posteroanterior radiographs.

The objective of this study was to evaluate the dentoskeletal changes consequent to orthodontic treatment in subjects with Class II subdivision malocclusions, treated with asymmetric extractions, compared with a normal-occlusion control group. The sample consisted of 3 groups, with 30 subjects in each: normal-occlusion subjects (group 1), untreated Class II subdivision subjects (group 2), and Class II subdivision patients treated with asymmetric extractions (group 3). All subjects had a full complement of permanent teeth at the beginning of treatment. The average ages of the subjects were 22.42, 15.76, and 18.57 years, respectively, in groups 1, 2, and 3. Measurements of relative differences in the spatial position of dental and skeletal bilateral landmarks were obtained from the submentovertex and posteroanterior cephalometric (PA) radiographs. The t test for independent samples was used to compare group 1 with groups 2 and 3 at different times. Results from the submentovertex radiograph showed that asymmetric extractions in Class II subdivision malocclusions will maintain the differences in the anteroposterior positions of right and left, maxillary and mandibular first molars, as would be expected with the treatment protocols used. There were no significant skeletal changes that could be attributed to the treatment approaches investigated or transverse collateral effects with the asymmetric mechanics used. It was also demonstrated that treatment of Class II subdivision malocclusions with asymmetric extractions produced corrections of maxillary and mandibular dental midline deviations with the midsagittal plane, without canting the occlusal plane or any other investigated horizontal plane, as seen in the PA radiograph. Treatment of Class II subdivision malocclusions with asymmetric extractions constitutes a beneficial approach to this problem.

Adolescent↗

Occlusal changes of Class II malocclusion treatment between Fränkel and the eruption guidance appliances.

The objective of this study was to compare the occlusal changes of Class II malocclusion treatment provided by two different types of appliances. Group 1 comprised 25 patients treated with the Fränkel appliance and group 2 comprised 30 patients treated with the eruption guidance appliance. Evaluations were performed on the initial and final study models of the patients using the peer assessment rating (PAR) index. The final mean PAR index, the mean PAR change, and the percent PAR reduction of each group were compared using the Student's t-test. Results demonstrated that there were no statistically significant differences between the final PAR index, the PAR changes, and the percent PAR reduction of the two groups. Therefore, it was concluded that the occlusal changes provided by the two appliances are similar, as evaluated by the PAR index.

Child↗

Stability of Class II, division 1 treatment with the headgear-activator combination followed by the edgewise appliance.

This study assessed the stability of the headgear-activator combination treatment, followed by edgewise mechanotherapy, 5.75 years after treatment. The experimental group consisted of 23 patients who were evaluated during treatment and after treatment. Two compatible control groups consisting of 15 Class II, division 1 patients and 24 normal occlusion individuals were used. This enabled us to evaluate the changes during treatment and after treatment, respectively. Results showed that the anteroposterior dentoalveolar changes and the maxillary and the mandibular positions remained stable in the long term. However, there was a slight relapse of the maxillomandibular relationship probably because the maxilla resumed its normal development and the mandibular growth rate was smaller than in the control group. The overbite demonstrated a statistically significant relapse that was directly proportional to the amount of its correction. There were low but significant inverse correlations between the changes in Go-Gn during and after treatment. These included the uprighting of the maxillary incisors, labial tipping of the mandibular incisors, and the amount of molar relationship correction during treatment and their stability. Active retention time, length of posttreatment period, initial Class II malocclusion severity (ANB and Wits), and initial molar relationship did not present any correlation with molar relationship and overjet relapse. However, the initial overjet presented a low but statistically significant correlation with molar relationship relapse and overjet relapse.

Activator Appliances↗

Comparative radiographic evaluation of the alveolar bone crest after orthodontic treatment.

This study evaluated and compared the heights of the alveolar bone crests (AC) among orthodontic patients treated with either the simplified standard edgewise technique (group 1, n = 30), the edgewise straight-wire system (group 2, n = 30), or bioefficient therapy (group 3, n = 26). These 3 groups were compared with an untreated control group (group 4, n = 30). A comparison by sex of AC height was also conducted. The first premolars were extracted in every treated patient, and measurements were performed on bitewing radiographs taken after a mean posttreatment period of 2.17 years. The distances from the AC to the cementoenamel junction (CEJ) on the mesial and distal surfaces of the first molars and second premolars and on the distal surface of the canines were measured; the larger the distance, the greater the alveolar bone loss. The data were analyzed by 1-way analysis of variance and the Newman-Keuls test (P <.05) for comparison among the groups. Sex differences of the AC height were evaluated with the t test. All treated groups had larger, statistically significant CEJ-AC distances than the untreated group, primarily at the extraction areas. There were no consistent statistically significant differences in the areas among the treated groups. Mean distances of the CEJ-AC in boys were larger than or similar to those in girls. The patients in the treated groups showed a greater number of proximal surfaces with statistically significant differences between sexes, compared with the control subjects.

Adolescent↗

Class II subdivision treatment success rate with symmetric and asymmetric extraction protocols.

The purpose of this study was to compare the success rates of Class II subdivision malocclusion patients treated with either symmetric or asymmetric extractions. The sample consisted of 51 patients with Class II subdivision malocclusion. The patients were divided into 2 groups. Group 1 included 28 patients who were treated with 4 premolar extractions. The 23 patients in group 2 were treated with 3 premolar extractions (2 maxillary premolars and 1 mandibular premolar on the Class I side). The initial and final study models were evaluated by means of Grainger's treatment priority index (TPI). Individual evaluations of improvements in maxillary-to-mandibular dental midline deviation, overjet, and overbite were also made. The final mean TPI and the mean improvement in TPI and in the other variables of each group were compared with independent t tests. The results showed a statistically significant difference only for the improvement in maxillary-to-mandibular dental midline deviation of the groups. The 3-premolar-extraction group had a greater improvement of the initial interdental midline deviation. There is a tendency for a slightly better treatment success rate when Class II subdivision patients are treated with asymmetric extraction of 3 premolars, compared with extraction of 4 premolars.

Adolescent↗

Stability of anterior open bite nonextraction treatment in the permanent dentition.

This study cephalometrically evaluated the long-term stability of anterior open bite nonextraction treatment in the permanent dentition after a mean period of 5 years. The experimental group consisted of 21 patients who had undergone orthodontic treatment with fixed appliances from whom cephalometric headfilms were obtained at the pretreatment, posttreatment, and postretention stages. Two control groups were used. The first, with ages comparable with the experimental group before treatment, was used only to characterize it. The second control group, with normal occlusion, was longitudinally followed for a period comparable with the posttretention period and was used to compare the changes between groups during this period. The differences between the observation stages in the experimental group were analyzed with paired t tests, and the postretention changes were compared with the changes of the second control group with independent t tests. A statistically significant decrease of the obtained anterior overbite was demonstrated at the end of the postretention period. The primary factor that contributed to the overbite decrease was the smaller vertical development of the maxillary and mandibular incisors in the postretention period. Neither the pretreatment anterior open bite amount nor the magnitude of correction was associated with the long-term overbite decrease. However, 61.9% of the sample had a clinically stable open bite correction.

Adolescent↗

Relationship between signs and symptoms of temporomandibular disorders and orthodontic treatment: a cross-sectional study.

The aim of this study was to evaluate the prevalence of temporomandibular disorders (TMD) in individuals before and after orthodontic treatment. The sample comprised 200 individuals divided into four groups according to the type of malocclusion (class I or II) and the orthodontic treatment accomplished. An anamnestic questionnaire, comprising questions regarding the most frequent symptoms of TMD, was used to classify the sample according to the TMD presence and severity. A clinical examination, including TMJ and muscle palpation, mandibular range of motion, and joint noise analysis was performed. Based on the anamnestic questionnaire, 34% of the sample was considered as having mild TMD, whereas 3.5% had moderate TMD. A higher TMD prevalence was found in females. Joint noises (15.5%) followed by headache (13%) constituted the most frequent reported symptoms. The presence and severity of TMD have not shown any relationship with either the type of orthodontic mechanics or extraction protocols. On the other hand, a positive association was found between TMD and parafunctional habits and reported emotional tension. Orthodontic treatment is not associated with the presence of signs and symptoms of TMD.

Adolescent↗

Unusual orthodontic retreatment.

This case report describes the retreatment of a patient with a Class II Division 1 malocclusion; she had the same anteroposterior discrepancy after undergoing fixed appliance treatment with extraction of 4 first premolars.

Adult↗