Avaliação das alterações anteroposterior e transversal produzidas pelo uso dos aparelhos funcionais Bionator e Klammt no tratamento da má oclusão de Classe II, divisão 1 de Angle, por meio de modelos digitais
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Data
2018-07-12
Autores
Navarro Jugo, Eddy Eder
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O objetivo de evitar a progressão da má oclusão e propiciar um crescimento craniofacial mais harmonioso. Os ativadores monoblocos e elásticos induzem o posicionamento terapêutico anterior da mandíbula para correção da má oclusão de Classe II podendo expandir ou não as arcadas dentárias para melhorar a forma dos arcos e promover o alinhamento dentário. O objetivo deste estudo foi avaliar os efeitos do tratamento ortopédico funcional, sobre as relações anteroposteriores e transversais dos arcos dentários no tratamento da má oclusão de classe II com dois tipos de aparelhos ortopédicos funcionais, o Bionator de Balters e o Ativador elástico de Klammt utilizando modelos de estudo digitais. Foram coletadas as documentações ortodônticas de 15 indivíduos com má oclusão de Classe II divisão 1 acompanhados pelo período de 1 ano sem tratamento (grupo controle) e de 30 indivíduos com má oclusão de Classe II divisão 1 tratados com os dois tipos de aparelhos ortopédicos funcionais e acompanhados pelo período de 1 ano (grupo tratado). Modelos em gesso iniciais e após 1 ano de controle ou tratamento foram digitalizados no Scanner 3D R700 e obtidas as medidas de relação oclusal interarcos e das dimensões dos arcos com auxílio do software 3Shape's OrthoAnalyzer™ Advanced Orthodontic Diagnosis and Treatment Planning. As medidas obtidas foram transferidas para o programa SPSS (versão16, SPSS, Chicago, Ill) para análise estatística. Trabalho 1: O tratamento com o aparelho Bionator pode promover redução significativa no perímetro inferior com aumento do índice de irregularidade de incisivos inferiores (aumentando apinhamento dentário) mas com melhora significativa na relação sagital, com diminuição do overjet e na relação de molares. O tratamento com aparelho de Klammt por sua vez pode promover mudanças significativas na relação sagital, com diminuição do overjet e melhora na relação de molares sem significativa diminuição de perímetro de arco, sendo mais indicado para os casos de pacientes que já possuem apinhamento anteroinferior. Trabalho 2: O aparelho Bionator promoveu um aumento na largura do arco ao nível dos molares superiores e na profundidade do processo palatino e o aparelho Klammt promoveu um aumento na largura do arco ao nível dos caninos, molares inferiores ao nível da fossa, de molares superiores ao nível de cúspide mésio palatina e na profundidade de palato. Na Classe II não tratada foi observada uma redução significativa na largura de arco superior. Em relação a discrepância transversal, o aparelho Bionator de Balters se manteve estável e o aparelho ativador elástico de Klammt apresentou uma leve redução enquanto que a Classe II não tratada apresentou aumento da discrepância transversal. Além disso, ambos aparelhos Bionator e Klammt, mostraram uma redução na inclinação do processo palatino direito, no processo palatino e no inter processo palatino.
The objective to avoid the progression of the malocclusion and enable a more harmonious craniofacial growth. The monobloc and the elastic activator induce the mandible to an anterior therapeutic positioning to treat the Class II malocclusion and have different capabilities to expand or not the dental arches to improve the arch form and to promote the dental aligns. The aim of this study was to evaluate the differences in the antero-posterior and transverse dental arch relationship after orthopedic treatment of the Class II malocclusion two types of functional orthopedic appliances (Bionator of Balters and Elastic activator of Klammt) using digital study models. Orthodontic dental records of 15 individuals Class II division 1 malocclusion followed for one year without treatment (control group) and 30 individuals with Class II division 1 malocclusion treated with the two functional orthopedic appliances (Bionator of Balters and Elastic activator of Klammt) and followed for one year (treated group). Initial and final dental casts of these individuals will be digitalized in the 3D R700 Scanner and measurements of the interarch occlusal relationship and of the dimensions of arches were evaluated. The data was assessed through Descriptive Statistic and t test and analysis of variance (anova) statistical analysis. Paper 1: The treatment with the Bionator device can promote a significant reduction in the lower arch perimeter, with an increase in the lower incisor irregularity (increasing tooth crowding), but with a significant improvement in the sagittal relationship, with decrease of the overjet and molar relationship. The treatment with the Klammt device in turn can promote significant changes in the sagittal relationship, with decrease of the overjet and improvement in the relation of molars without significant reduction of arch perimeter, being more indicated for the cases of patients who already have antero-inferior crowding. Paper 2: The Bionator appliance promoted an increase in arch width at the level of the upper molars and in the depth of the palatal process, and Klammt appliance promoted an increase in arch width at the level of the canines, lower molars at the fossa level, upper molars at the level of cusp palate and in the depth of the palate. In untreated Class II a significant reduction in upper arch width was observed. Regarding the transverse discrepancy, the Balters Bionator remained stable and the Klammt elastic activator showed a slight reduction while the untreated Class II showed increased transverse discrepancy. In addition, both Bionator and Klammt appliances showed a reduction in the inclination of the right palatine process, in the palatine process and in the inter palatal process.
The objective to avoid the progression of the malocclusion and enable a more harmonious craniofacial growth. The monobloc and the elastic activator induce the mandible to an anterior therapeutic positioning to treat the Class II malocclusion and have different capabilities to expand or not the dental arches to improve the arch form and to promote the dental aligns. The aim of this study was to evaluate the differences in the antero-posterior and transverse dental arch relationship after orthopedic treatment of the Class II malocclusion two types of functional orthopedic appliances (Bionator of Balters and Elastic activator of Klammt) using digital study models. Orthodontic dental records of 15 individuals Class II division 1 malocclusion followed for one year without treatment (control group) and 30 individuals with Class II division 1 malocclusion treated with the two functional orthopedic appliances (Bionator of Balters and Elastic activator of Klammt) and followed for one year (treated group). Initial and final dental casts of these individuals will be digitalized in the 3D R700 Scanner and measurements of the interarch occlusal relationship and of the dimensions of arches were evaluated. The data was assessed through Descriptive Statistic and t test and analysis of variance (anova) statistical analysis. Paper 1: The treatment with the Bionator device can promote a significant reduction in the lower arch perimeter, with an increase in the lower incisor irregularity (increasing tooth crowding), but with a significant improvement in the sagittal relationship, with decrease of the overjet and molar relationship. The treatment with the Klammt device in turn can promote significant changes in the sagittal relationship, with decrease of the overjet and improvement in the relation of molars without significant reduction of arch perimeter, being more indicated for the cases of patients who already have antero-inferior crowding. Paper 2: The Bionator appliance promoted an increase in arch width at the level of the upper molars and in the depth of the palatal process, and Klammt appliance promoted an increase in arch width at the level of the canines, lower molars at the fossa level, upper molars at the level of cusp palate and in the depth of the palate. In untreated Class II a significant reduction in upper arch width was observed. Regarding the transverse discrepancy, the Balters Bionator remained stable and the Klammt elastic activator showed a slight reduction while the untreated Class II showed increased transverse discrepancy. In addition, both Bionator and Klammt appliances showed a reduction in the inclination of the right palatine process, in the palatine process and in the inter palatal process.
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Palavras-chave
Má oclusão de Angle classe II, Diagnóstico por imagem, Ortodontia, Malocclusion, Angle class II, Diagnostic imagen, Orthodontics