Orthopedics

Introduction: Posterior functional crossbite is a common malocclusion in children, with a prevalence between 7.5-24 %. It has an important impact on facial functions, and may cause asymmetries in craniofacial development. Different interventions have been used to correct this malocclusion but there is a lack of studies with methodological rigor that support these interventions. Planas Direct Tracks (PDT) constitute one of such interventions. They seek to reestablish the functional occlusal balance of children through selective grinding, complementing this adjustment with composites. Objective: To present the level of scientific evidence available on PDT to correct posterior crossbites. Method: A sensitive search was carried out in the main databases: Pubmed, BVS Odontology, Cochrane, SciElo and Google academic. The articles were selected, duplications removed and critical evaluation of the literature performed classifying the studies according to the evidence pyramid. The aim is to point out ways to improve the quality of the studies. Results: 32 studies were included. 30 studies were narrative reviews, case reports or case series and two were controlled trials. All studies had important biases. No randomized controlled trial was found. Conclusion: So far, there are no studies, sufficiently rigorous methodology, on Planas direct tracks to correct functional crossbites.

Class II treatment is the leader of seeking for dentofacial correction in offices all around the world due, mainly, to facial esthetics impairment caused by this malocclusion. Mandibular forward repositioned is needed for the majority of this treatment. Jaw Functional Orthopedics (JFO) is a recognized protocol to treat Class II in growing patients. The aim of this investigation is to study the behavior of mandibular length in class II non-growing patients treated with JFO. Distance between Gonion and Mento were measured in lateral teleradiographs at T0 and T1 (from 18 to 21 months of treatment) of non-growing class II patients under treatment with JFO and mandibular supplementary growth was found (P = 0,006). In the sample studied jaw functional orthopedics showed to be efficient to correct the overjet in class II non-growing patients. Mandibular advancement with functional orthopedic appliances promotes a supplementary mandibular growth in non-growing patients. Further studies are necessary for a better comprehension of the subject.

Investigate whether different results about the physical properties of the same biomaterial frequently found in the literature are due to chewing simulator deficiency. A literature review was performed by searching for data on indicators of test accuracy, reproducibility, maintenance of test parameters during all experiments, and standards in the articles or in the sites of manufacturers. The database searched was CAPES PORTAL, and the keywords used were “bite force” AND “simulator”, “chewing simulator” and “mastication simulator”. Including criteria for the papers are publication filter date of “January 1, 2016”, articles in English, Spanish and Portuguese language were accepted. The first 100 papers that seemed suitable when considering the title and abstract were recovered. Only one simulator used for food property studies had the parameters searched. In the customized simulators for biomaterial properties, only one showed standards, and 8 showed all other parameters searched. All manufactured simulators showed all parameters searched, and only two manufactures did not show standards. Based on the data obtained, the disparate results of experiments with dental materials appeared to be more related to the test conditions than to the testing machines. Knowledge Transfer Statement The findings of the current review suggest that the chewing simulators used in preclinical research are reliable, bringing safety to restorative processes regarding the material. Any difference in preclinical investigations about dental material physical properties is due to test conditions other than chewing simulators.

The vertical problems of the stomatognathic system that alter the overbite, either by increasing in the deep bite (DB) or decreasing in the anterior open bite (AOB), are among the great challenges of the dentofacial corrections in the treatment and the retention and stability protocols. In this paper the state of art of DB treatment with Jaw Functional Orthopedics (JFO) will be discussed. JFO has a unique diagnostic tool for changes in vertical growth of the face, the Articular Compass, developed by Simões. Individuals with hypodivergence and DB are, usually, difficult to treat and more difficult to stabilize the obtained results. Since 1950-decade Planas advocate that the Equiplan – a metal accessory used in functional orthopedic appliances (FOA) is efficient in deep bite treatment by levelling the occlusal plane. Promising results are found with a P = 0,00, but in aweak evidence study design based on the scientific evidence pyramid. Much of the discussion of incisor intrusion or molar extrusion to treat DB seems to be solved with the use of Equiplan, but it still has no scientific evidence, only clinical evidence. In conclusion Randomized Clinical Trials are needed to investigate the efficiency and Modus Operandi of JFO to treat DB.