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Joao Goncalves

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Texas A&M University

Venkat Veerappan

Università degli Studi di Udine / University of Udine

Liliane Rosas Gomes

Emanuela Basile

Andrea Rivaroli

Ary dos Santos-Pinto

Universidade Estadual Paulista "Júlio de Mesquita Filho"

Zoilo A . Nuñez Gil

Universidad Nacional Pedro Henriquez Urena

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Papers by Joao Goncalves

Three-dimensional stability analysis of maxillomandibular advancement surgery with and without articular disc repositioning

Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, Jan 18, 2018

This retrospective cohort study aimed to assess, three-dimensionally, mandible and maxilla change... more This retrospective cohort study aimed to assess, three-dimensionally, mandible and maxilla changes following maxillomandibular advancement (MMA), with and without repositioning of TMJ articular discs. The sample comprised cone-beam computed tomography data from 32 subjects: group 1 (n = 12) without disc displacement and group 2 (n = 20) with bilateral disc repositioning. An automatic cranial base superimposition method was used to register the images at three time points: T1 (preoperative), T2 (postoperative), and T3 (at least 11 months follow-up). To assess surgical changes (T2-T1) and adaptive responses (T3-T2), the images were compared quantitatively and qualitatively using the shape correspondence method. The results showed that surgical displacements were similar in both groups for all the regions of interest except the condyles, which moved in opposite directions - group 1 to superior and posterior positions, and group 2 to inferior and anterior positions. For adaptive respons...

Effect of temporomandibular joint articular disc repositioning on anterior open-bite malocclusion: An orthodontic-surgical approach

American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics, 2017

An anterior open bite is a challenge to orthodontic treatment; it has a multifactorial etiology a... more An anterior open bite is a challenge to orthodontic treatment; it has a multifactorial etiology and a wide range of intervention options. Temporomandibular joint (TMJ) disorders are a risk factor for the development of malocclusions such as the anterior open bite, especially in patients who have TMJ osteoarthritis with disc displacement. Articular disc repositioning surgery is an available option for treating this pathology, and it contributes to maintaining the condyles in a more stable position. The aim of this article was to report the case of a 20-year-old woman diagnosed with anterior open bite and TMJ osteoarthritis with bilateral disc displacement. The patient received both orthodontic treatment and TMJ disc repositioning surgery. Cone-beam computed tomography was used to create 3-dimensional models of the condyles with regional superposition, and assessment of bone remodeling was performed at different time intervals. Complete orthodontic and surgical treatment time was appr...

Common 3-dimensional coordinate system for assessment of directional changes

American Journal of Orthodontics and Dentofacial Orthopedics, 2016

Cone beam computed tomography-based models versus multislice spiral computed tomography-based models for assessing condylar morphology

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2016

Objective-To quantitatively compare condylar morphology using CBCT and MSCT virtual 3D surface mo... more Objective-To quantitatively compare condylar morphology using CBCT and MSCT virtual 3D surface models. Study Design-The sample consisted of secondary data analysis of CBCT and MSCT scans obtained for clinical purposes from 74 patients treated with condylar resection and prosthetic joint replacement. 3D surface models of 146 condyles were constructed from each scan modality. Across-subject models were approximated and voxel-based registration was performed between homologous CBCT and MSCT images, making it possible to create an average CBCT and MSCTbased condylar models. SPHARM-PDM provided matching points on each correspondent model. ShapeAnalysisMANCOVA assessed statistical significant differences between observers and imaging modalities. One-sample t-test evaluated the null hypothesis that the mean differences between each CBCT and MSCT-based model were not clinically significant (<0.5mm). Tests were conducted at a significance level of P<0.05. Results-ShapeAnalysisMANCOVA showed no statistically significant difference between the average CBCT and MSCT-based models (P>0.68). During pairwise comparison, the mean difference observed was 0.406mm, SD 0.173. One sample t-test showed that mean differences between each paired CBCT and MSCT-based models were not clinically significant (P=0.411). Conclusion-3D surface models constructed from CBCT images are comparable to those derived from MSCT scans and may be considered reliable tools for assessing condylar morphology.

Diagnostic index of three-dimensional osteoarthritic changes in temporomandibular joint condylar morphology

Journal of Medical Imaging, 2015

This study aimed to investigate imaging statistical approaches for classifying three-dimensional ... more This study aimed to investigate imaging statistical approaches for classifying three-dimensional (3-D) osteoarthritic morphological variations among 169 temporomandibular joint (TMJ) condyles. Cone-beam computed tomography scans were acquired from 69 subjects with long-term TMJ osteoarthritis (OA), 15 subjects at initial diagnosis of OA, and 7 healthy controls. Three-dimensional surface models of the condyles were constructed and SPHARM-PDM established correspondent points on each model. Multivariate analysis of covariance and direction-projection-permutation (DiProPerm) were used for testing statistical significance of the differences between the groups determined by clinical and radiographic diagnoses. Unsupervised classification using hierarchical agglomerative clustering was then conducted. Compared with healthy controls, OA average condyle was significantly smaller in all dimensions except its anterior surface. Significant flattening of the lateral pole was noticed at initial diagnosis. We observed areas of 3.88-mm bone resorption at the superior surface and 3.10-mm bone apposition at the anterior aspect of the long-term OA average model. DiProPerm supported a significant difference between the healthy control and OA group ([Formula: see text]). Clinically meaningful unsupervised classification of TMJ condylar morphology determined a preliminary diagnostic index of 3-D osteoarthritic changes, which may be the first step towards a more targeted diagnosis of this condition.

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts® total joint prostheses. Part IV - Soft tissue response

The purpose of this study was to evaluate the anatomical changes and stability of the oropharynge... more The purpose of this study was to evaluate the anatomical changes and stability of the oropharyngeal airway and head posture following TMJ reconstruction and mandibular advancement with TMJ Concepts custom-made total joint prostheses and maxillary osteotomies with counterclockwise rotation of the maxillo-mandibular complex. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). The lateral cephalograms of 47 patients were analyzed to determine surgical and post-surgical changes of the oropharyngeal airway, hyoid bone and head posture. Surgery increased the narrowest retroglossal airway space 4.9 mm. Head posture showed flexure immediately after surgery (À5.6 AE 6.78) and extension long-term post surgery (1.8 AE 6.78); cervical curvature showed no significant change. Surgery increased the distances between the third cervical vertebrae and the menton 11.7 AE 9.1 mm and the third cervical vertebrae and hyoid 3.2 AE 3.9 mm, and remained stable. The distance from the hyoid to the mandibular plane decreased during surgery (À3.8 AE 5.8 mm) and after

Can cone-beam computed tomography superimposition help orthodontists better understand relapse in surgical patients?

American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics, 2014

This case report describes the interdisciplinary treatment of a 19-year-old Brazilian man with a ... more This case report describes the interdisciplinary treatment of a 19-year-old Brazilian man with a Class I malocclusion, a hyperdivergent profile, an anterior open bite, and signs of temporomandibular joint internal derangement. The treatment plan included evaluation with a temporomandibular joint specialist and a rheumatologist, orthodontic appliances, and maxillomandibular surgical advancement with counterclockwise rotation. Cone-beam computed tomography images were taken before and after surgery at different times and superimposed at the cranial base to assess the changes after orthognathic surgery and to monitor quantitatively the internal derangement of the temporomandibular joints and surgical relapse. Our protocol can improve the orthodontist's understanding of surgical instability, demonstrate the clinical value of cone-beam computed tomography analysis beyond the multiplanar reconstruction, and guide patient management for the best outcome possible.

Desenvolvimento de um torquímetro de precisão para o estudo do desempenho de implantes osseointegrados

Rem: Revista Escola de Minas, 2003

Esse artigo tem como objetivo apresentar o projeto, a construção e os resultados obtidos no estud... more Esse artigo tem como objetivo apresentar o projeto, a construção e os resultados obtidos no estudo da osseointegração com um torquímetro de alta precisão. Esse torquímetro, especialmente desenvolvido para este tipo de pesquisa, pode ser usado para desenvolver pesquisas odontológicas da osseointegração de implantes dentários. Os implantes foram feitos em sete coelhos que foram avaliados após 21 e 42 dias. Alguns coelhos sofreram estimulações ultra-sônicas em seus implantes, enquanto outros foram analisados sem se submeterem a estas estimulações. Os resultados mostraram o bom funcionamento do torquímetro e que o torque para remover o implante do coelho é diretamente proporcional ao tempo de osseintegração e que as estimulações ultra-sônicas podem influenciar o torque necessário para remover o implante em alguns casos.

Análise cefalométrica padrão Unesp Araraquara

Revista Dental Press de Ortodontia e Ortopedia Facial, 2005

O objetivo desse artigo é descrever a análise cefalométrica que vem sendo aplicada nos cursos de ... more O objetivo desse artigo é descrever a análise cefalométrica que vem sendo aplicada nos cursos de mestrado, doutorado e especialização da Faculdade de Odontologia de Araraquara - UNESP. A mesma foi desenvolvida utilizando medidas cefalométricas já existentes e descritas na literatura as quais foram agrupadas em campos a fim de permitir que o profissional faça a interpretação adequada de cada área e tenha, no final da mesma, todas as informações necessárias para um correto diagnóstico e plano de tratamento. Da mesma forma, após o tratamento, a comparação das diferentes medidas e áreas de análise permitirão a interpretação de quais foram os efeitos provocados pelo tratamento aplicado.

Postsurgical Stability of Counter-Clockwise Maxillo-Mandibular Advancement Surgery: Influence of Articular Disc Repositioning

Journal of Oral and Maxillofacial Surgery, 2007

Fellow in Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A&amp;amp;amp;... more Fellow in Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A&amp;amp;amp;amp;M University System, Baylor University Medical Center, Dallas, TX. ... Clinical Professor, Department of Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A&amp;amp;amp;amp;M University, and ...

Postsurgical Stability of Oropharyngeal Airway Changes Following Counter-Clockwise Maxillo-Mandibular Advancement Surgery

Journal of Oral and Maxillofacial Surgery, 2006

This study evaluated oropharyngeal airway changes and stability following surgical counter-clockw... more This study evaluated oropharyngeal airway changes and stability following surgical counter-clockwise rotation and advancement of the maxillo-mandibular complex. Fifty-six adults (48 females, 8 males), between 15 and 51 years of age, were treated with Le Fort I osteotomies and bilateral mandibular ramus sagittal split osteotomies to advance the maxillo-mandibular complex with a counter-clockwise rotation. The average postsurgical follow-up was 34 months. Each patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s lateral cephalograms were traced, digitized twice, and averaged to estimate surgical changes (T2-T1) and postsurgical changes (T3-T2). During surgery, the occlusal plane angle decreased significantly (8.6 +/- 5.8 degrees ) and the maxillo-mandibular complex advanced and rotated counter-clockwise. The maxilla moved forward (2.4 +/- 2.7 mm) at ANS and the mandible was advanced 13.1 +/- 5.1 mm at menton, 10 +/- 4.4 mm at point B, and 6.9 +/- 3.7 mm at lower incisor edge. Postsurgical hard tissue changes were not statistically significant. While the upper oropharyngeal airway decreased significantly (4.2 +/- 3.4 mm) immediately after surgery, the narrowest retropalatal, lowest retropalatal airway, and the narrowest retroglossal airway measurements increased 2.9 +/- 2.7, 3.7 +/- 3.2, and 4.4 +/- 4.4 mm, respectively. Over the average 34 months postsurgical period, upper retropalatal airway increased 3.9 +/- 3.7 mm, while narrowest retropalatal, lowest retropalatal airway, and narrowest retroglossal airway remained stable. Head posture showed flexure immediately after surgery (4.8 +/- 5.9 degrees ) and extension postsurgically (1.6 +/- 5.6 degrees ). Maxillo-mandibular advancement with counter-clockwise rotation produces immediate increases in middle and lower oropharyngeal airway dimensions, which were constrained by changes in head posture but remain stable over the postsurgical period. The upper oropharyngeal airway space increased only on the longest follow-up.

Orthodontic traction of impacted canine using magnet: a case report

Cases Journal, 2008

A 15 year and 1 month old Chinese female with palatally impacted upper left canine was successful... more A 15 year and 1 month old Chinese female with palatally impacted upper left canine was successfully treated with an upper removable appliance with a magnet incorporated to provide orthodontic traction force. This case report indicates the possibility of using magnetic force as a safe, effective and comfortable way for orthodontic traction.

Estudo cefalométrico das alterações no perfil facial em pacientes Classe III dolicocefálicos submetidos à cirurgia ortognática bimaxilar

O presente estudo avaliou as modificações no perfil facial de 15 pacientes portadores de má oclus... more O presente estudo avaliou as modificações no perfil facial de 15 pacientes portadores de má oclusão Classe III esquelética que foram submetidos a tratamento ortodôntico pré-cirúrgico e cirurgia ortognática bimaxilar estabilizada com fixação rígida. Oito pacientes foram submetidos à mentoplastia. Foram utilizadas telerradiografias pré-cirúrgicas (T1) e pós-cirúrgicas (T2) com um intervalo mínimo de 6 meses. Foram analisados deslocamentos horizontais e verticais em pontos do tecido ósseo e tecido mole. Foi realizada uma comparação entre os casos tratados com e sem mentoplastia (teste t) mostrando não haver diferenças entre os grupos. A regressão linear múltipla evidenciou uma correlação significante no sentido horizontal para os pontos Pg e Pgm e vertical para os pontos Me e Mem. Foi encontrada baixa correlação para movimentos no sentido horizontal nos pontos Sena e A, e para os pontos Pn, Sn e Ph. No sentido vertical, os deslocamentos mais evidentes foram entre os pontos Pg, Gn e Me e Sena e A, porém com correlações de baixa intensidade. Resumo Palavras-chave: Perfi facial. Cirurgia ortognática. Classe III.

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts< sup>®</sup> total joint prostheses: Part IV–Soft tissue response

The purpose of this study was to evaluate skeletal and dental stability in patients who had tempo... more The purpose of this study was to evaluate skeletal and dental stability in patients who had temporomandibular joint (TMJ) reconstruction and mandibular counterclockwise advancement using TMJ Concepts total joint prostheses (TMJ Concepts Inc. Ventura, CA) with maxillary osteotomies being performed at the same operation. All patients were operated at

Desenvolvimento de um torquímetro de precisão para o estudo do desempenho de implantes osseointegrados

This paper has as objective, to present the project, the construction and the results obtained in... more This paper has as objective, to present the project, the construction and the results obtained in the study of the osseointegration with a torque gauge of high precision. The torque gage, especially developed for this research type, was used to improvement of odontological research on osseointegration of dental implant. The implants were done in seven rabbits that were available after 21 and 42 days. In some rabbits were made ultra-sonic stimulations at rabbits' implants. The results showed that the torque to remove the implant of the rabbits is directly proportional at the time of osseointegration and that the ultra-sonic stimulations can also influence the torque in some cases.

Diagnostic index of 3D osteoarthritic changes in TMJ condylar morphology

SPIE Proceedings, 2015

The aim of this study was to investigate imaging statistical approaches for classifying 3D osteoa... more The aim of this study was to investigate imaging statistical approaches for classifying 3D osteoarthritic morphological variations among 169 Temporomandibular Joint (TMJ) condyles. Cone beam Computed Tomography (CBCT) scans were acquired from 69 patients with long-term TMJ Osteoarthritis (OA) (39.1 ± 15.7 years), 15 patients at initial diagnosis of OA (44.9 ± 14.8 years) and 7 healthy controls (43 ± 12.4 years). 3D surface models of the condyles were constructed and Shape Correspondence was used to establish correspondent points on each model. The statistical framework included a multivariate analysis of covariance (MANCOVA) and Direction-Projection-Permutation (DiProPerm) for testing statistical significance of the differences between healthy control and the OA group determined by clinical and radiographic diagnoses. Unsupervised classification using hierarchical agglomerative clustering (HAC) was then conducted. Condylar morphology in OA and healthy subjects varied widely. Compared with healthy controls, OA average condyle was statistically significantly smaller in all dimensions except its anterior surface. Significant flattening of the lateral pole was noticed at initial diagnosis (p < 0.05). It was observed areas of 3.88 mm bone resorption at the superior surface and 3.10 mm bone apposition at the anterior aspect of the long-term OA average model. 1000 permutation statistics of DiProPerm supported a significant difference between the healthy control group and OA group (t = 6.7, empirical p-value = 0.001). Clinically meaningful unsupervised classification of TMJ condylar morphology determined a preliminary diagnostic index of 3D osteoarthritic changes, which may be the first step towards a more targeted diagnosis of this condition. CONFLICT OF INTEREST STATEMENT This is an original work that has not been, submitted for publication or presentation elsewhere. All authors had no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work.

Avaliação cefalométrica do efeito do tratamento da má oclusão Classe II, divisão 1, com o bionator de Balters: estudo com implantes metálicos

by Ary dos Santos-Pinto and Joao Goncalves

Revista Dental Press de Ortodontia e Ortopedia Facial, 2006

Objetivos: julgamento descritivo dos efeitos do bionator no tratamento da má oclusão Classe II, d... more Objetivos: julgamento descritivo dos efeitos do bionator no tratamento da má oclusão Classe II, divisão 1, quando está presente uma retrusão mandibular ou uma deficiência do crescimento mandibular. Metodologia: são apresentados os resultados do tratamento em três pacientes que foram acompanhados sem tratamento por um período de um ano e, posteriormente, tratados com o bionator por um período de dois anos. Em todos os pacientes foram inseridos implantes metálicos que serviram como referência para as sobreposições dos traçados cefalométricos que, em conjunto com algumas medidas cefalométricas tradicionais, geraram dados para a avaliação do efeito ortopédico e ortodôntico do tratamento da má oclusão Classe II com este aparelho. Resultados e Conclusões: foi observada uma restrição do crescimento da maxila e um estímulo do crescimento da mandíbula, assim como alteração na direção do crescimento condilar. Foi também observada uma verticalização dos incisivos superiores e, no arco inferior, aumento na tendência natural de vestibularização dos incisivos inferiores.

Cephalometric study of the facial profile changes in Class III patients submitted to bimaxillary orthognathic surgery

by Ary dos Santos-Pinto and Joao Goncalves

ABSTRACT The present study evaluated the facial profile modifications in 15 skeletal Class III pa... more ABSTRACT The present study evaluated the facial profile modifications in 15 skeletal Class III patients that were submitted to presurgical orthodontic treatment and orthognathic bimaxillary surgery stabilized with a rigid fixation. Eight of the patients have undergone to genioplastic surgery. Presurgical (T1) and late postsurgical (T2) radiographs taken apart with a minimum of 6 month interval had been used. The horizontal and vertical displacement of skeletal and soft tissue profile points were analyzed. The comparison of the cases submitted or not to a genioplastic surgery (t Test) showed no differences for the displacement of the skeletal and soft tissue points. The multiple linear regression analysis showed a significant correlation for horizontal movements of the Pg and Pgm points and for vertical movements of the Me and Mem points. A low correlation was found for the horizontal movements of Sena and A points and for Pn, Sn and Ph points. The vertical movements were more evident for the points Pg, Gn, and Me and for the A and Sena points but also showed low correlation.

Bolton analysis: an alternative proposal for simplification of its use

by Ary dos Santos-Pinto and Joao Goncalves

RESUMO INTRODUÇÃO: as discrepâncias entre o tamanho mesiodistal dos dentes superiores e inferiore... more

Three-dimensional stability analysis of maxillomandibular advancement surgery with and without articular disc repositioning

Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, Jan 18, 2018

This retrospective cohort study aimed to assess, three-dimensionally, mandible and maxilla change... more This retrospective cohort study aimed to assess, three-dimensionally, mandible and maxilla changes following maxillomandibular advancement (MMA), with and without repositioning of TMJ articular discs. The sample comprised cone-beam computed tomography data from 32 subjects: group 1 (n = 12) without disc displacement and group 2 (n = 20) with bilateral disc repositioning. An automatic cranial base superimposition method was used to register the images at three time points: T1 (preoperative), T2 (postoperative), and T3 (at least 11 months follow-up). To assess surgical changes (T2-T1) and adaptive responses (T3-T2), the images were compared quantitatively and qualitatively using the shape correspondence method. The results showed that surgical displacements were similar in both groups for all the regions of interest except the condyles, which moved in opposite directions - group 1 to superior and posterior positions, and group 2 to inferior and anterior positions. For adaptive respons...

Effect of temporomandibular joint articular disc repositioning on anterior open-bite malocclusion: An orthodontic-surgical approach

American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics, 2017

An anterior open bite is a challenge to orthodontic treatment; it has a multifactorial etiology a... more An anterior open bite is a challenge to orthodontic treatment; it has a multifactorial etiology and a wide range of intervention options. Temporomandibular joint (TMJ) disorders are a risk factor for the development of malocclusions such as the anterior open bite, especially in patients who have TMJ osteoarthritis with disc displacement. Articular disc repositioning surgery is an available option for treating this pathology, and it contributes to maintaining the condyles in a more stable position. The aim of this article was to report the case of a 20-year-old woman diagnosed with anterior open bite and TMJ osteoarthritis with bilateral disc displacement. The patient received both orthodontic treatment and TMJ disc repositioning surgery. Cone-beam computed tomography was used to create 3-dimensional models of the condyles with regional superposition, and assessment of bone remodeling was performed at different time intervals. Complete orthodontic and surgical treatment time was appr...

Common 3-dimensional coordinate system for assessment of directional changes

American Journal of Orthodontics and Dentofacial Orthopedics, 2016

Cone beam computed tomography-based models versus multislice spiral computed tomography-based models for assessing condylar morphology

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2016

Objective-To quantitatively compare condylar morphology using CBCT and MSCT virtual 3D surface mo... more Objective-To quantitatively compare condylar morphology using CBCT and MSCT virtual 3D surface models. Study Design-The sample consisted of secondary data analysis of CBCT and MSCT scans obtained for clinical purposes from 74 patients treated with condylar resection and prosthetic joint replacement. 3D surface models of 146 condyles were constructed from each scan modality. Across-subject models were approximated and voxel-based registration was performed between homologous CBCT and MSCT images, making it possible to create an average CBCT and MSCTbased condylar models. SPHARM-PDM provided matching points on each correspondent model. ShapeAnalysisMANCOVA assessed statistical significant differences between observers and imaging modalities. One-sample t-test evaluated the null hypothesis that the mean differences between each CBCT and MSCT-based model were not clinically significant (<0.5mm). Tests were conducted at a significance level of P<0.05. Results-ShapeAnalysisMANCOVA showed no statistically significant difference between the average CBCT and MSCT-based models (P>0.68). During pairwise comparison, the mean difference observed was 0.406mm, SD 0.173. One sample t-test showed that mean differences between each paired CBCT and MSCT-based models were not clinically significant (P=0.411). Conclusion-3D surface models constructed from CBCT images are comparable to those derived from MSCT scans and may be considered reliable tools for assessing condylar morphology.

Diagnostic index of three-dimensional osteoarthritic changes in temporomandibular joint condylar morphology

Journal of Medical Imaging, 2015

This study aimed to investigate imaging statistical approaches for classifying three-dimensional ... more This study aimed to investigate imaging statistical approaches for classifying three-dimensional (3-D) osteoarthritic morphological variations among 169 temporomandibular joint (TMJ) condyles. Cone-beam computed tomography scans were acquired from 69 subjects with long-term TMJ osteoarthritis (OA), 15 subjects at initial diagnosis of OA, and 7 healthy controls. Three-dimensional surface models of the condyles were constructed and SPHARM-PDM established correspondent points on each model. Multivariate analysis of covariance and direction-projection-permutation (DiProPerm) were used for testing statistical significance of the differences between the groups determined by clinical and radiographic diagnoses. Unsupervised classification using hierarchical agglomerative clustering was then conducted. Compared with healthy controls, OA average condyle was significantly smaller in all dimensions except its anterior surface. Significant flattening of the lateral pole was noticed at initial diagnosis. We observed areas of 3.88-mm bone resorption at the superior surface and 3.10-mm bone apposition at the anterior aspect of the long-term OA average model. DiProPerm supported a significant difference between the healthy control and OA group ([Formula: see text]). Clinically meaningful unsupervised classification of TMJ condylar morphology determined a preliminary diagnostic index of 3-D osteoarthritic changes, which may be the first step towards a more targeted diagnosis of this condition.

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts® total joint prostheses. Part IV - Soft tissue response

The purpose of this study was to evaluate the anatomical changes and stability of the oropharynge... more The purpose of this study was to evaluate the anatomical changes and stability of the oropharyngeal airway and head posture following TMJ reconstruction and mandibular advancement with TMJ Concepts custom-made total joint prostheses and maxillary osteotomies with counterclockwise rotation of the maxillo-mandibular complex. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). The lateral cephalograms of 47 patients were analyzed to determine surgical and post-surgical changes of the oropharyngeal airway, hyoid bone and head posture. Surgery increased the narrowest retroglossal airway space 4.9 mm. Head posture showed flexure immediately after surgery (À5.6 AE 6.78) and extension long-term post surgery (1.8 AE 6.78); cervical curvature showed no significant change. Surgery increased the distances between the third cervical vertebrae and the menton 11.7 AE 9.1 mm and the third cervical vertebrae and hyoid 3.2 AE 3.9 mm, and remained stable. The distance from the hyoid to the mandibular plane decreased during surgery (À3.8 AE 5.8 mm) and after

Can cone-beam computed tomography superimposition help orthodontists better understand relapse in surgical patients?

American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics, 2014

This case report describes the interdisciplinary treatment of a 19-year-old Brazilian man with a ... more This case report describes the interdisciplinary treatment of a 19-year-old Brazilian man with a Class I malocclusion, a hyperdivergent profile, an anterior open bite, and signs of temporomandibular joint internal derangement. The treatment plan included evaluation with a temporomandibular joint specialist and a rheumatologist, orthodontic appliances, and maxillomandibular surgical advancement with counterclockwise rotation. Cone-beam computed tomography images were taken before and after surgery at different times and superimposed at the cranial base to assess the changes after orthognathic surgery and to monitor quantitatively the internal derangement of the temporomandibular joints and surgical relapse. Our protocol can improve the orthodontist's understanding of surgical instability, demonstrate the clinical value of cone-beam computed tomography analysis beyond the multiplanar reconstruction, and guide patient management for the best outcome possible.

Desenvolvimento de um torquímetro de precisão para o estudo do desempenho de implantes osseointegrados

Rem: Revista Escola de Minas, 2003

Esse artigo tem como objetivo apresentar o projeto, a construção e os resultados obtidos no estud... more Esse artigo tem como objetivo apresentar o projeto, a construção e os resultados obtidos no estudo da osseointegração com um torquímetro de alta precisão. Esse torquímetro, especialmente desenvolvido para este tipo de pesquisa, pode ser usado para desenvolver pesquisas odontológicas da osseointegração de implantes dentários. Os implantes foram feitos em sete coelhos que foram avaliados após 21 e 42 dias. Alguns coelhos sofreram estimulações ultra-sônicas em seus implantes, enquanto outros foram analisados sem se submeterem a estas estimulações. Os resultados mostraram o bom funcionamento do torquímetro e que o torque para remover o implante do coelho é diretamente proporcional ao tempo de osseintegração e que as estimulações ultra-sônicas podem influenciar o torque necessário para remover o implante em alguns casos.

Análise cefalométrica padrão Unesp Araraquara

Revista Dental Press de Ortodontia e Ortopedia Facial, 2005

O objetivo desse artigo é descrever a análise cefalométrica que vem sendo aplicada nos cursos de ... more O objetivo desse artigo é descrever a análise cefalométrica que vem sendo aplicada nos cursos de mestrado, doutorado e especialização da Faculdade de Odontologia de Araraquara - UNESP. A mesma foi desenvolvida utilizando medidas cefalométricas já existentes e descritas na literatura as quais foram agrupadas em campos a fim de permitir que o profissional faça a interpretação adequada de cada área e tenha, no final da mesma, todas as informações necessárias para um correto diagnóstico e plano de tratamento. Da mesma forma, após o tratamento, a comparação das diferentes medidas e áreas de análise permitirão a interpretação de quais foram os efeitos provocados pelo tratamento aplicado.

Postsurgical Stability of Counter-Clockwise Maxillo-Mandibular Advancement Surgery: Influence of Articular Disc Repositioning

Journal of Oral and Maxillofacial Surgery, 2007

Fellow in Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A&amp;amp;amp;... more Fellow in Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A&amp;amp;amp;amp;M University System, Baylor University Medical Center, Dallas, TX. ... Clinical Professor, Department of Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A&amp;amp;amp;amp;M University, and ...

Postsurgical Stability of Oropharyngeal Airway Changes Following Counter-Clockwise Maxillo-Mandibular Advancement Surgery

Journal of Oral and Maxillofacial Surgery, 2006

This study evaluated oropharyngeal airway changes and stability following surgical counter-clockw... more This study evaluated oropharyngeal airway changes and stability following surgical counter-clockwise rotation and advancement of the maxillo-mandibular complex. Fifty-six adults (48 females, 8 males), between 15 and 51 years of age, were treated with Le Fort I osteotomies and bilateral mandibular ramus sagittal split osteotomies to advance the maxillo-mandibular complex with a counter-clockwise rotation. The average postsurgical follow-up was 34 months. Each patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s lateral cephalograms were traced, digitized twice, and averaged to estimate surgical changes (T2-T1) and postsurgical changes (T3-T2). During surgery, the occlusal plane angle decreased significantly (8.6 +/- 5.8 degrees ) and the maxillo-mandibular complex advanced and rotated counter-clockwise. The maxilla moved forward (2.4 +/- 2.7 mm) at ANS and the mandible was advanced 13.1 +/- 5.1 mm at menton, 10 +/- 4.4 mm at point B, and 6.9 +/- 3.7 mm at lower incisor edge. Postsurgical hard tissue changes were not statistically significant. While the upper oropharyngeal airway decreased significantly (4.2 +/- 3.4 mm) immediately after surgery, the narrowest retropalatal, lowest retropalatal airway, and the narrowest retroglossal airway measurements increased 2.9 +/- 2.7, 3.7 +/- 3.2, and 4.4 +/- 4.4 mm, respectively. Over the average 34 months postsurgical period, upper retropalatal airway increased 3.9 +/- 3.7 mm, while narrowest retropalatal, lowest retropalatal airway, and narrowest retroglossal airway remained stable. Head posture showed flexure immediately after surgery (4.8 +/- 5.9 degrees ) and extension postsurgically (1.6 +/- 5.6 degrees ). Maxillo-mandibular advancement with counter-clockwise rotation produces immediate increases in middle and lower oropharyngeal airway dimensions, which were constrained by changes in head posture but remain stable over the postsurgical period. The upper oropharyngeal airway space increased only on the longest follow-up.

Orthodontic traction of impacted canine using magnet: a case report

Cases Journal, 2008

A 15 year and 1 month old Chinese female with palatally impacted upper left canine was successful... more A 15 year and 1 month old Chinese female with palatally impacted upper left canine was successfully treated with an upper removable appliance with a magnet incorporated to provide orthodontic traction force. This case report indicates the possibility of using magnetic force as a safe, effective and comfortable way for orthodontic traction.

Estudo cefalométrico das alterações no perfil facial em pacientes Classe III dolicocefálicos submetidos à cirurgia ortognática bimaxilar

O presente estudo avaliou as modificações no perfil facial de 15 pacientes portadores de má oclus... more O presente estudo avaliou as modificações no perfil facial de 15 pacientes portadores de má oclusão Classe III esquelética que foram submetidos a tratamento ortodôntico pré-cirúrgico e cirurgia ortognática bimaxilar estabilizada com fixação rígida. Oito pacientes foram submetidos à mentoplastia. Foram utilizadas telerradiografias pré-cirúrgicas (T1) e pós-cirúrgicas (T2) com um intervalo mínimo de 6 meses. Foram analisados deslocamentos horizontais e verticais em pontos do tecido ósseo e tecido mole. Foi realizada uma comparação entre os casos tratados com e sem mentoplastia (teste t) mostrando não haver diferenças entre os grupos. A regressão linear múltipla evidenciou uma correlação significante no sentido horizontal para os pontos Pg e Pgm e vertical para os pontos Me e Mem. Foi encontrada baixa correlação para movimentos no sentido horizontal nos pontos Sena e A, e para os pontos Pn, Sn e Ph. No sentido vertical, os deslocamentos mais evidentes foram entre os pontos Pg, Gn e Me e Sena e A, porém com correlações de baixa intensidade. Resumo Palavras-chave: Perfi facial. Cirurgia ortognática. Classe III.

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts< sup>®</sup> total joint prostheses: Part IV–Soft tissue response

The purpose of this study was to evaluate skeletal and dental stability in patients who had tempo... more The purpose of this study was to evaluate skeletal and dental stability in patients who had temporomandibular joint (TMJ) reconstruction and mandibular counterclockwise advancement using TMJ Concepts total joint prostheses (TMJ Concepts Inc. Ventura, CA) with maxillary osteotomies being performed at the same operation. All patients were operated at

Desenvolvimento de um torquímetro de precisão para o estudo do desempenho de implantes osseointegrados

This paper has as objective, to present the project, the construction and the results obtained in... more This paper has as objective, to present the project, the construction and the results obtained in the study of the osseointegration with a torque gauge of high precision. The torque gage, especially developed for this research type, was used to improvement of odontological research on osseointegration of dental implant. The implants were done in seven rabbits that were available after 21 and 42 days. In some rabbits were made ultra-sonic stimulations at rabbits' implants. The results showed that the torque to remove the implant of the rabbits is directly proportional at the time of osseointegration and that the ultra-sonic stimulations can also influence the torque in some cases.

Diagnostic index of 3D osteoarthritic changes in TMJ condylar morphology

SPIE Proceedings, 2015

The aim of this study was to investigate imaging statistical approaches for classifying 3D osteoa... more The aim of this study was to investigate imaging statistical approaches for classifying 3D osteoarthritic morphological variations among 169 Temporomandibular Joint (TMJ) condyles. Cone beam Computed Tomography (CBCT) scans were acquired from 69 patients with long-term TMJ Osteoarthritis (OA) (39.1 ± 15.7 years), 15 patients at initial diagnosis of OA (44.9 ± 14.8 years) and 7 healthy controls (43 ± 12.4 years). 3D surface models of the condyles were constructed and Shape Correspondence was used to establish correspondent points on each model. The statistical framework included a multivariate analysis of covariance (MANCOVA) and Direction-Projection-Permutation (DiProPerm) for testing statistical significance of the differences between healthy control and the OA group determined by clinical and radiographic diagnoses. Unsupervised classification using hierarchical agglomerative clustering (HAC) was then conducted. Condylar morphology in OA and healthy subjects varied widely. Compared with healthy controls, OA average condyle was statistically significantly smaller in all dimensions except its anterior surface. Significant flattening of the lateral pole was noticed at initial diagnosis (p < 0.05). It was observed areas of 3.88 mm bone resorption at the superior surface and 3.10 mm bone apposition at the anterior aspect of the long-term OA average model. 1000 permutation statistics of DiProPerm supported a significant difference between the healthy control group and OA group (t = 6.7, empirical p-value = 0.001). Clinically meaningful unsupervised classification of TMJ condylar morphology determined a preliminary diagnostic index of 3D osteoarthritic changes, which may be the first step towards a more targeted diagnosis of this condition. CONFLICT OF INTEREST STATEMENT This is an original work that has not been, submitted for publication or presentation elsewhere. All authors had no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work.

Avaliação cefalométrica do efeito do tratamento da má oclusão Classe II, divisão 1, com o bionator de Balters: estudo com implantes metálicos

by Ary dos Santos-Pinto and Joao Goncalves

Revista Dental Press de Ortodontia e Ortopedia Facial, 2006

Objetivos: julgamento descritivo dos efeitos do bionator no tratamento da má oclusão Classe II, d... more Objetivos: julgamento descritivo dos efeitos do bionator no tratamento da má oclusão Classe II, divisão 1, quando está presente uma retrusão mandibular ou uma deficiência do crescimento mandibular. Metodologia: são apresentados os resultados do tratamento em três pacientes que foram acompanhados sem tratamento por um período de um ano e, posteriormente, tratados com o bionator por um período de dois anos. Em todos os pacientes foram inseridos implantes metálicos que serviram como referência para as sobreposições dos traçados cefalométricos que, em conjunto com algumas medidas cefalométricas tradicionais, geraram dados para a avaliação do efeito ortopédico e ortodôntico do tratamento da má oclusão Classe II com este aparelho. Resultados e Conclusões: foi observada uma restrição do crescimento da maxila e um estímulo do crescimento da mandíbula, assim como alteração na direção do crescimento condilar. Foi também observada uma verticalização dos incisivos superiores e, no arco inferior, aumento na tendência natural de vestibularização dos incisivos inferiores.

Cephalometric study of the facial profile changes in Class III patients submitted to bimaxillary orthognathic surgery

by Ary dos Santos-Pinto and Joao Goncalves

ABSTRACT The present study evaluated the facial profile modifications in 15 skeletal Class III pa... more ABSTRACT The present study evaluated the facial profile modifications in 15 skeletal Class III patients that were submitted to presurgical orthodontic treatment and orthognathic bimaxillary surgery stabilized with a rigid fixation. Eight of the patients have undergone to genioplastic surgery. Presurgical (T1) and late postsurgical (T2) radiographs taken apart with a minimum of 6 month interval had been used. The horizontal and vertical displacement of skeletal and soft tissue profile points were analyzed. The comparison of the cases submitted or not to a genioplastic surgery (t Test) showed no differences for the displacement of the skeletal and soft tissue points. The multiple linear regression analysis showed a significant correlation for horizontal movements of the Pg and Pgm points and for vertical movements of the Me and Mem points. A low correlation was found for the horizontal movements of Sena and A points and for Pn, Sn and Ph points. The vertical movements were more evident for the points Pg, Gn, and Me and for the A and Sena points but also showed low correlation.

Bolton analysis: an alternative proposal for simplification of its use

by Ary dos Santos-Pinto and Joao Goncalves

RESUMO INTRODUÇÃO: as discrepâncias entre o tamanho mesiodistal dos dentes superiores e inferiore... more