Page 32 - SPEMD_58-4

220 rev port estomatol med dent cir maxilofac. 2017;58(4):219-224

Resistência adesiva ao cisalhamento de diferentes acessórios utilizados
para tração de dentes impactados

r e s u m o

Palavras-chave: Objetivos: Avaliar a resistência adesiva ao cisalhamento e o Índice de Adesivo Remanescen-
Adesão te (IAR) de diferentes acessórios ortodônticos utilizados na tração de dentes impactados.
Impactado Métodos: 120 incisivos bovinos foram utilizados para esse estudo. Inicialmente, em todos
Aparelho ortodôntico realizou-se profilaxia, seguida do condicionamento com ácido fosfórico 37%, aplicação de
Dente adesivo e fotopolimerização. Em seguida, dividiu-se aleatoriamente os dentes em oito gru-
pos: (1) Botão língual em resina composta; (2) Gancho para tracionar dentes inclusos; (3)
Gancho com corrente; (4) Cleat; (5) Brackets; (6) Botão lingual convexo; (7) Botão lingual
côncavo e (8) Malha metálica ortodôntica. Os grupos foram submetidos a testes de resistên-
cia adesiva ao cisalhamento em máquina de ensaios universais e avaliação do IAR.
Resultados: O grupo constituído pelas malhas metálicas ortodônticas apresentou os melho-
res resultados nos testes resistência adesiva ao cisalhamento com diferenças estatistica-
mente significativas quando comparados com os botões linguais em resina composta
(p<0,001), Ganchos para tracionar dentes inclusos (p=0,002), Ganchos com corrente (p=0,001),
Cleat (p=0,011), Brackets (p< 0,001), Botão lingual convexo (p=0,003) e Botão lingual côncavo
(p<0,001). As maiores médias do IAR foram obtidos também pelo grupo das Malhas metáli-
cas ortodônticas, com diferenças estatisticamente significativas quando comparadas aos
Botões linguais em compósito (p=0,008), Cleat (p=0,004), Brackets (p=0,001), Botão lingual
convexo (p=0,017) e Botão lingual côncavo (p=0,005).
Conclusões: As forças de adesão maiores foram obtidas com a malha ortodôntica, tendo sido
estatisticamente diferente de todos os outros grupos e as menores com os botões linguais
em compósito. (Rev Port Estomatol Med Dent Cir Maxilofac. 2017;58(4):219-224)
© 2017 Sociedade Portuguesa de Estomatologia e Medicina Dentária.
Publicado por SPEMD. Este é um artigo Open Access sob uma licença CC BY-NC-ND
(http://creativecommons.org/licenses/by-nc-nd/4.0/).

incisal angle in the vestibular-lingual direction and fixation of
Introduction
an orthodontic wire). However, many complications resulted
Impacted teeth are a prevalent problem in the orthodontic from these procedures, such as root resorptions and pulp per-
treatment, and are defined as teeth that remain in the oral forations, with the need for future endodontic treatment. 8,12
1
mucosa or bone after their period of eruption. 2-5 There are var- With the advent of materials for bonding directly to the
ious causes for this anomaly, which may be due to an obstruc- surface of teeth, these once common problems ended. There
tion of the trajectory between its site of development and the are bonding materials available on the market with excellent,
functional occlusal position, or due to a loss of eruptive force. 6,7 clinically proven bond strength. However, doubts persist about
In the large majority of cases, the etiology of teeth impac- the best accessory to bond in these situations, considering the
tion can be determined, and there is no symptomatology. Nev- infinite number of devices available for this purpose. 11,13 Based
ertheless, there are cases in which pathological repercussions, on this premise, the authors’ proposal in the present study was
such as the resorption of the root of an adjacent tooth, loss of to evaluate the in vitro shear bond strength and adhesive rem-
dental arch size, cyst formation, referred pain, among other nant index (ARI) of different orthodontic accessories used for
problems, may be associated. 8 applying traction to impacted teeth. In addition, the null hy-
The methods described in the literature for the treatment pothesis tested was that the shear bond strength and the ARI
of impacted teeth vary between extraction, autotransplanta- were similar for all orthodontic traction objects.
tion and surgical exposure, with a subsequent orthodontic
movement. The latter is the most recommended option, as it
9
presents the best results from both the aesthetic and function- Materials and methods
10
al points of view. When the treatment option is the applica-
tion of traction, it is necessary to adapt some accessory to the In this in vitro evaluation, 120 bovine permanent incisors
tooth in question, which will serve as a support for traction were used due to the similarity between bovine and human
11
with orthodontic forces. In the past, this support was ob- teeth. The inclusion criterion was that the teeth should be in-
tained using invasive methods, such as placing a wire loop tact – that is, without cavitation caused by caries and/or the
11
10
around the crown or transfixation (the perforation of the extraction process. The teeth were cleaned with water and