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Influence of anatomical barriers on maxillary incisor root resorption after orthodontic treatment with premolar extractions

Oliveira, Antonio Geraldo de; Castro, Fabiana Guilhermina Ferreira
Fonte: Dental Press International Publicador: Dental Press International
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.32%
INTRODUCTION: Apical root resorption is a frequent and occasionally critical problem in orthodontic patients undergoing induced tooth movement. One of the factors that might influence prognosis, especially in maxillary incisors, which most frequently present resorptions, are the so-called the anatomical barriers; that is, proximity of the buccal and palatal cortical bones to the maxillary incisor roots. OBJECTIVE: The purpose of this research was to investigate whether patients with excessive vertical growth really present a small distance between the alveolar cortical bones and the maxillary incisor roots, and whether there is a correlation between this distance and the root resorption index in comparison with patients presenting horizontal growth. METHODS: The sample comprised orthodontic records of 18 patients with extraction planning of first maxillary premolars and treatment by the standard and/or preadjusted edgewise brackets. Their initial and final periapical radiographs were evaluated to determine the amount of root resorption that occurred. RESULTS: On the palatal side, patients with excessive vertical growth (Group 2 - SN-GoGn > 43º) showed a narrower alveolar bone than the horizontal growth patients (Group 1 - SN-GoGn < 29º). However...

Acurácia de medidas lineares em softwares de planejamento de implantes sobre imagens de mandibulas atróficas obtidas por tomografias computadorizadas de feixe cônico com diferentes protocolos de aquisição; Accuracy of linear measurements in implant planning software on images of atrophic jaws obtained by cone beam computed tomography with different acquisition protocols

Barbosa, Jorge de Sá
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 13/06/2014 PT
Relevância na Pesquisa
36.19%
O objetivo neste estudo foi avaliar a acurácia de softwares de planejamento de implantes sobre imagens de mandíbulas atróficas obtidas por tomografia computadorizada de feixe cônico (TCFC) com diferentes protocolos de aquisição. Foram utilizadas 10 mandíbulas desdentadas totais que receberam 8 marcações em regiões normalmente utilizadas para colocação de implantes (4 em região anterior e 4 em região posterior), sobre estas foram aderidos fios ortodônticos a fim de padronizar as regiões. Então as mandíbulas foram submetidas à TCFC com 2 protocolos de aquisição, P1 (voxel 0,25mm) e P2 (voxel 0,125mm), e as imagens analisadas por 3 softwares de planejamento de implantes, sendo eles: Xoran versão 5.0 (XR) (Xoran Technologies® Inc, Ann Harbor, MI, USA); DentalSlice versão 2010 (DS) (Bioparts®, Brasília, Brasil) e OsiriX 1.2 (OX) (Pixmeo®, Genebra, Suiça). Foram realizadas medidas lineares nas regiões de maior extremidade em altura, largura , e altura da crista do rebordo até o teto do canal mandibular. Exatamente sobre as 8 demarcações as mandíbulas foram seccionadas para mensuração direta por meio de paquímetro digital. A correlação intraclasse (ICC) foi utilizada para calcular a confiabilidade intraexaminador (ICC=0...

Montagem e confecção do set up ortodôntico

Porto, Betina Grehs; Raveli, Dirceu Barnabé; Porto, Cecília Helena Soares; Pendenza, Diego Cardoso; Martins, Lídia Parsekian
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 26-34
POR
Relevância na Pesquisa
26.53%
Diagnosis and planning stages are critical to the success of orthodontic treatment, in which the orthodontist should have many elements that contribute to the most appropriate decision-making. The orthodontic set-up is an important resource in the planning of corrective orthodontics therapy. It consists of the repositioning of the teeth previously removed from the study dental casts and reassembled on its remaining basis. When properly made, the set-up allows a three-dimensional preview of problems and limitations of the case, assisting in decision-making regarding tooth extractions in cases with problems of space, amount of anchorage loss extent and type of tooth movement, discrepancy of dental arch perimeter, discrepancy of inter-arch tooth volume, among others, indicating the best option for treatment. This paper outlines the most important steps for its confection, an evaluation system and its application in the preparation of orthodontic treatment planning.; O diagnóstico e o planejamento constituem etapas fundamentais para o sucesso do tratamento ortodôntico, nas quais o ortodontista deve ter inúmeros elementos que contribuem na tomada das decisões mais acertadas. O set-up, ou montagem de diagnóstico em modelo, é um importante recurso no planejamento da terapia ortodôntica corretiva. Consiste no reposicionamento dos dentes previamente removidos dos modelos de estudo e remontados sobre a base remanescente dos mesmos. Quando corretamente confeccionado...

Influence of anatomical barriers on maxillary incisor root resorption after orthodontic treatment with premolar extractions

Oliveira,Antonio Geraldo de; Castro,Fabiana Guilhermina Ferreira
Fonte: Dental Press International Publicador: Dental Press International
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2012 EN
Relevância na Pesquisa
36.32%
INTRODUCTION: Apical root resorption is a frequent and occasionally critical problem in orthodontic patients undergoing induced tooth movement. One of the factors that might influence prognosis, especially in maxillary incisors, which most frequently present resorptions, are the so-called the anatomical barriers; that is, proximity of the buccal and palatal cortical bones to the maxillary incisor roots. OBJECTIVE: The purpose of this research was to investigate whether patients with excessive vertical growth really present a small distance between the alveolar cortical bones and the maxillary incisor roots, and whether there is a correlation between this distance and the root resorption index in comparison with patients presenting horizontal growth. METHODS: The sample comprised orthodontic records of 18 patients with extraction planning of first maxillary premolars and treatment by the standard and/or preadjusted edgewise brackets. Their initial and final periapical radiographs were evaluated to determine the amount of root resorption that occurred. RESULTS: On the palatal side, patients with excessive vertical growth (Group 2 - SN-GoGn > 43º) showed a narrower alveolar bone than the horizontal growth patients (Group 1 - SN-GoGn < 29º). However...

Preparation and evaluation of orthodontic setup

Araújo,Telma Martins de; Fonseca,Lílian Martins; Caldas,Luciana Duarte; Costa-Pinto,Roberto Amarante
Fonte: Dental Press International Publicador: Dental Press International
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2012 EN
Relevância na Pesquisa
36.51%
INTRODUCTION: An orthodontic or diagnostic setup consists in cutting and realigning the teeth in plaster models, making it an important resource in orthodontic treatment planning. OBJECTIVE: The aim of this article is to provide a detailed description of a technique to build an orthodontic setup model and a method to evaluate it. CONCLUSIONS: Although laborious, orthodontic setup procedure and analysis can provide important information such as the need for dental extractions, interproximal stripping, anchorage system, among others.

Angle Class II malocclusion treated with extraction of permanent teeth

Barreto,Gustavo Mattos
Fonte: Dental Press International Publicador: Dental Press International
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2013 EN
Relevância na Pesquisa
36.25%
Angle Class II malocclusion associated with anterior open bite in adult patients demands a carefully elaborated orthodontic planning, aiming at restoring not only harmonious dental and facial esthetics, but also a balanced masticatory function. Orthognathic surgery or permanent teeth extraction are often the choice of treatment, therefore, treatment decision is related to all dental, skeletal and functional aspects. The present report discusses orthodontic compensation carried out by means of upper premolar extraction performed to correct the Class II canine relationship and, consequently, the anterior open bite, accepting that the upper incisors be retroclined. This clinical case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as part of the requirements for obtaining the BBO Certification.

Orthodontic movement in deciduous teeth

Consolaro,Alberto
Fonte: Dental Press International Publicador: Dental Press International
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2015 EN
Relevância na Pesquisa
36.32%
Deciduous teeth exfoliate as a result of apoptosis induced by cementoblasts, a process that reveals the mineralized portion of the root while attracting clasts. Root resorption in deciduous teeth is slow due to lack of mediators necessary to speed it up; however, it accelerates and spreads in one single direction whenever a permanent tooth pericoronal follicle, rich in epithelial growth factor (EGF), or other bone resorption mediators come near. The latter are responsible for bone resorption during eruption, and deciduous teeth root resorption and exfoliation. Should deciduous teeth be subjected to orthodontic movement or anchorage, mediators local levels will increase. Thus, one should be fully aware that root resorption in deciduous teeth will speed up and exfoliation will early occur. Treatment planning involving deciduous teeth orthodontic movement and/or anchorage should consider: Are clinical benefits relevant enough as to be worth the risk of undergoing early inconvenient root resorption?

Mandibular prognathism caused by acromegaly – a surgical orthodontic case

Gosau, Martin; Vogel, Corinna; Moralis, Antonios; Proff, Peter; Kleinheinz, Johannes; Driemel, Oliver
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 06/08/2009 EN
Relevância na Pesquisa
36.25%
A 22-year-old man presented for orthodontic surgery because of mandibular prognathism. Clinical symptoms suggested acromegaly, and diagnosis was verified by an endocrinologist as well as by radiograph. Bilateral mandibular prognathism often represents the first and most striking physical characteristic of acromegaly; usually, it is also the main reason why patients seek help from orthodontists or maxillo-facial surgeons. This case report recapitulates the clinical and histopathological findings in pituitary growth hormone (GH) adenomas and emphasises their importance in surgical orthodontic planning. Mandibular prognatism, macroglossia and abnormal growth of hands and feet represent strong indicators for the diagnosis of acromegaly. This disease and its complications not only affect the entire body but increase mortality if the pituitary gland tumour remains untreated.

Biomechanics and orthodontic treatment protocol in maxillofacial distraction osteogenesis

Maheshwari, Sandhya; Verma, Sanjeev K.; Tariq, Mohd.; Prabhat, K. C.; Kumar, Shailendra
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
26.51%
As in the traditional combined surgical and orthodontic procedures, an Orthodontist can plays vital role in treatment planning and the orthodontic treatment of patient undergoing distraction osteogenesis. This role includes predistraction assessment of the craniofacial skeleton and occlusal function, pre-distraction, and post-distraction orthodontic care. Based on clinical evaluation, dental study models, photographic analysis, cephalometric evaluation, and three-dimensional computed tomographic analysis, the Orthodontist, in collaboration with the Surgeon, plans distraction device placement and the predicted vectors of distraction. Finally, as in other forms of orthognathic surgery, the practice of distraction osteogenesis depends on the cooperation and planning between orthodontist and surgeon as a team. Purpose of this paper is to review biomechanics and orthodontic treatment protocol of distraction osteogenesis in the maxillofacial region.

The Trimeric Model: A New Model of Periodontal Treatment Planning

Azouni, Khalid G; Tarakji, Bassel
Fonte: JCDR Research and Publications (P) Limited Publicador: JCDR Research and Publications (P) Limited
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.4%
Treatment of periodontal disease is a complex and multidisciplinary procedure, requiring periodontal, surgical, restorative, and orthodontic treatment modalities. Several authors attempted to formulate models for periodontal treatment that orders the treatment steps in a logical and easy to remember manner. In this article, we discuss two models of periodontal treatment planning from two of the most well-known textbook in the specialty of periodontics internationally. Then modify them to arrive at a new model of periodontal treatment planning, The Trimeric Model. Adding restorative and orthodontic interrelationships with periodontal treatment allows us to expand this model into the Extended Trimeric Model of periodontal treatment planning. These models will provide a logical framework and a clear order of the treatment of periodontal disease for general practitioners and periodontists alike.

EXAMINATION OF TEMPOROMANDIBULAR DISORDERS IN THE ORTHODONTIC PATIENT: A CLINICAL GUIDE

Conti, Ana Claúdia de Castro Ferreira; Oltramari, Paula Vanessa Pedron; Navarro, Ricardo de Lima; de Almeida, Márcio Rodrigues
Fonte: Faculdade de Odontologia de Bauru da Universidade de São Paulo Publicador: Faculdade de Odontologia de Bauru da Universidade de São Paulo
Tipo: Artigo de Revista Científica
Publicado em /02/2007 EN
Relevância na Pesquisa
26.4%
The possible association between orthodontic treatment and temporomandibular disorders (TMD) is a topic of great interest in the current literature. The true role of orthodontic therapy on the etiology of TMD, however, is still uncertain. From the clinical prospective, a thorough examination of the stomatognathic system is always necessary in order to detect possible TMD signs and symptoms prior to the beginning of the orthodontic therapy. Caution should be exercised when planning, performing and finalizing orthodontics, especially in patients who with history of signs and symptoms of TMD. The clinician must always eliminate patient’s pain and dysfunction before initiating any type of orthodontic mechanics. Muscle incoordination, unstable disc-condyle relationship and bone alterations are usual TMD conditions that can interfere with the presenting occlusal relationship. This article reviews these aspects and presents a detailed clinical guide for the examination of the orthodontic patient, considering aspects related to facial pain and dysfunction.

Orthodontic movement in deciduous teeth

Consolaro, Alberto
Fonte: Dental Press International Publicador: Dental Press International
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
36.32%
Deciduous teeth exfoliate as a result of apoptosis induced by cementoblasts, a process that reveals the mineralized portion of the root while attracting clasts. Root resorption in deciduous teeth is slow due to lack of mediators necessary to speed it up; however, it accelerates and spreads in one single direction whenever a permanent tooth pericoronal follicle, rich in epithelial growth factor (EGF), or other bone resorption mediators come near. The latter are responsible for bone resorption during eruption, and deciduous teeth root resorption and exfoliation. Should deciduous teeth be subjected to orthodontic movement or anchorage, mediators local levels will increase. Thus, one should be fully aware that root resorption in deciduous teeth will speed up and exfoliation will early occur. Treatment planning involving deciduous teeth orthodontic movement and/or anchorage should consider: Are clinical benefits relevant enough as to be worth the risk of undergoing early inconvenient root resorption?

Predictors of fixed orthodontic treatment in 15-year-old adolescents in South Australia

Spencer, A.; Allister, J.; Brennan, D.
Fonte: Munksgaard International Publishers Ltd. Publicador: Munksgaard International Publishers Ltd.
Tipo: Artigo de Revista Científica
Publicado em //1995 EN
Relevância na Pesquisa
36.53%
An understanding of the determinants of the provision of fixed orthodontic treatment would be beneficial in the planning of any system aimed at rationalising supply. The aim of this longitudinal study was to determine those factors which were predictive of the provision of fixed orthodontic treatment in adolescents. Baseline data, at age 13 years, on oral health, the history of orthodontic consultation and interceptive orthodontic care, a dental appearance score (DAI), socio‐demographic characteristics and self and parental perceptions of both dental appearance and need for fixed orthodontic treatment were obtained from 2793 adolescents under the care of the South Australian School Dental Service who had not undergone fixed orthodontic treatment. Data on the orthodontic care provided to these adolescents in the ensuing 2 years were collected. At the end of the 24‐month period 433 adolescents (15.5%) had undergone fixed orthodontic treatment. Significant bivariate associations were found between the provison of fixed orthodontic treatment and the DAI score, sex of the adolescent, familial history of fixed orthodontic treatment, income, private insurance, orthodontic consultation and interceptive orthodontic care before the age of 13 years and self and parental perceptions of both dental appearance and the need for fixed orthodontic treatment. Logistic regression was used to produce a predictive model of fixed orthodontic treatment. The model explained 30.2% of the variance...

Oral diagnosis and treatment planning: Part 6. Preventive and treatment planning for periodontal disease

Corbet, E.; Smales, R.
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
36.22%
A high level of sustained personal plaque control is fundamental for successful treatment outcomes in patients with active periodontal disease and, hence, oral hygiene instructions are the cornerstone of periodontal treatment planning. Other risk factors for periodontal disease also should be identified and modified where possible. Many restorative dental treatments in particular require the establishment of healthy periodontal tissues for their clinical success. Failure by patients to control dental plaque because of inappropriate designs and materials for restorations and prostheses will result in the long-term failure of the restorations and the loss of supporting tissues. Periodontal treatment planning considerations are also very relevant to endodontic, orthodontic and osseointegrated dental implant conditions and proposed therapies.; E. Corbet and R. Smales

Creation of 3D Multi-Body Orthodontic Models by Using Independent Imaging Sensors

Barone, Sandro; Paoli, Alessandro; Razionale, Armando Viviano
Fonte: Molecular Diversity Preservation International (MDPI) Publicador: Molecular Diversity Preservation International (MDPI)
Tipo: Artigo de Revista Científica
Publicado em 05/02/2013 EN
Relevância na Pesquisa
26.46%
In the field of dental health care, plaster models combined with 2D radiographs are widely used in clinical practice for orthodontic diagnoses. However, complex malocclusions can be better analyzed by exploiting 3D digital dental models, which allow virtual simulations and treatment planning processes. In this paper, dental data captured by independent imaging sensors are fused to create multi-body orthodontic models composed of teeth, oral soft tissues and alveolar bone structures. The methodology is based on integrating Cone-Beam Computed Tomography (CBCT) and surface structured light scanning. The optical scanner is used to reconstruct tooth crowns and soft tissues (visible surfaces) through the digitalization of both patients' mouth impressions and plaster casts. These data are also used to guide the segmentation of internal dental tissues by processing CBCT data sets. The 3D individual dental tissues obtained by the optical scanner and the CBCT sensor are fused within multi-body orthodontic models without human supervisions to identify target anatomical structures. The final multi-body models represent valuable virtual platforms to clinical diagnostic and treatment planning.

A Systematic Review of Individual Motivational Factors in Orthodontic Treatment: Facial Attractiveness as the Main Motivational Factor in Orthodontic Treatment

Samsonyanová, Lusine; Broukal, Zdenek
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.4%
Introduction. Physical, mental, and social consequences of malocclusion may impact the quality of life. The aim of this review is to describe main factors motivating parents for orthodontic treatment for their children. Methods. A systematic review study design was used to identify articles analyzing different motivational factors in orthodontic treatment appearing in Medline database, EMBASE, and Google Scholar. The search terms used were teasing, motivating factors, orthodontics, malocclusion, quality of life, smile attractiveness, and perception of malocclusion. Papers selected up to May 2013 included retrospective and prospective longitudinal studies, randomized control trials, cross-sectional studies, reviews, and meta-analyses. Results. 13 articles included in this review identified aesthetics as the main motivational factor in orthodontic treatment. Children mention teeth crowding, large overbite, missing teeth, and largest maxillary anterior irregularities also as motivational factors. Parents want their children to look nice and worry of being accused of neglecting parental duties. Conclusions. Dissatisfaction with one's appearance, dentist recommendation, interest and worries of parents, and the impact of peers who wear braces rank among the main motivation factors of seeking orthodontic treatment. Understanding these factors allows better planning of resources and better assessment of the requirements and priorities of treatment.

Early Treatment Protocol for Skeletal Class III Malocclusion

Oltramari-Navarro,Paula Vanessa Pedron; Almeida,Renato Rodrigues de; Conti,Ana Cláudia de Castro Ferreira; Navarro,Ricardo de Lima; Almeida,Marcio Rodrigues de; Fernandes,Leandra Sant'Anna Ferreira Parron
Fonte: Fundação Odontológica de Ribeirão Preto Publicador: Fundação Odontológica de Ribeirão Preto
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2013 EN
Relevância na Pesquisa
26.54%
Skeletal Class III malocclusion, with its unpredictable and unfavorable nature, has been characterized by a growth pattern with doubtful prognosis regarding orthodontic mechanics, even when performed early. For a long time, Class III malocclusion was regarded as a synonym of mandibular prognathism, regardless of the affected skeletal structures. Mandibular growth, essentially determined by genetic factors, could barely be controlled by early orthodontic interventions. Therefore, the treatment choice was to wait for the patient to grow, and then make an orthodontic intervention associated with an orthognathic surgery. Maxillary involvement in the etiology of Class III malocclusion was conclusive to change orthodontic therapeutics. Maxillary intramembranous growth has a better response to orthopedic treatment, based on growth control and redirection, thus contributing for early intervention success. In several cases, excellent results have been achieved with rapid maxillary expansion and protraction. The aim of this study was to describe and discuss the treatment of a patient with Class III malocclusion, whose treatment planning comprised two phases: interceptive (mechanical orthopedic appliances) and comprehensive (fixed orthodontic appliance). The results of this case showed that Class III malocclusion should be intercepted as early as possible to permit growth redirection...

Optimization of orthodontic treatment using the Centrex System to retract anterior teeth

Meireles,José Kleber Soares de; Ursi,Weber
Fonte: Dental Press International Publicador: Dental Press International
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2012 EN
Relevância na Pesquisa
36.4%
INTRODUCTION: In the end of 90's the adoption of mini-implants as Anchorage allowed a paradigm change influencing even the way of thinking orthodontic mechanics. The overlapping of the specialties of Orthodontics and Implantology started with orthodontic preparations for prosthetic implants insertion, aroused with the use of palatal implants and late with the introduction of mini-implants. The improvement of mini-implants insertion technique with the appearing of self-drilling screws has allowed orthodontists to plan and to place this precious Anchorage piece. Taking into account the versatility of positioning of these screws it was developed a concept that allows the construction of force action lines aiming at optimize the planning and predictability of orthodontic motion. OBJECTIVE: To present some clinical results treatments conduct using Centrex System of orthodontic treatment, approximating the force line action of resistance center of units to be moved. The traced way to its development, previously treated in this journal, will be detailed for better understanding of its functioning.

Orthodontic and pediatric dental treatment approach in patient with multiple dental anomalies

SOUZA,Ricardo Alves; CARVALHO,Alberic Costa; BARRETTO,Larissa Passos; SIMÕES,Francisco Xavier Paranhos Coêlho
Fonte: Faculdade São Leopoldo Mandic Publicador: Faculdade São Leopoldo Mandic
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 EN
Relevância na Pesquisa
36.25%
The purpose of this clinical case report is to discuss the approach to oral rehabilitation of a patient with severe dental alterations such as enamel hypoplasia, change in shape, supernumerary tooth, dental ankylosis, agnesia and crowing in the incisor region. All of these problems compromised not only the esthetical and functional aspects of this patient, but his social relationships as well. Thus integrated planning between Pediatric Dentistry and Orthodontics made it possible to provide the best treatment alternative to recover the patient's stomatognathic system. Esthetic restorations were performed in the anterior tooth region with the use of resin composites, in addition to the use of removable orthodontic appliances, associated with serial extractions and supernumerary tooth removal. There were significant improvements in the esthetic and functional aspects of dentition, in addition to the patient demonstrating good evolution in his psychosocial condition, as he smiled and was more communicative during each follow-up appointment, also according to his mother's reports.

Examination of temporomandibular disorders in the orthodontic patient: a clinical guide

Conti,Ana Claúdia de Castro Ferreira; Oltramari,Paula Vanessa Pedron; Navarro,Ricardo de Lima; Almeida,Márcio Rodrigues de
Fonte: Faculdade De Odontologia De Bauru - USP Publicador: Faculdade De Odontologia De Bauru - USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2007 EN
Relevância na Pesquisa
26.4%
The possible association between orthodontic treatment and temporomandibular disorders (TMD) is a topic of great interest in the current literature. The true role of orthodontic therapy on the etiology of TMD, however, is still uncertain. From the clinical prospective, a thorough examination of the stomatognathic system is always necessary in order to detect possible TMD signs and symptoms prior to the beginning of the orthodontic therapy. Caution should be exercised when planning, performing and finalizing orthodontics, especially in patients who with history of signs and symptoms of TMD. The clinician must always eliminate patient's pain and dysfunction before initiating any type of orthodontic mechanics. Muscle incoordination, unstable disc-condyle relationship and bone alterations are usual TMD conditions that can interfere with the presenting occlusal relationship. This article reviews these aspects and presents a detailed clinical guide for the examination of the orthodontic patient, considering aspects related to facial pain and dysfunction.