ABSTRACT
When the shape, structure, and/or function of one of the parts of the components of the stomatognathic system change, structural and physiological changes also occur to absorb or compensate the consequent loads. Hence, an insightful rehabilitation of this type of patient involves essential procedures, such as: correct orientation of the occlusal plane, determination of the vertical dimension of occlusion, and a stable and healthy maxillomandibular relationship, since the nonobservance of these aspects may result in prosthodontic rehabilitation failure. The objective of the present case study is to report the preoperative planning and prosthodontic rehabilitation of an edentulous patient with severe maxillary atrophy and signs and symptoms of temporomandibular disorders. The patient underwent flat occlusal plane splint therapy to reestablish the condyle-fossa and maxillomandibular relationships and muscle activity, followed by prosthodontic rehabilitation with implant-supported complete dentures. The maxillomandibular relationship was determined by the intraoral tracing technique, with a 24-month follow-up.
Quando os componentes do sistema estomatognático sofrem alterações na forma, estrutura e/ou função de uma das partes, também ocorrem modificações estruturais e fisiológicas para a absorção ou compensação das resultantes criadas. Assim, uma criteriosa reabilitação deste tipo de paciente envolve procedimentos fundamentais, como: correta orientação do plano oclusal, determinação da dimensão vertical de oclusão adequada e a relação maxilo-mandibular estável e saudável, sendo que a não observação destes aspectos pode levar ao fracasso da reabilitação protética. O objetivo do presente caso é relatar o planejamento pré-cirúrgico e a reabilitação protética de um paciente edêntulo com atrofia severa dos maxilares e sinais e sintomas de Desordens Temporomandibulares, que foi submetido à terapia com aparelhos oclusais planos e lisos para restabelecimento das relações côndilo-fossa, maxilo-mandibular e da atividade muscular e, posterior reabilitação oral com próteses totais fixas implantossuportadas,onde a determinação da relação maxilo-mandibular foi realizada pela técnica do registro intraoral, com um período de proservação de 24 meses.
ABSTRACT
A desordem temporomandibular (DTM) é considerada uma síndrome pela diversidade de sinais e sintomas a ela associados. O sucesso do seu tratamento depende dentre outros fatores, do conhecimento profundo dos profissionais de várias áreas médicas e odontológicas, sendo a sua interelação imprescindível. Este trabalho tem como objetivo relatar por meio de um caso clínico, a remissão da sintomatologia dolorosa relacionada a esta patologia e da região cervical e, a alteração da postura da cabeça e pescoço; obtida com o tratamento odontológico reabilitador, recuperação da tonicidade muscular, otimização da posição mandibular e restituição da relação maxilo-mandibular com aparelho oclusal plano, com um período de proservação de 24 meses; em um paciente do gênero masculino, na Clínica do Curso de Especialização em Prótese Dental da Faculdade de Odontologia de Piracicaba - UNICAMP.
The temporomandibular joint dysfunction symdrome (TMJDS) is considered a syndrome due the diversity of signs and symptoms associeted. The success of its treatment depends amongst other factors, on the professional's knowledge regarding its medial and dental aspects. The case report describes the remission of paintful symptomatology on the cervical region and the cervical region and the alteration of the position of the head and neck obtained after prosthetic treatment, recovery of the muscular tonus, optimization of the mandibular position and establishment occlusal vertical dimension. The male patient was treated at the Dental Clinic of the Specialization Course of Prosthetic Dentistry at Piracicaba Dental College-UNICAMP.
Subject(s)
Humans , Male , Neck Pain , Diagnosis, Differential , Temporomandibular Joint DisordersABSTRACT
Quantification and assessment of the evolution of painful symptomology in patients with temporomandibular disorders, during the pre-, trans- and post-therapeutic stages is one of the greatest difficulties found by dental surgeons. Various authors have studied and discussed the use of verbal and non-verbal scales for this purpose. Therefore, this study aimed, by means of a combined experimental scale, to assess the evolution of painful symptomology in patients with completely edentulous maxilla and partly edentulous mandible, with Class I or Class II Kennedy prosthetic spaces, treated with flat occlusal appliances, before, during and after 150 of starting treatment. A selection was made of 16 patients with a mean age of fifty-two years, with signs and symptoms of temporomandibular disorders and diminished vertical occlusion dimension. The patients were submitted to treatment with flat occlusal appliances and fortnightly consultations for a period of 150 days. During these consultations, patients recorded their painful symptomology on a combined experimental pain scale. The results obtained were grouped into tables and submitted to the Friedman Test at a level of 5% probability. These revealed statistically significant differences between the values obtained at each assessment made. According to the methodology used and the results obtained, it was concluded that the therapy used was effective and that the experimental scale was efficient for registering the evolution of the symptoms initially detected.