ABSTRACT
AbstractIntroduction: Sleep Bruxism (SB) is a non-functional rhythmic movement of the mandible with multifactorial aetiology and complex diagnose. It has been the subject of various studies over the past decades and it is considered a result of actions of the Central Nervous System modulated by Autonomous Nervous System. In this work, we test the hypothesis that SB subjects present a typical and defined neurobehavioral pattern that can be distinct from that of non-bruxers subjects and can be measured during wakefulness. Methods Fifteen sleep bruxers (experimental-group EG) and fifteen non-bruxers (control-group CG) took part in the experiments. To verify the presence and severity of SB, clinical examinations, anamneses and questionnaires, including Visual Analogic Scale - faces (VAS-f) and State-Trait Anxiety Inventory (STAI) were applied. To legitimate the diagnoses of SB, a disposable instrument (Bitestrip®) to assess the masseter activity during sleep was employed. All subjects were submitted to a set of experiments for measuring various visual evoked responses during the presentation of visual stimuli (pleasant, unpleasant and neutral images). Events in Visual Evoked Potential (VEP) were used to compare the neural responses of both CG and EG. Results VAS-f showed EG with higher perception of stress than CG (trait: p=0.05), and lower quality of life for (state: p=0.007). STAI I and II showed significant differences of anxiety between CG and EG (p=0.013 and p=0.004, respectively), being EG the highest. The EG Bitestrip scores confirmed that 100% of subjects were sleep bruxers. Significant differences were found between EG and CG for events associated with emotional (pleasant and unpleasant) images in the first 250 ms after stimulation. In general, EG subjects showed higher amplitude and shorter latency of VEP events. Conclusion It is possible to distinguish between SB and non-bruxers subjects during wakefulness, based on differences in amplitude and latency of cortical event related potentials elicited by visual stimulation. SB subjects show greater amplitudes in specific events in frontal areas when non-pleasant images are shown. Latencies tend to be anticipated in SB compared to CG subjects.
ABSTRACT
O bruxismo do sono (BS) é uma manifestação intensa da atividade muscular mastigatória rítmica, caracterizado pelo ranger e apertar dos dentes durante o sono. Sua etiologia ainda não foi definida, o que dificulta o diagnóstico e, consequentemente, o plano de tratamento. As abordagens terapêuticas convencionais são o uso de placas e fármacos, questionadas por serem padronizadas, sem abordagem individualizada e com efeitos colaterais adversos. Conforme revisões da literatura, hipóteses etiológicas apontam a participação expressiva do sistema nervoso central (SNC), especialmente do sistema límbico (SL), sistema nervoso autônomo (SNA) e do reflexo vago-trigeminal, na origem do BS. Um postulado consistente relaciona o BS como um ajuste para o estresse. Estudos demonstram que o BS pode ser um mecanismo fisiológico de autorregulação do sistema autonômico, como resposta para estabelecer alostasia do sistema corporal frente a ocorrências noturnas de taquicardias decorrentes da atividade cerebral, quando ocorrem microdespertares fisiológicos de sentinela, durante o sono. Este estudo apresentou um protocolo com instrumentos para coleta e retroalimentação de sinais biológicos, com a finalidade de identificar alterações fisiológicas que sejam compatíveis ou não com alterações emocionais, que possam desencadear o bruxismo. Esses instrumentos possibilitam a autorregulação dos eventos psicofisiológicos e o desenvolvimento de habilidades pelo próprio indivíduo, permitindo o controle de suas emoções e comportamento. Esse processo terapêutico é conhecido como biofeedback (BF). O treinamento com o BF permite regularizar rítmos internos, propiciando desaceleração das funções neurofisiológicas, atenuando os efeitos desta atividade não funcional...
Sleep bruxism (SB) is a severe manifestation of rhythmic masticatory muscle activity characterized by grinding and clenching of teeth during sleep. Its etiology has not been set yet which complicates the diagnosis and therefore the treatment plan. The more conventional therapeutic approaches are the use of intra oral plates and drugs, that are being questioned for being a standardized approach and not individualized, with adverse side effects. Describe in the literature, etiological hypotheses suggest significant participation of the central nervous system (CNS), especially the limbic system (LS), autonomous nervous system (ANS) and the vague-trigeminal reflex, in the SB source. A consistent postulate relates SB to a mechanism for adjustment to stress. Some studies show that BS may be a physiological mechanism of self-regulation of the autonomic system, as a response to establish body system alostasia when tachycardia occurs during sleep associated to physiological sentinel microarousals. This work is meant to provide information to assist health professionals to assess the behavioral and emotional relation with BS. Furthermore, this study presents a protocol with instruments to collect and feedback data related to biological signals, in order to identify physiological changes which are compatible or not with emotional changes that may trigger bruxism. These instruments, allow self-regulation of psychophysiological events by the individual and the development of habilities that enables to control of emotions and behavior. This therapeutic process is known as Biofeedback (BF). Training with the BF allows to regularize the heart and respiratory rate, providing deceleration of neurophysiological functions, mitigating the effects of this nonfunctional activity...
Subject(s)
Humans , Central Nervous System , Limbic System , Neurofeedback , Sleep BruxismABSTRACT
A Síndrome Paquioníquia Congênita é uma doença displásica, autossômica dominante, rara, caracterizada por uma desordem na queratinização. É classificada em dois subtipos: 1 ou Síndrome de Jadassohn-Lewandowsky e 2 ou Síndrome de Jackson-Lawer. A principal característica é a distrofia hipertrófica das unhas associada à hiperhidrose palmoplantar e queratose folicular em áreas de maior atrito. Descreve-se neste artigo, um caso clínico de uma criança de quatro anos, do sexo masculino, leucoderma, que apresentou-se para tratamento na Clínica de Odontologia Preventiva e Social da Universidade Federal de Uberlândia para tratamento. Observou-se ao exame, cistos epidermóides na face, espessamento anormal das unhas das mãos e dos pés, queratose folicular nos joelhos e cotovelos e lesões hiperqueratóticas circundadas por halos inflamatórios na planta dos pés. O exame intrabucal revelou ausência de alguns dentes decíduos na arcada inferior e, após tomadas radiográficas, verificou-se a presença dos germes de todos os dentes permanentes e ausência de dentes decíduos inclusos. Os sinais e sintomas presentes no quadro clínico permitiram classificar a síndrome apresentada pelo paciente em Paquioníquia Congênita do tipo 2. Após a instituição de medidas educativas, preventivas e atenção curativa aplicou-se, para tratamento das disfunções oclusais, os princípios da Reabilitação Neuro-Oclusal e Ortopedia Funcional dos Maxilares visando conquistar espaço funcional e perímetro ósseo, promover a liberdade mandibular e a mastigação bilateral alternada, garantir espaço funcional para língua e remodelação do plano oclusal, por meio da instalação seqüencial de um aparelho simplificado, de um aparelho funcional, de um Planas Simples e de um Planas Composto.
The Pachyonychia Congenita Syndrome is a displasic, dominant autossomic and rare illness, characterized by a clutter in the queratinization. It is classified in two subtypes: 1 or Jadassohn-Lewandowsky Syndrome and 2 or Jackson-Lawer Syndrome. The main characteristic is the hypertrofic dystrophy of the nails associated to the palmoplantar hyperhidrosis and follicular keratosis in areas of bigger attrition. This article describes a clinical case of a four-year-old child, who is male and leucoderma and went through a treatment in the Clinic of Preventive and Social Dentistry of the Federal University of Uberlândia. During the examination process, it could be observed the presence of epidermoid cysts in the face, abnormal thicking of the nails of both hands and feet, follicular keratosis in the knees and elbows and hyperkeratotic injuries surrounded by inflammatory halos in the plant of the feet. The intrabucal examination revealed absence of some deciduous teeth in the inferior jaw and, after X-ray procedures, it was verified the presence of the embryos of all the permanent teeth and absence of enclosed deciduous teeth. The signals and symptoms present in the clinical case allowed the classification of the patient's syndrome as Pachyonychia Congenita type 2. After the application of educative and preventive measures and curative attention, it was applied, for treatment of the occlusal dysfuction, the principles of the Neuro-Oclusion Rehabilitation and Functional Orthopaedic of the Jaws aiming at conquering functional space and osseous perimeter, promoting mandibular freedom and the alternating bilateral chew, guaranteeing functional space for the tongue and the remodelation of the occlusal plain, by means of the sequential installation of a simplified device, of a functional device, of a Simple Plain one and of a Compound Plain.
ABSTRACT
A má-oclusão dentária aliada a outras disfunções que acometem crianças em sua fase de crescimento e desenvolvimento provocam repercussões orgânicas. Crianças desde a mais tenra idade podem apresentar essas disfunções e ações educativas, preventivas e interceptativas podem reequilibrar seu sistema estomatognático, aproveitando sua alta capacidade fisiológica de remodelaçãoóssea nesta fase. O objetivo deste trabalho foi avaliar a prevalência de alterações oclusofuncionais em crianças entre dois a nove anos, por meio de método de estudo retrospectivo, pesquisando 16 1 prontuários da Clínica de Odontologia Preventiva e Social da Universidade Federal de Uberlândia, e divulgar protocolo de diagnóstico com critérios já existentes, com conduta acessível para ser utilizado em Saúde Pública e em clínicas de formação acadêmica. Como resultado, 95% das crianças apresentaram algum tipo de oclusopatia, sendo que 49,7% possuíam atrofia grau 3. O estudo permitiu concluir que se faz necessário o uso de métodos de diagnóstico e terapêuticas preventivas menos invasivas, para possibilitar um maior acesso as informações pelos profissionais da saúde e que as crianças possam crescer e se desenvolver com equilíbrio oclusal, facial e orgânico.
The dental malocclusions associated with other dysfunctions which affect children in their growth and development phase can provoke organic repercussions. Children since early ages can present these dysfunctions. Educational, preventive and interceptive actions can 1-ebalance the stomatognathic system, taking advantage of the high physiologic bone capacity of remodeling at this phase. The aim of this study was to evaluate the prevalence of malocclusions in children aged two to nine years. by means of a retrospective study, researching 161 record charts from children who attended the Clinical Program of the Preventive and Social Dental Area of the Federal University of Uberlândia to propagate a diagnostic protocol witlz criteria that already exists, which also gives simplified conduct and treatment plan to be used in Public Health Dental Programs and in graduation academic clinics. The study results showed that95% of children presented a kind of malocclusion, with 49.7% with atrophy 3rd degree. The study allowed to conclude that the use of diagnostic methods and preventive therapeutics less invasive are necessary, permitting an easier access of information by dental professionals, so children can grow and develop in occlusal, facial and organic balance.