ABSTRACT
Introdução: os protocolos de avaliação das assimetrias faciais em pacientes com disfunção temporomandibular são, em grande parte, realizados por meio da avaliação cefalométrica, que possibilita a visualização, mensuração e análise apenas do tecido duro. A análise facial pela biofotogrametria computadorizada tem sido utilizada como meio auxiliar diagnóstico, não expondo o indivíduo a radiação nociva, promovendo avaliação das estruturas craniofaciais, musculares e a disposição do tecido adiposo. Objetivo: avaliar a assimetria facial em pacientes com disfunção temporomandibular por meio da biofotogrametria computadorizada. Material e métodos: a amostra consistiu de 36 pacientes com disfunção temporomandibular (31 mulheres e 05 homens), e 11 indivíduos controles (06 mulheres e 05 homens). Para a seleção e classificação da amostra foi utilizado o Índice Clínico de Fonseca (1994), seguido do exame físico, odontológico e fisioterapêutico. Resultados: foram encontradas diferenças significativas (p=0,041) quando comparados o ângulo referente à boca, entre os lados direito e esquerdo, nos pacientes com disfunção temporomandibular. Conclusão: alterações na simetria facial podem estar presentes em pacientes com disfunção temporomandibular, e que a mesma se encontra localizada no terço inferior da face, principalmente na região da maxila, mandíbula e mento.
Introduction: the protocols of evaluation of the asymmetry facial in patients with temporomandibular disorders are, in general, realized by using cephalometric analysis, which provide the visualization, measurement and analysis of the hard tissue only. The facial analysis by computerized biophotogrammetry has been used as an auxiliary manner of diagnostic, not exposing the patient to harmful radiation, promoting the evaluation of craniofacial and muscular structures and fat layer disposition. Aim: evaluate the facial asymmetry in patients with temporomandibular disorders by computerized biophotogrammetry. Material and methods: the sample was 36 patients (31 women and 05 men) and 11 controls (06 women and 05 men) with temporomandibular disorders. For selection and classification of the sample, the Clinical Index of Fonseca (1994) was used, according to physical, dentistry and physiotherapic examination. Results: significant differences (p=0,041) were found between the mouth angle and the right and left sides in patients with temporomandibular disorders. Conclusion: alteration in facial symmetry can be observed in patients with temporomandibular disorders and it is located in lower portion of face, mainly in maxillary, mandibular and menton regions.
Subject(s)
Humans , Male , Female , Adult , Facial Asymmetry/physiopathology , Photogrammetry/methods , Temporomandibular Joint Disorders/physiopathology , Cephalometry/methods , Image Processing, Computer-AssistedABSTRACT
OBJECTIVES: Alterations in the temporomandibular complex can reflect in adaptations of the individual's entire muscular system, intervening with the head position and scapular waist, developing postural alterations and modifying all corporal biomechanics. The aim of this study was to evaluate the head position (HP) and head postural alterations before and after installation of occlusal splints. MATERIAL AND METHODS: Twenty patients with temporomandibular disorders (TMD) underwent clinical and postural examination, before the installation of an occlusal splint, and after 1 week and 1 month of use. RESULTS: There were statistically differences for HP, between the initial values and after 1 week of use of the occlusal device (p= 0.048) and also between 1 week and 1 month of evaluation (p= 0.001). Decrease of the painful symptomatology and maintenance of the rectification were also observed. CONCLUSIONS: The individual's postural position can suffer biomechanical alterations due to stomatognathic alterations, causing clinically visible changes in dysfunctional individuals and affecting the performance of the involved structures.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Head/anatomy & histology , Occlusal Splints , Temporomandibular Joint Disorders/therapy , Adaptation, Physiological , Centric Relation , Dental Occlusion, Centric , Follow-Up Studies , Facial Pain/therapy , Posture/physiology , Sleep Bruxism/therapy , Treatment Outcome , Young AdultABSTRACT
Alterações na coluna cervical podem interferir no sistema muscular do indivíduo, levando inicialmente a uma compensação na cintura escapular devido à sua ligação óssea e neuromuscular. Apartir daí, as cadeias musculares atuam por uma sucessão de tensões associadas, onde a posição do corpo pode ser capaz de influenciara postura da cabeça e posição mandibular. O propósito deste trabalho foi verificar a presença e o grau de severidade da disfunção temporomandibular (DTM) em pacientes portadores de cervicalgia. Para isso, 32 pacientes da Clínica Escola do Centro Universitário do Triângulo (UNITRI), já diagnosticados com cervicalgia, foram submetidos a uma nova anamnese, exame clínico e preenchimentodos Índices Clínico de Helkimo (ICH) e Protocolo Anamnésicode Fonseca (PAF). Os resultados demonstraram que, em ambosos índices utilizados, 100 por cento dos pacientes apresentavam DTM,dos quais, segundo ICH, 22 por cento com DTM moderada (M) e 78 por centosevera (S). Já para PAF, encontrou-se 21,87 por cento leve (L), 40,62 M e37 por cento S. Tais dados foram submetidos ao teste de Pearson (p < 0,05),observando valores estatisticamente significantes (p = 0,001) entreas correlações efetuadas. Conclui-se que existe uma relação clínica importante entre cervicalgia e DTM, independente do índiceaplicado, e a inspeção do pescoço e avaliação da coluna cervical sãorecomendados em pacientes com DTM.
Alterations in cervical column can interfere in individual muscular system, leading initially to scapular waist compensation due to its osseous and neuromuscular connection. Then, muscular chains act by an associated sequences of tension, and the body position can influence the head posture and mandibular position.The purpose of this work was to verify the presence and severity of temporomandibular disorders (TMD) in patients with cervical pain. 32 patients of Triangle University Center School Clinic(UNITRI) diagnosed as having cervical pain were submitted to a new anamnesis and clinical exam, and filling out Helkimo ClinicalIndex (HCI) and Fonsecas Anamnesis Protocol (FAP). The results showed that, in both indexes used, 100 percent with cervical pain hadTMD. According to HCI, 22 percent had moderate TMD (M) and 78 percent had severe one (S) and as per FAP 21.87 percent had light (L), 40.62 percent(M) and 37 percent (S). Data were submitted to Pearson test (p < 0.05), observing statistically signifi cant values (p = 0.001) between effected correlations. It was concluded that there was a clinical relation between cervical pain and TMD independently on the appliedindex, and neck examination and cervical column evaluation are recommended on TMD patients.