RESUMEN
Introducción: Los dientes anteriores tienen una función predominante en el sistema estomatognático, esencial para la estética, la fonación y la masticación. Objetivo: Caracterizar a los adultos con guía anterior de la oclusión dentaria disfuncional según variables clínicas y epidemiológicas. Métodos: Se realizó un estudio descriptivo y transversal, desde octubre de 2021 hasta abril de 2022, en la Clínica Estomatológica Docente 3 de Octubre de Las Tunas. El universo estuvo conformado por 825 historias clínicas que contenían el diagnóstico de pacientes con bruxismo, oclusión traumática y trastornos temporomandibulares, quienes presentaban disfunción de la guía anterior de la oclusión dentaria. Mediante el muestreo no probabilístico intencional, fue seleccionada una muestra de 615 con fórmula dentaria íntegra o desdentamiento parcial de clase III de Kennedy y atención estomatológica concluida o inactivación de los procesos de caries e inflamatorios agudos. Resultados: Primaron el sexo femenino (54,8 %) y las edades de 40-49 años (33,5 %). El bruxismo prevaleció como diagnóstico clínico (41,9 %) con predominio del correspondiente al sueño (39,1 %), el secundario (51,2 %), el probable (59,7 %) y el moderado (69,4 %); entre sus clasificaciones más relevantes se destacó el sistema estomatognático disfuncional (84,4 %). Las manifestaciones clínicas dentarias predominantes fueron las facetas de desgaste (87,5 %). Conclusiones: La caracterización de los pacientes con guía anterior de la oclusión dentaria disfuncional permite establecer una panorámica actualizada de esta problemática de salud para un mejor seguimiento y tratamiento a dichos pacientes.
Introduction: Anterior teeth have a predominant function in the stomatognatic system, essential for the aesthetics, phonation and mastication. Objective: To characterize adults with anterior guide of dysfunctional dental occlusion according to clinical and epidemiological variables. Methods: A descriptive and cross-sectional study, was carried out from October, 2021 to April, 2022, in the 3 de Octubre Teaching Stomatological Clinic from Las Tunas. The universe was formed by 825 medical records that contained the diagnosis of patients with bruxism, traumatic occlusion and temporomandibular disorders who presented anterior guide of the dysfunctional dental occlusion. By means of the intentional non probabilistic sampling, a sample of 615 with entire dental formula or class III partial toothlessness of Kennedy and concluded stomatologic care or inactivation of the cavity and acute inflammatory processes was selected. Results: There was a prevalence of the female sex (54.8%) and the 40-49 age group (33.5%). Bruxism prevailed as clinical diagnosis (41.9%) with prevalence of the corresponding to sleep (39.1%), secondary (51.2%), probable (59.7%) and moderate (69.4%); among the most outstanding classifications was the dysfunctional stomatognatic system (84.4%). The predominant dental clinical manifestations were the wear facets (87.5%). Conclusions: The characterization of patients with anterior guide of the dysfunctional dental occlusion allows to establish an up-to-date panoramic of this health problem, for a better follow-up and treatment to these patients.
RESUMEN
Objetivo: O presente trabalho busca avaliar radiograficamente a possível inter-relação dos guias condiliana e anterior em pacientes com oclusão fisiológica. Material e métodos: Para tal, foram selecionadas telerradiografias laterais de 74 pacientes que foram divididos em dois grupos distintos, denominados grupo Um e grupo Dois. O grupo Um, constituído de 56 pacientes, apresentou trespasse horizontal igual a zero e oclusão fisiológica. Já o grupo Dois, composto de 18 participantes, apresentou trespasse horizontal diferente de zero. Foi realizada uma análise cefalométrica avaliada por meio da relação entre o plano de Frankfurt e a parede anterior da superfície articular do osso temporal e da face palatina dos incisivos superiores. Utilizou-se um transferidor de plástico, com variação de 0 a 180o, adaptado com um ponteiro fixado no seu centro e móvel, por meio do qual obteve-se as mensurações pela movimentação do ponteiro, cujos os dados foram anotados em uma ficha. Resultado: Do grupo Um, 52 (92,86%) apresentaram coincidência entre o guia condiliana guia anterior, e somente 4 pacientes (7,14%) não tiveram os guias coincidentes. Já o grupo Dois 17 pacientes (94,44%) apresentou guia anterior diferente da guia condiliana, e um paciente (5,56%) apresentou coincidência entre os guias. Conclusão: Com base nos resultados obtidos pode-se concluir que os guias condiliana e anterior apresentaram uma interrelação direta, que constituem parâmetros para a reconstrução e/ou posicionamento da guia anterior em tratamentos reabilitadores.
Objective: This study aims to evaluate radiographically the possible inter-relation of the condylar and previous guidances in patients with physiological occlusion. Methods: For this purpose, lateral cephalometric radiographs were selected from 74 patients who were divided into two distinct groups, called group one and group two. The group one consisting of 56 patients, showed overjet equal to zero and physiological occlusion. While group two, made up of 18 patients presented different overjet zero. The cephalometric analysis was evaluated through the relationship between the Frankfurt plane and the front surface wall joint of the temporal bone and the palatal face of the upper incisors was performed. It were used a plastic measuring protractor, ranging from 0 to 180o, fitted with a fixed pointer at its center and mobile, through which were obtained measurements by moving the pointer, whose data were recorded on a card. Results: From a group, 52 (92.86%) had coincidence between the condylar guidance and the previous guidance, and only 4 patients (7.14%) did not have the matching guidances. Already the group two 17 patients (94.44%) had different previous guide condylar guide, and one patient (5.56%) had coincidence between the guides. Conclusion: Based on the results it can be concluded that the condylar guidances and earlier had a direct inter-relation, which are parameters for reconstruction and / or positioning of the previous guidance rehabilitation treatments.
RESUMEN
El uso de la telerradiografía lateral ha tomado gran importancia en Rehabilitación Oral ayudando al clínico en el diagnóstico y planificación del tratamiento a través de la identificación del biotipo facial del paciente, la inclinación del plano oclusal, la relación anteroposterior entre maxilar y mandíbula, inclinación de los ejes dentarios y como ayuda complementaria en casos de alteraciones de la Dimensión Vertical. El problema surge cuando estamos frente a pacientes desdentados que han perdido puntos de referencia cefalométricos necesarios para el análisis. El presente trabajo muestra una técnica para poder visualizar radiográficamente el plano oclusal y la guía anterior utilizando láminas de plomo.
The use of lateral cephalometric radiographs has become very important in Oral Rehabilitation, helping the clinician in the diagnosis and treatment planning through the identification of facial biotype, occlusal plane inclination, sagittal relationship between maxilla and mandible, inclination of the dental axes, and a valuable help in assessing alterations of the vertical dimension of occlusion. The problem arises when treating partially edentulous patients who have lost their cephalometric reference points necessary for the analysis. This paper shows a technique to visualize the occlusal plane and anterior guidance in partially edentulous patients who have lost these anatomical landmarks in a lateral cephalometric radiograph, using lead sheets.