Discrepancia anteroposterior en registro de relación céntrica con apoyo central intraoral en cubetas rodetes acrílicas (BOPAYACU) e inducción manual en adultos mayores desdentados totales / Anteroposterior discrepancy in centric relation record with intraoral central support in acylic impaction cups (BOPAYACU) and manual induction in edentulous older adults

Objetivo: Comparar la discrepancia anteroposterior medida a nivel de la platina incisiva de 2 métodos de registro intermaxilar en la misma sesión que la im-presión definitiva en adultos mayores desdentados totales. Materiales y métodos. Se incluyeron en el es-tudio 20 pacientes (n=20) con edad promedio de 70 años. En cada uno de ellos se obtuvieron registros intermaxilares con cubetas rodete de acrílico: uno con inducción manual (IM) y otro autoinducido con el sistema de cubeta rodete de acrílico y apoyo central único utilizando una superficie palatina de registro curva (BYC). Los modelos fueron montados en un ar-ticulador Whip Mix modelo 2240 al que se le adicio-nó un dispositivo de papel milimetrado, Orthodent, a nivel de la platina incisiva, para registrar las dife-rencias existentes entre las posiciones obtenidas. El análisis estadístico se llevó a cabo mediante el cálcu-lo de intervalos de confianza (95%) para las diferen-cias medias y prueba de t de student para datos apa-reados (nivel de significancia: α<0,05). Resultados. En el plano mesiodistal a nivel de la platina incisiva se encontró diferencia estadísticamente significativa entre las dos variables de registro (p<0,001). A este nivel el BYC proporcionó registros más retrusivos que IM. Media aritmética (desviaciones estándar) en milímetros: 3,82 (2,1). Conclusión. El sistema de re-gistro con cubetas rodete acrílicas y BYC incorpora-do a las mismas proporciona un registro intermaxi-lar más retrusivo que IM en adultos mayores des-dentados totales cuando se realizan dichos registros en la misma sesión que la impresión definitiva (AU)

Objective: To compare the anteroposterior discre-pancy measured at the level of the incisal plate of 2 methods of intermaxillary registration in the same session as the definitive impression in fully edentu-lous older adults. Materials and methods. Twenty pa-tients (n=20) with an average age of 70 years were included in the study. On each of them, intermaxillary recordings were obtained with acrylic rims trays: one with manual induction (MI) and the other with a self-induced system and single central support using a curved recording palatal surface (BYC). The models were mounted in a Whip Mix model 2240 articula-tor to which an Orthodent graph paper device was added, at the level of the incisal plate, to record the di-fferences between the positions obtained. Statistical analysis was carried out by calculating confidence intervals (95%) for mean differences and T-student for paired data (significance level: α<0.05). Results. On the mesiodistal plane at the level of the incisal plate, a statistically significant difference was found between the two recording variables (p<0.001). At this level the BYC provided more retrusive recordings than MI. Arithmetic mean (standard deviations) in mi-llimeters: 3.82 (2.1). Conclusions. The registration system with acrylic rim trays and BYC incorporated into them provides a more retrusive intermaxillary registration than MI in fully edentulous older adults when such registrations are made in the same ses-sion as the final impression.(AU)

Centric relation registration with intraoral central bearing on curved vs. flat plates with rim trays in edentulous patients / Registro de relación céntrica con apoyo central intraoral en platinas curvas vs. rectas con cubetas rodete en edéntulos

ABSTRACT The aim of this study was to compare jaw relation record in the completely edentulous patient using acrylic rim trays with curved or flat registration plates or using the manual guidance technique. The study included 17 patients - 11 female and 6 male, average age 70 years. Three jaw relation records were taken during one session, in the same vertical dimension, using acrylic rim trays: (1) with manual guidance (IM), (2) with self-guided recording system with acrylic rim tray and central support using a curved plate (BYC) and (3) with self-guided recording system with acrylic rim tray and central support using a flat plate (BYR). The models were mounted on a Whip Mix 2240 articulator to which a condyle position device (Orthodent) was added to register, at the level of the condyle box and incisal table, the differences among the positions recorded with the different setups (IM, BYC and BYR). The distances were measured on millimeter paper provided by the recording system manufacturer. For statistical analysis, confidence intervals (95%) were calculated for the mean differences and Student's t-test for paired data (significance level: alpha<0.05). On both the mesiodistal plane and the vertical plane at the level of each condyle box and the incisal table, there were statistically significant differences among the three systems (p<0.001). At the level of incisal table, BYC and BYR provided more retrusive records than IM [arithmetic means (standard deviations) in millimeters: 3.82 (2.10) and 4.53 (2.18), respectively). The records obtained with BYR were significantly more retrusive with BYC [arithmetic mean (standard deviation) in millimeters: 1.41 (1.00)]. We reject the null hypothesis that proposes that all three registration systems described are clinically equivalent for establishing a jaw relation record in completely edentulous patients.

RESUMEN El objetivo de este estudio fue comparar el registro de la posición intermaxilar en el paciente desdentado total obtenido con el uso de cubetas rodete de acrílico y platinas de registro curva o recta y con la técnica de inducción manual. Se incluyeron en el estudio 17 pacientes, 11 mujeres y 6 varones con edad promedio de 70 años. En cada uno de ellos se obtuvieron en la misma sesión y en la misma dimensión vertical tres registros intermaxilares con cubetas rodete de acrílico: uno con inducción manual (IM), otro autoinducido con el sistema de cubeta rodete de acrílico y apoyo central único utilizando una superficie palatina de registro curva (BYC) y un tercero con este mismo sistema pero con la superficie palatina recta (BYR). Los modelos correspondientes fueron montados en un articula-dor Whip Mix modelo 2240 al que se le adicionó un dispositivo de posición condilar (Orthodent) para registrar, a nivel de la caja condílea y la platina incisiva, las diferencias existentes entre las posiciones obtenidas con cada una de las variantes de las platinas en las cubetas rodete acrílicas y la posición registrada con inducción manual. Las distancias fueron medidas sobre papel milimetrado provisto por el fabricante del sistema de registro. El análisis estadístico se llevó a cabo mediante el cálculo de intervalos de confianza (95%) para las diferencias medias y prueba de t de student para datos apareados (nivel de significancia: alfa<0,05). Tanto en el plano mesiodistal como en el vertical a nivel de cada caja condilea como en la platina incisiva, se encontró diferencia estadísticamente significativa entre las tres variables de registro (p<0,001). A nivel de las platinas incisivas tanto BYC como BYR proporcionaron registros más retrusivos que IM [medias aritméticas (desviaciones estándar) en milímetros: 3,82 (2,1°) y 4,53 (2,18), respectivamente). Los obtenidos con BYR fueron significativamente más retrusivos que en el grupo BYC [media aritmética (desviación estándar) en milímetros: 1,41 (1,00)]. Rechazamos la hipótesis nula que propone que los tres sistemas de registro expuestos son clínicamente equivalentes para establecer una posición de registro intermaxilar en desdentados totales.

Comparação clínica entre diferentes técnicas para registro de relação central em indivíduos edêntulos / Clinical comparison between different techniques for //registering a central relation in edentulous individuals

As reabilitações protéticas baseadas em técnicas adequadas podem promover um melhor desempenho, conforto e longevidade à prótese, com o intuito de restabelecer o equilíbrio muscular e articular com o seu uso. Uma das etapas da reabilitação é o registro da relação central (RC) do indivíduo. Para que este registro seja feito, a literatura descreve diversas técnicas aplicáveis, partindo de métodos fisiológicos, guiados ou gráficos. Infelizmente, não existe um consenso se diferentes técnicas para registro da RC oferecem resultados semelhantes. Diante disto, o objetivo deste estudo foi comparar a semelhança entre diferentes técnicas para registro da RC em indivíduos edêntulos, levando em consideração a posição condilar em relação à cavidade glenóide no sentido anteroposterior e o tempo para realização de cada registro, adotando-se uma técnica inicial como controle (técnica do arco gótico extra oral) e uma posição fixada em articulador como referência. Foram incluídos no estudo 12 voluntários (2 homens e 10 mulheres, idade média de 68,58 anos) desdentados bimaxilares usuários de prótese total insatisfatória, considerando critérios de inclusão específicos. Diferentes técnicas foram analisadas pelo posicionamento em um articulador personalizado para mensurar movimentos no sentido anteroposterior, sendo elas: arco gótico extra oral (AGEO), deglutição (D), manipulação frontal associada ao levantamento da língua (MFLL) e arco gótico intra oral (AGIO). Todos os registros foram realizados pelo mesmo operador no mesmo período do dia, com intervalo de 30 minutos entre cada registro e o tempo para realização de cada técnica foi mensurado. Os dados relacionados à confiabilidade das técnicas e o tempo de realização das mesmas foram submetidos à Análise de Variância um fator, seguido do teste de Tukey. Todas as análises foram realizadas com significância de 5%. Considerando as medidas da posição condilar do lado direito, houve diferença estatística (P < 0,05) no registro da técnica D em relação ao registro de AGEO, onde a mandíbula posicionou-se mais anteriorizada. No lado esquerdo, não houve diferença estatística entre os grupos. O registro das técnicas MFLL e AGIO não mostrou diferença estatisticamente significativa em comparação à técnica AGEO em relação a posição de registro da RC em ambos os lados. Em relação ao tempo para realizar cada registro, as técnicas AGEO e AGIO apresentaram diferenças significativas em relação as técnicas D e MFLL, despendendo maior tempo. Pode-se concluir que a técnica D apresentou maior diferença quando comparada às técnicas MFLL e AGIO sobre a posição condilar, onde esta posicionou-se retruída. Os registros de AGEO, MFLL e AGIO não apresentaram diferenças significativas, bem como entre as técnicas D e AGEO. Considerando-se semelhança posição condilar em cada técnica registrada e tempo para execução, as técnicas MFLL mostrou-se adequada, por promover menor tempo clínico ao paciente durante o registro e ser estatisticamente semelhante ao controle. A técnica D também mostrou-se interessante, apresentando-se semelhante ao controle, com erro padrão equilibrado e fisiologicamente confortável ao paciente. Mais estudos precisam ser realizados sobre o comportamento das estruturas do sistema estomatognático quanto quando ao registro de posição condilar protruido ou retruido a longo prazo(AU)

Prosthetic rehabilitation based on appropriate techniques can promote better performance, comfort and longevity to the prosthesis, in order to restore muscle and joint balance with its use. One of the stages of rehabilitation is the registration of the individual's central relationship (CR). For this record to be made, the literature describes several applicable techniques, starting from physiological, guided or graphic methods. Unfortunately, there is no consensus on whether different techniques for recording CR offer similar results. In view of this, the aim of this study was to compare the similarity between different techniques for recording CR in edentulous individuals, taking into account the condylar position in relation to the glenoid cavity in the anteroposterior direction and the time to perform each record, adopting a technique initial as a control (extra oral gothic arch technique) and a position fixed on the articulator as a reference. Twelve volunteers (2 men and 10 women, mean age 68.58 years) were included in the study, toothless bimaxillary users of unsatisfactory complete dentures, considering specific inclusion criteria. Different techniques were analyzed by positioning in a personalized articulator to measure movements in the anteroposterior direction, namely: extra oral gothic arch (AGEO), swallowing (D), frontal manipulation associated with tongue lifting (MFLL) and intra oral gothic arch (AGIO ). All records were made by the same operator at the same time of the day, with an interval of 30 minutes between each record and the time to perform each technique was measured. The data related to the reliability of the techniques and the time they were performed were submitted to one-way analysis of variance, followed by the Tukey test. All analyzes were performed with a 5% significance level. Considering the measurements of the condylar position on the right side, there was a statistical difference (P <0.05) in the registration of technique D in relation to the registration of AGEO, where the mandible was positioned more anteriorly. On the left side, there was no statistical difference between the groups. The registration of the MFLL and AGIO techniques showed no statistically significant difference compared to the AGEO technique in relation to the CR registration position on both sides. Regarding the time to perform each record, the AGEO and AGIO techniques showed significant differences in relation to the D and MFLL techniques, spending more time. It can be concluded that technique D presented a greater difference when compared to the techniques MFLL and AGIO on the condylar position, where it was retracted. The records of AGEO, MFLL and AGIO showed no significant differences, as well as between the techniques D and AGEO. Considering the similarity of the condylar position in each registered technique and time for execution, the MFLL techniques were shown to be adequate, as they promote less clinical time for the patient during registration and are statistically similar to the control. Technique D was also interesting, being similar to the control, with balanced standard error and physiologically comfortable to the patient. More studies need to be carried out on the behavior of the structures of the stomatognathic system regarding the recording of protruded or retracted condylar position at long term(AU)

Research and development of digital design and fabrication of complete denture / 中华口腔医学杂志

Removable complete denture are still the primary prosthetic solution for edentulous patients. Functional pressure impression obtaining, jaw relation recording, personalized balance occlusion and highly precise fabrication of denture are difficult. The digital restoration technique represented by intraoral three-dimensional scanning and three-dimensional (3D) printing compensates for the shortages of the manual techniques, but there are still many limitations in the application of complete dentures. At present, a few computer aided design and computer aided manufacture (CAD/CAM) complete denture systems have been developed both domestically and abroad, and these system are mainly focused on the digital design and manufacture of denture, and are seldom used for the recording of impression and jaw relation. This review is based on the main clinical procedures of the traditional complete denture restoration, elaborating the research and application status of digital technique in each steps, in order to provide reference for clinical application.

A preliminary study on the three-dimensional trajectory of condyle / 中华口腔医学杂志

Objective@#To calculate the three-dimensional trajectory and motion morphology of condyle by combining the trajectory of the mandible movement and the three-dimensional model of the mandible.@*Methods@#Cone beam CT (CBCT) scanning was performed on the volunteer. The mandible three-dimensional model was built with image data transferred to the graphical user interface of the computer workstation. The novel virtual articulator PN300 recorded the three-dimensional trajectory of mandible. All these data were transferred to software system of computer workstation calculating the three-dimensional trajectory of condyle. The motion morphology of condyle was simulated by merging function surface at each point.@*Results@#When the mandible moved in an opening process, the recorded data was calculated and it was shown that: the condylar functional surface moved moved forward and downward inward in advance, and in the process of continuously increasing the opening degree, the function faced the front upper inner side. The straight-line distance between the position and the final position was 8.34 mm. During the forward movement of the mandible, the coracoid process slided forward downward and inward with a sliding distance of 8.64 mm. During lateral movement, the range of the working side condyle function surface motion was small, only slight rotation, the maximum range of motion was 1.97 mm; in the process of row side movement, the non-working condyle function surface had a larger movement range than the working side, the movement direction was the front lower inner side, and the movement distance was 7.65 mm.@*Conclusions@#The novel virtual articulator PN300 and digital technology can achieve the accurate measurement of three-dimensional trajectory of the condyle, and furthermore simulate the motion morphology of the condyle.

Levantamento de marcas de mordidas humanas em vítimas de violência periciadas no Instituto Médico Legal de Feira de Santana-BA, entre 2007 e 2014 / Bites brand survey on human violence victims examined in the Legal Medical Institute of Feira de Santana-BA, between 2007 and 2014

Objetivo: Descrever a prevalência de marcas de mordidas em vítimas de violência periciadas no Instituto Médico Legal de Feira de Santana no período de 2007 até 2014, levando em consideração a análise do perfil sociodemográfico das vítimas, a relação destas com os supostos agressores, bem como fatores inerentes às particularidades da violência, características da mordida e região do corpo atingida. Métodos: Estudo de casuística, de caráter exploratório com base em dados secundários, produzidos a partir das perícias realizadas por peritos odontolegistas registradas em laudos arquivados no Instituto Médico Legal (IML), no período de 2007 à 2014. Resultados: Os resultados apontam um maior índice de vítimas do sexo feminino (78,1%), entre 20-60 anos (53,1%), faiodermas, estudantes (28,6%) e naturais de Feira de Santana (56,2%). A região de cabeça e pescoço (29,2%) e membros superiores (29,2%) tiveram destaque nas agressões e a maioria das vítimas apresentaram mais de uma lesão, apresentando-se clinicamente como escoriações (34,2%) e equimoses (31,6%). Em nenhum dos casos houve tentativa de identificação do agressor pela mordida. Conclusão: Desse modo, conclui-se que a maior parte das vítimas de violência física que apresentaram lesão provocada por mordida humana era do sexo feminino, faioderma e adultos. Os supostos agressores na maioria dos casos tem ou tiverem um vínculo conjugal com a vítima. As marcas de mordidas foram predominantes na região de cabeça e pescoço e membros superiores. Como manifestação clínica destacou-se as escoriações e equimoses.(AU)

Aim: To describe the prevalence of bitemarks in victims of physical violence logged in forensics reports at the Legal Medical Institute (IML) of Feria de Santana, BA, Brazil, between 2007 and 2014, taking into account the analysis of the sociodemographic profile of the victims, their relationships with their aggressors, as well as factors inherent to the particularities of the violence, characteristics of thebite, and the region of the body that was affected. Methods: Exploratory study of the cause, based on secondary data, identified in forensics reports carried out by dental forensics experts, duly recorded in reports at the IML from 2007 to 2014. Results: The results point out a higher index of female victims (78.1%), between 20 and 60 years of age (53.1%), light-skinned black students (28.6%), and natives of the city of Feira de Santana (56.2%). The head and neck region (29.2%) and upper limbs (29.2%) were the most commonly attacked regions, and the majority of victims presented more than one lesion, appearing clinically as excoriations (34.2%) and ecchymosis (31.6%). None of the cases attempted to identify the aggressor through the bitemark. Conclusion: Therefore, it can be concluded that the majority of the victims of physical violence who presented lesions provoked by human bites were female, light-skinned back, adults. The supposed aggressors, in the majority of cases, have or had some form of marital relationship with the victim. Bitemarks were predominantly found in the head and neck region and upper limbs. Excoriations and ecchymosis stood out as the main clinical manifestations.(AU)

Paralelismo entre plano oclusal y plano de Camper / Parallelism between the occlusal plane and the Camper's line

Objetivo: El propósito de este estudio fue verificar la relación de paralelismo entre el plano oclusal y 3 definiciones de plano de Camper en una población eugnásica chilena. Material y métodos Estudio transversal. Se seleccionaron 60 adultos jóvenes chilenos eugnásicos (32 hombres y 28 mujeres) entre 18 y 35 años. Se utilizaron telerradiografías de perfil digitales y fotografías faciales laterales estandarizadas. Se superpuso la cefalometría en las fotografías laterales con el programa Quick-Ceph®. Los planos de Camper se trazaron desde 3 diferentes puntos de inicio en el tragus (superior, medio e inferior) hacia el punto más inferior del ala de la nariz. Se midieron los ángulos formados entre el plano oclusal y los 3 planos de Camper resultantes con el programa Screen Protractor®. Resultados El análisis ANOVA muestra diferencias significativas entre los 3 ángulos. El ángulo promedio entre el plano de Camper medio y el plano oclusal fue -0,63°. En hombres, el plano de Camper medio fue más paralelo al plano oclusal (1,11°) y en mujeres el plano de Camper superior fue el más paralelo con el plano oclusal (1,39°). Conclusión El paralelismo fue verificado para el plano de Camper medio en hombres y para el plano de Camper superior en mujeres.

Objective: The aim of this study was to verify the parallelism between the occlusal plane and three different Camper's line definitions in a Chilean eugnathic population. Material and methods Cross-sectional study was conducted on 60 Chilean eugnathic young adults (32 males and 28 females) between 18 and 35 years old. Lateral digital standardised cephalometric radiographs and facial photographs were used. The cephalometric analysis was superimposed over the lateral photographs with Quick-Ceph® software. The Camper's line was traced from three different starting points at the Tragus (upper, middle and lower) to the lowest point below the nostrils. The angles obtained between the occlusal plane and the resulting Camper's lines were measured with Screen Protractor® software. Results The ANOVA test showed significant differences for the obtained angles. The mean parallelism between the medium Camper's line and the occlusal plane was -0.63°. In males, the medium Camper's line was more parallel to the occlusal plane (1.11°), and for females, the upper Camper's line was the most parallel to the occlusal plane (1.39°). Conclusion The parallelism was verified for the medium Camper's line in males, and for the upper Camper's line in females.

Determination of final occlusal vertical dimension by cephalometric analysis

Introduction: Most of techniques for determining the occlusal vertical dimension (OVD) of edentulous patients are based on soft tissues references, which lead to measurement discrepancies. Objective: To propose a method to obtain the OVD of edentulous patients during the confection of complete dentures considering the lower facial height established by Ricketts (LFHr) or the lower facial height obtained from cephalometric analysis of dentulous patients (LFHd). Material and methods: The OVD of 11 edentulous patients was determined by the association of 3 clinical methods. On each patient's bite plates a metallic ball was fixed and the patient was submitted to lateral radiographic to obtain the lower facial height (LFHe) from cephalometric analysis. Additionally, from 40 lateral cephalograms of dentulous patients the LFHd was obtained. After that, the distance between metallic balls (DMB, in mm) was calculated to verify the linear difference when LFHe was changed to LFHd or LFHr, which provided the amount of wax to be added or removed from the bite plates, establishing a new method of OVD determination. LFHe, LFHd and LFHr values were submitted to t e z statistical tests and DMB differences were analyzed by Student's t-test (α=0.05). Results: LFHr (47.0±4.0o a) was statistically higher than LFHd (44.9±5.6o b) and LFHe (43.5±3.5o b). There was statistical difference on linear discrepancies calculated between the LFHe and LFHd (1.7±4.1mm a) or LFHr (4.2±4.1mm b). Conclusion: The use of the cephalometric analysis showed to be a useful auxiliary tool in determining the intermaxillary relationship. However, this method must be associated with different clinical methods of OVD determination and it is recommended that regional references are used to calculate the linear discrepancies.

Relación entre el espesor del registro interoclusal en céntrica y el error oclusal en la posición retruída de contacto en el articulador semiajustable de tipo arcon / Relation between the thickness of the interocclusal centric registration and occlusal error in the retruded contact position in an arcon semiadjustable articulator

Objetivo. Relacionar el espesor del registro interoclusal en céntrica con el error oclusal en la posición retruída de contacto en el articulador semi ajustable, tipo arcon. Materiales y métodos. Se utilizó un juego de modelos de 42 alumnos de la asignatura de Oclusión de una universidad particular, con oclusión clase I, dentición natural, completa hasta segunda molar, libres de signos-síntomas de trastornos temporomandibulares, y con contacto prematuro unilateral y posterior perfectamente verificable. Para reproducir la posición retruída de contacto, se tomaron tres registros de relación céntrica (espesores de 1, 2 y 3 mm). Se observaron tres contactos prematuros a los que se les denominó A1, B1, C1 de acuerdo a los tres registros usados, su ubicación se registró usando folio de 8 µm y cinta de 12 µm. Se cuantificó el error oclusal usando un calibrador digital. Resultados. El error oclusal fue de 0,0 mm,0,46 mm, y 2,01 mm, para el registro A, B y C, respectivamente. El test de Friedman determinó que hay diferencias significativas en el error oclusal presentado por los tres tipos de registro (p=0,00). La prueba de signo de rangos de Wilcoxon, demostró que existen diferencias significativas en el error oclusal ocurrido entre los pares de registros...

Objective. To relate the thickness of the centric interocclusal record with occlusal error in retruded contact position in arcon type se-miadjustable articulator. Materials and methods. A set of 42 casts of occlusion students were taken from a private university presenting occlusion Class I, natural and complete dentition to second molar, free of signs and symptoms of temporomandibular disorders, and with premature and unilateral contact perfectly verifiable. To reproduce the retruded contact position three centric relation records were taken with different thicknesses of 1. 2 and 3 mm. Tree premature contacts were observed and were called A1, B1, C1, according to the three records used, its location were recorded using foil tape of 8 and 12 pm. Occlusal error was quantified using a digital caliper. Results. The occlusal error was 0.0 mm, 0.46 mm and 2.01 mm, for the record A, B and C, respectively. Friedman test determined a significant difference in occlusal errors introduced by the three record types (p = 0.00). Wilcoxorf s Sign Test Rank showed significant differences in the occlusal error that occurred between pairs of records A...

Descrição de Técnica para Reprodução de Gomas de Mascar para Análise de Marcas de Mordida em Odontologia Legal / Chewing Gum Reproduction Technique for Bitemark Analysis in Forensic Dentistry

A análise pericial de uma goma de mascar presente na cena de um crime e a sua ligação com um suspeito é mais uma ferramenta de identificação que as Ciências Forenses dispõem. A goma de mascar possui a capacidade de registrar, com relativos detalhes, as superfícies oclusais dos dentes posteriores, contendo informações únicas e incomuns do indivíduo, sendo que a combinação das características e das singularidades apresentadas pelos dentes, somadas às características do arco dental, podem ser de grande valia na inclusão ou exclusão de um suspeito. A característica elástica dessa prova dificulta o trabalho pericial, não permitindo a adequada manipulação que esse processo exige. Nesse sentido, o objetivo desse trabalho foi descrever uma técnica para a reprodução da goma de mascar em silicona de adição e de condensação, adaptando técnica inicialmente descrita para a duplicação de próteses, por meio da inclusão em alginato, em um duplicador ou qualquer outro objeto adaptado para esse fim. A adaptação dessa técnica para a duplicação da goma de mascar mostrou ser de fácil execução, garantindo a preservação da prova real e a reprodução fiel do material questionado, permitindo ao perito odontolegista uma análise minuciosa e precisa das gomas de mascar quando constituem elemento de análise pericial.

The forensic analysis of a chewing gum found at a crime scene and its connection to a suspect is a further tool for forensic identification. Chewing gums have the ability to record biting surfaces of posterior teeth in detail, providing unusual and unique information of an individual. The combination of these characteristics and peculiarities of teeth and the characteristics of dental arch may be valuable for inclusion or exclusion of a suspect. The elastic characteristic of these evidences hinders the work of the expert,,preventing the proper handling that this process requires. In this sense, the objective of this study was to describe a technique to reproduce gum with vinyl polysiloxane and silicone impression material, by adapting a technique initially described for prosthesis duplication using alginate in a container or any object adapted for this purpose. This technique showed to be easily performed, ensuring the preservation and reproduction of the material, and allowing a thorough and accurate analysis to the expert when chewing gum is a factor of proof.

Tratamento de perda óssea por trauma oclusal primário. Relato de caso / Treatment of bone loss by occlusal trauma. Case report

A distribuição correta de forças oclusais deve ser uma preocupação constante para os profissionais da odontologia, isto para que propicie a manutenção do equilíbrio entre os elementos do sistema estomatognático. Quando as forças oclusais excedem o limite fisiológico dos tecidos, pode ocorrer injúria nos tecidos periodontais decorrente do trauma oclusal. A paciente MLC, branca do sexo feminino 53 anos compareceu à pesquisa de oclusão e dor orofacial da Faculdade de Odontologia da UFG com quadro clínico de mobilidade no primeiro pré-molar inferior esquerdo, hipersensibilidade ao toque no mesmo e reabsorção óssea na região face mesial. Ao exame clínico observou-se desvio da mandíbula para a esquerda, devido a interferência na vertente mesial da cúspide mésio palatina do primeiro molar superior esquerdo, a referida interferência projetava a mandíbula para anterior e para a esquerda resultando em trauma oclusal no segundo pré-molar inferior esquerdo. O dente sob trauma não apresentava bolsa periodontal e respondeu positivamente ao teste de vitalidade pulpar. Observou-se que a dor e a mobilidade foram causadas pela interferência, caracterizando trauma oclusal primário. Para eliminar o contato prematuro, o tratamento indicado foi o ajuste oclusal por desgaste seletivo, num total de cinco sessões. Após quatro meses de acompanhamento verificou-se ao exame radiográfico neoformação óssea na região mesial do referido dente, com desaparecimento da mobilidade e de toda sintomatologia associada. Concluindo, assim, o ajuste oclusal por desgaste seletivo pode ser indicado em casos de trauma oclusal, desde que este seja o fator tiológico.

The correct distribution of occlusal forces should be a constant concern for dental professionals, to ensure that conducive to maintaining the equilibrium between the elements of the stomatognathic system. When occlusal forces exceed the physiological limit tissue, injury can occur in periodontal tissues resulting from occlusal trauma. The patient MLC, white female 53 years old attended the search occlusion and orofacial pain, School of Dentistry of UFG with clinical mobility in the first premolar left, hypersensitivity to touch and even bone reabsorption in the mesial region. On clinical examination there was deviation of the jaw to the left, because interference in mesial aspect mesial palatal cusp of the maxillary first molar left, the interference projected the mandibular anterior and to the left resulting in injury in the second premolar left . The tooth under trauma showed no periodontal pocket and responded positively to the test pulp vitality. It was observed that the pain and mobility were caused by interference, characterizing primary occlusal trauma. To eliminate premature contact, the indicated treatment was occlusal adjustment by selective grinding. After four months of follow-up was found to radiographic bone formation in the region of the mesial said tooth, with disappearance of mobility and all associated symptoms. In conclusion, therefore, occlusal adjustment by selective grinding can be used in cases of occlusal trauma, since this is the etiologic factor.

Estudo comparativo da inclinação do plano oclusal de modelos para cirurgia ortognática montados em dois tipos de articuladores semiajustáveis / Comparative study of occlusal plane angulation of dental casts for orthognathic surgery mounted in two types of semi-adjustable articulators

Objetivo: este estudo busca comparar a inclinação do plano oclusal obtida em dois tipos diferentes de articuladores semiajustáveis com aquela obtida na telerradiografia em norma lateral. Metodologia: 20 pacientes a serem submetidos à cirurgia ortognática tiveram seus modelos de gesso montados em 2 diferentes articuladores semiajustáveis por meio da transferência com arcos faciais da posição da maxila e registro oclusal para a mandíbula. Após montagem, à inclinação do plano oclusal nos articuladores foi mensurada e comparada com a inclinação mensurada nas telerradiografias cefalométricas laterais e entre os articuladores entre si. Os resultados obtidos foram submetidos a análise estatística pertinente. Resultados: os valores médios dos ângulos obtidos nos articuladores Bio Art (7,55º) e Kavo (-5,70º) diferem entre si em 13,25º, sendo essa diferença estatisticamente significante (p=0,00). Quando comparados individualmente à telerradiografia (5,075º), o articulador Bio Art apresentou valor mais próximo, com uma diferença de 2,475º, enquanto que o articulador Kavo apresentou uma diferença de 10,775º. Conclusão: os dois modelos de articuladores semiajustáveis testados não reproduzem, com fidelidade, a inclinação do plano oclusal maxilar de pacientes portadores de deformidades dentofaciais; a diferença encontrada entre o articulador Bio Art e a telerradiografia foi menor do que aquela encontrada entre o articulador Kavo e a telerradiografia.

Purpose: The aim of this study was to compare occlusal plane angulation measured in two different types of semi-adjustable articulators with that obtained on the lateral cephalometric radiograph. Materials and Methods: 20 patients due to undergo orthognathic surgery had dental casts mounted in two different types of semi-adjustable articulators through face bow transfer from the position of the maxilla and occlusal recording to the mandible. After mounting, the inclination of the occlusal plane in the articulators was measured and compared with the inclination measured at on both articulators and compared with the inclination measured on the lateral cephalometric radiographs and between the articulators themselves. The results obtained werestatistically analyzed. Results: Mean angulation values for the Bio Art (7.55º) and Kavo (-5.70º) articulators differ by 13.25º, which is statistically significant (p=0.00). When individually compared to the lateral cephalometric radiograph (5.075º), the Bio Art articulator showed more similar angulation values, with a difference of 2.475º, while the Kavo articulator presented a difference of 10.775º. Conclusion: Neither of the models of semi-adjustable articulators accurately reproduced the inclination of the maxillary occlusal plane of patients with dentofacial deformities; the difference between the two articulators tested and the lateral cephalometric radiograph was lower for the Bio Art than for the Kavo articulator.

Las falacias de la relación céntrica / The fallacies of centric relation

El método empleado para validar los argumentos de la Relación céntrica fue en base a silogismos deductivos, las conclusiones fueron apoyadas en premisas con referencias científicas lo que garantiza su relación con los hechos. La revisión bibliográfica se dio conforme aparecían las dudas por despejar. Las conclusiones más resaltantes fueron: La RC no es un estado de contracción Isotónica de los músculos por lo que tampoco es un estado ideal del sistema estomatognático. Todo patología articular relacionada con el desplazamiento anterior del disco esta asociado a una posición superior y posterior del cóndilo mandibular lo que excluye a la posición condilar en MIC de asociarse a problemas articulares. Se infiere de manera inmediata, que si la MIC es lo contrario a la posición posterior superior del cóndilo, entonces no es una posición que produce desplazamiento anterior del disco. Entonces, es una posición protectora ya que no sobrecarga la ATM por ser contraria a la posición hallada en los estudios clínicos. El estado ideal del cóndilo mandibular estaría asociado al Espacio Libre Interoclusal (ELI) por el equilibrio muscular. Pero se sabe que es una posición variable y asociada a factores funcionales, sistémicos, biotipo, tensionales, etc

The used method to validate the arguments of the central Relation was on the basis of deductive syllogisms, findings were reclined what your relation with the facts guarantees premises with scientific references. The bibliographic revision took place agreeable the doubts to solve appeared. The noteworthiest findings were: The RC is not a status of isotonic contraction of the muscles so that a system's ideal status is not stomatognathic either. Everything articular related pathology with the previous displacement of the record this once a superior and posterior position of the mandibular condyle was associated to what you exclude to the condylar position in MIC of associating to articular problems. We can infer of immediate way, that if the MIC is the opposite to the posterior superior position of the condyle, then it is not a position that produces previous displacement of the record. Then, she is a protective position since you do not overload the NICE to be contrary to the position found in the clinical studies. The ideal state of the mandible's condyle would be associated in favor of ( ELI ) the muscular equilibrium to the Interocclusal Clearance. But he is known that a variable and associated to position is functional, systemic factors, biotype, stress, etc

Evaluation of the reproducibility of two techniques used to determine and record centric relation in angle's class I patients

The centric relation is a mandibular position that determines a balance relation among the temporomandibular joints, the chew muscles and the occlusion. This position makes possible to the dentist to plan and to execute oral rehabilitation respecting the physiological principles of the stomatognathic system. The aim of this study was to investigate the reproducibility of centric relation records obtained using two techniques: Dawson's Bilateral Manipulation and Gysi's Gothic Arch Tracing. Twenty volunteers (14 females and 6 males) with no dental loss, presenting occlusal contacts according to those described in Angle's I classification and without signs and symptoms of temporomandibular disorders were selected. All volunteers were submitted five times with a 1-week interval, always in the same schedule, to the Dawson's Bilateral Manipulation and to the Gysi's Gothic Arch Tracing with aid of an intraoral apparatus. The average standard error of each technique was calculated (Bilateral Manipulation 0.94 and Gothic Arch Tracing 0.27). Shapiro-Wilk test was applied and the results allowed application of Student's t-test (sampling error of 5 percent). The techniques showed different degrees of variability. The Gysi's Gothic Arch Tracing was found to be more accurate than the Bilateral Manipulation in reproducing the centric relation records.

Influência das etapas clínicas da prótese total sobre a separação maxilomandibular durante a pronúncia do som /S/ e a deglutição / Influence of complete denture clinical stages on the maxillomandibular spaces during the production of /s/ sound and swallowing

A pronúncia de sons sibilantes e a deglutição têm sido amplamente indicadas para a tomada da dimensão vertical para próteses totais. Não obstante, pouco se sabe sobre o comportamento dessas funções fisiológicas perante as diversas fases clínicas envolvidas na reabilitação de pacientes edentados. Portanto, foi objetivo deste estudo avaliar as mudanças no espaço de pronúncia do som /s/ e as distâncias interoclusais de repouso e de deglutição, em diversos momentos clínicos, durante e após o tratamento com próteses totais. Um total de 12 indivíduos edentados (5 homens) participaram deste estudo, e 7 medidas foram feitas: 1) Bases de prova, após determinação das relação intermaxilares; 2) Bases de prova, após provas funcionais; 3) Instalação; 4) uma semana; 5) 2 semanas; 6) um mês; 7) 3 meses após instalação. Um cinesiógrafo (K6-I Diagnostic System, Myotronics Research Inc., Seattle, WA, EUA) mensurou os espaços interoclusais em sentido vertical e ântero-posterior. O espaço de pronúncia do /s/ foi aferido durante a fala da palavra 'seis' e compreendeu a distância da posição de pronúncia do /s/ à máxima intercuspidação. A distância interoclusal de repouso foi determinada pedindo-se aos indivíduos que ocluíssem a partir da posição de repouso postural. O espaço interoclusal da deglutição foi testado pelo registro da posição mandibular mais fechada durante a deglutição de 20 mL de água. As diferenças entre os registros das sete etapas foram determinadas pela ANOVA para fatores vinculados, seguida pelo teste de Student-Newman-Keuls (α=0,05). A etapa "1" resultou em um espaço de pronúncia do /s/ médio significativamente maior que nas demais etapas, no sentido vertical (A = 4,1 mm, B a G apresentaram médias de 2,8 mm a 3,0 mm). Não houve diferença significante entre as sete etapas para o espaço de pronúncia do /s/ ântero-posterior, distância interoclusal de repouso e de deglutição. A presença dos roletes de oclusão pode influenciar a posição mandibular durante o som /s/, e a montagem dos dentes modifica o espaço de pronúncia do /s/. No entanto, as posições de repouso e de deglutição mantêm-se estáveis durante a confecção das próteses totais e uso a curto prazo

Sibilant sounds and swallowing have been widely used for vertical dimension assessment in complete denture wearers. Nevertheless, little is known about the behavior of these physiological parameters during the rehabilitation of edentulous patients. Thus, the aim of this study was to investigate the changes in speaking space of /s/ sound, interocclusal distance of rest and during swallowing, during and after treatment with complete denture. A total of 12 edentulous subjects (5 men) participated in this study and 7 measures were carried out: A) Record bases following intermaxillary relation record; B) Trial dentures; C) Insertion; D) 1 week-; E) 2 weeks-; F) 1 month); G) 3 months after insertion. A jaw-tracking device (K6-I Diagnostic System, Myotronics Research Inc., Seattle, WA, EUA) measured the interocclusal space vertically and anteroposteriorly. Speaking space of /s/ sound was measured during the pronunciation of the word 'seis' and comprised the mean distance from the /s/ speaking position to maximal intercuspation. Interocclusal distance was determined by asking the subjects to occlude from the postural rest position. Interocclusal space of swallowing was tested by recording the closest mandibular position during the swallow of 20mL of water. Repeated-measures ANOVA was used to determine differences between registration for the 7 stages, followed by Student-Newman-Keuls test (α=0,05). A significant reduction in the mean speaking space of /s/ sound was found when the trial base stage was compared with the other stages, at the vertical axis (A= 4,1mm, B a G showed means ranging from 2,8 to 3,0mm). There was no significant difference between the 7 stages for anteroposterior speaking space of /s/ sound, interocclusal distance and IDS. The presence of occlusion rims can influence mandibular position during /s/ sound. The set up of artificial teeth changes the speaking space of /s/ sound. However, rest position and swallowing were not affected, neither during denture construction or short-term use