Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: a randomized clinical trial

Abstract The effectiveness of photobiomodulation (PBM) and manual therapy (MT), alone or combined (CT), were evaluated in pain intensity, mandibular movements, psychosocial aspects, and anxiety symptoms of temporomandibular disorder (TMD) patients. Fifty-one TMD patients were randomly assigned to three groups: the PBM group (n = 18), which received PBM with 808 nm, 100 mW, 13.3 J/cm2, and 4 J per point; the MT group (n=16) for 21 minutes each session on masticatory muscles and temporomandibular joint TMJ; and the CT group (n = 17), applied during twelve sessions. Seven evaluations were performed in different moments using visual analogue scale (VAS), Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II, and Beck anxiety inventory (BAI). All groups demonstrated reductions in pain and improvement in jaw movements during treatment and at follow-up (< 0.001). The assessment of psychosocial aspects of TMD, comparing baseline and follow-up in all treatment groups, revealed that treatment did not promote modification in the intensity of chronic pain (p > 0.05). However, depression symptoms showed a reduction in PBM and CT groups (p≤0.05). All treatments promoted reduction in physical symptoms with and without pain and enhancement of jaw disabilities (p ≤ 0.05). MT promotes improvement in 5 functions, PBM in 2, and CT in 1 (p < 0.001). BAI analysis revealed that all treatments lead to a reduction in anxiety symptoms (p≤0.05). All protocols tested were able to promote pain relief, improve mandibular function, and reduce the negative psychosocial aspects and levels of anxiety in TMD patients. However, the combination of PBM and MT did not promote an increase in the effectiveness of both therapies alone.

Copaiba oil effect on experimental jaw defect in Wistar rats

PURPOSE: To evaluate the effects of copaiba oil on jaw defects repair in Wistar rats treated with bioglass or adipose tissue. METHODS: A jaw defect was randomly created in forty-two rats and filled with bioglass or adipose tissue. The two groups (Gbio and Gcell) were subdivided in three subgroups with seven animals each according to gavage administration: control (distillated water), oil (copaiba oil) and melox (meloxicam). Euthanasia was performed after forty post-operative days. The bone formation was analyzed regarding the histological aspects. RESULTS: The osteoclasts activity was observed only in four subgroups (p=0.78). Regarding the osteoblasts presence, it was very similar between the subgroups, the difference was due to Gcell-melox (p=0.009) that presented less osteoblastic activity. The inflammatory cells were more evident in Gcell-melox subgroup, however, there was no difference in comparison with the other subgroups (p=0.52). Bone formation was observed in all subgroups, just two animals showed no bone formation even after 40 days. More than 50% of bone matrix mineralization was observed in 56% (23 animals) of the analyzed areas. The bone matrix mineralization was not different between subgroups (p=0.60). CONCLUSIONS: The subgroups that received copaiba oil showed bone repair, although not statistically significant in comparison to subgroups treated whit meloxicam or controls. Copaiba oil administered by gavage had no effect on bone repair in this experimental model. .

Importancia del primer molar permanente y consecuencias clínicas de su pérdida en edades tempranas del desarrollo / Importance of the first permanent molar and clinical consequences of its loss at early developmental stages

El primer molar permanente es la undiad más importante de la masticación y es esencial en el desarrollo de una oclusión funcionalmente deseable. La pérdida de este molar en un niño puede conducir a cambios en las arcadas dentarias que se perpetúan a lo largo del tiempo. Si no se toman medidas preventivas o correctivas apropiadas, podrán encontrarse: disminución en la función local, desviaciones de las piezas dentarias, extrusión de la pieza antagonista y trastornos de las articulaciones temporomandibulares, entre otras alteraciones. El presente artículo pretende evidenciar el protagonismo del primer molar permanente en la cavidad bucal y las consecuencias negativas que derivan de su ausencia. Además, deja entrever las necesidades de conocimiento por parte del odontólogo en los cuidados preventivos de dichas piezas dentarias y sobre la existencia de posibles tratamientos al momento de una pérdida inminente.

Tratamento cirúrgico de granuloma central de células gigantes agressivo em maxila com Acesso Weber Ferguson: relato de caso / Surgical treatment of aggressive central giant cell granuloma on the jaw using the Weber Ferguson Approach: a case report

O Granuloma central de células gigantes (GCCG) é uma entidade não neoplásica, tendo em vista suas características clínicas e imaginológicas faz-se a definição do padrão da lesão em agressiva ou não-agressiva que irá determinar o tratamento de escolha, quando agressiva causa destruição óssea considerável. O presente trabalho visa relatar um caso clínico de Granuloma Central de Células Gigantes agressiva em maxila com tratamento cirúrgico de enucleação com acesso cirúrgico de Weber Ferguson, atualmente esse paciente encontra-se com dezoito meses de acompanhamento sem sinais de recidiva... (AU)

Central giant cell granuloma is a non-neoplastic entity in which the clinical and imaging characterisitics identify the injury as an aggressive or nonaggressive lesion, a distinction that will determine the choice of treatment, bearing in mind that the aggressive form may cause significant bone destruction. This paper describes a case of aggressive central giant cell granuloma in the maxilla treated surgically using the Weber Ferguson approach. After eighteen months of follow-up the patient shows no signs of recurrence... (AU)

Evaluation of bone alterations in the jaws of HIV-infected menopausal women

The advent of highly active antiretroviral therapy (HAART) has caused a reduction in mortality, thus contributing to an increase in the number of women with HIVࢧAIDS who reach the climacteric period, experience decline in ovarian function, and develop complications of viral infection and HAART, which can accelerate bone loss. The aim of this study was to detect possible alterations in the jaws of HIV-infected women by panoramic radiography. The study comprised a total of 120 women above 40 years of age who were divided into the following two groups: women who are HIV positive (Group I) and women with no known HIV infection (Group II). Measurement of the following three radiomorphometric indexes was performed by panoramic radiography: Mental Index (MI), Panoramic Mandibular Index (PMI) and Antegonial Depth (AD). A total of 70% of women in the control group and 50% of women in the HIV group were in the postmenopausal period, and the average values of both MI (p = 0.0054) and AD (p < 0.0001) for this period were lower in the HIV group than in the control group. For patients who were in the premenopausal period, the average AD was lower in the HIV group than in the control group (p = 0.0003). Despite the difference in the average age between groups, greater bone resorption in the mandible was found in the group of HIV-positive women.

Atrofia paraprotética de los maxilares / Paraprosthetic atrophy of the jaws

El objetivo de esta presentación es describir las alteraciones provocadas por la desadaptación o sobrecarga sectorizada de las prótesis mucosoportadas sobre el terreno de soporte óseo. Luego, relacionarlas con las alteraciones periprotéticas asociadas más comunes, y realizar la descripción de una de las alteraciones atróficas paraprotéticas de mayor casuística, con sus consecuencias en el sistema estomatognático. Finalmente, describir los tratamientos protéticos no implantológicos y la prevención de estas alteraciones con prótesis convencionales e implanto-asistidas

Prevalência de dentes supranumerários em pacientes que procuraram tratamento ortodôntico / Prevalence of supernumerary teeth in patients who sought orthodontic treatment

Objetivo: Este trabalho teve como objetivo avaliar a prevalência de dentes supranumerários em pacientes que procuraram atendimento na clínica odontológica no Programa de Pós-Graduação em Odontologia, área de concentração em Ortodontia da Pontifícia Universidade Católica do Paraná (PUCPR). Materiais e Métodos: Foram analisadas 247 radiografias panorâmicas, de pacientes com idades entre 6 anos e 12 anos e 11 meses, 112 do gênero masculino e 135 do feminino, em um negatoscópio em sala escura. Resultados: A prevalência dos dentes supranumerários foi de 2,43% (seis dentes), acometendo apenas a maxila de 6 indivíduos do gênero masculino, sendo todos localizados na região da linha mediana. O Teste de Diferença entre duas Proporções demonstrou que houve diferença estatística (p = 0,0063) entre os gêneros, considerandotanto “Arcada Dentária” quanto “Região”. Conclusão: Os dentes supranumerários foram encontradosexclusivamente no gênero masculino, na maxila e na linha mediana. Evidenciou-se a importância do exameradiográfico panorâmico no estudo da prevalência dessa anomalia dentária de desenvolvimento, para queprocedimentos preventivos, interceptivos e/ou corretivos possam ser planejados.

Objective: The aim of this study was to assess supernumerary teeth prevalence in patients who sought orthodontic treatment at Pontifical Catholic University of Paraná. Materials and methods: Standard viewbox with background light masked was utilized in order to evaluate 247 panoramic radiographs of both genders patients aging from 6 years-old to 12 years and 11 months. Results: Prevalence of supranumerary teeth was 2.43% (six teeth), localized only in maxillary arch and in the midline region of male subjects. Difference Between Two Proportions test showed that there was statistical difference (p = 0.0063) between genders, considering both “Dental Arch” and “Region”. Conclusions: Supranumerary teeth were only found in male patients, in maxilla and in the midline. Panoramic radiographs assessment is important in order to study the prevalence of this dental development anomaly and permits that interceptive and/or corrective procedures may be planned.

Inverse Marcus Gunn phenomenon.

Inverse Marcus-Gunn phenomenon is very rare. It is usually acquired. We report a young male patient presenting with congenital ptosis and inverse Marcus-Gunn phenomenon.

Unusual Marcus Gunn phenomenon in adults.

Two unusual cases of Marcus Gunn phenomenon in adults are presented. The first case was characterised by a bilateral jaw-winking phenomenon along with an asymmetric bilateral congenital ptosis, whereas the second case had bizarre spontaneous movements of the affected lid, deficient abduction and pseudoptosis in association with jaw-winking. The pathogenesis of Marcus Gunn phenomenon is discussed.