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1.
Arch Oral Biol ; 58(9): 1100-8, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23684155

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the maximal bite force (MBF), electromyographic (EMG) activity and thickness of the masseter, anterior part of the temporalis and sternocleidomastoid (SCM) muscles in a group of young adults with and without temporomandibular disorders (TMDs). DESIGN: Nineteen individuals comprised the TMD group (6 males/13 females, aged 25.4±3.8 years), classified based on the Research Diagnostic Criteria for TMD (RDC/TMD), and 19 comprised the control group (6 males/13 females, aged 24.1±3.6 years). The MBF was determined with a transducer placed between the dental arches at the first molars level (N). The muscles were evaluated bilaterally at rest and during maximal voluntary clenching (MVC) by assessing EMG activity and performing ultrasonography (USG). The mean values of these measures for both sides of the mouth were used. The normality of the distributions was assessed by the Shapiro-Wilks test. Variables between groups and genders were compared using two-way factorial ANOVA test and correlated using the Spearman coefficient (α=0.05). Unpaired t test was used to compare variables between TMD subgroups. Logistic regression analysis was used to identify the variables associated with the presence of TMD. RESULTS: MBF, EMG and USG data were similar among clinical groups and among TMD subgroups. The thickness of masseter and SCM muscles in the relaxed and clenching states were significantly higher in males than females. On the other hand, the EMG of the temporalis muscle in the rest state was significantly higher in females than males. Additionally, the MBF was positively correlated with the USG characteristics of masseter and SCM muscles, as well as with the EMG activity of masseter and temporalis muscles in the TMD group. In this group, there was also a positive correlation between the thickness of the masseter muscle and its activity. On the other hand, the thickness of the SCM muscle was negatively correlated with its activity. A lower MBF was independently associated with the presence of TMD. CONCLUSIONS: Subjects with TMD exhibited similar values of MBF, thickness and electrical activity of masticatory and cervical muscles when compared with controls; positive correlations observed between these variables may suggest a muscular alteration in TMD patients and a co-activation of masticatory and cervical muscles during mandibular movement. This fact may also be confirmed by the negative association between bite forces and presence of TMD.


Subject(s)
Bite Force , Masseter Muscle/physiology , Neck Muscles/physiology , Temporal Muscle/physiology , Temporomandibular Joint Disorders/physiopathology , Adult , Analysis of Variance , Case-Control Studies , Electromyography/methods , Female , Humans , Male , Masseter Muscle/diagnostic imaging , Masseter Muscle/physiopathology , Neck Muscles/physiopathology , Regression Analysis , Sex Factors , Temporal Muscle/diagnostic imaging , Temporal Muscle/physiopathology , Temporomandibular Joint Disorders/diagnostic imaging , Ultrasonography
2.
RFO UPF ; 16(2)maio-ago. 2011.
Article in Portuguese | LILACS | ID: lil-611997

ABSTRACT

Objetivo: analisar a performance mastigatória (PM) em pacientes submetidos ao uso de próteses removíveis imediatas (PRTI). Métodos: Selecionaram-se três pacientes que foram submetidos aos testes de performance mastigatória com dentes naturais (DN) e com PRTI superior, inferior e bimaxilares, mantendo o padrão oclusal, imediatamente antes das exodontias e seis meses após a instalação e reembasamento dessas. Um simulador de alimento "Optocal" foi mastigado por quarenta golpes, monitorados visualmente por um único examinador calibrado. O material mastigado foi colocado num conjunto de oito peneiras granulométricas. Completada a tamisação, o conteúdo retido em cada peneira foi secado em estufa e pesado individualmente. Resultados: Os pacientes reabilitados com PRTI bimaxilares e superior demonstraram comportamento mastigatório semelhante, resultando em redução da performance mastigatória. No entanto, a paciente com PRTI inferior demonstrou melhora na PM. Conclusão: O teste de performance mastigatória demonstrou ser um importante auxiliar na compreensão e avaliação da função mastigatória diante dos procedimentos clínicos adotados.

3.
Arch Oral Biol ; 56(12): 1521-7, 2011 Dec.
Article in English | MEDLINE | ID: mdl-21763639

ABSTRACT

OBJECTIVE: To investigate the relationship of orofacial dysfunction and salivary cortisol levels with oral health quality of life (ORHQoL) in young adults. DESIGN: Thirty individuals of both genders (22.93±2.42 years) participated. The orofacial dysfunction was evaluated using the Nordic Orofacial Test-Screening (NOT-S) and the ORHQoL using the Oral Health Impact Profile (OHIP-49). Saliva samples were collected during three days, at waking up and 30 min after, obtaining the awakening cortisol response - ACR. The data were analysed by Mann-Whitney test, Spearman's correlation and multiple linear regression (α=0.05). The NOT-S scores and ACR (µg/dl) were dichotomized by the median (2.0 and 0.15, respectively). RESULTS: NOT-S and ACR showed similar values between genders (P>0.05). The individuals with NOT-S scores above the median presented values of "physical pain" domain significantly higher than the individuals with scores bellow or equal to the median. Significant correlations were found between the OHIP-49 domains "physical pain" and "physical disability" and NOT-S scores. In multiple linear regression, significant values were observed between NOT-S and OHIP-49 and the domains physical pain, physical disability, psychological disability, social disability and handicap, with determination coefficients ranging from 0.09 to 0.15. There was not association with the ACR. CONCLUSIONS: Individuals with orofacial dysfunction presented impairment in ORHQoL, but not enough to change salivary cortisol levels. Furthermore, gender did not have influence on ORHQoL in the studied sample.


Subject(s)
Hydrocortisone/analysis , Mouth Diseases/physiopathology , Oral Health , Quality of Life , Saliva/chemistry , Sensation Disorders/physiopathology , Speech Disorders/physiopathology , Adult , Chi-Square Distribution , Deglutition Disorders/physiopathology , Disability Evaluation , Facial Expression , Female , Humans , Male , Respiration , Salivary Gland Diseases/physiopathology , Sickness Impact Profile , Statistics, Nonparametric , Surveys and Questionnaires
4.
Odonto (Säo Bernardo do Campo) ; 18(35): 5-13, jan.-jun. 2010. ilus, tab, graf
Article in English | LILACS, BBO - Dentistry | ID: lil-578081

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-Assisted
5.
J Appl Oral Sci ; 17(5): 539-43, 2009.
Article in English | MEDLINE | ID: mdl-19936539

ABSTRACT

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)
Head/anatomy & histology , Occlusal Splints , Temporomandibular Joint Disorders/therapy , Adaptation, Physiological , Adolescent , Adult , Centric Relation , Dental Occlusion, Centric , Facial Pain/therapy , Female , Follow-Up Studies , Humans , Male , Posture/physiology , Sleep Bruxism/therapy , Treatment Outcome , Young Adult
6.
J. appl. oral sci ; 17(5): 539-543, Sept.-Oct. 2009. ilus, tab
Article in English | LILACS | ID: lil-531410

ABSTRACT

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 Adult
7.
Odonto (Säo Bernardo do Campo) ; 17(33): 42-47, jan.-jun. 2009. graf
Article in Portuguese | LILACS, BBO - Dentistry | ID: lil-542838

ABSTRACT

Introdução: alterações funcionais do complexo temporomandibular podem refletir em adaptações no sistema muscular do indivíduo, interferindo com a postura mandibular e conseqüentemente com a posição da cabeça e da cintura escapular, modificando a biomecânica corporal. Objetivo: avaliar as alterações posturais da cabeça e ombros, bem como o lado de contato prematuro e de preferência mastigatória, em pacientes com disfunção temporomandibular, antes e após o uso de placa oclusal. Materiais e Métodos: um exame clínico (intra e extra-oral) e físico foi realizado em 20 pacientes com a disfunção, antes, uma semana e um mês após o uso de um dispositivo oclusal. Resultados: os resultados demonstraram uma redução da sintomatologia dolorosa e alteração do lado de inclinação da cabeça. Conclusão: pode-se concluir que existe uma inter-relação entre a oclusão e a postura do indivíduo que pode sofrer alterações no seu funcionamento decorrente de modificações estomatognáticas.


Introduction: an altered function in temporomandibular complex can reflect in adaptations for the muscular device of the individual, intervening with the mandibular position and consequently with head and scapular waist posture, modifying the corporal biomechanics. Purpose: evaluated the postural alterations of skull and shoulders as well the contact premature side and masticatory preference side, in patients with Temporomandibular Disorder (TMD), before and after an occlusal splint insertion. Materials and Methods: Clinical (intra and extra-oral) and physical examinations were done in 20 patients with dysfunction, before, one week and one month after myorelaxant occlusal splint instalation. Results: the results showed reductions in pain symptoms and alteration of the side of head inclination. Conclusion: it can be concluded that exists an interrelation between occlusion and the postural position of the individual that can suffer alterations in its operation decurrently from stomatognathic modifications.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Mandible/physiology , Occlusal Splints , Temporomandibular Joint Dysfunction Syndrome , Biomechanical Phenomena
8.
Braz. j. oral sci ; 7(26): 1627-1630, July-Sept. 2008.
Article in English | LILACS, BBO - Dentistry | ID: lil-521329

ABSTRACT

Halitosis, also known as bad breath or oral malodor, is the general term used to describe any disagreeable odor in expired air, regardless of whether the odorous substances originate from oral or non-oral sources. Bad breath can be detrimental to one’s self-image and confidence, causing social, emotional and psychological anxiety. This paper provides a comprehensive review of the historical background, prevalence, social aspects and pathological causes of halitosis as well as the dental professional’s responsibility.


Subject(s)
Halitosis/etiology , Halitosis/pathology , Halitosis/prevention & control
9.
Fisioter. Bras ; 9(4): 264-268, jul.-ago. 2008.
Article in Portuguese | LILACS | ID: lil-546490

ABSTRACT

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 Fonseca’s 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.


Subject(s)
Dystonia , Manipulation, Spinal , Muscle Contraction , Muscle Development , Muscular Diseases , Neck Pain , Temporomandibular Joint Disorders
10.
Fisioter. Bras ; 9(1): 64-69, jan.-fev. 2008.
Article in Portuguese | LILACS | ID: lil-491106

ABSTRACT

O fisioterapeuta é um profissional habilitado a atuar na prevenção, promoção, proteção e reabilitação da saúde, em nível individual e coletivo. Dessa forma, objetiva-se encaixar o papel do fi sioterapeuta no âmbito da saúde pública e sua inclusão no Programa de Saúde da Família (PSF), além de entender suas atividades dentro de um aspecto preventivo e como atuar junto à população, auxiliando toda a equipe de saúde. Para isso, um profi ssional capaz de estudar e investigar o movimento humano e as funções corporais é fundamental. Associado ao PSF, suas práticas se traduzem em um novo modelo de atenção que privilegia toda a comunidade. Em atuação na saúde da família, seu trabalho ganha resolutividade e efetividade, oferecendo ações de baixo custo, criando vínculo com a comunidade, valorizando a profissão e garantido o reconhecimento de sua profissão por todos que a assistem. O PSF surge, assim, como mais uma oportunidade para o fisioterapeuta desenvolver suas habilidades no âmbito social oferecendo ao indivíduo uma melhora na qualidade de vida. Por meio de uma alta motivação do paciente, também garante uma educação continuada e possibilita a recuperação da harmonia do corpo e do convívio social.


The physiotherapist is a qualified professional that can work in prevention, promotion, protection and rehabilitation of the health, in individual and collective levels. In that way, the aim of this paper is to discuss the insert of the physiotherapist in public health and in the Family Health Program (FHP), besides to understand the preventive activities and how they act together with the population, assisting all the health team. For that, it’s necessary a professional capable to study and to investigate the human movement and the corporal functions. Associated to the FHP, the therapist actions should be transformed in a new attention model that privileges the whole community. Working in the healthy of the family, they can become their acts effectiveness and essential, offering low cost procedures, creating bond with the community, valuing the profession and guaranteeing the profession recognition for everybody that attend it. The FHP appears, thus, as one more chance for the physiotherapist to develop its abilities in the social ambit offering to the patient an improvement in the quality of life. By means of a high motivation of the patient, it also guarantees a continuous education and makes possible the recovery of the harmony of the body and the social conviviality.


Subject(s)
Disease Prevention , Family Health , Physical Therapy Modalities , Public Health
11.
Periodontia ; 18(2): 36-43, 2008. tab
Article in Portuguese | LILACS, BBO - Dentistry | ID: lil-544206

ABSTRACT

Promover a eliminação de periodontopatias e manter o elemento dental funcional na cavidade bucal ainda são desafios encontrados atualmente. Com isso, novos materiais vêm sendo utilizados para controlar tais processos infecciosos orais. Este trabalho busca avaliar os tecidos periodontais em seis indivíduos portadores de doença periodontal crônica avançada submetidos à terapia não cirúrgica associada ao uso de membrana bovina absorvível impregnada com tetraciclina (Mbt) a 25%. Após mensuração do índice de placa (IP), índice gengival (IG), margem gengival (MG) e profundidade de sondagem (OS), os pacientes passaram por procedimentos de raspagem e alisamento radicular (AR). A partir daí, pequenos cortes de MbT foram inseridos no interior de bolsas periodontais com PS igual ou maior que 5 mm. Este procedimento foi repetido no 7º, 14º e 21º dias. No dia 28º dia, um novo exame clínico foi realizado. Os resultados indicam diferenças estatisticamente significantes no valores de MG e OS tanto para as áreas experimentais como para o grupo controle, sendo que a utilização da Mbt mostrou-se importante na redução do sangramento gengival juntamente com R e AR. Conclui-se que a terapia mecânica associada ao uso do dispositivo de liberação medicamentosa como a MbT representa um método eficiente para tratamento da doença periodontal.


Subject(s)
Humans , Male , Female , Adult , Dental Plaque Index , Periodontal Index , Periodontitis , Tetracycline
12.
RFO UPF ; 11(2): 11-15, 2006. ilus, tab
Article in Portuguese | LILACS, BBO - Dentistry | ID: lil-457375

ABSTRACT

O bloqueio do nervo alveolar inferior é uma das técnicas anestésicas que apresenta maior índice de falhas em odontologia, em razão da variação anatômica do forame mandibular (FM), que é de suma importância para o êxito da anestesia dos dentes inferiores, por ser utilizado como referência anatômica para deposição da solução anestésica. Este estudo se propõe a avaliar a localização topográfica do FM em cem mandíbulas humanas maceradas, de indivíduos total ou parcialmente edentados, utilizando paquímetro milimetrado e compasso de ponta seca. Observou-se que no sentido craniocaudal o FM encontrava-se no terço médio do ramo mandibular em 80,4 por cento e 89,1 por cento das mandíbulas parcialmente dentadas (md) em em 63 por cento e 74 por cento das mandíbulas edêntulas (mdd), no antímero direito (D) e no esquerdo (E), respectivamente. No sentido ântero-posterior (AP), 97,8 por cento (D/E) das md apresentavam o FM no terço médio do ramo mandibular e, nas mdd, em 96,3 por cento (D) e 92,6 por cento (E) o FM localizava-se nesta posição. Também nos entido AP, em 2,2 por cento (D) e 4,4 por cento (E) das md e em 11,1 por cento (D) e 9,2 por cento (E) das mdd o FM encontrava-se centralizado entre os bordos anterior e posterior do ramo ascendente da mandíbula. Pode-se conluir que não há exata correlação topográfica do FM em antímeros opostos para o mesmo indivíduo, tampouco entre indivíduos diferentes.


Subject(s)
Humans , Male , Female , Mandible , Mandible/anatomy & histology , Vertical Dimension , Xenarthra , Anesthesia, Dental , Mandibular Nerve/anatomy & histology
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