RESUMO
Health promotion and disease prevention link intricately with lifestyle habits such as a healthy diet, physical activity, and good sleep quality. Temporomandibular joint (TMJ) dysfunction and associated disorders can take away sleep and well-being depending on the form and intensity that affect the individual. A multidisciplinary effort has contributed to significant health advances, improving clinical outcomes concerning TMJ dysfunction. This report presents the case of a 37-year-old Caucasian female physical educator with a good healthy diet with complaints of tooth tightening, constant TMJ and neck pain, and tinnitus. The patient was treated with inferior occlusal splint placement and selective occlusal adjustments based on neuro-occlusal rehabilitation. The patient reported relief of pain symptoms with occlusal and body balance, discontinued analgesic medication, and maintained the occlusal splint to practice sports and sleep due to the perception of improved physical performance and sleep, and quality of life. Based on this report, it is necessary to analyze the causes and define the effects of different disorders to establish their diagnosis and treatment and changing patterns to reestablish functional balance.
RESUMO
OBJECTIVES: Obstructive sleep apnea is an inflammatory, chronic, and evolutive disease often needing adequate treatment and follow-up. The oral appliance (OA) is an accepted alternative therapy for obstructive sleep apnea (OSA) control. Due to greater adherence, OA with mandibular advancement (OAm) is being recommended treatment for patients who refuse or do not tolerate continuous positive airway pressure. The mode of action of OAm is to promote the advancement of the mandible or tongue with a subsequent increase in the tone of the pharyngeal muscles and the permeability of the upper airway, but most OAm use conventional models as reference, analogic, or digital, dissociating dental arches of the skull structures. MATERIALS AND METHODS: A retrospective longitudinal study of 33 OSA patient treated with a different OAm, that use Camper plane as reference with skull structures for dental arches disocclusion, where polysomnographic, cephalometric measures, and subjective data from questionnaires pre- and post-treatment were assessed and correlated. Descriptive analysis, correlated Chi-square tests, and basic statistics were used. Generalized linear mixed model for repeated measure and post hoc Tukey-Kramer test compares the variables pre- and post-treatment. Shapiro-Wilk test and Pearson's correlation coefficients were used. All statistical tests were set in 5% level of significance. RESULTS: Regarding polysomnography data, there was a significant association between apnea hypopnea index (AHI) with oxygen saturation, arousal index (AI) and the maximum heartbeats, and sleep improvement and health risk reduction. Additionally, from cephalometric data, it was found a significant association between the tongue posture with the soft palate, hioyd-C3 and, lower and posterior airway. When both parameters are correlated, there are a significant dependent association with hyoid bone position with AHI and AI. The limitation of this study was the two-dimensional image used without provide volumetric measurements, but this limitation was reduced with the follow-up polysomnography parameters. CONCLUSION: In this pilot study, DIORS OAm as an uniquely designed device using Camper plane as a reference for disocclusion was effective in the control of OSA.
RESUMO
OBJECTIVE: This study aimed to evaluate the influence of three different inclinations of the incisal edge of Planas direct tracks (PDTs) on the upper deciduous incisors (15, 30, and 45 degrees) through simulations using the finite-elements method. MATERIALS AND METHODS: A three-dimensional virtual model of tooth 51 was elaborated by using the Rhinoceros computer-aided design (CAD) software. A mesh was constructed by using the Patran software, and the evaluations were processed by using the ANSYS 15.0 software. The geometry of the elements used consisted of a triangular-base tetrahedron composed of 2,167,386 elements and 3,012,995 nodal points. RESULTS: Progressive alterations of proportional intensity and distribution were seen in the areas of tension on the dentoalveolar structures, with increasing inclination of the edge of the PDT. The tractive contact tensions were seen to be concentrated in the vestibular apical thirds and palatine cervical thirds, while the compressive contact tensions were in the palatine apical thirds and vestibular cervical thirds. CONCLUSION: It was concluded that a 30-degree inclination for the PDT was most appropriate for the cases of anterior crossbite in the deciduous dentition. Nevertheless, because this was a laboratory evaluation, clinical criteria and complementary examinations for each case need to be taken into consideration in making therapeutic decisions.
