Electromiografía de Superficie y Articulografía Electromangética para Análisis de Dimensión Vertical. Reporte de Protocolo / Surface Electromyography and Electromagnetic Articulography to Analyze VerticalDimension. Protocol Report

INTRODUCCIÓN: La correcta determinación de la Dimensión Vertical (DV) es esencial al momento de rehabilitar a un paciente. En la literatura existen escasas investigaciones que relacionen en conjunto la DV con otras variables como actividad electromiográfica.El objetivo de este estudio es describir una técnica para el análisis de la DVa través del Espacio Libre de Inoclusión (ELI), mediante la utilización de articulografíaelectromagnética y electromiografía de superficie. MATERIAL Y MÉTODOS: Se registró la DV mediante el uso de un articulógrafo electromagnético AG501 simultáneamente con la actividad electromiográfica de músculos masetero y temporal mediante la utilización de electromiógrafo de superficie EMG VIII, según protocolo de DVO y DVP.El estudio se realizó en el Laboratorio de Fisiología Oral del Centro de Investigación en Ciencias Odontológicas (CICO) con la Aprobación del Comité Ético Científico de la Universidad de La Frontera. RESULTADOS: Se obtuvo un protocolo para el uso de electromiografía y articulografía electromagnética 3D en el análisis de dimensión vertical, el cual permite caracterizar la dimensión vertical mediante una medición de distanciavertical, medición de distancia 3D, ángulo de apertura y la actividad eléctrica de los músculos elevadores de la mandíbula a distintos grados de apertura

INTRODUCTION: The correct determination of the Vertical Dimension (VD) is essential when rehabilitating a patient. There is little research in the literature that collectively relates the VD to other variables such as electromyographic activity. The objective of this study is to describe a technique for the analysis of the VD through the Interocclusal Distance, using electromagnetic articulography and surface electromyography. MATERIAL AND METHODS: The VD was recorded by using an AG501 electromagnetic articulgraph simultaneously with the electromyographic activity of masseter and temporal muscles using EMG VIII surface electromyograph, according to DVO and DVP protocol. The study was carried out in the Oral Physiology Laboratory of the Center for Research in Dental Sciences (CICO) with the approval of the Scientific Ethical Committee of the University of La Frontera. RESULTS: A protocol was obtained for the use of electromyography and 3D electromagnetic articulography in the vertical dimension analysis, which allows the vertical dimension to be characterized by a vertical distance measurement, 3D distance measurement, opening angle and the electrical activity of the lifting muscles of the jaw to different degrees of opening

Las tres caras de la sonrisa gingival. Revisión bibliográfica / The three faces of the gummy smile. Literature review

Hablamos de sonrisa gingival cuando se altera la armonía establecida entre los dientes, labios y encía, exponiendo más allá de 2 mm de encía coronal a los incisivos maxilares, una circunstancia que, en ocasiones, genera un problema estético para algunos pacientes. La etiopatogenia de dicha condición se resume en tres facetas: dentoperiodontal (erupción pasiva alterada y erupción activa alterada), ósea (esquelética y/o dentoalveolar) y muscular (labio superior corto e hipermovilidad labial).Una condición multifactorial como la sonrisa gingival precisa un abordaje multidisciplinar: cirugía plástica periodontal, ortodoncia, cirugía ortognática, reposición labial, infiltración de toxina botulínica y tratamiento estético complementario

The excessive gingival display when a patient smiles (from 2 mm or more) is known as gummy smile. When the harmony established between the teeth, lips and gum is altered, exhibiting short clinical crown of the maxillary anterior teeth, in occasions generates an aesthetic problem for some patients.There are different etiologies of gummy smile, it concludes in three facets: dentoperiodontal (Altered Passive Eruption and Altered Active Eruption), bone defect (excessive vertical bone growth, dentoalveolar extrution) and muscular (short upper lip and upper lip hyperactivity), and the combination of some of these factors.A multifactorial condition requires a multidisciplinary boarding: plastic periodontal surgery, orthodontic, orthognathic surgery, lip reduction, infiltration of Botulinum toxin and complementary aesthetic treatment

Topographic anatomy of mandibular foramen in different age groups using panoramic radiographs

The purpose of this investigation was to document the most common position of the mandibular foramen and to compare its position in three different age groups, gender and sides on panoramic radiographs. The knowledge regarding the location of mandibular foramen is essential for administering the inferior alveolar nerve block, peripheral neurectomy and for performing osteotomy cuts with low inferior alveolar nerve morbidity. Two hundred mandibular foramina were studied on panoramic radiographs of one hundred patients (51 female and 49 male) with a mean age of 20.15±10.7 years. The patients were grouped into three age groups (≤13, 14-25, >25 years). Various measurements for the position of mandibular foramen were performed in horizontal and vertical dimensions using different landmarks and reference points. The ratios of horizontal and vertical dimensions were compared within three different age groups, gender and side. The majority of mandibular foramina were in the ratio range of 0.31-0.40 in all the three age groups horizontally and vertically with a significant difference in patients within the age group of ≤ 13 years from the other two age groups. The study showed that the mandibular foramen was located in the middle third of the ramus and the location of the mandibular foramen maintained bilateral symmetry in all the cases. The study indicated that the location of the mandibular foramen is variable. However, the superior and posterior fifths are found to be the safer zones. So, the positional changes of mandibular foramen with age are imperative, as in children they may be occasionally found in inferior third and therefore preoperative knowledge of the exact position of the mandibular foramen may guide the surgeon to develop a safe and accurate surgical technique avoiding any violation of the neurovascular bundle

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Jaw mobility changes in patients with upper aerodigestive tract cancer undergoing radiation therapy

BACKGROUND: Radiation therapy is a therapeutic modality widely used for treatment of upper aerodigestive tract (UADT) neoplasms. However, its action is not restricted to tumor cells, and it may cause a variety of adverse reactions, including reduced jaw mobility. MATERIAL AND METHODS: A prospective cohort study was conducted to assess changes in jaw mobility in patients with UADT cancer undergoing radiation therapy. RESULTS: Fifty-six patients completed the study. The results showed a significant reduction in mouth opening (p < 0.001), right lateral excursion (p = 0.038) and left lateral excursion (p = 0.035) of the jaw, a significant increase in the presence (p < 0.001) and severity of oral mucositis (p < 0.001), and a significant decrease in performance status (p < 0.001) after radiation therapy. Thirty-six patients (64.3%) exhibited reduction in mouth opening after treatment. The variables significantly associated with mouth opening reduction on bivariate analysis were: modification of diet (p = 0.037), radiation field (p = 0.024), presence of mucositis (p = 0.003), and reduction in performance status (p = 0.007). After adjustment by the multivariate model, the only variables that remained significantly associated with reduction in mouth opening were presence of mucositis (p = 0.018) and reduction in performance status (p = 0.47). CONCLUSIONS: These findings indicate that patients with upper aerodigestive tract cancer experience reduced jaw mobility after radiation therapy, which is strongly correlated with mucositis and reduced functional ability

Técnica Semidirecta para Disfunciones en FRS de C3 / Semidirect techniques for FRS dysfunctions of C3

Algunas de las recomendaciones basadas en la evidencia científica disponible establecen que, aunque se han hecho muchos estudios sobre la eficacia de la manipulación, existen escasas descripciones sobre la manipulación cervical para disfunción en FRS, y sus consideraciones clínicas de aplicación. El objetivo de nuestro estudio es aportar las generalidades básicas para la adecuada aplicación de este procedimiento terapéutico (AU)

Some of the recommendations based on the available scientific evidence establish that although there are many trials about the effectiveness of manipulation, there are few descriptions about cervical manipulation for dysfunctions in FRS, and their clinical considerations of being applied. The objective of our trial is to provide the basic generalities for the appropriate application of this therapeutic procedure (AU)

The effects of image compression on quantitative measurements of digital panoramic radiographs

Objectives: The aims of this study were to explore how image compression affects density, fractal dimension, linear and angular measurements on digital panoramic images and assess inter and intra-observer repeatability of these measurements. Study Design: Sixty-one digital panoramic images in TIFF format (Tagged Image File Format) were compressed to JPEG (Joint Photographic Experts Group) images. Two observers measured gonial angle, antegonial angle, mandibular cortical width, coronal pulp width of maxillary and mandibular first molar, tooth length of maxillary and mandibular first molar on the left side of these images twice. Fractal dimension of the selected regions of interests were calculated and the density of each panoramic radiograph as a whole were also measured on TIFF and JPEG compressed images. Intra-observer and inter-observer consistency was evaluated with Cronbach’s alpha. Paired samples t-test and Kolmogorov-Smirnov test was used to evaluate the difference between the measurements of TIFF and JPEG compressed images.Results: The repeatability of angular measurements had the highest Cronbach’s alpha value (0.997). There was statistically significant difference for both of the observers in mandibular cortical width (MCW) measurements (1st ob. p: 0.002; 2nd ob. p: 0.003), density (p<0.001) and fractal dimension (p<0.001) between TIFF and JPEG images. There was statistically significant difference for the first observer in antegonial angle (1st ob p< 0.001) and maxillary molar coronal pulp width (1st ob. p< 0.001) between JPEG and TIFF files. Conclusions: The repeatability of angular measurements is better than linear measurements. Mandibular cortical width, fractal dimension and density are affected from compression. Observer dependent factors might also cause statistically significant differences between the measurements in TIFF and JPEG images (AU)

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Cambios electromiográficos tras corregir la mordida cruzada posterior unilateral / No disponible

La finalidad de este estudio fue analizar los cambios electromiográficos (EMG)durante el reposo y máximo apretamiento que se producen tras la corrección ortodóncica de la mordida cruzada posterior unilateral en una muestra de 25pacientes de clase I de 10 a 15 años de edad. Empleamos la electromiografía de superficie para medir la actividad de los músculos masticatorios antes y después del tratamiento. Comparamos las actividades musculares del lado de la mordida cruzada frente al otro, en el momento inicial y en el final, así como las actividades en el lado de la mordida cruzada antes y después del tratamiento, y en el lado sin mordida cruzada antes y después. Durante el reposo no hubo cambios significativos, aunque si disminuyó la asimetría muscular y se mantuvo elevada la actividad de los temporales posteriores. En el apretamiento final se produce un aumento significativo de las actividades de maseteros y temporales anteriores, aproximándosela actividad de los maseteros a la de los temporales anteriores que predominaba al inicio (AU)

The aim of this study was to assess the neurofunctional alterations (EMG) at rest and during clenching that occur after orthodontic correction of unilateral posteriorcrossbites (UPCB) in 25 Class I patients aged 10 to 15 years. Surface electrodes were used to record electromyographic (EMG) activity of masticatory muscles before and after orthodontic therapy. EMG activity comparisons between the cross-bite and the non-crossbite side were performed before and after treatment. Pretreatment and posttreatment comparisons were performed within each side. At rest position there were no significant pre-posttreatment changes although the differences in the EMG activities between sides decreased. EMG activity of the posteriortemporalis was still high after treatment. During posttreatment clenching there was a significant increase in EMG activities of the masseters and anteriortemporalis. The increase in the masseter activity equaled its activity to one of the temporalis that had dominated before treatment (AU)

Gestación incipiente y prolapso uterino / Early pregnancy and uterine prolapse

La gestación como complicación de un prolapso uterino preexistente es una entidad infrecuente y no exenta de grandes complicaciones que evitarán la resolución con éxito de la gestación. Se expone un caso acontecido en nuestro hospital, así como su tratamiento y resolución, intentando determinar unas pautas terapéuticas generales tras una revisión exhaustiva de la escasa bibliografía existente (AU)