Effect of a rapid maxillary expansion on snoring and sleep in children: a pilot study.

AIM: The aim of this study was to assess the efficacy of the McNamara rapid palatal expansion device for the treatment of sleep disorders in children. METHODS: The sample enrolled 12 children aged 4-11 years. Children with snoring and bruxism whose parents did not agree to tonsil surgery were included in the study. During the initial evaluation, a questionnaire addressing sleep was administered, and plaster models were made for the construction of the McNamara rapid maxillary expansion device. The expansion period was 7-15 days, and the McNamara device was removed after 6-8 months. The same questionnaire was administered again after 30 days of use of the orthopedic appliance. The data were analyzed using the McNemar test, with the level of significance set to 5% (P<0.05). RESULTS: Significant improvements were found in tiredness upon waking (P=0.002), mood (P=0.008), lip seal (P=0.031), drooling during sleep (P=0.031), snoring (P=0.001), and bruxism (P=0.0062). CONCLUSION: The use of non-invasive methods, such as rapid maxillary expansion, can be an effective treatment for snoring and other undesirable sleep behaviors in children.

Randomized controlled clinical trial of long-term chemo-mechanical caries removal using Papacarie™ gel.

OBJECTIVES: Compare the effectiveness of Papacarie™ gel for the chemo-mechanical removal of carious lesions on primary teeth to conventional caries removal with a low-speed bur with regard to execution time, clinical aspects and radiographic findings. MATERIAL AND METHODS: A randomized controlled clinical trial with a split-mouth design was carried out. The sample was composed of 20 children aged four to seven years, in whom 40 deciduous teeth were randomly divided into two groups: chemo-mechanical caries removal with Papacarie™ and removal of carious dentin with a low-speed bur. Each child underwent both procedures and served as his/her own control. Restorations were performed with glass ionomer cement. The time required to perform the procedure was also analyzed. The patients underwent longitudinal clinical and radiographic follow-up of the restorations. RESULTS: No statistically significant difference between groups was found regarding the time required to perform the procedures and the radiographic follow up. Statistically significant differences between groups were found in the clinical evaluation at 6 and 18 months after treatment. CONCLUSION: Papacarie™ is as effective as the traditional method for the removal of carious dentin on deciduous teeth, but offers the advantages of the preservation of sound dental tissue as well as the avoidance of sharp rotary instruments and local anesthesia.

Chemo-mechanical caries removal with Papacarie™: case series with 84 reports and 12 months of follow-up.

AIM: The aim of the present study was to determine the success rate after 12 months of follow-up in a series of cases in which chemo-mechanical caries removal (CMCR) was performed with Papacarie(TM), followed by restoration with glass ionomer cement. BACKGROUND: The development of conservative techniques for carious tissue removal and improvements in dental restoration materials have allowed better preservation of dental structures in the treatment of decayed teeth. Chemo-mechanical caries removal (CMCR) is a conservative atraumatic treatment option. Papacarie(TM) is a papain-based material developed to act only on the carious dentin, allowing its easy removal with a blunt curette. CASE REPORT: The study involved a total of 84 deciduous posterior teeth with occlusal dentinal caries. Only teeth without risk of pulp exposure were studied. After a period of 12 months, the restorations were evaluated based on criteria employed in previous studies. The radiographic evaluation revealed resorption and calcification of the affected teeth. The data were submitted to descriptive statistical analysis with the aid of the XLSTAT program. The success rate was 88.1% and 98.8% based on the clinical and radiographic evaluations, respectively. The difference between the success and failure rates was statistically significant (p < 0.0001). CONCLUSION: Papacarie(TM) is an effective product for CMCR on occlusal dentinal tissue in deciduous teeth, demonstrating a high clinical and radiographic success rate after 12 months of follow-up.

Assessment of type of bite and vertical dimension of occlusion in children and adolescents with temporomandibular disorder.

The aim of the present study was determine the type of bite and abnormalities in the vertical dimension of occlusion (VDO) among children and adolescents with temporomandibular disorder (TMD). The Helkimo index was employed for the diagnostic investigation of TMD. A clinical examination was performed for the determination of occlusion. The VDO was measured using a digital caliper. Fisher's exact text was used to determine associations between type of bite, gender and TMD. The Student's t-test was used to compare age and VDO by gender. The significance level was set to 5% or corresponding p-value. Children and adolescents with anterior open bite were 1.2-fold more likely to develop TMD in comparison to those without any type of malocclusion. The same was found for those with posterior crossbite and mixed malocclusion. A statistically significant association was found between the VDO and age in both genders. TMD affected 68.85% of the sample. No correlation was found between malocclusion, VDO and TMD in the sample. The present findings suggest that individuals with malocclusion are more prone to TMD. Therefore, it is important to evaluate all variables capable of influencing the harmony of the stomatognathic system for an effective diagnosis of TMD and malocclusion.

Randomized controlled clinical trial of long-term chemo-mechanical caries removal using PapacarieTM gel

Objectives: Compare the effectiveness of PapacarieTM gel for the chemo-mechanical removal of carious lesions on primary teeth to conventional caries removal with a low-speed bur with regard to execution time, clinical aspects and radiographic findings. Material and Methods: A randomized controlled clinical trial with a split-mouth design was carried out. The sample was composed of 20 children aged four to seven years, in whom 40 deciduous teeth were randomly divided into two groups: chemo-mechanical caries removal with PapacarieTM and removal of carious dentin with a low-speed bur. Each child underwent both procedures and served as his/her own control. Restorations were performed with glass ionomer cement. The time required to perform the procedure was also analyzed. The patients underwent longitudinal clinical and radiographic follow-up of the restorations. Results: No statistically significant difference between groups was found regarding the time required to perform the procedures and the radiographic follow up. Statistically significant differences between groups were found in the clinical evaluation at 6 and 18 months after treatment. Conclusion: PapacarieTM is as effective as the traditional method for the removal of carious dentin on deciduous teeth, but offers the advantages of the preservation of sound dental tissue as well as the avoidance of sharp rotary instruments and local anesthesia. .

Efeito citotóxico dos cimentos de ionômero de vidro em cultura celular / Cytotoxic effect of glass ionomer cements in cell culture

Objetivo: Avaliar a toxicidade de cimentos de ionômero de vidro (CIV) quimicamente ativados em culturas de células, após aglutinação do material e reação de presa. Materiais e Métodos: Dividiu-se os materiais em 9 grupos experimentais: I: controle, li (AP) Riva Self Cure (SOl), 111 (PP) Riva Self Cure (SOl), IV (AP) Maxxion R (FGM), V (PP) Maxxion (FGM), VI (AP) Vitro Molar (DFL), VII (PP) Vitro Molar (OFL), VIII (AP) KetacMolar Easymix, IX (PP) Ketac Molar Easymix (3M!ESPE). Manipularam-se os CIV conforme instruções do fabricante sendo depositados em laminulas em contato com a cultura de células logo após a aglutinação do material e após a reação de presa. A ação dos materiais sobre os fibroblastos cultivados foi analisada sobre o crescimento celular no curto, longo prazo e no ensaio de viabilidade e proliferação celular. Resultados: Grupos que receberam materiais após a presa apresentaram número de células viáveis e porcentagens menores que o grupo controle, porém permitiram crescimento celular durante todo experimento. Quando colocados em contato com as células logo após a aglutinação, induziram morte celular imediata. O material que demonstrou menor atividade citotóxica em fibroblastos foi o Ketac- Molar Easymix (3M!ESPE). Conclusão: Todos os CIV testados apresentaram-se tóxicos antes da reação de presa, entretanto após a reação de presa, permitiram crescimento celular

Aim: The aim of the present study was to assess the toxicity of different chemically activated GICs in fibroblast cell cultures post-agglutination (PA) and post-setting reaction (PS). Material and Methods: The materiais were divided into nine experimental groups: Group I - control; Group li (PA) - Riva Self Cure (SOl); Group 111 (PS) - Riva Self Cure (SOl); Group IV (PA) - Maxxion R (FGM); Group V (PS) - Maxxion (FGM); Group VI (PA) - Vitro Molar (OFL); Group VII (PS) - Vitro Molar (OFL); VIII (PA) - Ketac Molar Easymix; and Group IX (PS) - Ketac Molar Easymix (3M! ESPE). The cements were mixed following the manufacturers' instructions, deposited on glass slip covers and placed into contact with the cell cultures immediately following the agglutination of the material or after the setting reaction. The effect of the materiais on the cultivated fibroblasts was analyzed in terms of short-term and long-term cell growth as well as in viability and cell proliferation assays. Results: When placed in contact with the cells immediately follo- wing agglutination, the materiais caused immediate cell death. The groups having received the materiais following the setting reaction had a lower number and percentage of viable cells in comparison to the control, but the materiais allowed cell growth throughout the experiment. KetacMolar Easymix (3M!ESPE) was the glass ionomer cement with the least amount of cytoto- xic activity on fibroblasts. Conclusion: Ali glass ionomer cements tested were toxic prior to the setting reaction.However after setting reaction, allowed cell growth

Efficacy of Papacarie(®) in reduction of residual bacteria in deciduous teeth: a randomized, controlled clinical trial.

OBJECTIVES: The aim of the present study was to analyze the efficacy of Papacarie(®) gel compared with the traditional method (low-speed bur) in reducing the counts of total bacteria, Lactobacillus, total Streptococcus and Streptococcus mutans group. METHODS: A randomized, controlled clinical trial with a split-mouth design was performed. The sample comprised 40 deciduous teeth in 20 children (10 males and 10 females) aged four to seven years. The teeth were randomly allocated to two groups: G1, or chemomechanical caries removal with Papacarie Duo(®), and G2, or the removal of carious dentin tissue with a low-speed bur. Infected dentin was collected prior to the procedure, and the remaining dentin was collected immediately following the removal of the carious tissue. Initial and final counts of bacterial colonies were performed to determine whether there was a reduction in the number of colony-forming units (CFUs) of each microorganism studied. ClinicalTrials.gov: NCT01811420. RESULTS: Reductions were found in the numbers of total bacteria, total Streptococcus and Streptococcus mutans group following either of the caries removal methods (p<0.05). A reduction was also noted in the number of Lactobacillus CFUs; however, this difference did not achieve statistical significance (p>0.05). CONCLUSION: Papacarie(®) is an excellent option for the minimally invasive removal of carious tissue, achieving significant reductions in total bacteria, total Streptococcus and S. mutans with the same effectiveness as the traditional caries removal method.

Production of extracellular matrix proteins by human pulp fibroblasts in contact with papacárie and carisolv.

PURPOSE: To evaluate the effect of two products for the chemomecanical removal of carious tissue (Papacárie and Carisolv) on human dental pulp fibroblasts and the synthesis of extracellular matrix proteins. MATERIALS AND METHODS: Fibroblasts were divided into three groups: group 1 (control), group 2 (Papacárie) and group 3 (Carisolv). Collagen I, III , fibronectin and osteonectin were analysed by immunofluorescence and compared among the groups. RESULTS: The groups exhibited similar immunolabeling for vimentin, type I collagen and fibronectin, but were negative for type III collagen. Osteonectin staining was strongly positive in the cells treated with Papacárie and Carisolv and weakly positive in the control group. CONCLUSION: The findings of the present study showed that Papacárie and Carisolv are not cytotoxic to pulp fibroblast cells. Moreover, these products stimulate fibroblasts to produce osteonectin, likely leading to the formation of dentin matrix. These findings confirm the safe, beneficial use of both gels in minimally invasive techniques.

Accuracy study of the main screening tools for temporomandibular disorder in children and adolescents.

The aims of the present study were to assess the degree of sensitivity and specificity of the screening questionnaire recommended by the American Academy of Orofacial Pain (AAOP) and the patient-history index proposed by Helkimo (modified by Fonseca) and correlate the findings with a clinical exam. All participants answered the questionnaires and were submitted to a clinical exam by a dentist who had undergone calibration training. Both the AAOP questionnaire and Helkimo index achieved low degrees of sensitivity for the detection of temporomandibular disorder (TMD), but exhibited a high degree of specificity. With regard to concordance, the AAOP questionnaire and Helkimo index both achieved low levels of agreement with the clinical exam. The different instruments available in the literature for the assessment of TMD and examined herein exhibit low sensitivity and high specificity when administered to children and adolescents stemming from difficulties in comprehension due to the age group studied and the language used in the self-explanatory questions.

Efficacy of Papacarie¯ in reduction of residual bacteria in deciduous teeth: a randomized, controlled clinical trial

OBJECTIVES: The aim of the present study was to analyze the efficacy of Papacarie¯ gel compared with the traditional method (low-speed bur) in reducing the counts of total bacteria, Lactobacillus, total Streptococcus and Streptococcus mutans group. METHODS: A randomized, controlled clinical trial with a split-mouth design was performed. The sample comprised 40 deciduous teeth in 20 children (10 males and 10 females) aged four to seven years. The teeth were randomly allocated to two groups: G1, or chemomechanical caries removal with Papacarie Duo¯, and G2, or the removal of carious dentin tissue with a low-speed bur. Infected dentin was collected prior to the procedure, and the remaining dentin was collected immediately following the removal of the carious tissue. Initial and final counts of bacterial colonies were performed to determine whether there was a reduction in the number of colony-forming units (CFUs) of each microorganism studied. ClinicalTrials.gov: NCT01811420. RESULTS: Reductions were found in the numbers of total bacteria, total Streptococcus and Streptococcus mutans group following either of the caries removal methods (p<0.05). A reduction was also noted in the number of Lactobacillus CFUs; however, this difference did not achieve statistical significance (p>0.05). CONCLUSION: Papacarie¯ is an excellent option for the minimally invasive removal of carious tissue, achieving significant reductions in total bacteria, total Streptococcus and S. mutans with the same effectiveness as the traditional caries removal method. .

Pain during Removal of Carious Lesions in Children: A Randomized Controlled Clinical Trial.

The aim of the present study was to assess pain and the need for anesthesia during chemomechanical caries removal with Papacarie gel and the traditional method (low-speed bur) in pediatric patients. A randomized, controlled, clinical trial with a "split-mouth" design was carried out involving 20 children (10 girls and 10 boys) aged four to seven years. Forty primary teeth (two per child) were randomly allocated to either Group 1 (G1: chemomechanical caries removal with Papacarie gel) or Group 2 (G2: removal of carious dentin with low-speed bur). A face scale was used to classify the sensation of pain during the procedure (1: absence of pain; 2: mild pain; 3: moderate pain; 4: moderately intense pain; 5: intense pain; and 6: extremely intense pain). Statistical analysis of the data was performed using the Wilcoxon-Mann-Whitney (U) test. Pain scores were higher in G2, with statistically significant differences in comparison to G1 (U = 148.0; W = 358.0; P = 0.041). Chemomechanical caries removal with Papacarie provides a lesser degree of pain in comparison to conventional caries removal and does not require the use of local anesthesia. The clinical trial registration number is NCT01811420.

Are occlusal characteristics, headache, parafunctional habits and clicking sounds associated with the signs and symptoms of temporomandibular disorder in adolescents?

[Purpose] To assess the association between the oclusal characteristics, headache, parafunctional habits and clicking sounds and signs/symptoms of TMD in adolescents. [Subjects] Adolescents between 14 and 18 years of age. [Methods] The participants were evaluated using the Helkimo Index and a clinical examination to track clicking sounds, parafunctional habits and other signs/symptoms of temporomandibular disorder (TMD). Subjects were classified according to the presence or absence of headache, type of occlusion, facial pattern and type of bite. In statistical analyse we used the chi-square test and Fisher's exact test, with a level of significance of 5%. [Results] The sample was made up of 81 adolescents with a mean age of 15.64 years; 51.9% were male. The prevalence of signals/symptoms of TMD was 74.1%, predominantly affecting females. Signals/symptoms of TMD were significantly associated with clicking sounds, headache and nail biting. No associations were found between signals/symptoms of TMD and angle classification, type of bite and facial pattern. [Conclusion] Headache is one of the most closely associated symptoms of TMD. Clicking sounds were found in the majority of cases. Therefore, the sum of two or more factors may be necessary for the onset and perpetuation of TMD.

Effect of an occlusal splint on sleep bruxism in children in a pilot study with a short-term follow up.

The aim of the present study was to evaluate the effect of the use of an occlusal splint in children with bruxism in a pilot study with a short-term follow up. Seventeen children were recruited, only nine of whom formed the sample following the application of the inclusion criteria: presence of sleep bruxism for at least six months (based on parents' reports); presence of at least the first permanent molars; and no previous history of treatment involving an occlusal splint. The sample was submitted to a clinical exam. Other sleep problems were screened with the use of a sleep questionnaire filled out by parents before and after 90 days of occlusal splint usage. The children received a flat acrylic resin splint with full coverage of the occlusal surfaces to be worn in the maxilla. In children with erupting teeth, a space was created in the splint to allow normal eruption. After the 90-day period, the absence of sleep bruxism and sleep movements was noted in most of children. Moreover, snoring was reduced in nearly 50%, which raises a new issue to be investigated with regard to the pathophysiology of sleep bruxism. The use of an occlusal splint was effective in reducing the symptoms of sleep bruxism and other sleep problems. Further investigations should be carried out on the relationship between snoring and sleep bruxism in children.

Assessment of chemomechanical removal of carious lesions using Papacarie Duo™: randomized longitudinal clinical trial.

BACKGROUND: Chemomechanical removal of carious lesions consists of the dissolution of carious tissue by the application of a natural or synthetic agent, followed by atraumatic mechanical removal. AIM: The aim of the present study was to assess the effectiveness of Papacarie Duo ® gel in the chemomechanical removal of carious lesions in primary teeth in comparison to the traditional method (low-speed bur). SETTINGS AND DESIGN: A randomized clinical trial was conducted with 20 children between 5 and 8 years of age. MATERIALS AND METHODS: Two teeth were treated in each child (split-mouth design), with the randomization of two methods: Group 1 - chemomechanical caries removal with Papacarie Duo™; and Group 2 - removal of carious dentin tissue using a low-speed bur. Both methods involved restoration with glass ionomer cement and follow up. The following aspects were evaluated: time required for the procedure; pain (face evaluation scale); retention of the restorative material in the cavity; and the presence of secondary caries after 30 days. STATISTICAL ANALYSIS USED: Chi-squared test, Student's t-test, and Wilcoxon test. RESULTS: No statistically significant differences between methods were found regarding time required for the procedure (P = 0.13), the occurrence of pain (P = 0.585), or restoration status at the 30-day clinical evaluation (P = 0.713). CONCLUSION: The findings of the present study demonstrate that the two methods achieve similar results. The advantages of minimally invasive treatment, such as chemomechanical caries removal with Papacarie Duo™, are its ease of use, patient comfort, and the fact that it causes less damage to dental tissue.

Tratamento de cárie proximal com infiltrante de resina em paciente adolescente / Treatment of proximal caries with resin infiltration in an adolescent patient

Este artigo apresenta um relato de caso de um paciente de 12 anos de idade, atendido em clínica de odontopediatria de instituição privada de odontologia. Mancha branca foi detectada na mesial do dente 16 durante o exame oral e foi confirmada através de radiografia bitewing. Tratamento microinvasivo da cárie foi realizado utilizando o Icon® (DMG). Verificação radiológica foi feita após 12 meses de acompanhamento e nenhuma lesão foi observada no dente tratado. Esse caso demonstra que o tratamento microinvasivo é uma alternativa viável para cáries proximais.

This article presents a case report of a twelve-year-old female patient treated at a pediatric clinic of a private school of dentistry. A mesial bright spot was detected on tooth 16 during the oral examination and confirmed by a bitewing x-ray. Micro-invasive treatment of caries was carried out using Icon® (DMG). A radiological check was made at the 12-month follow up and no lesion was observed in the treated tooth. This case report demonstrates that micro-invasive treatment is a viable alternative for proximal caries.

Correção de erupção passiva alterada por meio de cirurgia plástica periodontal / Correction of altered passive eruption by periodontal plastic surgery

Vários aspectos influenciam nas características do sorriso, tais como: linha mediana, posicionamento dental, linha do sorriso e características gengivais. A erupção passiva alterada é uma condição que interfere na estética do sorriso, por originar coroas clínicas curtas e estar associada ao sorriso gengival. Este trabalho relata um caso clínico de paciente do sexo feminino com erupção passiva alterada que, devido às suas características, interferia na harmonia do sorriso, sendo corrigida pela técnica de gengivectomia com bisel interno associada à osteotomia. A queixa da paciente estava relacionada à estética do seu sorriso, devido à diferença no tamanho das coroas clínicas dos elementos anteriores e excessiva exposição gengival na região. Após o diagnóstico de erupção passiva alterada tipo 1B na face vestibular do elemento 11, seu tratamento consistiu na realização de gengivectomia com incisão de bisel interno. Após 12 meses, pôde-se observar que o resultado almejado foi alcançado sem necessidade de cirurgias adicionais. Concluiu-se que a técnica de gengivectomia mostra-se eficaz para a correção e o restabelecimento da harmonia do sorriso, em casos de erupção passiva alterada associada apenas ao posicionamento coronário do tecido gengival em relação à junção cemento-esmalte.

Clinical status of permanent first molars in children aged seven to ten years in a Brazilian rural community

Aim: To evaluate the clinical status of permanent first molars and associations with dental caries, gingival bleeding, dental fluorosis and malocclusion. Methods: An observational study wascarried out in a rural community denominated Morro do Saboó in the city of São Roque, state of São Paulo, Brazil. A total of 194 children aged seven to ten years were examined for dental caries using the index proposed by the World Health Organization. Other conditions were determined using the Gingival Alterations Index, Dean’s Index and Dental Aesthetic Index. The chi-squared test was used for the statistical analysis of the data. Results: A total of 85.5% of the sample exhibited gingival bleeding and 69.9% exhibited malocclusion. A total of 53.6% had a clinical aspect of normality with regard to dental fluorosis. There was a predominance of sound teeth in the upper arch and teeth with carious lesions in the lower arch. No significant differences were found between sexes regarding gingival bleeding, dental fluorosis or malocclusion. Significant associations were found between tooth status and oral alterations (gingival bleeding, malocclusion and fluorosis) in teeth 16, 26 and 46 and between tooth status and gingival bleeding in tooth 36 (p<0.001). Conclusions: Caries activity in the permanent first molars was mainly associated with dental fluorosis and malocclusion. Strategies aimed at health promotion should be adopted on a large scale to minimize the prevalence of oral diseases.

Remoción quimico-mecánica de lesión de caries en diente permanente con Papacárie Duo(TM): reporte de un caso / Chemomechanical removal of carious lesion in a permanent tooth with Papacárie Duo(TM): report of a case

Este trabajo tiene como objetivo presentar el protocolo clínico de Papacárie Duo(TM), desde el diagnóstico de la lesión de caries hasta el procedimiento restaurador. Una paciente femenina de 12 años de edad se presentó a la consulta odontopediátrica por dolor al frío y durante la ingesta de alimentos dulces. El examen clínico y radiográfico reveló caries en la pieza 46, clasificada como score 6, según el sistema ICDAS (cavidad extensa con exposición de la dentina). La conducta clínica consistió en la eliminación del tejido infectado por medio de la remoción quimico-mecánica de la caries utilizando el gel a base de papaína y restauración con ionómero vítreo. Se concluye, a partir de este protocolo, que la eliminación quimico-mecánica de la lesión de caries es un método de fácil aplicación basdado en la odontología mínimamente invasiva.

Gender as risk factor for mouth breathing and other harmful oral habits in preschoolers

Aim: To analyze associations between the mouth-breathing pattern and other harmful oral habits among preschoolers. Methods: An observational, cross-sectional study was carried out involving 198 children from 3 to five 5 of age. A questionnaire, clinical evaluation and specific tests (mirror and water tests) were used for confirmation of the mouth-breathing pattern. Results: Mean age of the participants was 4.13 ± 0.8 years and 57.1% were male. A total of 87.4% exhibited one or more harmful oral habits. Harmful habits were more common in the male gender (61.8%); this association was statistically significant (p<0.001). Mouth breathing was the most prevalent habit (49%), followed by biting/sucking on objects (33.3%). Regarding gender, statistically significant associations were found for bottle feeding (p=0.02) and nail biting (p=0.02). Mouth breathing was associated with biting on object (p=0.00), pacifier use (p=0.02) and thumb sucking (p=0.00). Conclusions: The results of the present study suggest that mouth breathing is significantly associated with biting/sucking on objects, pacifier use and thumb sucking in preschoolers and that the occurrence of harmful oral habits is more prevalent among the male gender. Early diagnosis and intervention should be established in order to avoid future consequences involving the orofacial region.

Impacto da terapia de suporte nas alterações otológicas em pacientes com desordem temporomandibular / Impact of supportive therapy for otological changes in patients with temporomandibular joint disorders

JUSTIFICATIVA E OBJETIVOS: As queixas de sintomas otológicos podem estar associadas a quadros de disfunção temporomandibular (DTM). A placa miorrelaxante é uma alternativa de tratamento para a DTM, pois oferece oclusão ideal para o paciente, atuando nos sintomas de dor. Considerando as características conservadoras e reversíveis da terapia de suporte com placa miorrelaxante, o objetivo deste estudo foi avaliar seu impacto na frequência de alterações otológicas em pacientes com DTM. MÉTODO: Realizou-se estudo de intervenção em 35 pacientes com sintomas otológicos associados à DTM. Foram considerados portadores de DTM aqueles que apresentassem pelo menos três sinais e três sintomas da morbidade, sendo um deles otalgia, zumbido, sensação de hipoacusia, sensação de plenitude auricular ou tontura. Os pacientes foram submetidos a exame clínico, orientações e confecção de placa miorrelaxante maxilar em resina acrílica termoplastificável. Ajustes da placa e avaliação dos sintomas foram realizados quinzenalmente. Utilizou-se o teste Exato de Fisher para análise estatística da diferença entre a prevalência de sinais e sintomas antes (AN) e após (AP) a terapia, com nível de significância de 5% (p < 0,05). RESULTADOS: Dezenove pacientes concluíram o tratamento. Observou-se redução na prevalência de sinais e sintomas otológicos: zumbido (AN = 14; AP = 6; p = 0,009), otalgia (AN = 13; AP = 4; p = 0,003), sensação de plenitude auricular (AN = 12; AP = 4; p = 0,006), tontura (AN = 11; AP = 4; p = 0,009) e de hipoacusia (AN = 10; AP = 2; p = 0,001). CONCLUSÃO: A placa miorrelaxante é uma terapia conservadora e reversível que mostrou ser capaz de melhorar os sintomas otológicos associados à DTM.

BACKGROUND AND OBJECTIVES: Otological symptoms complaints may be associated to temporomandibular joint disorders (TMJD). Occlusal splint is an alternative to treat TMJD because it provides ideal occlusion to patients, acting on painful symptoms. Considering the conservative and reversible characteristics of supportive therapy with occlusal splints, this study aimed at evaluating its impact on the frequency of otological changes in TMJD patients. METHOD: An intervention study was carried out with 35 patients with TMJD-associated otological symptoms. TMJD patients were considered those with at least three signs and three symptoms of morbidity, being one of them earache, tinnitus, sensation of hypoacusis, ear fullness or dizziness. Patients were submitted to clinical evaluation, orientations and fabrication of maxillary occlusal splint in thermoplastic acrylic resin. Splint adjustments and symptoms evaluation were performed fortnightly. Fisher Exact test was used for statistical analysis of the prevalence of signs and symptoms before (BE) and after (AF) therapy with significance level of 5% (p < 0.05). RESULTS: Nineteen patients have finished the treatment. There has been decrease in the prevalence of otological signs and symptoms: tinnitus (BE = 14; AF = 6; p = 0.009), earache (BE = 13; AF = 4; p = 0.003), ear fullness (BE =12; AF = 4; p = 0.006), dizziness (BE = 11; AF = 4; p = 0.009) and hypoacusis (BE = 10; AF = 2; p = 0.001). CONCLUSION: Occlusal splint is a conservative and reversible therapy able to improve TMJD-related otological symptoms.