RESUMO
Objetivo: este artigo relata uma técnica de reabilitação por prótese nasal constituída externamente por uma camada de silicone aderida a uma base de resina acrílica. Material e método: o paciente J.A. de 62 anos apresentava perda da estrutura externa do nariz por carcinoma espinocelular. Após moldagem e obtenção do modelo facial, foi feito o enceramento da prótese nasal. O modelo do nariz em cera, após ter sido remodelado no paciente, foi duplicado e um dos modelos incluído em mufla para microondas para eliminação da cera e polimerização da peça em resina acrílica com pigmentação intrínseca. Esta foi reduzida em espessurae realizadas perfurações que serviram de retenção para o silicone que recobriu toda a porção externa da peça. O silicone foi pigmentado e manipulado após seleção prévia da cor da pele do paciente. Depois foi inserido sobre a resina e incluído na mufla, e polimerizado sob pressão em prensa de bancada durante 24 horas. A prótese polimerizada foi provada no paciente, corrigida quanto à caracterização de cor, e após sua aprovação, foi fixada à pele por meio de adesivo à base de hidroxipropil celulose. O paciente foi orientado quanto à higiene diária da prótese e retornou em sessões sucessivas para proservação. Conclusão: a prótese nasal com base interna de resina e superfície externa de silicone, fixada com adesivo a base de hidroxipropil celulose admitiu bons resultados estéticos e boa qualidade.
Purpose: this article reports a technique of rehabilitation with nasal prosthesis made by a layer of silicone and acrylic resin. Material and methods: the patient J.A.S., 62 years old, had his nose lost in order to remove a squamous cell carcinoma. After getting the facial model, the nasal prosthesis was waxed. After being refurbished in the patient, the wax model was duplicated and one of the models was included in microwave oven for removal of wax and polymerization of the acrylic resin base with intrinsic pigmentation. The base thickness was reduced and retention holes were made to retain the silicone that recovered theentire external surface. The silicone was pigmented and manipulatedaccording to the patient?s skin color. The silicone was added over the acrylic resin base and the set was flasked and cured under pressure in a bench press for 24 hours. After color and adaptation adjustments, the nasal prosthesis was fixed to the skin with hydroxypropyl cellulose based adhesive. The patient was instructed to clean the prosthesis daily and to return to successive proservation sessions. Conclusion: the nasal prosthesis made with inner bases of resin and external surface ofsilicone fixed with adhesive admitted esthetic results and great quality.
RESUMO
OBJECTIVE: Investigate the incidence of symptoms of craniomandibular disorder in elderly Brazilian wearers of full dentures. DESIGN: In this cross-sectional study, a questionnaire based on Helkimo's anamnestic index was applied to a group of 65-year-olds or older individuals who wear a set of full dentures. SETTING: Interviews were carried out at the dental clinics of the University of Taubaté and the University of Vale do Paraíba, Brazil. SUBJECTS: From a total of 384 patients, 84 elderly wearers of full dentures were interviewed. MAIN OUTCOME MEASURES: The questionnaire identified the most commonly related symptoms of craniomandibular disorders. RESULTS: The patient's average age was 73.5 years (ranging from 65 to 89 years), 81% of them females. Only 5% reported pain when opening their mouths, and the same percentage complained of temporomandibular joint luxation and a sensation of tired muscles during mastication. Similar rates were found for pain in the temporomandibular joint area (6%), pain in the temporal muscle area (7%), difficulty to move the mandible in the morning (4%) and pain during excursive (protrusive and lateral) movements (8%). The highest rates were found for pain in the masseter muscle area (39%) and articular noises (24%). CONCLUSION: The incidence of craniomandibular disorder symptoms was low in this group of elderly wearers of full dentures, except for pain in the masseter (39%) and articular noises (24%).