Is Muscle Pain in Temporomandibular Disorder a Hyperactivity Problem? A Clinical, Thermographic, and Electromyographic Analysis.

ABSTRACT: This study aimed to report clinical data on muscle pain in temporomandibular disorders using thermography, algometry, and surface electromyography (EMG). This was done to support or rule out the hypothesis that painful muscles are always related to muscular hyperactivity. This cross-sectional, analytical study included 50 participants who underwent clinical examination and evaluation of anterior temporal muscles and bilateral masseters using thermography, algometry, and EMG. The muscles with greater pain symptoms had hyporadiation and a lower temperature compared with both contralateral muscles and muscles in the asymptomatic group. There was no muscle hyperactivity at rest on EMG analysis; however, there was a greater capacity for muscle recruitment of these symptomatic muscles after a joint decompression test with cotton rolls, suggesting hypoactivity of the affected muscles in the symptomatic patient group. Muscle pain may be related to hypoactivity of the musculature when there is neurological inhibition of the recruitment of muscle fibers, and treatment must consider these neurophysiological alterations. LEVEL OF EVIDENCE: Level IV.

Surgical Treatment of Blow-out Fracture: A New Perspective.

The present work aims to report 2 clinical cases of the use of current technologies for the treatment of orbital fractures. The cases are of patients who were victims of car accidents and who developed a blow-out orbital fracture. Clinically, they presented periorbital ecchymosis, blepharoedema, enophthalmos, and ophthalmoplegia and, therefore, underwent surgical reconstructive treatment. For both cases, preoperative computed tomography and biomodel impression of the orbits were performed. The modeling of the titanium mesh covering the defect in the biomodel that would be used in the surgery was performed. In the intraoperative period of reduction and fixation of the fracture with the titanium mesh, optics were used to better visualize the posterior defect, as well as computed tomography to ensure that the entire affected area was reconstructed. Both patients were followed up in the postoperative period and evolved without clinical and functional complaints.