Strategies for Preventing and Treating Oral Mucosal Infections Associated with Removable Dentures: A Scoping Review.

Oral infections occur due to contact between biofilm rich in Candida albicans formed on the inner surface of complete dentures and the mucosa. This study investigated historical advances in the prevention and treatment of oral mucosal infection and identified gaps in the literature. Bibliographic research was conducted, looking at PubMed, Embase, Web of Science, and Scopus, where 935 articles were found. After removing duplicates and excluding articles by reading the title and abstract, 131 articles were selected for full reading and 104 articles were included. Another 38 articles were added from the gray literature. This review followed the PRISMA-ScR guidelines. The historical period described ranges from 1969 to 2023, in which, during the 21st century, in vitro and in vivo studies became more common and, from 2010 to 2023, the number of randomized controlled trials increased. Among the various approaches tested are the incorporation of antimicrobial products into prosthetic materials, the improvement of oral and denture hygiene protocols, the development of synthetic and natural products for the chemical control of microorganisms, and intervention with local or systemic antimicrobial agents. Studies report good results with brushing combined with sodium hypochlorite, and new disinfectant solutions and products incorporated into prosthetic materials are promising.

Relation between the risk factors for the severity of denture stomatitis and quality of life of complete edentulous individuals: a cross-sectional study.

OBJECTIVE: To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. METHODOLOGY: Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. RESULTS: 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. CONCLUSION: Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.

Effect of Hygiene Protocols on the Mechanical and Physical Properties of Two 3D-Printed Denture Resins Characterized by Extrinsic Pigmentation as Well as the Mixed Biofilm Formed on the Surface.

To assess the effect of hygiene protocols and time on the physical-mechanical properties and colony-forming units (CFU) of Candida albicans, Staphylococcus aureus, and Streptococcus mutans on 3D-printed denture resins (SmartPrint and Yller) with extrinsic pigmentation compared to conventional resin (CR). The protocols were evaluated: brushing (B), brushing and immersion in water (W), 0.25% sodium hypochlorite (SH), and 0.15% triclosan (T), simulating 0, 1, 3, and 5 years. The data were analyzed by ANOVA with repeated measurements, ANOVA (Three-way) and Tukey's post-test, generalized linear model with Bonferroni adjustment, and ANOVA (Two-way) and Tukey's post-test (α = 0.05). The protocols influenced color (p = 0.036) and Knoop hardness (p < 0.001). Surface roughness was influenced by protocols/resin (p < 0.001) and time/resin (p = 0.001), and flexural strength by time/protocols (p = 0.014). C. albicans showed interactions with all factors (p = 0.033). Staphylococcus aureus was affected by protocols (p < 0.001). Streptococcus mutans exhibited no count for SH and T (p < 0.001). Yller resin showed more color changes. The 3D-printed resins displayed lower microhardness, increased roughness, and decreased flexural strength compared to CR with all protocols in a simulated period of 5 years. The indication of printed resins should be restricted to less than 3 years.

Electrical carotid sinus nerve stimulation attenuates experimental colitis induced by acetic acid in rats.

AIMS: The carotid bodies are sensors that detect physiological signals and convey them to the central nervous system, where the stimuli are processed inducing reflexes through efferent pathways. Recent studies have demonstrated that electrical stimulation of the carotid sinus nerve (CSN) triggers the anti-inflammatory reflex under different conditions. However, whether this electrical stimulation attenuates colitis was never examined. This study aimed to evaluate if the electrical CSN stimulation attenuates the experimental colitis induced by intrarectal administration of acetic acid in rats. METHODS: Electrodes were implanted around the CSN to stimulate the CSN, and a catheter was inserted into the left femoral artery to record the arterial pressure. The observation of hypotensive responses confirmed the effectiveness of the electrical CNS stimulation. This maneuver was followed by a 4 % acetic acid or saline administered intrarectally. After 24 h, colons were segmented into distal and proximal parts for macroscopy, histological and biochemical assessment. KEY FINDINGS: As expected, the electrical CSN stimulation was effective in decreasing arterial pressure in saline and colitis rats. Moreover, electrical CSN stimulation effectively reduced colonic tissue lesions, colitis scores, and histopathologic parameters associated with colitis. In addition, the CSN stimulation also reduced the colonic mucosa pro-inflammatory cytokine interleukin-1 beta, and increased the anti-inflammatory interleukin-10, in rats submitted to colitis. SIGNIFICANCE: These findings indicated that electrical CSN stimulation breaks the vicious cycle of local colon inflammation in colitis, which might contribute to its better outcome.

Risk factors and immunological biomarkers in denture stomatitis: An observational cross-sectional study.

OBJECTIVE: Assess risk factors, local and systemic immunological biomarkers in healthy individuals and with Denture Stomatitis (DS). DESIGN: For this observational transversal study, 27 participants without DS (Group 0), 24 with moderate DS (Group 1), and 25 with severe DS (Group 2) were assessed for sociodemographic, behavioral, and clinical parameters, microbial load of Candida spp., Staphylococcus spp., Streptococcus mutans, Pseudomonas spp., and enterobacteria, and cytokine and C-reactive protein levels. ANOVA, Fisher's exact, Kruskal-Wallis, Mann-Whitney, Wilcoxon and Pearson's chi-square tests were used for data analysis (α = 0.05). RESULTS: Group 1 had a significantly higher mean age compared to the other groups (P = 0.018), but no correlation was identified between age and DS (P = 0.830; r = 0.025). No significant differences were found among the groups for other sociodemographic and behavioral characteristics. Group 1 had significantly older upper and lower dentures; however, no correlation was identified between age of upper (P = 0.522; r = 0.075) and lower (P = 0.143; r = 0.195) dentures and DS. The microbial load of Candida albicans on the dentures (P = 0.035) and Candida spp. on the palate (P = 0.008) of the groups 1 and 2 was higher than group 0. Group 1 and 2 had higher Candida spp. counts on denture (P = 0.003) than group 0. There was no difference among groups for bacterial analyzed. Group 1 showed higher and Group 2 intermediate salivary levels of IL-6 compared to Group 0. There was no difference in the C-reactive protein levels among groups. CONCLUSIONS: Microbial load of Candida spp. is the factor with the strongest relationship with DS, with capacity for local signaling through IL-6.

Taste perception in complete denture wearers / Percepção do sabor em usuários de prótese dentária total

ABSTRACT Purpose: to assess the recognition of salty, sweet, and citrus tastes in complete denture wearers. Methods: the study included toothless individuals (experimental group) who had been using, for at least 3 months and at the most 5 years, acrylic resin removable bimaxillary complete dentures in good condition and with adequate maxillo-mandibular relationship. The same assessment was performed in the control group, which had 26 toothed individuals. Volunteers had no difficulties ingesting any type of food. Salty, sweet, and citrus tastes were assessed with filter paper strips soaked in such solutions and placed on the tongue dorsum. Assessments were performed in duplicate and in random order. Results: the percentage rate of errors was similar between the control (9.6±13.5%) and experimental groups (10.5±15.5%) (p=0.80). There was no difference in the frequency of correct perception of tastes between denture wearers and toothed individuals. Conclusion: individuals who wore acrylic resin removable bimaxillary complete dentures perceived salty, sweet, and citrus tastes like toothed individuals did.

RESUMO Objetivo: avaliar o reconhecimento dos sabores salgado, doce e cítrico em usuários de prótese dentária total. Métodos: foram incluídos indivíduos desdentados (grupo experimental) usuários de prótese total removível bimaxilar confeccionada em resina acrílica, com tempo mínimo de uso de três meses e máximo de cinco anos, em bom estado de conservação e com adequada relação maxilo-mandibular. Como grupo controle, a mesma avaliação foi realizada em 26 indivíduos dentados. Os voluntários não tinham dificuldade na ingestão de nenhum tipo de alimento. Os sabores salgado, doce e cítrico foram testados com fitas de papel filtro embebidas nas soluções e colocadas na parte dorsal da língua. As avaliações foram realizadas em duplicata e em ordem ao acaso. Resultados: a taxa percentual de erros foi igual entre os grupos controle (9,6±13,5%) e experimental (10,5±15,5%) (p=0,80). Não houve diferenças na frequência de percepção correta dos sabores entre indivíduos usuários de prótese e indivíduos dentados. Conclusão: usuários de prótese total removível bimaxilar confeccionada em resina acrílica têm a mesma percepção dos sabores salgado, doce e cítrico que indivíduos dentados.

Relation between the risk factors for the severity of denture stomatitis and quality of life of complete edentulous individuals: a cross-sectional study

Abstract Objective To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. Methodology Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. Results 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. Conclusion Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.

Effect of a Hygiene Protocol on Denture-Related Stomatitis Remission, Local Inflammatory Factors, and Hemodynamic Responses by Arterial Pressure.

Denture-related stomatitis (DRS) is frequent oral inflammation in complete denture wearers. This study evaluated the effect of a hygiene protocol on DRS remission, local inflammatory factors, and hemodynamic responses. Thirty-three individuals were enrolled in the study. The outcomes were measured before and after 10 days of a hygiene protocol treatment consisting of brushing the palate with a soft brush and water and denture brushing with a denture-specific brush and mild soap, as well as immersion of the denture for 20 min in a 0.25% sodium hypochlorite solution. Data were analyzed by paired Wilcoxon for biofilm removal and CFU count of microorganisms. The paired T test was used to assess salivary MUC 1, cytokines, and arterial pressure (p < 0.05). A significant difference was found in the DRS degree (p < 0.001), biofilm (p < 0.001), microbial load of Candida spp. (p < 0.001), Gram-negative (p < 0.004), Staphylococcus spp. (p < 0.001), and S. mutans (p < 0.001) of the denture, and S. mutans (p < 0.001) of the palate after use of the protocol. The salivary flow (p = 0.2) and pH (p = 0.97) did not change; there was an increase of MUC 1 (p = 0.049) and a decrease in IL-6 (p = 0.038), IL-2 (p = 0.04), IL-10 (p = 0.041), and IFNγ (p = 0.04). There was also a decrease in systolic (p = 0.012) and mean arterial pressure (p = 0.02). The current hygiene protocol reduced the inflammation degree of DRS and promoted an improvement of local inflammatory factors and a reduction in the systolic arterial pressure of the patients.

Effect of short-term increase in occlusal vertical dimension on masticatory muscle electrical activities and pressure-to-pain threshold: A crossover clinical study.

STATEMENT OF PROBLEM: Increasing the occlusal vertical dimension (OVD) is a common procedure in clinical practice. However, few studies have assessed the short-term influence of an increased OVD on the masticatory muscles. PURPOSE: The purpose of this crossover clinical study was to investigate the effect of increased OVD on the electrical activity of masticatory muscles and the pressure-to-pain threshold (PPT) in asymptomatic participants. MATERIAL AND METHODS: Twenty asymptomatic participants (22.7 ±2.39 years of age; 10 men, 10 women) were submitted to an increase in OVD by using interocclusal devices of different thicknesses (3- and 6-mm) for 24 hours. Masticatory muscle activity was assessed with electromyography (EMG), expressed in microvolts (µV), while the participants masticated 2 pieces of latex of different consistency (latex S and H) with and without the device. The PPT was measured with a digital algometer before and after the mastication. The results were assessed by using analysis of variance (ANOVA) and the Tukey honestly significant difference (HSD) test (α=.05). RESULTS: The change of OVD did not significantly affect the electrical activity of the muscles. The latex of hard consistency (latex H) showed higher electrical activity values than the soft texture (latex S). For the working side anterior temporal muscle, a change in the PPT was detected on the day the 6-mm-device was inserted, but for the other muscles, device thickness and latex mastication did not change the PPT. CONCLUSIONS: For a short time, an increase in occlusal vertical dimension did not affect the electrical activity in the masticatory muscles or pressure-to-pain threshold in asymptomatic participants.

Comparing a tablet computer and paper forms for assessing patient-reported outcomes in edentulous patients.

PURPOSE: The aim of this study was to determine whether two methods of documentation, print and electronic forms, for the assessment of patient-reported outcomes (PRO) in complete denture wearers provide comparable results. The study also quantified the time needed for filling the forms by each method. MATERIALS AND METHODS: Thirty participants enrolled in a university clinic answered two forms (a questionnaire for denture satisfaction and OHIP-EDENT). They provided answers with two application methods in a random order, with a one-month interval between them: (1) electronic forms on a tablet computer; and (2) print forms. The methods were compared in terms of mean results, correlation/agreement, internal consistency, and spent time. RESULTS: Mean results for both methods were similar for each denture satisfaction item (100-mm VAS) and OHIP-EDENT summary score. Both questionnaires presented good internal consistency regardless of the application method (Cronbach's α=0.86 or higher). Correlation and agreement between the methods regarding specific items was at least moderate for the majority of cases. Mean time for the electronic and print forms were 9.2 and 8.5 minutes, respectively (paired t test, P=.06, non-significant). CONCLUSION: The electronic method is comparable to print forms for the assessment of important PRO of prosthetic treatment for edentulism, considering the results and time needed. Findings suggest the viability of replacing print forms with a tablet for applying the tested inventories in clinical trials.

Preliminary In Vitro Study on O-Ring Wear in Mini-Implant-Retained Overdentures.

This preliminary in vitro study evaluated the simulated retention force of O-rings used for mini-implant overdenture treatment and the effect of mechanical fatigue corresponding to 6 months of wear. A mandibular overdenture analog device was attached to two mini-implants and underwent a tensile strength test before and after the application of insertion-removal and simulated masticatory cycles. Insertion-removal cycles led to a retention loss of 24%, whereas masticatory cycles did not influence retention. Micro-CT scans showed minor deformation following mechanical cycling, but the changes were milder than those observed in similar clinical specimens. Both experimental loading methods led to physical changes in the O-rings, which explains in part the similar clinically observed wear.

Traumatic ulcerative granuloma with stromal eosinophilia around mini dental implants without the protection of a denture base.

This is a report of a case of an unusual oral lesion after the placement of mini implants for the retention of a mandibular overdenture. A patient received four 2-mm-wide dental implants in the anterior mandible and had her mandibular denture relined with a soft material. After 3 months, she was not wearing her mandibular denture, and two nodular ulcerated lesions were observed near the mini implants. The lesions ceased following excision and regular denture wearing. Clinical and microscopic examination led to the diagnosis of traumatic ulcerative granuloma with stromal eosinophilia (TUGSE). TUGSE is rare lesion with a benign course that may occur following injury of the oral mucosa by mini implants under certain circumstances.

Desafios da atuação dos psicólogos nos CREAS do Rio Grande do Norte / Psychologist's working challenges in CREAS in Rio Grande do Norte

O presente estudo objetiva discutir os aspectos contextuais que condicionam e possibilitam a prática profissional do psicólogo no campo da Assistência Social, utilizando como recorte a fala dos psicólogos que atuam nos Centros de Referência Especializados de Assistência Social (CREAS) do estado do Rio Grande do Norte (RN). Coloca-se em debate a atuação do psicólogo nesses espaços, pensando a sua contribuição na consolidação da política pública em questão. A análise dos dados demonstra a necessidade da construção de uma identidade do psicólogo como trabalhador social, apontando para a importância de mudanças no corpo conceitual e técnico da Psicologia.

This paper aims to discuss about contextual aspects that can determine and enable psychological professional exercise in Social Welfare area, using as data the speech of psychologists who work at the Centro de Referência Especializado de Assistência Social (CREAS) from the state of Rio Grande do Norte (RN). It debates the psychologist's performance in these new spaces, thinking about their contribution for the consolidation of this Social Welfare policy. Analysis shows the need of building an identity of psychologist as a social worker, pointing to the importance of changes in the conceptual and technical framework of Psychology.

Método simplificado versus convencional de confecção de próteses totais: práticas adotadas pelos Cirurgiões-Dentistas / Simplified versus conventional method for the fabrication of complete dentures: procedures adopted by dentists

Introdução: A fim de reduzir custos e tempo clínico envolvidos com o tratamento, Dentistas têm utilizado métodos simplificados, omitindo ou abreviando partes da técnica de confecção das próteses totais. Objetivo: Levantar as práticas utilizadas pelos Cirurgiões-Dentistas para a confecção de próteses totais. Material e método: Os dados foram levantados por meio de um formulário eletrônico contendo perguntas relativas ao perfil e aos procedimentos clínicos utilizados, a fim de quantificar o uso de métodos simplificados e convencionais, bem como para determinar a relação com o perfil desses profissionais. Os resultados foram analisados por meio de análise de Aglomerados. Resultado: As respostas foram dadas, em sua maioria, por homens, tendo a prática clínica como sua principal fonte de renda e clínica privada ou conveniada como ambiente principal de trabalho (n=119). Grande parte dos entrevistados relatou realizar duas moldagens por arcada, utilização de articulador semiajustável com arco facial, determinação de plano oclusal por meio de guias anatômicos, utilização de meios métricos para análise da dimensão vertical de oclusão e determinação direta da relação cêntrica. O próprio Cirurgião-Dentista relatou ser o responsável na fase de seleção de dentes. A estatística identificou dois Aglomerados, com base nas características demográficas e na prática clínica, sendo um grupo formado por generalistas adeptos de perfis mais simplificados e outro formado por profissionais mais especializados em prótese que realizam técnicas convencionais. Conclusão: A adoção de técnicas simplificadas é associada àqueles Dentistas com perfil mais generalista, ...

Introduction: In order to reduce costs and clinical time involved with complete denture treatment, dentists have employed simplified methods based on the reduction or preclusion of certain traditional technical procedures. Purpose: To survey the procedures used by dentists to fabricate complete dentures. Material and method: Data was obtained by an electronic form containing questions about dentists' profile and clinical procedures, in order to quantify traditional and simplified approaches at several moments and to determine them to different professional profiles. Results were evaluated by means of cluster analysis. Result: The majority of respondents were male dentists with clinical practice as their main income source, mainly in private service (n=119). Most participants use to take a pair of impressions from each arch, employ semiadjustable articulators with facebow transfers, shape the occlusal plane with the aid of anatomic references, determine occlusal vertical dimension by metric methods and use mandibular manipulation for centric relation. The dentists performed tooth selection in most cases. Statistical analysis identified two clusters based on demographic characteristics and clinical procedures. General practitioners adopting simplified methods formed the first cluster, whereas prosthodontists used to conventional methods formed the second. Conclusion: General dentists tend to adopt simplified approaches, and prosthodontists tend to work according to traditional academic methods. .

Variação da temperatura superficial dos músculos masseter e temporal anterior durante o apertamento dental voluntário com placas interoclusais maxilares de duas diferentes espessuras / Variation of surface temperature on superficial masseter and anterior temporal muscles during voluntary teeth clenching with maxillary splints of two different thicknesses

A atividade muscular tem sido estudada de maneira indireta pela análise da variação da temperatura superficial cutânea sobre os músculos mastigatórios. Essas mensurações podem representar uma ferramenta valiosa na avaliação clínica da atividade e do progresso das desordens temporomandibulares, bem como no acompanhamento do protocolo terapêutico adotado, justificando sua utilização para verificar alterações patológicas na circulação sanguínea e/ou atividade metabólica nos tecidos abaixo da pele, como os músculos mastigatórios. Em vista disso, o objetivo do presente estudo foi verificar o efeito da espessura da placa interoclusal sobre a variação da temperatura superficial dos músculos temporal anterior e masseter, durante o repouso e o apertamento dental, considerando-se a condição assintomática de 20 indivíduos (10 do gênero masculino e 10 do gênero feminino) selecionados através do questionário Research Diagnostic Criteria (RDC). A temperatura em graus Celsius (ºC) da superfície dos músculos masseter e temporal anterior foi medida com o auxílio de um termômetro digital, com um sistema de leitura por irradiação infravermelha. A temperatura superficial dos músculos temporal anterior e masseter apresentou redução significativa diante do apertamento dental em relação à posição de repouso mandibular. Entretanto, não houve diferenças significantes entre as condições com e sem placa interoclusal, bem como entre as distintas espessuras de placas interoclusais analisadas. Adicionalmente, os músculos mastigatórios apresentaram uma considerável semelhança entre os lados, sem haver também distinções significantes entre o gênero masculino e o feminino.

Muscle activity has been studied indirectly through analyses of temperature variation in skin surface temperature on the masticatory muscles. These procedure may be an important tool for clinical evaluation and assessment of the evolution of temporomandibular disorders, as well as monitoring the adopted protocol. Thus, its utilization for identified pathological alterations on blood circulation and/or on metabolic activity in subcutaneous tissues, such as the masticatory muscles, is justified. The aim of this study was to investigate the effect of occlusal splintsÆ thickness on the variation of surface temperature of the anterior temporal and masseter muscles during rest and clenching. It were analyzed 20 asymptomatic subjects (10 males and 10 females) selected through the Research Diagnostic Criteria (RDC) questionnaire. Temperature expressed in degrees Celsius (ºC) was measured on the surface of both muscles measured with the aid of a digital thermometer with an infrared radiation reading system. The surface temperature of the anterior temporal and masseter muscles presented significant reduction during teeth clenching in relation to the mandibular rest position. However, there were no significant differences between conditions with and without occlusal splint or between the different thicknesses of splints analyzed. Masticatory muscles showed a considerable similar behavior for both sides, and no significant distinctions were observed between male and female patients.

Effect of occlusal splint thickness on electrical masticatory muscle activity during rest and clenching.

The extent of separation between the maxillary and mandibular teeth in the fabrication of interocclusal splints designed to achieve efficiency and muscle relaxation is controversial and undefined in the literature. Based on this premise, the aim of this study was to evaluate the effect of interocclusal splint thicknesses of 3 and 6 millimeters on the electrical activity of the anterior temporal and masseter muscles during rest and dental clenching. Twenty asymptomatic individuals (10 males and 10 females) were selected using the Research Diagnostic Criteria (RDC). Electromyography (EMG) was performed both with and without the 3- and 6-mm splints using the Bio EMG software package, which recorded values given in microvolts (µV). The results, which were assessed using analysis of variance (ANOVA) to a 5% significance level (p < 0.05), showed increased electrical activity of the masticatory muscles during dental clenching compared with at rest, with greater activity in the masseter muscle. The electrical activity did not differ according to the thickness of the splints or between males and females. We can conclude that both splint thicknesses are effective in treating muscle hyperactivity given their similar clinical behavior for asymptomatic individuals.

Effect of occlusal splint thickness on electrical masticatory muscle activity during rest and clenching

The extent of separation between the maxillary and mandibular teeth in the fabrication of interocclusal splints designed to achieve efficiency and muscle relaxation is controversial and undefined in the literature. Based on this premise, the aim of this study was to evaluate the effect of interocclusal splint thicknesses of 3 and 6 millimeters on the electrical activity of the anterior temporal and masseter muscles during rest and dental clenching. Twenty asymptomatic individuals (10 males and 10 females) were selected using the Research Diagnostic Criteria (RDC). Electromyography (EMG) was performed both with and without the 3- and 6-mm splints using the Bio EMG software package, which recorded values given in microvolts (µV). The results, which were assessed using analysis of variance (ANOVA) to a 5 percent significance level (p < 0.05), showed increased electrical activity of the masticatory muscles during dental clenching compared with at rest, with greater activity in the masseter muscle. The electrical activity did not differ according to the thickness of the splints or between males and females. We can conclude that both splint thicknesses are effective in treating muscle hyperactivity given their similar clinical behavior for asymptomatic individuals.

Sintomas auditivos e desordens temporomandibulares / Hearing symptoms and temporomandibular disorders

Introdução: Uma variedade de hipóteses tem sido propostas para esclarecer a associação entre desordens temporomandibulares e sintomas auditivos, entre elas as múltiplas possibilidades anatômicas e/ou neurológicas que, a partir de uma disfunção muscular ou articular, podem acarretar tais sintomas. Objetivo: O propósito do presente estudo é discutir, através de uma revisão sistemática de literatura, a inter-relação entre os sintomas auditivos e as desordens temporomandibulares. Material e Método: Foram consultados os indexadores Medline/PubMed, ISI e Scielo, no período de 1918 a 2008. Os termos relacionados para a pesquisa foram: “temporomandibular disorders”, “signs and symptoms of temporomandibular disorders”, “otologic symptoms” e “aural symptoms”, onde 19 artigos foram incluídos através dos critérios pré-selecionados para a confecção de uma metaanálise. Resultados: Segundo os dados encontrados, os sintomas auditivos mais frequentemente relacionados com desordens temporomandibulares foram otalgia e zumbido, seguido de vertigem e perda auditiva, respectivamente. Conclusões: Torna-se evidente a correlação entre os sintomas auditivos e as desordens temporomandibulares, entretanto há a necessidade de pesquisas clínico-científicas mais complexas para comprovarem as específicas relações causa-efeito entre ambos

Introduction: A variety of hypotheses have been proposed to explain the association between temporomandibular disorders and hearing symptoms, including the many anatomical and/or neurological ways, as of a muscle or joint dysfunction, can cause such symptoms. Objective: The purpose of this study is to discuss, through a systematic review of literature, the interrelation between hearing symptoms and temporomandibular disorders. Material and Methods: We consulted the Medline/PubMed, ISI and Scielo in the period 1918 to 2008. The terms related to the research were: “temporomandibular disorders”, “signs and symptoms of temporomandibular disorders”, “otologic symptoms” and “aural symptoms”, where 19 papers were included using the pre-selected criteria for the manufacture of a meta-analysis. Results: According to the findings, the hearing symptoms most often associated with temporomandibular disorders were otalgia and tinnitus, followed by vertigo and hearing loss, respectively. Conclusions: It’s clear the correlation between hearing symptoms and temporomandibular disorders, however there is a need clinical and scientific research more complex to prove the specific cause-effect relationships between them

Avaliação da atividade elétrica e limiar de dor à pressão dos músculos masseter e temporal anterior com placas de diferentes espessuras / Evaluation of electrical activity and threshold of pain the pressure masseter and anterior temporal plates of different thicknesses

A hiperatividade muscular associada ou não a alterações oclusais pode ser um fator desencadeante das desordens temporomandibulares (DTMs). Qualquer alteração nas estruturas do aparelho estomatognático pode promover um desequilíbrio funcional da mandíbula. A algometria por pressão bem como a eletromiografia tem sido utilizadas como métodos de diagnóstico e controle da evolução terapêutica dos músculos da mastigação. Diversos tratamentos buscam diminuir os sintomas característicos das DTMs pelo restabelecimento do equilíbrio, dentre os quais vale citar a terapia oclusal por meio da placa interoclusal. Uma das dificuldades durante a confecção dos dispositivos interoclusais é determinar a sua espessura. Este critério pode influenciar a eficiência, o desempenho da função de relaxamento e o tratamento da dor muscular. O objetivo deste estudo foi avaliar o efeito da espessura da placa, da consistência do alimento e do gênero, na atividade elétrica e no limiar de dor à pressão (LDP) nos músculos masseter e temporal anterior. Para verificar o efeito de diferentes espessuras de placas interoclusais foram selecionados 20 pacientes assintomáticos que utilizaram placas com espessuras 3 e 6 mm. Foram obtidas médias a partir dos valores encontrados em cada paciente, sendo avaliados lados de trabalho e não-trabalho, por meio de registros da atividade elétrica durante a mastigação de dois tipos diferentes de látex e limiar de sensibilidade dos músculos masseter e temporal anterior. Após sua obtenção, os dados foram tabulados e submetidos à análise estatística, a um nível de 5% de significância (p<0,05). Pode-se concluir que as placas de diferentes espessuras (tratamentos) e o gênero não alteraram a atividade elétrica, porém a maior consistência do alimento proporcionou atividades elétricas mais elevadas. O limiar de dor à pressão foi alterado com a utilização das placas de diferentes espessuras somente para o músculo temporal do lado de trabalho, bem como foi superior para os...

The muscular hyperactivity with or without occlusal changes can is a trigger of temporomandibular disorders (TMD). Any change in the structures of the stomatognathic system can promote a functional imbalance of the jaw. The algometry pressure and electromyography has been used as methods of diagnosis and therapy control of the evolution of the muscles of mastication. Several treatments seek to reduce the symptoms characteristic of TMD by restoring the occlusal, among which worth mentioning the occlusal therapy through the plate interocclusal. One of the difficulties during the construction of the splint device is to determine its thickness. This criterion can influence the efficiency, performance of the function of relaxation and treatment of muscle pain provided by interocclusal devices. The objective of this study was to evaluate the thickness of the plate, consistency of the food and gender, in the electric activity and threshold of pain to the pressure (LDP) in the muscles to masseter and anterior temporal. patients in whom signs were established with thickness 3 and 6 mm. Medium were obtained from each side to work and working from records of electrical activity during mastication of two latex sensitivity threshold of the masseter and anterior temporal of all patients. After obtaining the data, the data were tabulated and subjected to statistical analysis, a 5% level of significance (p <0.05). It It was observed that the plates of different thicknesses (treatments) and the gender had not modified the electric activity, however the biggest consistency of the food provided higher electric activities. The threshold of pain to the pressure was modified with the use of the plates of different thicknesses only for the temporal muscle of the work side, as well as was superior for the men in all the muscles evaluated, however the mastication activity did not influence in the LDP

Relação da oclusão dentária com a postura de cabeça em pacientes portadores de DTM / Relationship between dental occlusion and head-position in DTM patients

A postura corporal global interfere na posição da cabeça a qual por sua vez determina a postura da mandíbula e da língua na cavidade bucal, o que pode provocar transtornos na articulação temporomandibular. O propósito deste trabalho foi avaliar, por meio de fotogrametria, a correlação entre a postura corporal global e má oclusão em pacientes atendidos no Núcleo de Diagnóstico e Tratamento de DTM/ DMOP. Foram selecionados 30 pacientes com diagnóstico de transtorno da articulação temporomandibular, atendidos no Núcleo de Diagnóstico e Tratamento de DTM/ DMOP da Faculdade de Odontologia de Araçatuba, Unesp. Para avaliação da postura corporal global foi utilizada tela plástica transparente quadriculada em preto, medindo 2,00 x 0,70m, com quadriculado de 10x10cm e realizada fotografia digital de cada paciente utilizando-se máquina fotográfica digital DSC-S2000 Sony Cyber-shot 10.1 mega pixels, posicionada em tripé na altura da cicatriz umbilical, nivelado a 310 cm de distância da tela. Cada paciente foi avaliado e fotografado em quatro vistas: anterior, posterior, lateral direita e lateral esquerda. As análises posturais foram realizadas por um mesmo fisioterapeuta e a má oclusão igualmente por cirurgião-dentista calibrado. Os dados obtidos foram submetidos à análise estatística e permitiram concluir que: a) a postura centralizada da cabeça se mostrou predominante nos pacientes com relação molar de classe I; b) a postura anteriorizada da cabeça foi observada em todos os pacientes com má oclusão de classe II; c) a posição posteriorizada da cabeça foi observada em todos os pacientes com má oclusão de classe III

The body posture interferes with the overall position of the head which in turn determines the position of the jaw and tongue in the oral cavity, which can cause temporomandibular joint disorders. The purpose of this study was to evaluate, by means of photogrammetry, the correlation between overall body posture and malocclusion in patients treated at the Center for Diagnosis and Treatment of TMD / DMOP. Were selected 30 patients diagnosed with temporomandibular joint disorder, seen in the Center for Diagnosis and Treatment of TMD / DMOP School of Dentistry of Araçatuba, Unesp. To assess the overall body posture was used transparent plastic screen checkered in black, measuring 2.00 x 0.70 m with a grid and held 10x10cm digital photo of each patient using a digital camera DSC-S2000 Sony Cyber-shot 10.1 mega pixels, positioned on a tripod at the height of the umbilicus, capped at 310 cm from the screen. Each patient was evaluated and photographed in four views: anterior, posterior, lateral right and left side. Postural Analyses were performed by the same physiotherapist and malocclusion also calibrated by the dentist. The data were statistically analyzed and showed that: a) centralized head posture showed predominant in patients with Class I molar relationship; b) the forward head posture was observed in all patients with Class II malocclusion; c) the posterior position of the head was observed in all patients with class III malocclusion