Association between oxidative stress and temporomandibular joint dysfunction: A narrative review.

BACKGROUND: The role of oxidative stress in temporomandibular disorders (TMDs) has been studied using synovial fluid, to evaluate oxidative stress (im)balance and its potential role in the onset and/or progression of the disease. OBJECTIVE: This review aimed to evaluate the association between oxidative stress markers and the etiopathogenesis of TMJ dysfunction by means of synovial fluid analysis. METHODS: Two independent reviewers searched the electronic databases from inception to March 2019: PubMed/MEDLINE, LILACS, SciELO, EMBASE, TRIPDATABASE, SCOPUS, and Google Scholar. The following key search terms were used: Temporomandibular Joint Disorders OR Temporomandibular Joint Disc OR Temporomandibular Joint Dysfunction Syndrome OR Temporomandibular Joint OR Facial Pain AND Free Radicals OR Oxidative Stress. Data were extracted from the selected articles, including study design, sample profile, TMJ disease reported, diagnostic method, reactive oxygen and nitrogen species evaluated, enzymatic and non-enzymatic antioxidants evaluated, and techniques used to measure free radicals and antioxidants. RESULTS: After title and abstract screening of 6974 results, and full-text reading, 19 studies were included. All selected articles were cross-sectional observational studies. Enzymatic and non-enzymatic antioxidant defences appeared to be reduced in these patients, resulting in the establishment of the oxidative stress process. In addition, the studies showed a positive correlation between the severity of the intra-articular TMD and the increase in oxidative damage. CONCLUSION: The establishment of oxidative stress, whether by an increase in reactive oxygen/nitrogen species or by a decrease in antioxidant defences, or a combination of both, may be associated with the establishment and maintenance of intra-articular damage.

Does the Misfit Volume of Prosthetic Crowns Differ Before and After Ceramic Application? An In Vitro Radiographic Microtomography Analysis.

PURPOSE: To estimate the misfit volume of zirconia vs metal-ceramic crowns. MATERIALS AND METHODS: Five specimens were fabricated from zirconia and five from nichrome (metal-ceramic). Microcomputed tomography techniques were used to obtain volumetric reconstructions of misfit volume before and after ceramic application. RESULTS: The mean misfit volume for metal-ceramic crowns was 8.80 mm3, and for zirconia crowns was 6.76 mm3 (P = .003, 95% confidence interval [CI] 0.714 to 3.358). Misfit volume also did not differ significantly before and after ceramic application (metal-ceramic, P = .375, 95% CI 0.513 to 1.363; zirconia, P = .253, 95% CI 0.257 to 0.977). CONCLUSION: Zirconia crowns had a smaller mean misfit volume than metal-ceramic crowns. The change in misfit volume after ceramic application was minimal and unlikely to be of clinical relevance.

The influence of caregivers qualification in oral health of dependent elders in Santa Maria/RS, Brazil / Influência da qualificação de cuidadores na saúde bucal de idosos dependentes de Santa Maria/RS, Brasil

Objective: This study aimed to evaluate the knowledge of professional caregivers of dependent elderly. Methods: The study population consisted (n=24) and dependent elders (n=157) in a nursing home in Santa Maria, Brazil. Participants answered a questionnaire to determine if they have qualifications to perform their activities regarding oral hygiene, and to the elderly were carried out clinical tests to assess the IMP. Data were analyzed according to descriptive and inferential analysis using Saphiro-Wilk, Mann-Whitney, Wilcoxon and Kruskal-Wallis test (p≤ 0.05). Results: It was found that 79% of caregivers were qualified, and as respect to the elders, was found that 20% had a bad mucosal and plaque index (IMP), 26% unacceptable and 54% acceptable. Conclusion: Caregivers had a high percentage of qualification which did not reflect the conservation of the elderly's oral hygiene.

Objetivo ­ Avaliar o conhecimento dos profissionais cuidadores de idosos dependentes. Métodos ­ A população do estudo foi composta por cuidadores (n=24) e idosas dependentes (n=157) de um lar de idosos de Santa Maria/RS, Brasil. Os participantes responderam a um questionário para determinar se possuíam qualificação para realizar suas atividades com relação à higiene bucal. Com relação às idosas, foram realizados exames clínicos para avaliar o índice de mucosa e placa (IMP). Os dados foram avaliados de acordo com análise descritiva e inferencial, utilizando os testes de Saphiro-Wilk, Mann-Whitney, Wilcoxon e Kruskal-Wallis (p ≤ 0.05). Resultados ­ Os resultados mostraram que 79% dos profissionais avaliados eram qualificados; com relação às idosas, 20% possuíam índice IMP ruim, 26% não aceitável e 54% aceitável. Conclusão ­ Os cuidadores apresentaram um alto percentual de conhecimento e qualificação, o que não se refletiu na manutenção da higiene bucal das idosas.

Reabilitação oral de paciente com fissura palatina e ausência de pré-maxila / Oral rehabilitation of a cleft palate patient without premaxillary bone ­ a clinical report

As fissuras labiopalatais são malformações faciais com sequelas funcionais e estéticas que causam grande impacto na qualidade de vida dos pacientes. O tratamento desses indivíduos requer uma abordagem multidisciplinar, incluindo tratamento plástico cirúrgico, fonoaudiológico e psicológico, além das intervenções odontológicas, ortodônticas e protéticas. Este relato de caso apresentou a reabilitação protética de uma paciente de 57 anos com fissura palatina anterior, com remoção da pré-maxila. Após vários tratamentos, a paciente ainda não havia sido reabilitada, apresentando deformidades provenientes dos tratamentos anteriores incompletos. Uma prótese parcial removível retida por dentes e implantes osseointegrados foi executada, promovendo a melhora na aparência facial, na função mastigatória, na fala e, consequentemente, na qualidade de vida da paciente.

Cleft lip and palate, which is a facial malformation with both functional and aesthetic characteristics, may have a large impact on the lives of those affected. Its correction requires an interdisciplinary approach, which includes surgical, orthodontic and prosthetic treatments. This clinical report presents the prosthetic rehabilitation of a 57-year-old woman with an anterior cleft palate defect that had not been closed completely with surgical repair. In this way, an implant-supported, retained removable partial prosthesis was delivered to improve the patient's facial aspect, masticatory function, speech, and her quality of life.