Virtual surgical planning in craniomaxillofacial surgery: a structured review.

Craniomaxillofacial (CMF) surgery is a challenging and very demanding field that involves the treatment of congenital and acquired conditions of the face and head. Due to the complexity of the head and facial region, various tools and techniques were developed and utilized to aid surgical procedures and optimize results. Virtual Surgical Planning (VSP) has revolutionized the way craniomaxillofacial surgeries are planned and executed. It uses 3D imaging computer software to visualize and simulate a surgical procedure. Numerous studies were published on the usage of VSP in craniomaxillofacial surgery. However, the researchers found inconsistency in the previous literature which prompted the development of this review. This paper aims to provide a comprehensive review of the findings of the studies by conducting an integrated approach to synthesize the literature related to the use of VSP in craniomaxillofacial surgery. Twenty-nine related articles were selected as a sample and synthesized thoroughly. These papers were grouped assigning to the four subdisciplines of craniomaxillofacial surgery: orthognathic surgery, reconstructive surgery, trauma surgery and implant surgery. The following variables - treatment time, the accuracy of VSP, clinical outcome, cost, and cost-effectiveness - were also examined. Results revealed that VSP offers advantages in craniomaxillofacial surgery over the traditional method in terms of duration, predictability and clinical outcomes. However, the cost aspect was not discussed in most papers. This structured literature review will thus provide current findings and trends and recommendations for future research on the usage of VSP in craniomaxillofacial surgery.

Effectiveness of the therapeutic laser in the syndrome of dysfunction of the temporomandibular joint of arthrogenic origin / Eficacia del láser terapéutico en el síndrome de disfunción de la articulación temporomandibular de origen artrogénico

Abstract Temporomandibular joint dysfunction syndrome (TMD), is a collective term characterized by symptoms involving chewing muscles, temporomandibular joint and orofacial structures. The efficacy of low intensity laser (LLLT) Gallium arsenide, in combination with a non-steroidal anti-inflammatory drug (NSAID) was evaluated. The main objective was to evaluate the maximum mouth opening without pain (ABM), arthralgia in the joint capsule through visual analog scale (VAS), laterality, protrusion, joint noises and count of tablets ingested per group. A controlled clinical trial (double-blind-randomized) was carried out in 30 subjects, who presented DTM of arthrogenic etiology; 5 applications of LLLT were made with wavelength of 810 nm, output optical power of 100-200 mw, emission PW=Pulsed (1-10,000Hz), dose of 10 jouls-cm², time of 1.44 minutes in mouth closed and with the mouth half open. One more follow-up appointment per month. There were two groups: experimental and control group, where different variables were analyzed (ABM, laterality, protrusion, VAS and sociodemographic). In the control group, a supposed LT application (not active) was made, for later comparison. Pain-free ABM was assessed in all appointments in addition to the other clinical parameters. Repeated measures analysis was performed with mixed models. Thirty patients were included of which 28 finished the treatment, two of them were lost during follow-up. The groups were similar in all their baseline variables. There were no statistically significant differences when applying the final multiple regression analysis, in the ABM, or in any other of the clinical parameters analyzed. LT was not effective in treating arthrogenic DTM.

Resumen El síndrome de disfunción de la articulación temporomandibular (DTM) es un término colectivo caracterizado por síntomas que involucran músculos de la masticación, articulación temporomandibular y estructuras orofaciales. Se evaluó la eficacia del láser de baja intensidad (LLLT) Arseniuro de galio, en combinación con un antiinflamatorio no esteroideo (AINE). El objetivo principal fue evaluar la apertura bucal máxima sin dolor (ABM), la artralgia en cápsula articular a través de escala visual análoga (EVA), lateralidades, protrusión, ruidos articulares y conteo de tabletas ingeridas por grupo. Se realizó un ensayo clínico controlado (doble ciego-aleatorizado) en 30 sujetos, que presentaban DTM de etiología artrogénica; se les realizaron 5 aplicaciones de LLLT con longitud de onda de 810 nm, potencia óptica de salida de 100-200 mw, emisión PW=Pulsed (1-10,000Hz), dosis de10 jouls-cm², tiempo de1.44 minutos a boca cerrada y con la boca semiabierta. Una cita más de seguimiento al mes. Se tuvieron dos grupos: experimental y grupo control, donde se analizaron diferentes variables (ABM, lateralidades, protrusión, EVA y sociodemográficas). En el grupo control se hizo una supuesta aplicación LT (no activo), para posterior comparación. En todas las citas se valoró la ABM sin dolor además de los otros parámetros clínicos. Se realizó análisis de medidas repetidas con modelos mixtos. Se incluyeron 30 pacientes de los cuales 28 finalizaron el tratamiento, dos de ellos se perdieron en el seguimiento. Los grupos fueron similares en todas sus variables basales. No hubo diferencias estadísticas significativas al aplicar los análisis de regresión múltiple finales, en la ABM, ni tampoco en ningún otro de los parámetros clínicos analizados. El LT no fue eficaz en el tratamiento de la DTM de origen artrogénico.

Desordens hiperostóticas em American Bully / Hiperostotic disorders in american bully

O complexo de desordens hiperostóticas é uma condição rara e autolimitante, que tem as mesmas características histopatológicas, que cursa com proliferação óssea de caráter não neoplásico. Acomete cães jovens de raças distintas, com variabilidade quanto ao tipo de proliferação óssea e quanto aos ossos acometidos. O complexo é composto pela osteopatia craniomandibular, hiperostose da calota craniana e osteodistrofia hipertrófica. Podendo estar presente nos ossos da calota craniana, mandíbulas, coluna cervical e esqueleto apendicular. O presente relato, descreveu o quadro de uma cadela, da raça American Bully, não castrada, três meses de idade, que foi atendida com queixa de aumento de volume doloroso das mandíbulas, hiporexia e sialorreia há 15 dias, apresentando ao exame físico, amplitude de movimento diminuída e sensibilidade dolorosa da articulação temporomandibular, espessamento firme bilateral do crânio em região de fossa temporal, espessamento palpável de consistência firme das mandíbulas e crepitação respiratória. Após avaliação clínica e realização de exames complementares, chegou-se ao diagnóstico presuntivo, de complexo de desordens hiperostóticas. Foi instituído como conduta terapêutica o suporte analgésico, sendo eficaz para a manutenção das necessidades fisiológicas até a paciente alcançar a fase adulta. O prognóstico para esta paciente foi considerado bom, uma vez que não havia indícios de anquilose da articulação temporomandibular e/ou manifestações neurológicas.

The complex of hyperostotic disorders is a rare and self-limiting condition, which has the same histophatological characteristics, which courses with non-neoplastic bone proliferations. It affects young dogs of different breeds, with variability the bones affected. The complex is composed of craniomandibular osteopathy, calvarial hyperostotic syndrome and hypertrophic osteodystrophy. It may be present in the bones of the skullcap, jaws, cervical spine and appendicular skeleton. The present report describes the condition of a female dog, American Bully breed, entire, three months old, with a complaint of painful swelling of the jaws, hyporexia and drooling for 15 days, presenting on physical examination, reduced amplitude and pain of the temporomandibular joint, bilateral firm thickening of the skull in the temporal fossa region, palpable firm-consistent thickening of the mandibles and respiratory crackle. After clinical evaluation and complementary tests, a presumptive diagnosis of hyperostotic disorders complex was reached. It was instituted pain management as a treatment, being effective for the maintenance of physiological needs until the patient reaches the adulthood. The prognosis for this patient was considered good, since there was no evidence of temporomandibular joint ankylosis and/or neurological manifestations.

What factors predict craniomandibular disorders in severe COVID-19 survivors after prolonged intubation?

PURPOSES: To estimate and identify predictors of craniomandibular disorders (CMDs) in severe COVID-19 survivors after prolonged intubation ≥ 1 week (SCOVIDS-PI). METHODS: This retrospective study enrolled two cohorts of SCOVIDS-PIs with vs. without CMD during a one-year period. The predictor variables were demographic, dental, anesthetic, and laboratory parameters. The main outcome was presence of CMD until six post-PI months (yes/no). Appropriate statistics were computed with α = 95%. RESULTS: The sample comprised 176 subjects aged 59.2 ± 17.2 years (range, 27-89; 11.9% with CMDs; 30.1% females). CMDs were significantly associated with (1) bilateral posterior tooth loss (P = 0; number needed to screen [NNS] = 1.6), (2) dentofacial skeletal class II/convex face (P = .01; NNS = 2.2), and (3) peak CRP during intensive care ≥ 40 mg/l (P = .01; NNS = 3.5). With combined predictors, NNS became 2 to 4.3. CONCLUSIONS: Three predictors of CMDs in SCOVIDS-PIs: bilateral molar loss, convex face, and CRP ≥ 40 mg/l, indicate CMD screening and/or referral to a CMD specialist, regardless of patients' age, gender, underlying CMDs, or previous dental checkups. Screening ∼2 to 4 "SCOVIDS-PIs with ≥ one predictor" will identify one CMD events/patients during the first six post-PI months.

What Role Does Synovitis Play in Craniomandibular Dysfunction (CMD)? A 3T-MRI Study. / Welche Rolle spielt die Synovialitis bei der kraniomandibulären Dysfunktion (CMD)? Eine 3T-MRT-Studie.

PURPOSE: The purpose of the present study was to investigate the degree and clinical relevance of synovitis in craniomandibular dysfunction. MATERIALS AND METHODS: In total, 140 temporomandibular joints were examined using a 3 T MRI scanner. Quantitative analysis of synovial enhancement was performed and interrelated with arthrosis deformans, degenerative disc disease, joint effusion, bone marrow edema and restriction of motion. RESULTS: We found a statistically high and significant correlation between the degenerative changes as mentioned above and the intensity of synovial enhancement. CONCLUSION: The study shows that typical MRI findings in CMD patients are often combined with signs of synovitis. Presumably joint inflammation has an effect on the clinical signs and symptoms and also the prognosis of CMD. These results should be taken into consideration when selecting treatment. KEY POINTS: · 3T-MRI using a dedicated coil is the method of first choice in the examination of CMD syndrome.. · MR imaging allows quantification of increased synovial enhancement.. · There is a highly significant correlation between degenerative changes of the disc or cartilage and synovitis.. · Results of the study are relevant for the clinical assessment and therapy of CMD syndrome.. CITATION FORMAT: · Stimmer H, Ritschl L, Goetz C et al. What Role Does Synovitis Play in Craniomandibular Dysfunction (CMD)? A 3T-MRI Study. Fortschr Röntgenstr 2019; 191: 924 - 931.

Fibromyalgia in patients with chronic CCD and CMD - A retrospective study of 555 patients.

OBJECTIVE: Craniomandibular dysfunction (CMD) and craniocervical dysfunction (CCD) are clearly defined musculoskeletal pain syndromes. Relationships with fibromyalgia syndrome (FMS) have not yet been investigated. The aim of the present study is to establish possible relationships between FMS and CMD/ CCD. METHODS: In a retrospective study, 555 patients with CCD and CMD were investigated with respect to the diagnostic criteria of FMS. In addition to otolaryngologic and dental examination, an instrumental functional analysis for the diagnosis of CMD/CCD was performed. RESULTS: Three hundred fifty-one (63%) of the 555 patients evaluated met the diagnostic criteria for FMS. Seventy-two percent of the patients had a widespread pain index of at least 7 and a severity scale score of at least 5. Twenty-nine percent had a widespread pain index of 3-6 and a severity scale score of at least 9. Using myocentric bite splint therapy and therapy with oral orthesis in combination with neuromuscular relaxation measures, a good to very good improvement of physical symptoms was seen in 84% of CMD-FMS patients, and an improvement of the symptoms in the jaw was achieved in 77% of cases. DISCUSSION: The substantial proportion of CMD and CCD patients who meet the criteria for FMS emphasizes the complexity of the two diseases. It must be assumed that FMS is a crucial factor for the formation of CMD and CCD. Conversely, CMD/ CCD could also be responsible for diverse clinical pictures of the FMS. FMS patients with synchronous CCD/CMD benefit from an interdisciplinary CMD/CCD treatment.

Prevalencia de los trastornos temporomandibulares y factores asociados más comunes presentados en las clínicas de la Universidad Santo Tomás en el segundo periodo del año 2016 / Prevalence of the temporomandibular disorders and most common associated factors presented in the ninth and tenth semester clinics of the Universidad Santo Tomás in the second period of the year 2016

Objetivo: Establecer la prevalencia de los trastornos temporomandibulares (TTM) presentados por los pacientes que acudieron a las clínicas odontológicas de noveno y décimo semestre de la Universidad Santo Tomás en el segundo período de 2016. Materiales y Métodos: Se realizó un estudio observacional descriptivo de corte transversal, con una muestra de 113 historias clínicas, se recolectó la muestra de historias clínicas ya diligenciadas de las clínicas de noveno y décimo semestre de la Universidad Santo Tomás en el segundo periodo del año 2016. Usando estadística descriptiva para el análisis Univariado. En el análisis bivariado, se estableció relación entre TTM y las variables de interés mediante la prueba t-student y Chi-cuadrado donde un valor de p≤0,05 fue considerado estadísticamente significativo. Resultados: De las 113 historias clínicas se obtuvieron 131 diagnósticos, la prevalencia de uno o más TTM fue del 55,7%, de los cuales el 30,1% fueron mujeres diagnosticadas con TTM; el TTM más prevalente fue la subluxación unilateral en el 11,4% de los casos. De los factores asociados, predominó el ruido articular con 43,4% donde el tipo predominante de ruido fue el clic con 91,8%, seguido por el dolor muscular. Conclusiones: La prevalencia de TTM fue alta, representada en el 55,7% de la población. El TTM más común fue la Subluxación unilateral con un 11,4%. Se encontró asociación estadísticamente significativa entre al menos un factor de tipo signo y síntoma, los factores dentales y uno o más TTM.

Aim: To establish the prevalence of temporomandibular disorders (TMD) presented by patients who attended the dental clinics of the ninth and tenth semester of the Santo Tomas University in the second period of 2016. Materials and Methods: A cross - sectional, observational, descriptive study was carried out, with a sample of 113 clinical records. The sample was collected from clinical records already completed from the clinics of ninth and tenth semester of the University Santo Tomas in the second period of the 2016. Using descriptive statistics for the univariate analysis. In the bivariate analysis, a relationship between TMD and the variables of interest was established using the t-student and Chi-square test, where a value of p≤0.05 was considered statistically significant. Results: Of the 113 clinical records, 131 diagnoses were obtained. The prevalence of one or more TMD was 55.7%, of which 30.1% were women diagnosed with TMD. The most prevalent TTM was the unilateral subluxation in 11.4% of the cases. Of the associated factors, joint noise predominated with 43.4% where the predominant type of noise was the click with 91.8%, followed by muscle pain. Conclusions: The prevalence of TMD was high, represented in 55.7% of the population. The most common TMD was unilateral Subluxation with 11.4%. We found a statistically significant association between at least one sign and symptom type factor, dental factors and one or more TMD.

Miopatia dorsal cranial como causa de condenação em abatedouros de frangos de corte

O Brasil é um dos líderes mundiais em criação e abate de frangos de corte e para tanto a genética, nutrição, instalações e equipamentos sofreram inúmeras evoluções,favorecendo principalmente a eficiência alimentar. Devido à necessidade de aumentar a escala de produção para atender às demandas do mercado, o sistema de produção e abate foi intensificado e automatizado, o que teve como consequência uma maior susceptibilidade das aves aos problemas de manejo e de condenações nos abatedouros. Em meio a diversas causas de condenação em abatedouros do Rio Grande do Sul pode-se destacar a Miopatia Dorsal Cranial (MDC) onde o músculo anterior latissimus dorsi (ALD) é afetado. A miopatia altera a qualidade visual da carne e não tem uma etiologia única conhecida, mas tem causado preocupações nas linhas de abate de frangos de corte em função da disparidade de condenações existentes entre abatedouros. Grandes prejuízos vêm ocorrendo,em virtude da condenação parcial e total por essa miopatia. Este trabalho teve por objetivo apresentar uma revisão bibliográfica sobre a miopatia dorsal cranial em frangos de corte e discutir os critérios de julgamento adotados pelo Serviço de Inspeção Federal (SIF) para esta lesão.

Brazil is one of the world leaders in breeding and slaughtering of poultries and for both the genetics, nutrition, plant and equipment have undergone numerous developments, favoring especially the feed efficiency. Due to the need to increase the scale of production to meet the market demands, the production system and slaughter was enhanced and automated, which has resulted in a greater susceptibility of poultries to the problems of management and condemnation in the slaughterhouses. Amid the various causes of condemnation in slaughterhouses of Rio Grande do Sul can highlight the Cranial Dorsal Myopathy (MDC) where the anterior latissimus dorsi muscle (ALD) is affected. The myopathy alters the visual quality of the meat and doesn't have a single known etiology, but has caused concerns in slaughtering of poultries in function of the disparity existing between condemnation criteria in slaughterhouses. Large losses have been taking place as a result of the partial and total condemnation by this myopathy. This work aims to present a bibliographical review about the cranial dorsal myopathy in poultries and discuss the judging criteria adopted by Brazilian Inspection Service (SIF)for this injury.

[Craniomandibular disorder/dysfunction. Characteristics and disorders of the masticatory organ]. / Craniomandibularis diszfunkció. A rágószerv sajátosságai és muködési zavarai.

The practising physician often meets patients with pain located in different parts of the face and facial skull, mouth opening restriction or other motion disorder of the mandible. It is not always easy to identify and explain the cause. It is not widely known among doctors that most of these problems are due to masticatory dysfunction. There is a special group of patients showing functional disorders and there are some others who present a variety of different symptoms and visit several doctors. The masticatory organ, a functional unit of the human organism has a definite and separate task and function. In the early years of life it is capable of adaptation, while later on it tends to compensation. The authors outline the functional anatomy of the masticatory organ and the characteristics of multicausal pathology, the dynamics of the process of the disease and their interdisciplinary aspects. They discuss the basic elements of craniomandibular dysfunction. Based on the diagnostic algorithm, they summarize treatment options for masticatory function disorders. They emphasize the importance that physicians should offer treatment, especially an irreversible treatment, without a diagnosis. It occurs very often that the causes are identified after the patients become symptom-free due to treatment. The aim of this report is to help the general practitioners, dentists, neurologists, ear-nose-throat specialists, rheumatologists or any other specialists in the everyday practice who have patients with different symptoms such as pain in the skull, acoustic phenomenon of the joint or craniomandibular dysfunction.

Prevalencia del síndrome de dolor y disfunción temporomandibular y factores de riesgo en estudiantes de odontología / Prevalence of temporomandibular dysfunction and pain syndrome and associated factors in dental students

Introducción: El síndrome de dolor y disfunción temporomandibular (SDDTM) se ha identificado como una de las princi - pales causas de dolor no dental en la región orofacial. Objetivo: Describir la prevalencia del SDDTM y factores asociados en los estu- diantes de la Facultad de Odontología de la Universidad Cooperativa de Colombia (UCC), sede Envigado. Materiales y métodos: estudio observacio - nal, descriptivo y transversal. Se evaluaron 98 estudiantes seleccionados aleatoriamen - te. Se realizó una encuesta, examen clíni - co, índice de Helkimo, test emocional de ansiedad y angustia. Se realizó un análisis univariado y bivariado (Chi 2 , p <0,05). Resultados: El 66% fueron mujeres. La edad promedio fue 21 años (DE±3). El 26,5% presentó hábito de apretamiento dental, 26,5% onicofagia y 18,4% bruxis- mo. El 31,6% refirió ruido articular, 30,6% cefalea-dolor de cuello, 18,4% dolor en articulación temporomandibular (ATM) y 12,2% rigidez mandibular. Clínicamente 44,5% presentó masticación unilateral. El 62,2% desviación durante la apertura y al cierre el 81,6%. El 42,9% presentó tras - torno de ansiedad y en menor proporción trastornos de angustia. El 74,7% presentó SDDTM leve. No se encontró diferen - cia con significación estadística entre la prevalencia del SDDTM por sexo (Chi 2 , p =0,255), ni asociación con los trastornos de ansiedad (Chi 2, p=0,060), ni angustia. Conclusión: El SDDTM leve fue el más frecuente entre la población estudiantil, se identificaron hábitos de apretamiento, onicofagia y masticación unilateral. No se encontró diferencia por sexo, ni asociación con trastorno de ansiedad ni de angustia. Llama la atención la alta prevalencia de masticación unilateral y del trastorno de ansiedad, son importantes estudiar

Background: Temporomandibular joint dysfunction and pain syndrome (TMJD) has been identified as one of the principle causes of non-dental pain in the orofacial region. Objective: To describe the prevalence of TMJD and associated factors in the students of the faculty of odontology of the Uni - versity Cooperativa de Colombia (UCC), Envigado campus Materials and methods: Observational, descriptive and cross-sectional study. 98 randomly selected students were evaluated. A survey, clinical examination, Helkimo index, emotional distress and anxiety test was performed. Univariate and bivariate analysis was performed (Chi 2 , p <0,05). Results: 66% were women. The average age was 21 years (SD±3). 26,5% had dental clenching habit, 26,5% and 18,4% onicofagia bruxism. 31,6% reported joint click, 30,6% headache or neck pain, 18,4% pain in the temporomandibular joint (TMJ) and 12,2% mandibular stiffness. Clinically, 44,5% presented unilateral chewing. 62,2% showed deviation on opening and 81,6% on closing. 42,9% had anxiety disorder and to a lesser extent panic disorder. 74,7% had mild TMJD. No difference was found with statistical significance between the preva - lence of sex TMJD. (Chi 2 , p =0,255) or any association with anxiety disorders (Chi 2 , p =0,060), and distress. Conclusions: Mild TMJD was most frequent among the student population. Clenching habits, nail biting and unilateral chewing were identified. No difference was found by gender or any association with anxiety disorder or anxiety. Particularly striking is the high prevalence of unilateral chewing and anxiety disorder, which are important to study

Hiperplasia do processo coronoide: relato de caso clínico / Mandibular coronoid process hyperplasia: case report

A hiperplasia do processo coronoide mandibular (HPCM) é uma condição rara, caracterizada pela limitação de abertura de boca. Causada pela impactação do processo coronoide na porção posterior do osso zigomático. Os autores apresentam um caso de uma criança de dois anos de idade em que a coronoidectomia por ser inviável, estimulou a busca por novos recursos terapêuticos para o tratamento e controle da condição. Sendo a coronoidectomia o tratamento de eleição sugerido pela literatura e não passível de realização, optou-se pela fisioterapia. Mediante uma revisão de literatura, foi possível concluir que os recursos fisioterápicos utilizados para as disfunções crâniomandibulares podem ser de grande ajuda para o controle da HPCM, tendo em vista que o principal sintoma da doença corresponde a um dos sintomas das DTMs...

The mandibular coronoid process hyperplasia (MCPH) is a rare condition characterized by the mouth opening limitation. Caused by an impaction of the coronoid process in the posterior portion of the zygomatic bone. The authors present a case of a child, 2 years old, which coronoidectomy treatment is unfeasible, therefore, stimulated the search for new therapeutic resources for the treatment and control the condition. Being the coronoidectomy the treatment of choice suggested by the literature and not possible to apply, we opted for the physiotherapy. Through a literature review, it was concluded that the physiotherapy resources used for craniomandibular dysfunctions can be a great help to control the MCPH, given that the main symptom of the disease corresponds to one of the symptoms of TMD...

Influence of craniomandibular and cervical pain on the activity of masticatory muscles in individuals with Temporomandibular Disorder / Influência da dor craniomandibular e cervical na atividade dos músculos mastigatórios em indivíduos com Disfunção Temporomandibular

Purpose: This study aimed to establish the prevalence of pain in the craniomandibular and cervical spine region in individuals with Temporomandibular Disorders (TMD) and to analyze the effects of these disorders on the bilateral activation of anterior temporalis (AT) and masseter (MA) muscles during the masticatory cycle. Methods: The participants were 55 female volunteers aged 18–30 years. The presence of TMD and craniomandibular and cervical spine pain was evaluated by applying the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire and using a combination of tests for the cervical region. The muscle activity of AT and MA during the masticatory cycle was assessed using the symmetry and antero-posterior coefficient indices. Results: The AT activity during the masticatory cycle is more asymmetric in individuals with TMD. The craniomandibular pain, more prevalent in these individuals, influenced these results. Conclusion: Individuals with TMD showed changes in the pattern activity of AT. The craniomandibular nociceptive inputs can influence the increase in asymmetry of the activation of this muscle. .

Objetivo: O objetivo deste estudo foi determinar a prevalência de dor nas regiões craniomandibular e cervical em indivíduos com Disfunção Temporomandibular (DTM) e analisar o efeito dessas desordens na ativação bilateral dos músculos temporal anterior (TA) e masseter (MA) durante o ciclo mastigatório. Métodos: Participaram deste estudo 55 voluntários do sexo feminino com idade de 18 a 30 anos. A presença de DTM e de dor craniomandibular e cervical foi avaliada por meio do questionário Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) e uma combinação de testes para a região cervical. A análise da ativação muscular do TA e MA durante o ciclo mastigatório foi realizada através dos índices de simetria e do coeficiente anteroposterior. Resultados: A atividade dos músculos TA, durante o ciclo mastigatório, é mais assimétrica em indivíduos com DTM. A dor craniomandibular, mais prevalente nesses indivíduos, influencia nesses resultados. Conclusão: Indivíduos com DTM apresentam alteração no padrão mastigatório do músculo TA e estímulos nociceptivos da região craniomandibular podem influenciar no aumento da assimetria de ativação dessa musculatura. .

[A pediatric case of hydatid cyst in the infratemporal fossa]. / Kyste hydatique de la fosse infratemporale chez un enfant.

INTRODUCTION: Hydatid cyst or disease is an anthropozoonosis due to the development of the larval form of the taenia Echinococcus granulosus in humans. It is endemic in Morocco. The location of a hydatid cyst in the infratemporal fossa (ITF) is extremely rare. The authors report a pediatric case. OBSERVATION: An 11 year old child was admitted to hospital with a history of left latero-facial swelling gradually increasing in volume for 2 months, CT scan of the face revealed a cystic formation of 7 cm diameter sitting at the left ITF, hydatid serology was negative. A transzygomatic approach allowed the excision of the cyst. The histopathological examination of the resected specimen confirmed the diagnosis of hydatid cyst. DISCUSSION: The location at the infratemporal fossa of an expansive process such as hydatid cyst in children may have a particular impact on adjacent structures and a more meaningful clinical expression. The rate of growth of hydatid cysts is highly variable and ranges from 1 to 5 cm a year. Hydatid serology is often negative. CT examination is the gold-standard radiological examination. Surgical removal of the hydatid cyst is the most effective treatment. The transzygomatic approach allowed a sufficient access to the cyst and a good quality of excision.

Craniofacial approaches and reconstruction in skull base surgery: techniques for the oral and maxillofacial surgeon.

Skull base surgery (SBS) is considered the standard of care in treating benign and malignant lesions of the cranial base. SBS is a multidisciplinary team approach used to treat these complex lesions that may have intracranial extension. SBS can be broken down into 3 steps. Transfacial access is performed, followed by resection with sound oncologic principles, and then reconstruction of the cranial base and facial structures. Functional and esthetic concerns must be addressed by the surgeons. Oral and maxillofacial surgeons frequently perform elective facial osteotomies and treat victims of cranial base trauma. These same principles can be applied to SBS as a part of the skull base team.

[Quantitative Sensory Testing in the facial area: a review]. / Quantitative Sensorische Testung im Gesichtsbereich - eine Übersicht.

Quantitative Sensory Testing is an established method to evaluate somatosensory function. In the facial area, the procedures depend on the localisation of disorders and the modalities of interest. The test stimuli are of thermal or mechanical nature (touch, pain, vibration, or pressure stimuli). According to the protocol of the German Neuropathic Pain Network, comprehensive information on the function of afferent nerves can be generated in the facial area as well. Standard values have been obtained for the cheek and intraoral mucosa. For various orofacial pain conditions, studies concerning the somatosensory function are available. Changed functional patterns are not limited to neuropathic pain, but also occur in other orofacial pain conditions, indicating, for example, central sensitisation. The standardised collection of QST parameters may improve the understanding of the pathophysiology of orofacial pain and effect therapeutic approaches. Comprehensive studies may lead to the development of specific screenings that are feasible in a clinical setting.

Disorders of the masticatory muscles.

Muscle disorders involving the masticatory muscles have been considered analogous to skeletal muscle disorders throughout the body. However, emerging research has shed new light on the varied etiology, clinical presentation, diagnosis, and treatment of myofascial pain and masticatory muscle disorders. This article reviews the etiology and classification of regional masticatory muscle disorders, the clinical examination of the patient, and evidence-based treatment recommendations.

Las hormonas sexuales femeninas como factor etiológico de los signos y síntomas de los desórdenes temporomandibulares (DTM) / Female sex hormones as an etiological factor of signs and symptoms in temporomandibular disorders (TMD)

La alta prevalencia de las diversas patologías incluidas dentro de los desórdenes temporomandibulares (DTM) en las mujeres, ha sido objeto de estudio desde hace muchos años. Entre las diversas hipótesis planteadas, la influencia de los altos valores de estrógenos parecería tener un sustento científico considerable. A continuación se describen las características y los efectos de dichas hormonas y su posible asociación con las patologías disfuncionales y el dolor orofacial.